Медицинские науки. Рубрика в журнале - Бюллетень науки и практики
About diversity circulation of the fetus and the newborn. Literature review
Статья обзорная
The article presents a modern understanding of the physiology of the fetal-placental circulation, reflects the characteristics of blood flow in the fetus and the newborn. The anatomical and physiological features of the cardiovascular system in newborns are covered in detail.
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Anxious sexual failure expectation syndrome (fear of sexual failure) in men
Статья научная
Results of the article authors researches are submitted. It is reported that anxious sexual failure expectation syndrome (ASFES) can exist in two forms: the form of anxious apprehension of sexual failure as well as the form of fear of sexual failure (coitophobia). Three variants in the formation of ASFES (premanifest, manifest, postmanifest with respect to the beginning of sexual dysfunctions) are isolated as well as its acute, subacute and gradual development. Some mechanisms of its pathogenesis are revealed (dysfunction of mesodiencephalic structures, which occurs during intimacy, hyposecretion of testosterone, weakening of its transformation into dihydrotestosterone, hyperprolactinaemia, etc.), and its sexological and nonsexoligical manifestations are characterized (sexual dysfunctions, psychoautonomic and psychosensory disturbances, behavioural changes during and outside intimacy). Types of “neurosis of failure expectation” are submitted. Variants of the ASFES course (continual and alternating) and its clinical variants (total, selective, androcentric, feminocentric and mixed) are isolated. Also, different variants of the ASFES influence on sexual harmony (decompensatory, compensatory and the one that does not have any significant effect on the harmony) and common information about therapy for this syndrome (psychotherapy, pharmacotherapy) are submitted.
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Aspects of diagnostics of neonatal pulmonary hypertension in the premature newborns
Статья научная
The formation of the pulmonary vascular system is due to the gradual development and is an integral part of the differentiation of the cardiovascular and pulmonary systems. In children born at a gestational age of 24 weeks, the lungs are at the canalicular stage of formation. At this stage, the alveoli and capillaries are not capable of ensuring proper gas exchange, due to failures in the remodeling of the interstitial extracellular matrix. Hypoxia and, as a result, post-hypoxic changes eventually lead to maladaptation syndrome of the cardiovascular system caused by a cascade of various disorders. One, perhaps, of the most severe clinic-pathogen etic forms of this pathology is neonatal pulmonary hypertension, characterized by the absence of specific manifestations, pathognomonic signs and accompanied by high mortality. The purpose of our study is to analyze the data of ECG and echocardiogram in children with neonatal pulmonary hypertension. We found that with persistent pulmonary hypertension on an ECG, signs of hypoxic-ischemic myocardial damage are more often detected. With persistent pulmonary hypertension, speeds of more than 1.4-1.6 m/s and diagnostically significant regurgitation to the tricuspid valve (++ / +++) are detected.
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Assessment of adaptation potential of foreign students studying in low and midlands conditions
Статья научная
Assessment of the adaptive potential of students studying in low- and midlands conditions is a very important task, since it allows students to timely identify pathological conditions that precede the development of the disease. The goal of this study is to assess the adaptive capabilities of foreign students studying in low- and midlands conditions. The 260 first-course male students aged 19.55±1.31 years from India were examined. The study was conducted in low mountains (760 m ASL) and middle mountains (1650 m ASL). The index of functional changes (IFCh), as calculated by R. M. Baevsky, took into account factors such as age, height, body weight, heart rate, and blood pressure. A comparative analysis of the indicators of the index of functional changes (IFCh) of foreign students studying in lowlands and midlands revealed significant differences in systolic blood pressure (SBP). In the low mountains group, the value of IFCh was higher than in the middle mountains group. The majority of students (77% in the lowlands and 86% in the midlands) demonstrated a satisfactory level of adaptation. However, a small percentage of students in both the lowlands (6%) and midlands (1%) showed unsatisfactory adaptation. Therefore, the educational environment in the midlands was found to be more favorable for the adaptation of Indian students.
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Статья научная
Несмотря на появление современных биомаркеров, инновационных методов обследования и лечения, проблемы сердечно-сосудистого риска в клинической медицине по-прежнему остаются достаточно актуальными. Широкое распространение факторов сердечно-сосудистого риска и высокая смертность от болезней органов кровообращения наблюдаются во всех странах мира, в том числе и Киргизской Республике. Цель исследования. Изучить клинико-функциональные значения СРБ и его взаимосвязь с факторами сердечно-сосудистого риска у пациентов с хроническими неинфекционными заболеваниями. Материал и методы. В одноцентровое открытое исследование было включено 290 человек с различными категориями сердечно-сосудистого риска, из них мужчин 150 (51,7%), женщин - 140 (48,3%). У всех участников были проанализированы параметры гемодинамики, показатели клинико-биохимических обследований. Экскреторная функция почек оценивалась по уровню сывороточного цистатина С. Скорость клубочковой фильтрации (СКФ) рассчитывалась по методике F. Hoek. Учитывались размер левого предсердие (ЛП), линейные размеры левого желудочка (ЛЖ) с оценкой структурной модификации миокарда. В зависимости от концентрации СРБ были сформированы две группы: 1А и 1Б. Результаты. У пациентов с высоким уровнем СРБ средний возраст, индекс массы тела, частота сердечных сокращений, число тромбоцитов, лейкоцитов, глюкоза, цистатин С крови были существенно выше, а средний уровень холестерина липопротеинов высокой плотности и СКФ были достоверно ниже. Размер левого предсердия, конечный диастолический размер ЛЖ, величины толщины межжелудочковой перегородки и задней стенки ЛЖ, относительная толщина стенки ЛЖ, масса миокарда ЛЖ, индекс массы миокарда ЛЖ, отношение Е/А правого желудочка, DT (deceleration time) ЛЖ, DT (deceleration time) правого желудочка были значимо выше в группе лиц с высоким содержанием СРБ крови. У пациентов с нормальным (1А) и повышенным (1Б) уровнем СРБ в структуре изменений геометрии ЛЖ значимо чаще выявлялся эксцентрический вариант гипертрофии ЛЖ (74,9% и 66,0% соответственно). Концентрация СРБ крови была положительно связана с размером левого предсердия и толщиной стенок ЛЖ, отрицательно - со скоростью СКФ. Заключение. У лиц с высоким и очень высоким сердечно-сосудистым риском повышенные уровни СРБ ассоциируются с более выраженными факторами сердечно-сосудистых осложнений. В группе пациентов с высоким уровнем СРБ структурная модификация миокарда представлена значимо чаще эксцентрическим вариантом гипертрофии ЛЖ.
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C1Q нефропатия (клинический случай)
Статья научная
С1q нефропатия редкая, недостаточно хорошо изученная патология, характеризующаяся отложением С1q компонента комплемента и иммунных комплексов в мезангии. Постановка диагноза требует выполнения биопсии почки c исследованием иммунных комплексов. При световой микроскопии данная патология проявляется болезнью минимальных изменений (БМИ), фокально-сегментарным гломерулосклерозом (ФСГС) и пролиферативным гломерулонефритом. Клиническая картина разнообразна, колеблющаяся от бессимптомной гематурии или протеинурии до нефротического синдрома. Кортикостероиды являются основой лечения, а иммуносупрессивные агенты зарезервированы для стероидорезистентных случаев. Наличие нефротического синдрома и ФСГС предсказывают неблагоприятные исходы в отличие от благоприятных исходов у пациентов с БМИ. В этой статье мы опишем клинический случай, гистопатологию, клиническую особенность C1q нефропатии.
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CAR T-клеточная терапия как современный метод лечения онкологических заболеваний
Статья обзорная
Ежегодный рост случаев онкологических заболеваний диктует необходимость поиска и разработки новых методов диагностики и терапии онкозаболеваний. В статье представлены результаты анализа современных литературных источников, посвященных CAR T-клеточной терапии, ставшей прорывным направлением в лечении ряда гематологических опухолей. В основе CAR T-клеточной терапии лежит создание пула опухоль-специфичных цитотоксических лимфоцитов путем внесения ex vivo трансгена, кодирующего химерный антигенный рецептор. В статье изложены основные принципы, возможные осложнения, преимущества и недостатки CAR T-клеточной терапии.
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Cerulein induced acute pancreatitis in experiment
Статья научная
Acute pancreatitis (AP) is an inflammatory disorder of the pancreas, which ranges from mild, self-limiting disease to a severe form that is associated with multiple organ dysfunction syndrome (MODS), high morbidity, and mortality. Unpredictable nature of the disease, heterogeneity of disease presentations, and limited access to human samples, make research on human tissues impractical and often very difficult. We tried to identify crucial events in the pathophysiology of AP, in the course of several in vivo experimental models of the AP induction. In vivo experiment was carried out on rats using the analog of cholecystokinin octapeptide - Cerulein. The rats were divided into groups, in each group there was a different dosing regimen of the drug. As a result of a series of experimental studies, it was found that the interval low-dosage induction of AP causes more severe damage of pancreas tissue than a single administration of higher doses of the test substance.
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Статья научная
One of the factors causing stress in society is exam stress. Taking exams is stressful and quite exciting in itself. However, under the influence of excitement, the student cannot show his little knowledge. From this point of view, the study of psychological and physiological development of students is also of special importance. The study is dedicated to the change of vegetative indicators due to the influence of the exam process depending on the temperament of the nervous system in students of the 5th year of choleric type. In this regard, the main goal of the study was to reveal the age characteristics of changes in vegetative indicators depending on the type of temperament as a result of the effect of emotional stress during the examination. In order to study the effect of the exam process on emotional stress, students were divided into three groups: The first group was students studying on regular school days 2 months before the exam, the second group was 30 minutes before the exam process, and the third group was the group after the exam and 30 minutes after the exam process. First of all, the physiological indicators of different states of excitement of the temperament type and the process of excitement were studied in the experiment. In order to comprehensively evaluate the effect of emotional stress, we measured the main hemodynamic parameters, arterial pressure and number of heart beats per minute. It was determined that, depending on the type of temperament, vegetative indicators before the exam process (heart pressure, systolic and diastolic pressure) of young people on an ordinary day, before and after the exam, are different. However, after the exam, these indicators do not fully return to the norm. The tone of the sympathetic nervous system prevails during the examination process in all age groups.
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Статья научная
The article reflects the study of the influence of climatic and seasonal factors on the body of people of middle, elderly and senile age. These factors significantly aggravate the course of many diseases, worsen health and reduce the body's performance. The incidence of cardiovascular disease is often associated with risk factors and seasons. Most people aged 65 years and older often suffer from hypertension. With age, the number of such patients increases significantly. Severe hypertension is rare in humans because patients with hypertension do not live to an advanced age or often develop complications. Changing seasonal factors requires great attention to the functional state of the cardiovascular system. Patients with hypertension are very difficult to adapt to changing weather conditions, which worsens the quality of life of the elderly and leads to various complications. Changes in blood pressure in people of middle, elderly and senile age depending on the season of the year have been established.
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Clinical acute bulbar syndrome in a 6-month-old child with cortical brain dysplasia
Статья научная
The article presents a rare clinical case of Autoimmune brain stem encephalitis of unknown etiology in a 6-month-old girl. The manifestation of the disease began with a subacute growing bulbar syndrome, however, in the clinical picture noted hemiparesis, which was not typical for the brain stem lesions. In the series of examinations, we revealed a concomitant congenital pathology of the cerebral cortex, which was the cause of child hemiparesis. The clinical case shows the importance of differential diagnosis in limited conditions and medical alertness for the correct diagnosis and further treatment.
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Clinical and epidemiological assessment of anthrax
Статья научная
The article presents the results of epidemiological, clinical analysis of the registered incidence of anthrax for the period from 2015 to 2020 in Osh, Jalal-Abad region of the Kyrgyz Republic. There is a pronounced tendency to increase the incidence of anthrax with a wide spread in disadvantaged inpatient facilities.
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Статья научная
It is now known that the SARS-CoV-2 virus can infect cells in the gastrointestinal tract as well as the liver. Liver dysfunction is found in 14-53% of patients with COVID-19. Scientists have found that the SARS-CoV-2 virus can directly infect liver cells and cells lining the intra- and extrahepatic bile ducts (cholangiocytes), since they contain, although in low concentrations, a special enzyme ACE-2, which serves as an entry point into cells of some coronaviruses, including SARS-CoV-2. The next stage in the development of pathology is inflammation and the formation of blood clots. With a violent reaction of the immune system, an excessive release of cytokines occurs, which aggravates the condition and, in some cases, leads to reactive hepatitis.
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Co-infection of hepatitis a and herpes simplex virus: a case report
Статья научная
Hepatitis A is a self-limiting disease where fulminant hepatitis and death occur in a small proportion of patients. Fulminant hepatic failure is more common in patients with underlying liver diseases, such as chronic hepatitis B and C, co-infection with more than one genotype of hepatitis A at the same time, non-alcoholic fatty liver disease or alcoholic steatohepatitis, in advanced age and with dependence on intravenous drugs. We present a case of infection of hepatitis A and herpes simplex virus that lead to acute liver failure. In this rare case, the importance of attention to the first manifestations of the disease in diagnosing severe cases of hepatitis A in adults is emphasized. At the same time, HSV hepatitis can also be the cause of fulminant hepatic insufficiency. Therefore, patients with severe hepatitis A need an early examination for HSV infection, and empirical treatment with acyclovir should begin at early stage.
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Статья научная
In the length of time, a wide variety of drug combinations emerged in the management of post-transplantation therapy in order to improve the survival of the recipient and graft. However, the efficacy and safety of the applied combinations regarding the rejection and other complications are continuing to be the subject of research. In our study, our aim is to compare the effects of various combinations, namely cyclosporine with mycophenolate mofetil/mofetil mycophenolic acid with prednisolone and tacrolimus with mycophenolate mofetil/mofetil mycophenolic acid with prednisolone in a length of time. Methods. A total of 204 patients included into the study who received post-renal transplantation treatment in Scientific-Research Institute of Heart Surgery and Organs Transplantation and followed-up over a 10-year period. The estimated survival probabilities in the study were determined by the Kaplan-Meier method; whereas intragroup comparisons were evaluated by Log-rang, Breslow, and Tarone-Ware tests. Complications occurred in patients with combinations were analyzed by Chi-square and its alternatives. Hazard risk factors were tested by Cox regression analysis. Results. Of these 204 patients, 36 received Cyclosporin combination (CCG) and 168 Tacrolimus combination (TCG). The estimated life expectancy of the patients of TCG was significantly longer than the CCG ones. Furthermore, gender and age did not have a significant effect on survival depending on time, however, gender and age-related hazard factor showed a significant difference in the groups. It was determined that chronic rejection was significantly different in patients who used tacrolimus combinations, the difference was close to the significant value in acute rejection analysis. Other adverse events, namely, infection, tumour and organ damage were statistically less common in the patient group treated with tacrolimus combinations. Conclusion. In general, TCG showed better results in contrast to CCG.
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Comparative analysis of prevalence of oral caries in the Kyrgyzstan and Indian population
Статья научная
Oral hygiene plays a very crucial role in every individual from the birth of a human. Oral health cannot be denied specially when it comes to the initial stage of life. The aim of this article is to compare the oral health in the population of India and Kyrgyzstan (6-15 years). It is important to notice, diagnose treat and prevent the prevalence of dental diseases as it has an impact on the physical mental and social life of an individual. Due to the consumption of unhealthy fast food, high quantity of sugar, and deteriorated oral hygiene has resulted into dental impairment and has made room for various dental diseases as toddlers are more easily prone to oral complications or conditions that have a very negative effect on their quality of life. Oral cavity carries out the basic and vital functions for the eventual and progressive tasks for rest of the human body. A smile is a confinement of a person’s self-confidence, self-esteem, personal and social habits, health and lifestyle. Therefore, it is obligatory to keep safe and prevent from disease as it can be fatal in the future or be a root cause of other health complications.
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Статья научная
Postoperative Ventral Hernias to this day remain one of the main pathologies of planned and urgent surgical interventions. The purpose of the study is to study the immune response in patients with postoperative ventral hernias who underwent auto and alloplastic hernioplasty methods. The study included 40 patients diagnosed with postoperative ventral hernia, including 25 men (62.25%) and 15 women (37.5%). In men, the average age was 45.6±2.3 years, and in women 57.2±3.2 years. Patients are divided into 2 groups. Group I are patients who underwent autoplastic methods and group II patients who underwent alloplastic hernioplasty methods. The complex of immunological examination included the determination of a subpopulation of lymphocytes with CD3, CD4, CD8, CD20 receptors, interleukin 6, interleukin 10 and immunoglobulins A, M, G. Immunological examination of blood parameters in patients with postoperative ventral hernias revealed the following changes. There is an upward trend in all indicators. In group I, the leukocyte level was increased by +0.2±0.01, and in group II, the indicators were within the normal range. The level of monocytes in patients who underwent alloplasty increased by +1.5±0.2. There was an increase in the concentration of T and B lymphocytes with GD3, CD4, CD8, CD20 receptors on the 7th day after surgery in patients of the first group was +1.85±0.3, +1.6±0.4, +1.6±0.1, +1.5±0.2. And in patients of the second group, the initial level of indicators was lower and increased by +1.2±0.1, +1.4±0.2, +1.67±0.65, +1.03±0.45. The level of IL6 and IL 10 in the postoperative period increased in patients of the first group by +1.55±0.2 and +1±0.9, in the second group it was IL 6 +0.9±1.2, IL 10 +0.8±1.2. The study shows that the indicators of the humoral cell type tended to increase, which shows the result. Conclusions. Patients with postoperative ventral hernias who have undergone autoplastic and alloplastic hernioplasty methods in dynamics, the immunological reactivity indicators significantly increase on the 7th day, in comparison with the initial blood parameters. Namely, in patients who have undergone autoplastic methods of hernioplasty. The use of conventional suture materials in autogernioplasty increases the risk of developing an inflammatory process in the early and long-term postoperative period, in contrast to the use of polypropylene mesh prostheses.
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Статья обзорная
His article discusses the problems of diagnosis of diffuse hyperplastic processes of the endometrium in women in the menopausal transition. Endometrial hyperplasia is a heterogeneous set of pathological processes, ranging from benign proliferation to monoclonal tissue proliferation. During the study, the most optimal criteria for the diagnosis of endometrial hyperplasia in women during the transition to menopause based on the use of a modern diagnostic complex (immunohistochemical and endoscopic technologies) were selected and formed. Endometrium is a hormone-sensitive, cyclically renewed tissue that reacts to the slightest changes in the hormonal status. In this connection, an attempt was made to analyze the prospects and feasibility of using immunohistochemical technologies in gynecological practice. The authors found that the study and analysis of the hormone - receptor status in individuals with endometrial hyperplasia in gynecological practice, consists of two points, first, the hormone-receptor status in endometrial hyperplasia is individual, and the degree of expression of highly productive or low-productive receptor complexes speaks the mechanism of development of receptor desynchronosis, and secondly, the hormone-receptor status determines the sensitivity of endometrial hyperplasia to hormonal therapy.
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Employing algorithms in cosmetic facial surgery
Статья обзорная
The aim is to evaluate the scientific literature on the creation and application of algorithms in clinical settings, with a focus on their efficacy. Material and methods. The literature search was performed using the databases Scopus, Medline (PubMed), eLibrary (in total: 32 scientific papers).
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Статья научная
This study offers findings of endoscopic research of patients with stomach cancer after surgery of gastrectomy with different versions of small intestine plastic surgery. Total number of patients exposed to the research is 130, divided into 3 groups. Findings: veracious decrease of esophagitis (p
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