Pub Date : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-7-13
Allakhyarov D.Z., Petrov Yu.A., Palieva N.V.
This article presents reviews of literature sources on the issue of assessing the risk of developing gynecological cancer in women after an in vitro fertilization program. Infertility and infertile marriages have now become quite a big problem of modern medicine. Against the background of the unfavorable demographic situation in the Russian Federation, this problem is becoming quite urgent. The main way to solve this situation is assisted reproductive technologies, among which the most common is in vitro fertilization. The in vitro fertilization program is accompanied by a hormonal ovulation stimulation procedure to obtain a female germ cell capable of fertilization. Against the background of the active use of the in vitro fertilization procedure, many patients had concerns related to the risk of developing gynecological cancer after the IVF procedure, which is due to the use of hormonal drugs to stimulate the ovaries. Also of concern is the fact that certain types of cancer, including ovarian cancer, endometrial cancer and breast cancer, are hormone-dependent. In this regard, multiple large-scale studies were conducted, which showed that the risk of developing gynecological cancer is really increased in patients after the in vitro fertilization program. In particular, breast cancer in women after the in vitro fertilization program is more common by 10%, and in women without a history of pregnancy and over the age of 40, it is more common by 31%. The increased risk may be due to age-related vulnerability to the effects of hormones or higher doses of hormones during the IVF procedure. Ovarian cancer and endometrial cancer are also more common in patients after IVF. According to the research results, it is suggested that it is not the IVF procedure itself that causes the development of cancer, but excessive hormonal load of the body, which leads to the launch of carcinogenesis.
{"title":"THE RISK OF DEVELOPING GYNECOLOGICAL CANCER IN WOMEN AFTER AN IN VITRO FERTILIZATION PROGRAM","authors":"Allakhyarov D.Z., Petrov Yu.A., Palieva N.V.","doi":"10.26787/nydha-2686-6838-2021-23-9-7-13","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-7-13","url":null,"abstract":"This article presents reviews of literature sources on the issue of assessing the risk of developing gynecological cancer in women after an in vitro fertilization program. Infertility and infertile marriages have now become quite a big problem of modern medicine. Against the background of the unfavorable demographic situation in the Russian Federation, this problem is becoming quite urgent. The main way to solve this situation is assisted reproductive technologies, among which the most common is in vitro fertilization. The in vitro fertilization program is accompanied by a hormonal ovulation stimulation procedure to obtain a female germ cell capable of fertilization. Against the background of the active use of the in vitro fertilization procedure, many patients had concerns related to the risk of developing gynecological cancer after the IVF procedure, which is due to the use of hormonal drugs to stimulate the ovaries. Also of concern is the fact that certain types of cancer, including ovarian cancer, endometrial cancer and breast cancer, are hormone-dependent. In this regard, multiple large-scale studies were conducted, which showed that the risk of developing gynecological cancer is really increased in patients after the in vitro fertilization program. In particular, breast cancer in women after the in vitro fertilization program is more common by 10%, and in women without a history of pregnancy and over the age of 40, it is more common by 31%. The increased risk may be due to age-related vulnerability to the effects of hormones or higher doses of hormones during the IVF procedure. Ovarian cancer and endometrial cancer are also more common in patients after IVF. According to the research results, it is suggested that it is not the IVF procedure itself that causes the development of cancer, but excessive hormonal load of the body, which leads to the launch of carcinogenesis.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114924413","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}
Herbal sedatives have been popular for several centuries, and the accumulated knowledge that has been passed down from generation to generation laid the foundation for the development of traditional medicine, and over time for such a science as herbal medicine. Herbal sedatives have a wide range of therapeutic effects, are well tolerated and have no serious adverse reactions, and are not addictive. According to statistical data on the incidence of the population by main classes and individual diseases for 2010-2018, the number of patients with diseases of the nervous system is growing annually, along with this, the need for sedative drugs is increasing. In this regard, the search and development of effective and safe medicines based on medicinal plant raw materials is an urgent area [1, 2]. Pharmaceutical infusions and decoctions, according to the order of the Ministry of Health of the Russian Federation No. 751n dated October 26, 2015, have a shelf life of 2 days, which significantly limits the possibility of their use. The production of films based on aqueous extracts from medicinal plant raw materials will make it possible to obtain more stable drugs, in addition, films have a number of advantages over other dosage forms. Films containing biologically active substances of plant origin have received the unofficial name phytofilms, which are a type of transdermal therapeutic systems. Phytofilms are hydrophilic systems that swell when in contact with water (or biological fluid), absorbing it in a certain amount, which leads to the dissolution of biologically active substances. They differ from synthetic polymeric therapeutic systems in that phytofilms are made in the form of matrix transdermal therapeutic systems on carriers of natural origin (gelatin, collagen, sodium alginate, agar-agar, etc.), which makes them safer [3, 4].
{"title":"DEVELOPMENT OF THE COMPOSITION AND TECHNOLOGY OF SEDATIVE FILMS","authors":"Zamakhaeva E.A., Oleshko O.A., Yaborova O.V., Smirnova M.M., Kuritsyn A.V.","doi":"10.26787/nydha-2686-6838-2021-23-9-162-168","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-162-168","url":null,"abstract":"Herbal sedatives have been popular for several centuries, and the accumulated knowledge that has been passed down from generation to generation laid the foundation for the development of traditional medicine, and over time for such a science as herbal medicine. Herbal sedatives have a wide range of therapeutic effects, are well tolerated and have no serious adverse reactions, and are not addictive. According to statistical data on the incidence of the population by main classes and individual diseases for 2010-2018, the number of patients with diseases of the nervous system is growing annually, along with this, the need for sedative drugs is increasing. In this regard, the search and development of effective and safe medicines based on medicinal plant raw materials is an urgent area [1, 2].\u0000Pharmaceutical infusions and decoctions, according to the order of the Ministry of Health of the Russian Federation No. 751n dated October 26, 2015, have a shelf life of 2 days, which significantly limits the possibility of their use. The production of films based on aqueous extracts from medicinal plant raw materials will make it possible to obtain more stable drugs, in addition, films have a number of advantages over other dosage forms.\u0000Films containing biologically active substances of plant origin have received the unofficial name phytofilms, which are a type of transdermal therapeutic systems. Phytofilms are hydrophilic systems that swell when in contact with water (or biological fluid), absorbing it in a certain amount, which leads to the dissolution of biologically active substances. They differ from synthetic polymeric therapeutic systems in that phytofilms are made in the form of matrix transdermal therapeutic systems on carriers of natural origin (gelatin, collagen, sodium alginate, agar-agar, etc.), which makes them safer [3, 4].","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"138 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116866502","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-52-58
K. O.B.
The outpatient stage of therapy is the primary and very responsible link in the introduction of patients with chronic forms of VZOMT, since this pathology has a significant impact on such indicators as perinatal, maternal morbidity and mortality. In addition, VZOMT directly affects the development of infertility, ectopic pregnancy, habitual miscarriage, as well as a decrease in the ovarian reserve after unsuccessful attempts of in vitro fertilization, surgical interventions on the appendages of the uterus. To preserve the reproductive function in patients with VZOMT, an important stage is the implementation of a number of therapeutic and rehabilitation measures. The problems of treatment and rehabilitation of patients with VZOMT undoubtedly remain relevant, since cases of relapses and chronization of inflammatory processes significantly worsen the prognosis for a woman's reproductive function. These problems are both social and economic. Taking into account the wide range of infectious agents of VZOMT, it is recommended to use a complex of antibacterial drugs that cover as many varieties of pathogenic and conditionally pathogenic flora as possible. Moreover, an important aspect of the treatment of inflammatory diseases of the female reproductive system is the use of different forms of drugs and ways of their administration. It is rational to combine oral or parenteral with intravaginal. This combination makes it possible to increase the effectiveness of treatment and contributes to the prevention of relapse of the disease. The inclusion of prednisolone – 21 phosphate in the therapy complex also contributes to increasing the effectiveness of therapy, since it creates favorable conditions for the vital activity of normal microflora and unfavorable conditions for conditionally pathogenic microflora. The results obtained in the study indicate a good clinical effectiveness of complex therapy with the inclusion of Elzhina in the treatment regimen for the treatment of fibrotic processes in the fallopian tubes. The use of a combined drug for intravaginal use containing ornidazole-500 mg, prednisolone-3 mg, econazole-150 mg, neomycin 65000ME (Elzhina drug) allows optimizing the management tactics of patients with tubal – peritoneal infertility caused by chronic salpingitis and increasing the fertility rates in this group of patients.
{"title":"OPTIMIZATION OF TREATMENT OF TUBAL-PERITONEAL INFERTILITY CAUSED BY CHRONIC SALPINGITIS","authors":"K. O.B.","doi":"10.26787/nydha-2686-6838-2021-23-9-52-58","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-52-58","url":null,"abstract":"The outpatient stage of therapy is the primary and very responsible link in the introduction of patients with chronic forms of VZOMT, since this pathology has a significant impact on such indicators as perinatal, maternal morbidity and mortality.\u0000In addition, VZOMT directly affects the development of infertility, ectopic pregnancy, habitual miscarriage, as well as a decrease in the ovarian reserve after unsuccessful attempts of in vitro fertilization, surgical interventions on the appendages of the uterus.\u0000To preserve the reproductive function in patients with VZOMT, an important stage is the implementation of a number of therapeutic and rehabilitation measures. The problems of treatment and rehabilitation of patients with VZOMT undoubtedly remain relevant, since cases of relapses and chronization of inflammatory processes significantly worsen the prognosis for a woman's reproductive function. These problems are both social and economic.\u0000Taking into account the wide range of infectious agents of VZOMT, it is recommended to use a complex of antibacterial drugs that cover as many varieties of pathogenic and conditionally pathogenic flora as possible. Moreover, an important aspect of the treatment of inflammatory diseases of the female reproductive system is the use of different forms of drugs and ways of their administration. It is rational to combine oral or parenteral with intravaginal. This combination makes it possible to increase the effectiveness of treatment and contributes to the prevention of relapse of the disease. The inclusion of prednisolone – 21 phosphate in the therapy complex also contributes to increasing the effectiveness of therapy, since it creates favorable conditions for the vital activity of normal microflora and unfavorable conditions for conditionally pathogenic microflora.\u0000The results obtained in the study indicate a good clinical effectiveness of complex therapy with the inclusion of Elzhina in the treatment regimen for the treatment of fibrotic processes in the fallopian tubes. The use of a combined drug for intravaginal use containing ornidazole-500 mg, prednisolone-3 mg, econazole-150 mg, neomycin 65000ME (Elzhina drug) allows optimizing the management tactics of patients with tubal – peritoneal infertility caused by chronic salpingitis and increasing the fertility rates in this group of patients.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121189689","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-147-153
Sycheva A.S., Kebina A.L., Vertkin А.L.
Relevance. The pandemic of new coronavirus infection COVID-19 is the main topic and problem of modern medicine associated with the necessity of rapid diagnostics and medical care rendered to such patients Nowadays, individual pathogenetic mechanisms of infection COVID-19 are determined, however, clinical and epidemiological particularities of the disease are being intensively investigated, and new agents for prevention and treatment of infection COVID-19 are being developed. The determination of predictors of the severe disease course and exposure methods is definitely important. The studies have shown that the presence of various concurrent comorbid diseases in patients hospitalized with COVID-19 negatively affects the disease course and its prognosis. Study objective: the analysis of the observation results and clinical outcomes of clinical course (clinical masks) of new coronavirus infection COVID-19 with the distribution by age, gender and incidence of somatic diseases, identification of the pattern of visceral organ damages in coronavirus infection caused by virus SARS-CoV-2. Materials and methods: 110 patients with virus pneumonia caused by COVID-19 were enrolled to the study. The presence of risk factors of the severe disease course variants and intensity of the somatic disorder in necropsy of patients died were evaluated. Study results: The found analysis data suggest that the most significant predictors of the severe course of COVID-19 are arterial hypertension with a high and very high cardiovascular risk, followed by a renal disorder, type 2 diabetes mellitus, obesity, hepatic and heart failure. Conclusion. The found analysis data suggest that the most significant predictors of the severe course of COVID-19 are arterial hypertension with a high and very high cardiovascular risk, followed by a renal disorder, type 2 diabetes mellitus, obesity, hepatic and heart failure.
{"title":"CLINICAL AND PROGNOSTIC CRITERIA FOR THE COMPLICATED COURSE OF NEW CORONAVIRUS INFECTION (COVID-19).","authors":"Sycheva A.S., Kebina A.L., Vertkin А.L.","doi":"10.26787/nydha-2686-6838-2021-23-9-147-153","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-147-153","url":null,"abstract":"Relevance. The pandemic of new coronavirus infection COVID-19 is the main topic and problem of modern medicine associated with the necessity of rapid diagnostics and medical care rendered to such patients Nowadays, individual pathogenetic mechanisms of infection COVID-19 are determined, however, clinical and epidemiological particularities of the disease are being intensively investigated, and new agents for prevention and treatment of infection COVID-19 are being developed. The determination of predictors of the severe disease course and exposure methods is definitely important. The studies have shown that the presence of various concurrent comorbid diseases in patients hospitalized with COVID-19 negatively affects the disease course and its prognosis.\u0000Study objective: the analysis of the observation results and clinical outcomes of clinical course (clinical masks) of new coronavirus infection COVID-19 with the distribution by age, gender and incidence of somatic diseases, identification of the pattern of visceral organ damages in coronavirus infection caused by virus SARS-CoV-2. \u0000Materials and methods: 110 patients with virus pneumonia caused by COVID-19 were enrolled to the study. The presence of risk factors of the severe disease course variants and intensity of the somatic disorder in necropsy of patients died were evaluated. \u0000Study results: The found analysis data suggest that the most significant predictors of the severe course of COVID-19 are arterial hypertension with a high and very high cardiovascular risk, followed by a renal disorder, type 2 diabetes mellitus, obesity, hepatic and heart failure.\u0000Conclusion. The found analysis data suggest that the most significant predictors of the severe course of COVID-19 are arterial hypertension with a high and very high cardiovascular risk, followed by a renal disorder, type 2 diabetes mellitus, obesity, hepatic and heart failure.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116756190","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-98-105
Nosovich D.V., Epifanov S.Yu., Tassybayev B.B.
Relevance. The role of the coronary arteries angiographic changes severity in myocardial infarction complicated by acute kidney injury is assessed in different ways. Aim. To evaluate the features of the coronary arteries state in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 168 patients. A comparative assessment of coronary angiography indicators, also acute kidney injury and heart failure development risk analysis (ANOVA) were performed. Results. There were no differences in the compared groups in angiographic data, localization, depth of the lesion, and the frequency of the complicated course of the disease. The study group were characterized by akinesia in the middle anterior (in the studied% 100; control: 15.6%; p =0.02) and antero-septal (100 and 17.7%; respectively; p=0.04) segments , as well as the frequency of registration of chronic heart failure (72.0 and 43.2%; p=0.005) by the eighth week of myocardial infarction. Bypass surgery (absolute risk: 46.2%; relative - 4.37; p=0.0002) and unstable angina (absolute risk: 19.8%; relative - 2,46; p=0.02) in the medical history, as well as the presence of peripheral angiopathies (absolute risk: 18.9%; relative - 3.21; p=0.0008). Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction were not differ in the number and extent of large coronary artery lesions from the general group. They are characterized by large in area and severity of dysfunction lesions of the anterior middle segments of the left ventricle with a higher frequency of chronic heart failure than in the general group. The anamnestic data listed above associated with coronary arteries is advisable to use in the formation of groups at high risk for the acute kidney injury development formation, as well as prognostic modeling.
{"title":"CORONARY ARTERIES STATE IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION, COMPLICATED WITH ACUTE KIDNEY INJURY","authors":"Nosovich D.V., Epifanov S.Yu., Tassybayev B.B.","doi":"10.26787/nydha-2686-6838-2021-23-9-98-105","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-98-105","url":null,"abstract":"Relevance. The role of the coronary arteries angiographic changes severity in myocardial infarction complicated by acute kidney injury is assessed in different ways.\u0000Aim. To evaluate the features of the coronary arteries state in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes.\u0000Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 168 patients. A comparative assessment of coronary angiography indicators, also acute kidney injury and heart failure development risk analysis (ANOVA) were performed. \u0000Results. There were no differences in the compared groups in angiographic data, localization, depth of the lesion, and the frequency of the complicated course of the disease. The study group were characterized by akinesia in the middle anterior (in the studied% 100; control: 15.6%; p =0.02) and antero-septal (100 and 17.7%; respectively; p=0.04) segments , as well as the frequency of registration of chronic heart failure (72.0 and 43.2%; p=0.005) by the eighth week of myocardial infarction. Bypass surgery (absolute risk: 46.2%; relative - 4.37; p=0.0002) and unstable angina (absolute risk: 19.8%; relative - 2,46; p=0.02) in the medical history, as well as the presence of peripheral angiopathies (absolute risk: 18.9%; relative - 3.21; p=0.0008).\u0000Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction were not differ in the number and extent of large coronary artery lesions from the general group. They are characterized by large in area and severity of dysfunction lesions of the anterior middle segments of the left ventricle with a higher frequency of chronic heart failure than in the general group. The anamnestic data listed above associated with coronary arteries is advisable to use in the formation of groups at high risk for the acute kidney injury development formation, as well as prognostic modeling.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123055823","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-83-90
Lozhkina N.G., M. I.
Вackground. The last decade has seen an increase in the number of people who have had myocardial infarction (MI). This phenomenon contributes to an increase in the long-term incidence of chronic cardiovascular diseases, including chronic heart failure. Purpose of the study. To identify the most significant clinical and functional indicators characterizing acute and chronic heart failure after myocardial infarction. Patient Characterization and Research Methods. This analysis included 186 patients who had myocardial infarction from January 2019 to January 2020: 86 people, the main subgroup, with signs of CHF above FC 2 (NYHA) (mean age 64.3 g) and 100 people, the comparison subgroup, without signs of CHF or had CHF 1 FC (NYHA) (mean age 62.6 l). After 1 year, clinical outcomes were assessed: cardiovascular death, repeated hospitalizations due to decompensation of CHF, death from other causes, stroke, repeated myocardial infarction, unplanned coronary revascularization. Results. In the acute period of myocardial infarction in the main subgroup (MI + CHF more than 2cl NYHA), all patients had symptoms of acute heart failure (AHF) in the form of Killip II and Killip III. Predictors of the development of chronic heart failure were the presence of a history of ischemic heart disease, confirmed in accordance with the recommendations, before myocardial infarction; decreased fraction of the left ventricle, detected before discharge and on the 30th day of myocardial infarction; the presence of atrial fibrillation (AF). One-year unfavorable outcomes in the main group were significantly more frequent. Subanalysis of long-term drug therapy showed that cardiovascular death was significantly less common in the subgroup of patients taking ARNI than in the subgroup of enalapril. Conclusion. In the present study, we studied postinfarction myocardial remodeling, which is realized in the form of the formation of a syndrome of acute and chronic heart failure. It has been shown that immediate reperfusion and restriction of the necrosis zone, as well as long-term use of drugs that inhibit SAS and RAAS, stimulating NPP, can inhibit the development of AHF and death. The CHF problem requires further fundamental research in order to develop new approaches that can affect more subtle mechanisms, such as the expression of specific genes involved in the disease, in order to reduce the persisting excess mortality for this pathology.
{"title":"ACUTE AND CHRONIC HEART FAILURE AFTER MYOCARDIAL INFARCTION: CLINICAL AND FUNCTIONAL MARKERS","authors":"Lozhkina N.G., M. I.","doi":"10.26787/nydha-2686-6838-2021-23-9-83-90","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-83-90","url":null,"abstract":"Вackground. The last decade has seen an increase in the number of people who have had myocardial infarction (MI). This phenomenon contributes to an increase in the long-term incidence of chronic cardiovascular diseases, including chronic heart failure.\u0000Purpose of the study. To identify the most significant clinical and functional indicators characterizing acute and chronic heart failure after myocardial infarction.\u0000Patient Characterization and Research Methods. This analysis included 186 patients who had myocardial infarction from January 2019 to January 2020: 86 people, the main subgroup, with signs of CHF above FC 2 (NYHA) (mean age 64.3 g) and 100 people, the comparison subgroup, without signs of CHF or had CHF 1 FC (NYHA) (mean age 62.6 l). After 1 year, clinical outcomes were assessed: cardiovascular death, repeated hospitalizations due to decompensation of CHF, death from other causes, stroke, repeated myocardial infarction, unplanned coronary revascularization.\u0000Results. In the acute period of myocardial infarction in the main subgroup (MI + CHF more than 2cl NYHA), all patients had symptoms of acute heart failure (AHF) in the form of Killip II and Killip III. Predictors of the development of chronic heart failure were the presence of a history of ischemic heart disease, confirmed in accordance with the recommendations, before myocardial infarction; decreased fraction of the left ventricle, detected before discharge and on the 30th day of myocardial infarction; the presence of atrial fibrillation (AF). One-year unfavorable outcomes in the main group were significantly more frequent. Subanalysis of long-term drug therapy showed that cardiovascular death was significantly less common in the subgroup of patients taking ARNI than in the subgroup of enalapril.\u0000Conclusion. In the present study, we studied postinfarction myocardial remodeling, which is realized in the form of the formation of a syndrome of acute and chronic heart failure. It has been shown that immediate reperfusion and restriction of the necrosis zone, as well as long-term use of drugs that inhibit SAS and RAAS, stimulating NPP, can inhibit the development of AHF and death. The CHF problem requires further fundamental research in order to develop new approaches that can affect more subtle mechanisms, such as the expression of specific genes involved in the disease, in order to reduce the persisting excess mortality for this pathology.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134466020","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-76-82
Lebedev M.V., Zakharova I.Yu., Kerimova K.I.
The annual increase in patients and increased requirements for the quality of medical care lead to the reorganization of the work of various departments of medical hospitals. In order to improve the quality and accessibility of specialized medical care in the profile "maxillofacial surgery" in the territory of the Penza Region, in 2020, the structure of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko will be reorganized, which allows solving a number of existing problems. An important direction in the modernization of the Center was the structural and organizational restructuring. The purpose of the study: to analyze the quality and effectiveness of providing care to children with pathology of the maxillofacial region by doctors of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko. Materials and methods. A comprehensive assessment of the quality of care for children with maxillofacial pathology from 2018-2020 in the Penza region and in the period from November 2020 to July 2021 was carried out. Center of Maxillofacial Surgery of the N. N. Burdenko State Medical University. Results and discussion. Having analyzed the existing shortcomings and problems, established connections, the growth of patients in need of treatment by a maxillofacial surgeon contributed to the opening of the Maxillofacial Surgery Center in the N. N. Burdenko State Medical University, which included 10 specialized children's beds; 2 ultra-short stay beds; an outpatient office; a rehabilitation room; material and technical equipment, tools, medicines for children; maxillofacial surgeon, pediatrician, pediatric dentist, general dentist, clinical nurses, speech therapist. Conclusion. The opening of the Maxillofacial Surgery Center in the Penza region has shown high efficiency. The economic effect in obtaining specialized treatment due to the work of an outpatient office and a rehabilitation office based on a patient-oriented model is noted. In order to achieve maximum efficiency and fully meet the need for providing medical care to the children's population of the Penza region in the profile "maxillofacial surgery", it is necessary to open a department of pediatric maxillofacial surgery due to the projected workload of open beds.
患者数量的逐年增加和对医疗质量要求的不断提高，导致了医疗医院各部门工作的重组。为了提高奔萨地区“颌面外科”专业医疗服务的质量和可及性，2020年，以n·n·布尔登科命名的奔萨地区临床医院颌面外科中心的结构将进行重组，从而解决一些现有问题。中心现代化建设的一个重要方向是机构和组织结构的调整。本研究的目的:分析以N. N. Burdenko命名的奔萨地区临床医院颌面外科中心的医生为患有颌面病理的儿童提供护理的质量和效果。材料和方法。对Penza地区2018-2020年和2020年11月至2021年7月期间颌面病理儿童的护理质量进行了综合评估。布尔登科州立医科大学颌面外科中心。结果和讨论。分析了存在的不足和问题，建立了联系，需要颌面外科医生治疗的患者数量不断增加，促成了在N. N.布尔登科国立医科大学开设颌面外科中心，其中包括10张专科儿童床;2张超短期住宿床位;门诊部;康复室;儿童物资技术设备、工具、药品;颌面外科医生，儿科医生，儿科牙医，普通牙医，临床护士，语言治疗师。奔萨地区颌面外科中心的开业显示出高效率。注意到门诊办公室和康复办公室基于患者导向模式的工作在获得专门治疗方面的经济效果。为了达到最高效率并充分满足奔萨地区儿童人口在"颌面外科"方面的医疗需求，由于预计开放床位的工作量，有必要开设儿科颌面外科。
{"title":"ANALYSIS OF THE STRUCTURAL AND ORGANIZATIONAL RESTRUCTURING OF MEDICAL CARE FOR PEDIATRIC MAXILLOFACIAL SURGERY IN THE PENZA REGION IN 2021","authors":"Lebedev M.V., Zakharova I.Yu., Kerimova K.I.","doi":"10.26787/nydha-2686-6838-2021-23-9-76-82","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-76-82","url":null,"abstract":"The annual increase in patients and increased requirements for the quality of medical care lead to the reorganization of the work of various departments of medical hospitals. In order to improve the quality and accessibility of specialized medical care in the profile \"maxillofacial surgery\" in the territory of the Penza Region, in 2020, the structure of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko will be reorganized, which allows solving a number of existing problems. An important direction in the modernization of the Center was the structural and organizational restructuring.\u0000The purpose of the study: to analyze the quality and effectiveness of providing care to children with pathology of the maxillofacial region by doctors of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko.\u0000Materials and methods. A comprehensive assessment of the quality of care for children with maxillofacial pathology from 2018-2020 in the Penza region and in the period from November 2020 to July 2021 was carried out. Center of Maxillofacial Surgery of the N. N. Burdenko State Medical University.\u0000Results and discussion. Having analyzed the existing shortcomings and problems, established connections, the growth of patients in need of treatment by a maxillofacial surgeon contributed to the opening of the Maxillofacial Surgery Center in the N. N. Burdenko State Medical University, which included 10 specialized children's beds; 2 ultra-short stay beds; an outpatient office; a rehabilitation room; material and technical equipment, tools, medicines for children; maxillofacial surgeon, pediatrician, pediatric dentist, general dentist, clinical nurses, speech therapist.\u0000Conclusion. The opening of the Maxillofacial Surgery Center in the Penza region has shown high efficiency. The economic effect in obtaining specialized treatment due to the work of an outpatient office and a rehabilitation office based on a patient-oriented model is noted. In order to achieve maximum efficiency and fully meet the need for providing medical care to the children's population of the Penza region in the profile \"maxillofacial surgery\", it is necessary to open a department of pediatric maxillofacial surgery due to the projected workload of open beds.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125042340","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-91-97
Mushnikov D.L., Kozlov V.A., Polacov B.A.
The quality of medical care is one of the leading problems of both foreign and domestic healthcare. The purpose of the study: to assess the potential of the quality of medical care of the oncological profile and to give recommendations for its improvement. Materials and methods. A study was conducted on the basis of the oncological service of the Ivanovo region. The research program included the use of expert, sociological and statistical methods. A survey of 120 doctors and an expert assessment of 410 cases of oncological care were conducted. A feature of the study was the use of an original method of integral assessment of the quality potential of oncological care. The potential for improving the quality of medical care was assessed in three components: infrastructure (personnel, logistics and drug support), procedural (compliance of the technology of assistance with standards and clinical recommendations), expert (quality of examination of the quality of medical care). Outcomes. It is established that the infrastructure component of the quality of medical care is of priority importance from the point of position of improvement (reserve 11,0%), in second place – the procedural component (9,0%), on the third – expert (5,0%). The survey showed that among medical personnel there is a high prevalence of adverse socio-hygienic factors: unsatisfactory housing conditions; a high percentage of unmarried personnel; a significant number of people suffering from chronic diseases; not observing the principles of a healthy lifestyle. Findings. The developed approach to improving the quality of medical care of the oncological profile, tested in the conditions of medical organizations of the Ivanovo region, will ensure targeted correction of factors associated with quality and a steady trend towards improving the quality of medical care. The set of proposals developed during the study was tested in an organizational experiment conducted on the basis of medical organizations that provide assistance to patients of the oncological profile of the Ivanovo region in 2019. According to the results of the implementation, a positive dynamic of the potential for the quality of medical care was obtained - from 91,7% to 98,5%.
{"title":"POTENTIAL FOR IMPROVING THE QUALITY OF CANCER CARE","authors":"Mushnikov D.L., Kozlov V.A., Polacov B.A.","doi":"10.26787/nydha-2686-6838-2021-23-9-91-97","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-91-97","url":null,"abstract":"The quality of medical care is one of the leading problems of both foreign and domestic healthcare. The purpose of the study: to assess the potential of the quality of medical care of the oncological profile and to give recommendations for its improvement. Materials and methods. A study was conducted on the basis of the oncological service of the Ivanovo region. The research program included the use of expert, sociological and statistical methods. A survey of 120 doctors and an expert assessment of 410 cases of oncological care were conducted. A feature of the study was the use of an original method of integral assessment of the quality potential of oncological care. The potential for improving the quality of medical care was assessed in three components: infrastructure (personnel, logistics and drug support), procedural (compliance of the technology of assistance with standards and clinical recommendations), expert (quality of examination of the quality of medical care). Outcomes. It is established that the infrastructure component of the quality of medical care is of priority importance from the point of position of improvement (reserve 11,0%), in second place – the procedural component (9,0%), on the third – expert (5,0%). The survey showed that among medical personnel there is a high prevalence of adverse socio-hygienic factors: unsatisfactory housing conditions; a high percentage of unmarried personnel; a significant number of people suffering from chronic diseases; not observing the principles of a healthy lifestyle. Findings. The developed approach to improving the quality of medical care of the oncological profile, tested in the conditions of medical organizations of the Ivanovo region, will ensure targeted correction of factors associated with quality and a steady trend towards improving the quality of medical care. The set of proposals developed during the study was tested in an organizational experiment conducted on the basis of medical organizations that provide assistance to patients of the oncological profile of the Ivanovo region in 2019. According to the results of the implementation, a positive dynamic of the potential for the quality of medical care was obtained - from 91,7% to 98,5%.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125520556","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-36-44
Gordienko A.V., G. A.V., Tassybayev B.B., Reiza V.A.
Relevance. The role of hemodynamic changes in myocardial infarction complicated by acute kidney injury is interpreted in different ways. Aim. To evaluate the heart chambers and structures peculiarities in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 366 patients. A comparative assessment of the heart chambers and structures parameters in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, also acute kidney injury development risk analysis (ANOVA) were performed. Results. The study group differed from the control group in smaller sizes of the left atrium2 (38.1±6.0 and 42.0±5.4 (mm), respectively; p=0.01), a higher frequency of the middle anterior (100 and 15.6%; p=0.02) and antero-septal (100 and 17.7; p=0.04) segments akinesia and the absence (0 and 81.5%; p=0.04) of tricuspid regurgitation. In the study group, there was a smaller increase in the ventricles size than in the control group (left: 0.6 and 1.7%, respectively; right: 15.3 and 33.6%) and a greater decrease in the atria size, compared in the control group (left: -1.8 and -25.3%; right: -25.3 and -0.1%) (p<0.0001). The risk markers of the acute kidney injury developing were the dimensions of the left atrium1˂34 mm, interventricular septum≥12.0 mm, end systolic1≥4.23 and diastolic1≥5.3 of the left ventricle, right ventricle1˂2.6; of the right atrium1≥4.7 (cm), the mass of the left ventricle1≥328.8 g. Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by lesions of the middle anterior and antero-septal segments, the absence of tricuspid regurgitation, and a smaller left atrium in the subacute period of the disease. The above of the heart chambers dimensions values should be used in the high-risk groups for the acute kidney injury development formation, as well as for prognostic modeling.
{"title":"THE HEART DAMAGE AND ITS STRUCTURAL STATE FEATURES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION, COMPLICATED WITH ACUTE KIDNEY INJURY","authors":"Gordienko A.V., G. A.V., Tassybayev B.B., Reiza V.A.","doi":"10.26787/nydha-2686-6838-2021-23-9-36-44","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-36-44","url":null,"abstract":"Relevance. The role of hemodynamic changes in myocardial infarction complicated by acute kidney injury is interpreted in different ways.\u0000Aim. To evaluate the heart chambers and structures peculiarities in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes.\u0000Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 366 patients. A comparative assessment of the heart chambers and structures parameters in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, also acute kidney injury development risk analysis (ANOVA) were performed.\u0000Results. The study group differed from the control group in smaller sizes of the left atrium2 (38.1±6.0 and 42.0±5.4 (mm), respectively; p=0.01), a higher frequency of the middle anterior (100 and 15.6%; p=0.02) and antero-septal (100 and 17.7; p=0.04) segments akinesia and the absence (0 and 81.5%; p=0.04) of tricuspid regurgitation. In the study group, there was a smaller increase in the ventricles size than in the control group (left: 0.6 and 1.7%, respectively; right: 15.3 and 33.6%) and a greater decrease in the atria size, compared in the control group (left: -1.8 and -25.3%; right: -25.3 and -0.1%) (p<0.0001). The risk markers of the acute kidney injury developing were the dimensions of the left atrium1˂34 mm, interventricular septum≥12.0 mm, end systolic1≥4.23 and diastolic1≥5.3 of the left ventricle, right ventricle1˂2.6; of the right atrium1≥4.7 (cm), the mass of the left ventricle1≥328.8 g.\u0000Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by lesions of the middle anterior and antero-septal segments, the absence of tricuspid regurgitation, and a smaller left atrium in the subacute period of the disease. The above of the heart chambers dimensions values should be used in the high-risk groups for the acute kidney injury development formation, as well as for prognostic modeling.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126445764","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-14-22
Dmitriev D.A., Ivanov A.G.
Orphans and children left without parental care can be placed in adoptive families, which is supposed to ensure the best possible conditions for the upbringing and social adaptation of such children in a supportive family environment. Adaptation is seen as a social and psychological process of adjusting to new living conditions and psychological climate in the adoptive family. The study seeks to identify specific features of the upbringing and adaptation of adolescent females aged 15-17 who are children under wardship in adoptive families. The study is based on a questionnaire survey method. The object of the present study is adolescent females who are in the care of adoptive families and are undergoing medical treatment or screening in the adolescent unit for females aged 15-17 at the public healthcare institution “No. 4 Psychiatric Hospital” of the Moscow region. To investigate the upbringing and adaptation issues, a survey was conducted using the following questionnaires: 1) Adolescents’ perception of parents; 2) Family ambience scale; 3) Social and psychological adaptation scale. The questionnaire-based survey of adolescent females aged 15-17 raised in adoptive families yielded insights about the psychological aspect of relations between children and adoptive parents, which reveals the content and specificity of parenting practices from the perspective of the teenage girls. The study also evaluates the social climate in adoptive families and the sociopsychological adaptation of adolescent females to the new living conditions and parenting style. Questionnaire-based investigations can help identify existing problems in the upbringing of adolescent females in adoptive families, which may further advance evidence-based approaches to facilitating the social adaptation of adolescent females.
{"title":"PROBLEMS OF UPBRINGING AND ADAPTATION OF ADOLESCENT FEMALES AGED 15-17 IN ADOPTIVE FAMILIES","authors":"Dmitriev D.A., Ivanov A.G.","doi":"10.26787/nydha-2686-6838-2021-23-9-14-22","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-14-22","url":null,"abstract":"Orphans and children left without parental care can be placed in adoptive families, which is supposed to ensure the best possible conditions for the upbringing and social adaptation of such children in a supportive family environment. Adaptation is seen as a social and psychological process of adjusting to new living conditions and psychological climate in the adoptive family. The study seeks to identify specific features of the upbringing and adaptation of adolescent females aged 15-17 who are children under wardship in adoptive families. The study is based on a questionnaire survey method. \u0000The object of the present study is adolescent females who are in the care of adoptive families and are undergoing medical treatment or screening in the adolescent unit for females aged 15-17 at the public healthcare institution “No. 4 Psychiatric Hospital” of the Moscow region. To investigate the upbringing and adaptation issues, a survey was conducted using the following questionnaires: 1) Adolescents’ perception of parents; 2) Family ambience scale; 3) Social and psychological adaptation scale.\u0000The questionnaire-based survey of adolescent females aged 15-17 raised in adoptive families yielded insights about the psychological aspect of relations between children and adoptive parents, which reveals the content and specificity of parenting practices from the perspective of the teenage girls. The study also evaluates the social climate in adoptive families and the sociopsychological adaptation of adolescent females to the new living conditions and parenting style.\u0000Questionnaire-based investigations can help identify existing problems in the upbringing of adolescent females in adoptive families, which may further advance evidence-based approaches to facilitating the social adaptation of adolescent females.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128710312","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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