Vol 37, No 4 (2020)

Objective. To study the significance of the presence and absence of carbohydrate metabolism disorders as a factor affecting the development of vitamin B₁₂ deficiency.

Materials and methods. The data of 206 subjects, forming two main groups were analyzed: the group of carbohydrate metabolism disorders (CMDs), which included 76 women and 71 men (n = 147); the control group, which included 33 women and 26 men (n = 59). The inclusion criteria were the following: age over 35, availability of anamnestic data on pharmacotherapy, availability of data to clarify the state of carbohydrate metabolism, availability of data on vitamin B₁₂ and some other biochemical indices. Vitamin B₁₂ levels > 221 pmol / l were considered normal, vitamin B₁₂ levels from 148 pmol / l to 221 pmol/l were considered borderline (or mild deficiency), and levels of 148 pmol / l or less were considered severe vitamin B₁₂ deficiency.

Results. The group of absent carbohydrate metabolism disorders included 59 persons and the group of carbohydrate metabolism disorders (CMDs) included T2DM patients (n = 123) and individuals with prediabetes (n = 24), i.e. the total number of the examined persons in CMD group was equal to 147. The average level of vitamin B₁₂ in the control group (n = 59) was 401.6 ± and 138.06 pmol / l, and in CMD group (n = 147) it was equal to 342.1 ± 133.10 pmol/l. The differences between the groups were statistically significant (p < 0.01), that suggested the significance of CMDs as a risk factor for vitamin B₁₂ deficiency. Vitamin B₁₂ deficiency was combined with the presence of CMDs in 32 (21.8 %) cases. In 115 cases (78.2 %), the presence of CMDs was combined with the absence of vitamin B₁₂ deficiency. In 8 cases (13.5 %), there were no CMDs, but there was vitamin B₁₂ deficiency. In 51 cases (86.4 %), no CMDs and vitamin B₁₂ deficiency was noted.

Conclusions. Despite the presence of a statistically significant decrease in vitamin B₁₂ levels in CMD group (342.1 ± 133.10 pmol / l vs 401.6 ± and 138.06 pmol/ l; p < 0.01) and a high incidence rate of vitamin B₁₂ deficiency in CMD group (21.8 % and 13.5 %, respectively), the study results do not allow us to consider the presence of CMDs to be the risk factor for vitamin B₁₂ deficiency.

Objective. The aim of the study was to investigate the effectiveness of the preparation of thioctic acid combined with standard therapy among patients with angiodistonic syndrome and vegetative-sensory polyneuropathy of the extremities due to the influence of general vibration.

Materials and methods. A prospective randomized study of two groups of patients with vibration disease was conducted: the main group (n = 30) and the comparison group (n = 30). All patients received standard therapy, while the main group received additional therapy with octolipen (300 mg per os 2 times a day).

Results. The results of questionnaires and objective examination of patients did not establish the occurrence of any side effects when including the drug in the therapy. The survey data proved statistically significant differences in the assessment of pain syndrome at rest and in the occurrence of night pains (p = 0.022). At the same time, when assessing the severity of paresthesia, no statistically significant difference was found between the groups (p = 0.5536). The therapy was accompanied by normalization of the antioxidant status (AOS) in both groups: in the main group, the median AOS increased by 1.342 times and in the comparison group – by 1.267 times. In the statistical evaluation, the inclusion of thioctic acid in the treatment was accompanied by a statistically significant increase in the AOS not only with the initial data (p < 0.00001), but also in comparison with the results of treatment of patients in the comparison group (p = 0.0387). The data from the reovasographic study also showed that the therapy was more effective with additional inclusion of thioctic acid drug to it.

Conclusions. Thus, the data obtained justify the feasibility and effectiveness of using thioctic acid preparation in the treatment of angiodistonia and polyneuropathy syndromes.

Objective. To assess the pathogenetic value of vasculoendothelial growth factor (VEGF) and polymorphism of its gene in hepatobiliary pathology.

Materials and methods. The study included 190 patients with hepatobiliary pathology (HBP): 100 patients with chronic hepatitis C (CHC) in the reactivation phase, 50 – with HC in the outcome of CHC, 30 – with cholelithiasis, 10 – with focal liver lesions (including 8 with primary and secondary liver tumors).

Results. In case of hepatobiliary pathology, VEGF, as indicator neoangiogenesis and endothelial dysfunction (ED), is a marker of the severity of liver lesion: its production is increased in some patients with cholelithiasis, moderately elevated in all patients with CH and significantly elevated against the background of HC and liver pathology of the tumor genesis. In chronic diffuse diseases of the liver, there are detected multiple reliable relationships between VEGF and a number of ED indices, hepatic clinical and biochemical syndromes, liver fibrosis markers, viral load level that proves the obligate involvement of VEGF in the development and progression of liver pathology. VEGF can be used as a test for differential diagnosis of fibrosis in CH and HC with the sensibility of 90 % and specificity of 78 %. Carriage of the allele C in the locus of the VEGF gene (G-634C) in the form of homozygote CC can show the risk of more severe lesion of the liver in CHC and is interconnected with increased production of VEGF.

Conclusions. Vasculoendothelial growth factor and polymorphism of its gene is involved in the pathogenesis of hepatobiliary pathology, activating neoangiogenesis and fibrosis in the liver.

The experience of using thermal imager in diagnosis and treatment of musculoskeletal system diseases based on review of domestic and foreign literature is presented in the paper. Bibliographical method was applied. A short history of using thermovision in foreign and domestic practice is considered, the problem aspects of the offered technology are accentuated, the use of thermal imager in diagnosis and treatment of musculoskeletal system diseases is analyzed. The possible prospects for development of thermovision in domestic medical practice are determined.

The article presents a review of literature on the prevention of nosocomial pneumonia (NP), which has a high frequency in the resuscitation and intensive care unit, severe complications (up to 52.1 % of cases) and mortality. The following aspects are shown: risk factors for NP and multiple antimicrobial resistance; the goal and program of NP prevention aimed at reducing the likelihood of contamination and infection of patients; the need for epidemiological surveillance of health care associated infections and observance of principles of asepsis and antiseptics by medical personnel; the prevention of oropharyngeal colonization and aspiration; methods of timely verticalization of patients who suffered from acute cerebral insufficiency of any etiology; stimulating spirometry, respiratory gymnastics and chest massage.

Objective. To assess the comparability of the cytological and histological studies of material of different localizations.

Materials and methods. The work is based on the analysis of results of cytological and histological studies in 48 patients examined at Perm Regional Oncological Dispensary in 2019.

Results. It was established that out of 22 mammary punctates, diagnosis of “cancer” was confirmed in 20 patients with coincidence validity criterion of 91 %. Out of 14 preparations of skin, 13 cases were histologically confirmed that constituted 92.8 %. When studying the lymph node punctate, one mismatch was detected. Out of 6 thyroid punctates, there were 5 confirmed ones. Percentage of false-positive cytological conclusions was on average 7 %, false-negative – 1 %.

Conclusions. Comparability of cytological and histological studies according to the results of data analysis ranged from 50 to 100 % depending on localization and was on average 91.6 %.

Objective. To analyze the incidence rate in child population of the Republic of Sakha (Yakutia) according to the data of treatment and prevention institutions.

Materials and methods. The article presents an analysis of the incidence rate in child population of the Republic of Sakha (Yakutia) according to the data of treatment and prevention institutions for 2017–2019 including the data of Yakut Republican Medical Information and Analytical Center.

Results. The primary and general morbidity of children and adolescents in the Republic of Sakha (Yakutia) for the period 2017–2019 was analyzed. The morbidity rate in the republic regarding the disease classes and regions is described, and the increase and decrease rates are calculated. According to the analysis results, there is noted an increase in the general and primary morbidity of the child and adolescent population. In the context of regions of the Republic of Sakha, the highest incidence rate in child population was registered in Srednekolymsky, Allaikhovsky, Ust-Yansky, Oleneksky, and Tattinsky regions.

Conclusions. The increase in the general and primary morbidity among the child population and the heterogeneity of these indices in the regions of the Republic of Sakha (Yakutia) requires the implementation of regional and Federal programs to improve primary and specialized medical care in the region.

Objective. To study the analgesic and anti-inflammatory activity of water-soluble hydrazine derivatives of 2,4-dioxobutanoic acids, as well as to determine the relationship between the structure of substances and their biological effects.

Materials and methods. The laboratory synthesis methods were applied to obtain 2-hydrazine derivatives of 2,4-dioxobutanoic acids. The compounds were tested for biological activity using a hot plate test in mice and an acute inflammatory reaction caused by carrageenan-induced paw edema in rats.

Results. The analgesic activity of four compounds is comparable to that of nimesulide. One of the substances obtained is found to exhibit higher anti-inflammatory activity than nimesulide during the 1st and 3rd hours of the experiment. Two compounds with a combination of high analgesic and anti-inflammatory activity were identified. The effect of certain radicals in the structure of the substances on the activities studied was discovered.

Conclusions. The revealed relationship between the structure of original compounds and their biological activities can be used in the further synthesis and search for new domestic pharmaceutical substances with investigated effects.