Perm Medical Journal

”Perm Medical Journal” (ISSN Key title: Permskiĭ medit︠s︡inskiĭ zhurnal) is a referred scientific and practical journal. It was founded in 1923 by Medical Society of Perm University. Since 2001 the founders of “Perm Medical Journal” are Perm State Academy of Medicine and Perm Research Center of Russian Academy of Medicl Sciences and Administration of Perm Region. Since 2017, the founder is Academician E.A. Vagner Perm State Medical University.

Editor-in-Chief: Evgeny G. Furman, MD, PhD, Corresponding Member of the Russian Academy of Sciences (Wagner State Medical University, Ministry of Health of the Russian Federation, Vice-Rector for Research)

The journal is registered by the Roskomnadzor agency (licensee ЭЛ № ФС 77-75489 on 05.04.2019).

“Perm Medical Journal” is included into the list of the leading scientific journals and editions of the Russian Federation intended for publication of basic scientific results of theses for a degree of Doctor of Science.

01.14.01 - Obstetrics and gynecology (medical sciences)
01.14.02 - Endocrinology (medical sciences)
3.1.21 - Pediatrics (medical sciences)
01.14.12 - Oncology (medical sciences)
3.1.9 - Surgery (medical sciences)
01.14.25 - Pulmonology (medical sciences)
3.2.2 - Epidemiology (medical sciences)
03.14.09 - Clinical immunology, allergology (medical sciences)
03.14.10 - Clinical laboratory diagnostics (medical sciences)

PubMed News Global

 

Real-world clinical effectiveness of once-weekly semaglutide in patients with type 2 diabetes: a systematic literature review

27.01.2023

CONCLUSIONS: This systematic literature review provided complementary evidence to findings from the clinical trials and provided a more comprehensive picture of the use of O.W. semaglutide in routine clinical practice. Results of the review suggested that O.W. semaglutide therapy was associated with improving glycemic control and weight loss in both T2DM patients naïve to GLP-1RA and those previously treated with other GLP-1RA in routine clinical practice.

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Recycling tenofovir in second-line antiretroviral treatment with dolutegravir: outcomes and viral load trajectories to 72 weeks

27.01.2023

CONCLUSIONS: Recycling NRTIs with dolutegravir was effective for most participants to 72 weeks. Most with viraemia did not develop virologic failure and subsequently suppressed with enhanced adherence counselling or continued to have low-level viraemia. No integrase-inhibitor resistance was detected despite low-level viraemia in a minority of participants.

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Feasibility, Acceptability, and Preliminary HIV Care and Psychological Health Effects of iTHRIVE 365 for Black Same Gender Loving Men

27.01.2023

CONCLUSIONS: Findings suggest iTHRIVE 365 is feasible, acceptable, and positively impacts daily ART use, depressive symptoms, and emotion regulation difficulties.

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Hypofractionation in Breast Cancer Radiotherapy Across World Bank Income Groups: Results of an International Survey

27.01.2023

CONCLUSION: Preference for hypofractionation varied for curative indications, with greater acceptance in earlier-stage disease in HICs and in later-stage disease in LLMICs. Targeted educational interventions and greater inclusivity in radiation oncology clinical trials may support greater uptake.

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Novel Receptor-Binding-Based Assay for the Detection of Opioids in Human Urine Samples

27.01.2023

Consumption of opioids is a growing global health problem. The gold standard for drugs of abuse screening is immunochemical assays. However, this method comes with some disadvantages when screening for a wide variety of opioids. Detection of the binding of a compound at the human μ-opioid receptor (MOR) offers a promising alternative target. Here, we set up a urine assay to allow for detection of compounds that bind at the MOR, thus allowing the assay to be utilized as a screening tool for...

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Current Issue

Vol 39, No 6 (2022)

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Full Issue

Original studies

Role of vitamin D in formation of climacteric syndrome
Koval M.V., Udachina A.A.
Abstract

Menopause is a physiological period during which involutional processes in the reproductive system predominate in a woman's body. Vitamin D deficiency increases the risk of age-related diseases, so it is important to examine and, if necessary, adjust the level of vitamin D. Purpose of the study. To determine the relationship between vitamin D levels and the severity of menopausal syndrome in postmenopausal women. Materials and methods. A cross-sectional study was conducted, which included data on 150 patients who applied for a gynecological appointment with complaints of manifestations of menopausal syndrome (CS). Results. As a result of the study, it was revealed that out of 150 women with manifestations of menopausal syndrome, the average level of 25(OH)D in the blood serum was 25.3(7.5) ng/ml. At the same time, in 49 (33%) of the surveyed, the content of hydroxyvitamin D was normal, a deficiency was observed in 53 (35%), and in 48 (32%), the indicators corresponded to a deficiency. However, the correlation analysis of the relationship between the level of vitamin D and the severity of the climacteric syndrome did not reveal a statistically significant relationship between the studied parameters (p=0.317). Conclusions. The severity of menopausal syndrome does not depend on the level of vitamin D in the blood, which confirms the leading role of hypoestrogenism in the etiopathogenesis of this condition.

Perm Medical Journal. 2022;39(6):5-10
pages 5-10 views
Clinical and laboratory characteristics of acne tarda in women of Perm Krai
Elkin V.D., Kobernik M.Y., Sedova T.G., Kuznetsov I.D.
Abstract

Objective. To evaluate clinical and laboratory changes in patients with acne tarda. Acne is a common chronic inflammatory disease that develops on the seborrheic areas of the skin in the form of comedones, follicular papules and pustules, as well as nodes. Acne is mainly formed at puberty, but can also be observed at an older age, later acne (acne tarda), as a rule, occurs in women. At the age of 25, 45 % of women suffer from acne, at the age of 31–40 acne, is observed in 26 % of women, premenstrual acne periodically occurs in 78 % of women of different ages.

Materials and methods. The study involved 62 women aged 30–45 years, who formed two groups: group I included 30 patients with acne tarda, group II consisted of 32 women without acne acne tarda. The study included the investigation of complaints and anamnesis of disease and life, assessment of general and dermatological status, general blood and urine tests, biochemical blood analysis with indicators of lipid spectrum, carbohydrate metabolism, liver enzymes, pituitary hormones (LH, FSH, prolactin, TSH) and sex hormones. The methods of parametric and nonparametric statistics were used to analyze the data obtained, standard error (m) was used in the calculations, the level of statistical significance was noted at p < 0.05.

Results. Most of the patients with acne tarda had a history of pubertal acne and acne in relatives. Among them changes in lipid metabolism were detected significantly more often, primarily an increase in the level of leptin (46.7 ± 9.1 %) (p <0.05), as well as hyperlipidemia and elevated atherogenicity index. Ovarian pathology was also significantly more often observed in patients with acne tarda, mainly in the form of functional cysts (53.3 ± 9.1 %) (p < 0.05), and an increase in progesterone levels (80.0 ± 7.3 %) (p < 0.05). There were no significant differences in other sex hormones and pituitary hormones, indicators of carbohydrate metabolism and the function of hepatobiliary system in patients with acne tarda and without it.

Conclusions. Acne tarda develops mainly in women with a pubertal acne in anamnesis and a burdened heredity of acne. The disease is accompanied by a change in lipid metabolism, especially an increase in the blood leptin level, and proceeds against the background of hormonal homeostasis disorders in the form of hyperprogesteronemia with the formation of functional ovarian cysts.

Perm Medical Journal. 2022;39(6):11-16
pages 11-16 views
Prognosis of forming phenotype of comorbidity of arterial hypertension and erosive-ulcerative le-sions of gastroduodenal zone in railway transport workers
Malyutina N.N., Yuy N.D., Luzina S.V., Vatolin D.M., Sosnin D.Y.
Abstract

Objective. To study the clinical and laboratory features of the formation of a combination of arterial hypertension in patients with erosive and ulcerative lesions of the gastroduodenal zone and to develop a method for predicting the probability of developing this phenotype. Arterial hypertension and diseases of the gastrointestinal tract are among the common diseases, which are often observed in the same patients.

Materials and methods. Employees (n = 127, males only) of locomotive crews, who work for more than 10 years at Perm-II Railway Station of Sverdlovsk Branch of OJSC Russian Railways, were examined. The methods of examination included the analysis of anamnesis data, physical, laboratory and instrumental examinations of patients. Laboratory studies included the analysis of the results of a general blood test, the serum concentration of common biochemical parameters (glucose and cholesterol), as well as the concentration of individual proteins: endothelin-1, monocyte chemotactic protein-1 and C-reactive protein.

Results. The diagnostic value of determining a number of indicators for predicting the development of arterial hypertension in patients with erosive and ulcerative manifestations of the gastrointestinal tract was established. The greatest significance for the diagnosis of comorbidity was demonstrated by the level of endothelin-1, glucose and cholesterol as well as the content of white blood cells and platelets. The data obtained made it possible to develop a mathematical formula for calculating the risk of arterial hypertension in patients with erosive and ulcerative lesions of the gastroduodenal system.

Conclusions. Employees of locomotive crews have an increased risk for comorbid pathology formation – arterial hypertension against the background of erosive and ulcerative lesions of the gastroduodenal zone, which is accompanied by a change in a number of laboratory parameters that can be used to predict the risk of developing comorbid pathology.

Perm Medical Journal. 2022;39(6):17-27
pages 17-27 views
Analysis of congenital pneumonia incidence in newborns from high-risk mothers
Tezikov Y.V., Lipatov I.S., Zagrebelnaya N.V., Gogel L.Y., Kochergaeva T.V., Dremluga N.M.
Abstract

Objective. To detect the incidence of congenital pneumonia in newborns from mothers with placental insufficiency in combination with premature amniotic fluid discharge

Materials and methods. A retrospective analysis of 57 stories of newborn infants and their mothers was carried out. The newborns were divided into 3 groups: group 1 – 37 newborns from mothers with placental insufficiency and premature amniotic fluid discharge, group 2 – 9 infants from mothers with premature amniotic fluid discharge, group 3 – 11 infants born from mothers with placental insufficiency. The obstetric and gynecological history, the presence of extragenital pathology, the peculiarities of the course of pregnancy and childbirth, and the outcomes for newborns were analyzed.

Results. Congenital pneumonia was more common in newborns from mothers with placental insufficiency and premature amniotic fluid discharge. In newborn infants of the first group, severe asphyxia occurred more often, being a risk factor. At the same time, the identification of markers of the systemic inflammatory reaction did not always reflect the presence of infectious-inflammatory pathology in newborns. In addition, in the presence of inflammation of the fetal part of placenta, in a large number of newborns pathological microflora is detected during microbiological examination.

Conclusions. As a result of the study, the role of maternal pathology on the development of intrauterine infection and implementation of infection in the early neonatal period was revealed. The obtained data justify the need for pregravid preparation and prevention of perinatal complications in women with placental insufficiency.

Perm Medical Journal. 2022;39(6):28-37
pages 28-37 views

Review of literature

Normogonadotropic menstrual function disorders in reproductive period
Sandakova Е.А., Zhukovskaya I.G.
Abstract

Objective. To analyze and summarize the available literature data regarding the normogonadotropic menstrual function disorders in the reproductive period for identification of pathogenetic approaches to treatment of menstrual function disorders, sterility, miscarriage and pathological processes associated with them.  Most of menstrual function disorders (76 %) are caused by functional hypothalamic disorders, changes in the rhythm and gonadotropic hormone secretion amplitude, which are not accompanied by an altered level of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) – normogonadotropic menstrual function disorders (NMFD).

Materials and methods. Systematic review of native and foreign literature.

Results. The clinical lecture presents the current data on physiology of reproductive system regulation, characteristics of menstrual function in norm and pathology; it defines  normogonadotropic disorders, demonstrates their clinical forms, hypothalamic dysfunction-forming mechanisms as well as  predetermining, trigger, contributory factors, which  form the normogonadotropic disorders; describes clinical features of patients with the above pathology as well as algorithms for therapeutic approaches in the form of “step-type” tactics: elimination of contributory factors, prevention of trigger mechanisms, basic adaptogenic and situational  therapy that leads to restoration of ovulation, realization of reproductive plans and improvement of the quality of life among such patients in more than 90 % of cases.

Conclusions. It was stated, taking into account the variety of mechanisms forming normogonadotropic menstrual function disorders, that treatment of such patients is a complex goal, which requires a detailed studying of female health status, forming a proper clinical diagnosis, developing personified medical programs for a long period of time.

Perm Medical Journal. 2022;39(6):38-53
pages 38-53 views

Methods of diagnosis and technologies

Efficacy of enterosorption in treatment of Covid-19 in pregnant women
Romanovskaya A.V., Mikhailova E.V., Denisyuk N.E., Tyapkina D.A.
Abstract

Objective. To optimize the treatment of pregnant women with a moderate form of COVID-19 by including a sorbent in complex therapy.

Materials and methods. Pregnant women (n = 87) with a gestational term of 30 weeks or more were divided into 2 groups. Group 1 (n = 42) received standard treatment for COVID-19. Group 2 (n = 45) received an additional preparation of colloidal silicon dioxide. The following endotoxemia indicators were assessed: concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), medium mass molecules (MМM). The course of pregnancy and complications of childbirth were evaluated.

Results. At the peak stage of the disease, in patients of group 2 the level of МММ was 0,43 opt. units lower, CRP – 7.1 mg / l lower, IL-6 – 2.3 ng / ml lower than in women of group 1.

Anemia, fetal growth retardation, threatening preterm birth, fetoplacental insufficiency, polyhydramnios and oligohydramnios was diagnosed rarely in group 2; the average fetal weight was 256 g more, the average fetal height was 2.4 cm more than in group 1. In group 2, there were fewer children with moderate and severe asphyxia.

Conclusions. The addition of colloidal silicon dioxide to the standard treatment of pregnant women with a moderate form of COVID-19 helps to reduce the level of endogenous intoxication, which is manifested by positive dynamics.

Perm Medical Journal. 2022;39(6):54-61
pages 54-61 views
Development of “artificial intellect based dental android system” for simulation of medical manipulations and doctor – patient communication
Astashina N.B., Baydarov A.A., Arutyunov S.D., Yuzhakov A.A., Kokoulin A.N., Valikhmetova K.R., Mayorov P.V., Shamarina A.M., Lazarkov P.V., Vronsky A.S., Kharakh Y.N.
Abstract

Objective. The study is aimed at designing an inventive, multifunctional artificial intellect based anthropomorphic service robot, which could be integrated into an online learning system. An interdisciplinary research group in the framework of a newly formed university consortium is implementing a project in order to develop an artificial intellect based robotized Dental Android System able to simulate an actual clinical dental appointment.

Materials and methods. The system is based on an android (humanoid) robot comprising a multifunctional artificial intellect system. The factors, expanding  the applicability range of the system and elevating its realistic basis in the course of learning are the use of a high-similarity construction, and introduction of a well-developed sensorics in the model teeth and jaw, in particular: – the teeth have the form of heterogeneous objects made of polymer materials with  different stress-related characteristics typical for a natural tooth (enamel and dentin) with embedded contact sensors, a thermal sensor to read tooth heating parameters in the course of preparation for the purpose of training pulp burn prevention skills; – the smart jaw comprises several independent sectors and load cells allowing to determine the force applied to any part of the jaw.

Results. Possibility of audiovisual communication with the robot allows to implement a scenario approach to learning in the course of vocal communication.

Conclusions. The system being developed is an innovative solution of current goals of medical staff training in the rapidly emerging digital educational medium throughout the entire medical education process.

Perm Medical Journal. 2022;39(6):62-70
pages 62-70 views

Preventive and social medicine

Epidemiological aspects of pediculosis in Astrakhan region
Arakelyan R.S., Kurbangalieva A.R., Sivtsova L.A., Korolkova V.S., Efremova V.Y., Arakelyants O.A., Kovalenko A.V., Kiseleva A.A., Guseinova G.B., Boleubaeva L.T., Ishmuhambetova L.K., Mirmanova I.M., Manaeva D.A., Dodov T.R.
Abstract

Objective. To study and describe the clinical and epidemiological aspects of pediculosis in residents of Astrakhan Region for 2016–2020.

Materials and methods. In total, 1202553 cases of human infection with infectious and parasitic diseases were registered in Astrakhan Region during the analyzed period, of which pediculosis accounted for 0.4 % of all infectious diseases and 35.1 % (5380 cases) of all parasitic infestations. Cases of pediculosis were recorded in all age groups including children, who accounted for 74.6 % (4015 cases).

Results. Considering the number of registered cases of pediculosis for the period of 2016–2020, the largest number of cases was noted in 2016–2019 and amounted to 89 % (4789 cases). Cases of pediculosis have been recorded in both urban and rural areas. In total, 41.3 % (2220) cases of pediculosis were registered in the rural areas of Astrakhan Region during the analyzed period, of which the proportion of children was 77.7 % (1724 cases) of all registered cases of pediculosis in the rural areas and 42.9 % of all cases of pediculosis registered in children. The incidence of the urban residents is 1.4 times higher than that of the rural ones and is 58.7 % (3160 cases), of which the child population is 72.5 % (2291 people) of all cases of pediculosis registered in the urban areas and 57.1 % of all cases of pediculosis in children.

Conclusions. The epidemiological situation regarding pediculosis in Astrakhan Region remains very tense, as evidenced by the above indicators. The incidence of the urban residents is 1.4 times higher than that of the rural in Astrakhan Region. The most frequent cases of pediculosis are registered in children due to a large crowding of patients in various educational institutions, or epidemic outbreak in the class or school.

The results of the study. Considering the number of registered cases of pediculosis for the period 2016-2020, the largest number of cases was noted in 2016-2019 and amounted to 89% (4789 cases).

Cases of pediculosis have been recorded in both urban and rural areas. In total, 41.3% (2,220) cases of pediculosis were registered in rural areas of the Astrakhan region during the analyzed period, of which the proportion of children was 77.7% (1,724 cases) of all registered cases of pediculosis in rural areas and 42.9% of all cases of pediculosis registered in children.

The incidence of urban residents is 1.4 times higher than that of rural residents and is 58.7% (3160 cases), of which the child population is 72.5% (2291 people) of all cases of pediculosis registered in urban areas and 57.1% of all cases of pediculosis in children.

Conclusions. The epidemiological situation of pediculosis in the Astrakhan region remains very tense, as evidenced by the above indicators. The incidence of urban residents is 1.4 times higher than that of residents of rural areas of the Astrakhan region. The most frequent cases of pediculosis are registered in children, which may be due to a large crowding of patients in various educational institutions, or there may be an epidemic outbreak in the classroom or school.

Perm Medical Journal. 2022;39(6):71-79
pages 71-79 views
Climate warming in the Russian North: biomedical aspect
Solomennyi A.P.
Abstract

Objective. To summarize the data regarding the warming of climate in the Russian sector of the Arctic and the effect of this process on the population health.

Materials and methods. The search and review of official documents of the international organizations, Rosgidromet, the Ministry of Healthcare of the Russian Federation and other institutions as well as scientific publications with experimental data on the situation and plan of actions in conditions of the current changes in the Arctic climate.

Results. The data presented show that Siberia and Arctic warm up more strongly than the other regions of the planet. The temperatures in these regions grow twice as faster than the world average ones.

Conclusions. The problems of negative consequences of climate warming for Perm Krai are urgent since Gainsky, Kosinsky and Kochevsky regions are officially included in the list of the territories of the Extreme North. In Perm Krai, there is possible an increase in the number of weather phenomena and risks for health associated with them.

Perm Medical Journal. 2022;39(6):80-83
pages 80-83 views
Role of Republican Perinatal Council in reducing infant mortality rate in the Republic of Sakha (Yakutia)
Pavlova T.Y., Sukhomyasova A.L., Douglas N.I., Titova V.K., Burtseva T.E.
Abstract

Objective. To analyze the work of the Republican Perinatal Council in the Republic of Sakha (Yakutia).

Materials and methods. A retrospective analysis of the work of the Republican Perinatal Council in the Republic of Sakha (Yakutia) for 2018–2021 was carried out.

Results. A total of 1553 women were sent to the RPC in 2018–2021. The proportion of group 2 women with changes in biochemical screening, chromosomal and hereditary fetal pathology increased. According to the results of RPC, the routing of pregnant woman is clearly worked out. The effectiveness of RPC can be estimated by the infant mortality rate in the Republic of Sakha (Yakutia) (2021 – 3.6 %).

Conclusions. The work of the Republican Perinatal Council, strict control over the observance of the stages of obstetric care, the introduction of routing sheets in the Republic of Sakha (Yakutia), the concentration of pregnant women and women at high risk for maternal and perinatal pathology in third-level institutions allowed to reduce an early neonatal mortality, infant mortality.

Perm Medical Journal. 2022;39(6):84-89
pages 84-89 views
Modern view of medical university students on euthanasia
Utochkin Y.A., Popovskaya A.V., Minasanova A.V.
Abstract

Objective. To assess the level of knowledge and identify the modern view of medical students on the procedure of euthanasia.

Material and methods. During the study, 100 students of medical university were surveyed. More than half (52 %) of respondents aged 20–21, 36 % were young people aged 22–23, 10 % – students aged 18–19 and the remaining 2 % were respondents aged 24–25.

Results. During the survey of students, it was revealed that despite the fact that half (50 %) of students are adherents of the main world religions (who have a negative attitude towards the euthanasia procedure), only 7 % were against euthanasia because of religious considerations. Only one fifth of the students (23 %) knew about all options for euthanasia. In addition, 18 % of those surveyed did not know about any option for euthanasia. Almost half (47.5 %) of the students answered that everyone should manage life as they want, and the same part (47.5 %) of respondents – that this decision depends on the circumstances. Moreover, almost half (47 %) of the students would agree to euthanasia for relatives in case of a serious illness.

Conclusions. Such a procedure as euthanasia cannot have an unambiguous assessment. Despite the acquired medical knowledge, our students still do not have enough information about the procedure itself to rationally evaluate all the advantages and disadvantages.

Perm Medical Journal. 2022;39(6):90-96
pages 90-96 views
Risk factors of maternal and failed maternal mortality, prediction of severe obstetric conditions
Berseneva S.N., Isaeva N.V., Padrul M.M., Cherkasova E.V.
Abstract

Objective. To determine the priority risk factors for maternal mortality (MM) and failed maternal mortality (FMM) on the basis of clinical and epidemiological features and to develop scientifically based patient-centered models for predicting severe obstetric conditions.

Materials and methods. Primary documentation of successful and dysfunctional maternal outcomes that occurred at the levels I, II, III of medical organizations in Perm and the territories of Perm Krai from 2007 to 2018. Using random sampling, two observation groups were formed: women with failed maternal mortality, deceased women and the control group. Analytical epidemiological "case-control" studies were carried out, which included the determination of confidence intervals, etiological accuracy using Epi Info and Excel ® 2016 MSO programs, a package of applied electronic tables Stat2015 of the author (© V.S. Sheludko, 2001–2016), the MedCalc ® 15.8 Portable program.

Results. Socio-behavioral, general somatic, obstetric-gynecological risk factors, the frequency of occurrence of which among women with failed maternal mortality was 1,4–4,3; 1,2–25,5; 1,1–7,6 times more often, and in the group of deceased mothers 1,9–9,0; 1,7–29,5; 2,8–9,0 times higher than in the group of healthy participants. The "indicators of maternal death" have been identified, which increase the risk of a failed maternal death turning into maternal death. Early clinical and laboratory signs of severe obstetric conditions are the following: high leukocyte intoxication index (LII), elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea and creatinine, decreased levels of fibrinogen, prothrombin index (PTI), prolongation of thrombin time (TT). Infectious-inflammatory, hypertensive complications, comorbidity, a high percentage of premature births and, accordingly, severe perinatal conditions are significantly more common in groups with unfavorable outcomes.

Conclusions. In the course of the study, reliably significant risk factors were identified, on the basis of which scientifically based models for assessing the probability of developing critical obstetric conditions were worked out.

Perm Medical Journal. 2022;39(6):97-105
pages 97-105 views

Clinical case

Persistent long-term hyperglycemia in a premature newborn: clinical example
Shestak E.V., Evdokimova M.V.
Abstract

Objective. To analyze the clinical picture of premature baby A. with persistent hyperglycemia, the patient's treatment tactics and approaches to differential diagnosis of the causes of this pathological condition. Glucose occupies one of the central positions in the processes of fetal growth and development, timely and normal development of the newborn brain. Disorders of its metabolism often lead to hypo- or hyperglycemia, especially common among premature infants, from isolated episodes to long-lasting persistent conditions. This article discusses a clinical case of a patient with registration of persistent hyperglycemia for two months.

Materials and methods. The article presents the analysis of the treatment of premature patient A. with a birth weight of 450 g. Medical documents with the results of clinical, instrumental and laboratory research methods were used. Informed consent of legal representatives for examination and treatment was obtained.

Results. A change in the condition of the child against the background of deep prematurity, septic process, accompanied by prolonged episodes of hyperglycemia, oxygen dependence, episodes of anemia, the formation of retinopathy and bronchopulmonary dysplasia, is described.

Conclusions. The analysis of the clinical case showed that hyperglycemia in premature infants is a polyetiological condition, it has different duration and outcomes, can be both the main disease as well as manifestation of many other serious pathologies of the neonatal period. The further search for effective and safe methods of diagnosis and correction of hyperglycemia is justified.

Perm Medical Journal. 2022;39(6):106-117
pages 106-117 views
Effect of comorbid pathology on the outcome of gastric cancer with Krukenberg metastases in a patient of reproductive age: clinical case
Shevlyukova T.P., Chernaya V.A., Keln A.A., Shvedsky M.S., Shageeva M.R.
Abstract

Objective. To determine the features of the influence of comorbid pathology on the outcome of metastatic gastric cancer in a patient of reproductive age.

Materials and methods. A prospective analysis of a clinical case was carried out on the basis of the Department of Antitumor Drug Therapy № 1 of the Medical Center "Medical City", Tyumen.

Results. The patient’s case, taking into account the data of instrumental examinations, objective examination, general condition of 40 % on the Karnofsky Scale, ECOG-3 (Eastern Cooperative Oncology Group), diagnosis, morphology and complications, was diagnosed as incurable; special methods of antitumor treatment were not indicated. In the current clinical situation, there was used the post-syndrome therapy, prolongation of antiretroviral therapy, examination for searching an infectious agent in the liquor and blood.

Conclusions. Treatment of stage IV gastric cancer is aimed at prolonging the patient's life and improving its quality, stabilizing the disease; its goal is to achieve the same result in terms of quality of life and overall survival as in HIV-negative patients.

Perm Medical Journal. 2022;39(6):118-124
pages 118-124 views

Biology and experimental medicine

Effect of recombinant glycodelin on spleen structure in case of allogeneic bone marrow cells introduction
Troynich Y.N., Loginova N.P., Zamorina S.A., Raev M.B.
Abstract

Objective. To study the effect of recombinant glycodelin (Mybiosource, Germany) on the morphofunctional state of the spleen in case of transplantation of the allogeneic red bone marrow cells to Wistar rats in dynamics of in vivo experiment. From the point of view of immunology, pregnancy is a physiologically conditioned state of the tolerance of mother’s immune system to genetically foreign embryo. Glycodelin is a protein associated with pregnancy; it has an immunosuppressive effect and is perspective for medicine.

Materials and methods. The morphological picture of the organ was assessed; the following immunohistochemical indicators were studied: monoclonal antibodies to 1) CD68 – for identification of macrophages, membrane staining; 2) Ki-67 – for cells divided with mitosis and being in different phases of cellular cycle; 3) determination of macrophage colony-stimulating factor (M-CSF).

Results. When studying the histological slices of the spleen, it was shown that glycodelin against the background of allogeneic transplantation of the bone marrow contributes to the activation of immune system cells in the spleen, stimulates the proliferation of immune cells (Ki-67) and their differentiation that was manifested by an increase in the number of plasmacytes. By the end of the study, macrophage content is essentially reduced; eosinophil infiltration is verified that is an indirect positive sign of reaction to the transplant. Against the background of the bone marrow cells allotransplantation, there was observed an increase in M-CSF level in animals on the day 21st from the onset the experiment compared with the group of intact animals. Introduction of glycodelin against the background of BM cells allotransplantation caused the cancellation of this effect.

Conclusions. Thus, the action of glycodelin qualitatively determined the function of the spleen in direction of the development of a tolerant immune response to allogenate and excluded the development of severe post-transplantation complications.

Perm Medical Journal. 2022;39(6):125-132
pages 125-132 views

Anniversaries and information on events

Vladimir Nikolaevich Shamov – scientist, innovative surgeon, transfusiologist: the 140th anniversary of his birth (1882–1962)
Utochkin Y.A., Yaroshenko A.A., Polygalova N.L., Tiutiunykh Y.A.
Abstract

The article describes the life, scientific and professional career of Vladimir Nikolayevich Shamov, an outstanding scientist-transfusiologist, neurosurgeon, talented health care organizer, founder of a scientific school, full member of the Academy of Medical Sciences of the Union of Soviet Socialist Republics, Honored Scientist of the Russian Soviet Federative Socialist Republic, Lenin Prize laureate, Lieutenant General of medical service. During the Civil War, V.N. Shamov became one of the first in our country to work on the new problem – blood transfusion. Together with his assistants I.R. Petrov, N.N. Elansky, S.V. Heinats and P.I. Stradyn, he conducted research on isolating four isoagglutination blood groups and obtaining standard sera for their determination. On June 20, 1919, the first blood transfusion in the country was performed taking into account isoagglutination groups of a donor and a recipient. The works on the use of cadaveric blood constituted a small part of the topic, which V.N. Shamov was interested in all his life: the problem of organ and tissue transplantation. In 1940, he published the fundamental "Manual on Blood Transfusion" and made a report at the meeting of Pirogov's Surgical Society of Leningrad on the results of treatment of cranial gunshot wounds. The formed principles of treatment became the basis of neurosurgical care rendered to the wounded people during the Great Patriotic War.  In 1961, he organized the  first in this country Artificial Kidney Laboratory and became the head of the newly established Leningrad Laboratory of Blood Fibrinolysis Preparation and Use. After the Civil War, V.N. Shamov became the Head of the Department of General Surgery of Perm Medical Institute.

Perm Medical Journal. 2022;39(6):133-139
pages 133-139 views


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