Kazan medical journal

Medical peer-review journal for physicians and researchers.

Editor-in-Chief: Ayrat U. Ziganshin, MD, PhD, Professor.

Indexing:

  • SCOPUS (accepted 15/09/20)
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Published bimonthly since 1901, distributed by subscription.

About: the Kazan Medical Journal is a peer-reviewed journal for clinicians and medical scientists, practicing physicians, researchers, teachers and students of medical schools, interns, residents and PhD students interested in perspective trends in international medicine.

Missions of the Journal are to spread the achievements of Russian and international biomedical sciences, to present up-to-date clinical recommendations, to provide a platform for a scientific discussion, experience sharing and publication of original researches in clinical and fundamental medicine.


 

 

 

 

 

Current Issue

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Vol 104, No 1 (2023)

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“Kazan Medical Journal” — the successor of the “Diaries of the Physicians’ Society” at the Imperial Kazan University
Sozinov A.S., Ziganshin A.U., Ivanov A.Y., Ivanova R.G.
Abstract

The article defines the structural specifics of the scientific periodicals of the Kazan Physicians’ Society, characte¬rizes the logic of its evolution, shows its place in the development of the general logic of qualitative changes in the methods of constructing and manifesting medical knowledge broadcast on its pages. The stages of the evolutionary transformation of the ‘Diaries of the Physicians’ Society”, which were the printed organ of the Physicians’ Society at the Imperial Kazan University, into a special edition — the “Kazan Medical Journal” are analyzed in detail, the date of its official approval as a printed organ is specified. Based on the materials of the State Archives of the Republic of Tatarstan, many of which were not previously introduced into scientific circulation, the succession of the development of scientific periodicals was demonstrated, which makes it possible to reasonably indicate 1872 as the year when the “Kazan Medical Journal” started to be published. The article gives a brief description of the published volumes of this stage of the transformation of the “Diaries of the Physicians’ Society”, indicates the specifics of their formal, as well as content and, in particular, intertextual structure. The role and place of various types of published materials, such as original scientific articles, abstracts of current scientific literature of that time, annual literature reviews in various medical specialties, meeting reports of representatives of scientific societies, reports of medical congresses and the so-called “doctoral disputes” at Kazan University at that time, reports of practical health care institutions of Kazan, special correspondence, reviews of scientific works, scientific bibliography, were determined. An analysis of these elements’ evolution in the content of scientific periodicals made it possible to substantiate the logical model of the structural transformation of this printed organ as a special type of historical source, to determine the forms of its cultural and communicative functioning, to indicate its role in the development of the professional culture of the medical corporation of Kazan University and the city of Kazan.

Kazan medical journal. 2023;104(1):5-12
pages 5-12 views

Theoretical and clinical medicine

Improvement of the psycho-emotional state and cytokine profile of patients with rheumatoid ­arthritis and hepatic steatosis after therapy with thioctic (lipoic) acid and methotrexate
Gainetdinova A.N., Zalyalyutdinova L.N., Абдулганиева Д.И.
Abstract

Background. The social significance of such inflammatory diseases as rheumatoid arthritis is growing all over the world, which determines the need to find new ways to optimize the ongoing standard therapy.

Aim. Evaluation of the effect of combined use of thioctic (lipoic) acid with methotrexate in comparison with methotrexate and meloxicam therapy on the psycho-emotional state of patients with rheumatoid arthritis and hepatic steatosis.

Material and methods. The study included 60 women diagnosed with rheumatoid arthritis and hepatic steatosis. By the beginning of the observation, patients divided into two groups were comparable according to all criteria for inclusion in the study. The first group took methotrexate and thioctic (lipoic) acid, the second group — methotrexate and meloxicam daily for a month. The psycho-emotional state of the patients according to the Spielberger tests modified by Yu.L. Khanin and depression according to Beck were assessed. Determination of pro-inflammatory cytokines was carried out by enzyme immunoassay. The research results were subjected to statistical processing.

Results. An intergroup analysis showed that the use of thioctic acid and methotrexate led to a significant decrease in the level of anxiety in patients, in contrast to women taking methotrexate and meloxicam (the level of reactive anxiety decreased by 2.7 times compared with baseline data; p=0.03). It is also important to note the revealed correlation between the degree of decrease in the level of tumor necrosis factor α and the severity of anxiety 1 month after taking the cytostatic and the hepatoprotector (Kendal's Tay-b correlation coefficient, r=0.732, p=0.046).

Conclusion. The inclusion of thioctic (lipoic) acid in the basic therapy with methotrexate in patients with rheumatoid arthritis and hepatic steatosis improves their psycho-emotional state in the form of a decrease in anxiety-depressive spectrum disorders, practically normalizing the level of pro-inflammatory tumor necrosis factor α, the degree of reduction of which correlates with the degree of reduction in the level of anxiety.

Kazan medical journal. 2023;104(1):13-19
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Features of post-infarction chronic heart failure in patients with a new coronavirus infection COVID-19
Kalashnikova N.M., Zaitsev D.N., Govorin A.V., Mukha N.V., Chistyakova M.V.
Abstract

Background. The coronavirus pandemic has caused a rapid increase in the number of cases and high deaths worldwide. A new coronavirus infection in the presence of an initial cardiac pathology can provoke decompensation of chronic heart failure.

Aim. To study the clinical features of postinfarction chronic heart failure occurring against the background of a new coronavirus infection.

Material and methods. The study included 80 patients with decompensated chronic heart failure. Three groups have been formed. In patients of the first group (n=40), who underwent inpatient treatment for a new coronavirus infection, the cause of chronic heart failure was a previous Q-myocardial infarction. In patients of the second group (n=20), who did not tolerate COVID-19 earlier and at the time of the current hospitalization, the cause of chronic heart failure was a previous Q-myocardial infarction. The third group (n=20) consisted of patients with chronic heart failure of ischemic etiology without postinfarction cardiosclerosis, not previously and at the time of examination infected with the SARS-Cov-2 virus. Statistical analysis was carried out using the IBM SPSS Statistics V26 program. The Kolmogorov–Smirnov, Kruskal–Wallis, and Pearson χ2 tests were used.

Results. Symptoms of left and right ventricular heart failure were equally common in all groups. Patients of the studied groups had a history of paroxysmal and permanent forms of atrial fibrillation, while the latter variant was more common in patients of the first group — with chronic heart failure with postinfarction cardiosclerosis and coronavirus infection. According to echocardiography, the most pronounced structural and functional changes in the myocardium were also found in patients of the first group with postinfarction heart failure and a new coronavirus infection. Thus, statistically significant differences related to the size of the left atrium, end diastolic volume and end systolic volume of the left ventricle, systolic pressure in the pulmonary artery. An increase in the end systolic volume of the left ventricle by 94.6% was registered in the first group compared with the third group of patients (p=0.001). Systolic pressure in the pulmonary artery in the first group was 14.2% higher than the normal values (p ≤0.001), while in patients of the second and third groups this indicator was within the normal range.

Conclusion. In patients with postinfarction cardiosclerosis suffering from a new coronavirus infection, symptoms of chronic heart failure are more pronounced, characterized by a significant decrease in exercise tolerance; cardiac arrhythmias are more often recorded, and structural and functional changes in the myocardium are of a maladaptive nature.

Kazan medical journal. 2023;104(1):20-29
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Expression of microRNA-590 in patients with chronic coronary heart disease, atrial fibrillation, and their combination
Lerner D.D., Mayanskaya S.D., Kravtsova O.A., Tambovtseva R.S.
Abstract

Background. The role of microRNAs in the processes of remodeling, proliferation, and fibrogenesis of myocardial cells is not clear enough.

Aim. Analysis of the microRNA-590 expression level in patients with chronic coronary heart disease, atrial fibrillation, as well as their combination to assess the potential prognostic significance of the expression level.

Material and methods. The study included 94 patients divided into three clinical groups: the first — with non-valvular atrial fibrillation without coronary heart disease (39 people); the second — with non-valvular atrial fibrillation and coronary heart disease (22 patients); the third — with ischemic heart disease without atrial fibrillation (23 patients). The comparison group consisted of 10 people without atrial fibrillation and coronary heart disease. Venous blood was taken from all subjects, from the plasma of which microRNA was isolated. The relative level of microRNA expression was estimated based on real-time polymerase chain reaction data obtained during the reaction on a cycler using commercial TaqMan probes and primers. The statistical significance of differences between groups was determined using one-way analysis of variance, followed by post-hoc analysis using Tukey's contrasts, differences were considered statistically significant at p <0.05. The Shapiro–Wilk test was used to assess the normality of the distribution of residuals.

Results. A statistically significant decrease in the expression level of microRNA-590 was registered in the third (p=0.0104) and in the second (p=0.0046) groups compared with the control group, as well as in patients with atrial fibrillation and left atrial dilatation (p=0.0313), with recurrent arrhythmias after radiofrequency ablation (p=0.0083) and with permanent atrial fibrillation (p=0.0242).

Conclusion. Ischemic heart disease, including when combined with atrial fibrillation, and aggravating factors, such as left atrial dilatation, permanent atrial fibrillation, recurrence of arrhythmia after radiofrequency ablation, lead to a decrease in the expression level of microRNA-590.

Kazan medical journal. 2023;104(1):30-37
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Association of p53 protein expression with the presence of a 17p13 locus deletion of the TP53 gene and with the survival of patients with diffuse large B-cell lymphoma
Sarpova M.V., Vaneeva E.V., Diakonov D.A., Rosin V.A., Samarina S.V.
Abstract

Background. A significant role in the pathogenesis, resistance to treatment and progression of many types of lymphomas, including diffuse large B-cell lymphoma, is assigned to the TP53 gene. Literature data on the prognostic significance of the expression of its product, the p53 protein, and its association with aberrations at the 17p13 locus are ambiguous.

Aim. To assess the relationship of p53 protein expression with the presence of a 17p13 locus deletion of the TP53 gene and the survival of patients with diffuse large B-cell lymphoma.

Material and methods. The study included 75 patients with newly diagnosed diffuse large B-cell lymphoma who received R-CHOP therapy. The calculation of the relative content of tumor cells expressing p53 was carried out using immunohistochemical and morphometric methods on biopsy samples of lymph nodes. The 17p13/TP53 deletion was determined by fluorescent in situ hybridization. The threshold level of p53-positive tumor cells, corresponding to 43%, was calculated by ROC analysis. The association between p53 protein expression and the presence of a 17p13 deletion was assessed using Fisher's (F) and Pearson's χ2 tests. The correlation dependence was evaluated by the Cramer method (V). Five-year overall and progression-free survival was calculated using the Kaplan–Meier method. Differences between the indicators were considered statistically significant at p <0.05.

Results. The frequency of 17p13/TP53 deletion was higher in patients with high expression of p53 (≥43%) compared to the group of patients with low expression: 87.5 and 12.5%, respectively (p=0.018). A direct correlation between a high level of p53 expression (>43%) and the presence of a 17p13/TP53 deletion was found (p=0.018). Five-year overall and progression-free survival in patients with a proportion of p53-positive cells> 43% was significantly lower than in patients with its subthreshold value: 54.5 versus 81.0% (p=0.014) and 45.5 versus 66.7% (p=0.022), respectively.

Conclusion. High expression of the p53 protein is associated with the presence of a 17p13 locus deletion and a low five-year survival rate in patients with diffuse large B-cell lymphoma.

Kazan medical journal. 2023;104(1):38-46
pages 38-46 views
Micronutrient value and lipid profile of ethnic nutrition’s traditional dish of the Baikal region’s population
Bogdanova O.G., Vrzhesinskaya O.A., Beketova N.A., Kodentsova V.M., Tarmaeva I.Y.
Abstract

Background. Against the backdrop of stagnation in most industries, the production of semi-finished meat products is expanding, which is due to an increase in demand and, accordingly, an increase in consumption. This trend is also observed in the nutrition of the Baikal region’s population, however, the micronutrient value of meat semi-finished products of ethnic nutrition is not presented in the national tables of the chemical composition of food products.

Aim. To assess the micronutrient value and lipid profile of ethnic nutrition’s traditional dish of the Baikal region’s population — buuz.

Material and methods. Using spectrofluorimetry, high-performance liquid chromatography, atomic absorption and gas chromatography, the content of vitamins B1, B2, E, iron, sodium and the composition of fatty acids in buuzes, steamed from semi-finished meat in a packaged dough category B with beef and pork filling, were determined. The measurement was carried out in 3 samples, the detection was repeated twice. The data obtained were analyzed using the SPSS Statistics program for Windows using the descriptive statistics method: the arithmetic mean (M) and the standard error of the mean (m) were calculated. The results were compared with the tables’ data of the foodstuffs’ chemical composition.

Results. With comparable nutritional value (differences in calorie content of no more than 12%), the carbohydrate content in buuzes was approximately 1.5 times higher, and proteins and fats were less than in dumplings. The content of vitamins B1, B2 and E in 100 g of frozen buuzas steamed in a slow cooker was 0.20±0.01; 0.11±0.01 and 0.50±0.03 mg, respectively. The losses of vitamins during cooking were insignificant and amounted to 5–6%. The content of iron in 100 g of ready-to-eat buuzes was 2 mg, sodium — 354 mg. The content of sodium in ready-to-eat buuzes was 1.8 times less, and iron was 2.2 times more than in boiled dumplings. The results obtained by us on the content of vitamins B1, B2 and E, iron and sodium, the quantitative composition of fatty acids can be used in assessing the intake of nutrients by a questionnaire method.

Conclusion. Consumption of one serving of buuz (200 g) provides about 20% of the recommended daily intake of vitamin B1, 10–12% of vitamins E and B2, and 14% of iron.

Kazan medical journal. 2023;104(1):47-53
pages 47-53 views
Comparative evaluation of the results of anthropometric indicators and measurements of body composition by bioimpedancemetry
Dzen N.V., Gabbasova N.V., Esaulenko I.E., Mamchik N.P., Popov V.I.
Abstract

Background. Various anthropometric and instrumental methods are used to assess the correspondence between height and body weight of a person.

Aim. Carrying out a comparative assessment of the results of anthropometric indicators and bioimpedance ana­lysis among men and women — fitness center visitors.

Material and methods. A cross-sectional study of 58 men and 62 women was carried out. Participants underwent standard anthropometry (measurement of height with a stadiometer; body weight with an electronic scale; measurement of waist circumference and hip circumference with a centimeter tape) and bioimpedancemetry. Statistical processing was carried out by non-parametric methods: to study the relationship between the phenomena, the Spearman rank correlation coefficient was used, the differences in the average indicators were calculated by the Student's t-test, relative indicators — by the Pearson χ2 test, the differences were considered statistically significant at p <0.05.

Results. Correlation analysis of the main calculated anthropometric and bioimpedance parameters established a strong relationship between body mass index and adipose tissue content (r=0.87). According to the data of bioimpedance analysis in the group of men, there was a significant predominance of muscle mass over fat, both in normal and overweight (p <0.0001). In the course of a comparative assessment of body mass index and bioimpedance analysis indicators, it was found that the use of body mass index is more often associated with overdiagnosis of overweight (p=0.0067). In the group of women, bioimpedancemetry analysis showed the predominance of muscle tissue over adipose tissue only with a normal body mass index, with overweight, the predominance of adipose tissue was found (p <0.0001). According to the results of bioimpedancemetry, the frequency of the “norm” decreased by 1.5 times compared with the body mass index (p=0.0017), the proportion of obesity increased by 4 times (p=0.0017) and the proportion of overweight — almost 1.4 times.

Conclusion. A comprehensive assessment of the body composition by bioimpedancemetry in men established the predominance of muscle mass over fat, which made it possible to reduce the frequency of overdiagnosis of excess body weight by 2 times; in women, body mass index was associated with underdiagnosis of overweight.

Kazan medical journal. 2023;104(1):54-61
pages 54-61 views
Variant anatomy and codes of the human brachial plexus
Gorbunov N.S., Kober K.V., Kasparov E.V., Rostovtsev S.I.
Abstract

Background. Understanding the complexities of formation and structural features of the brachial plexus remains important for diagnosis, effective surgical treatment and regional anesthesia.

Aim. To identify variants of the brachial plexus structure and develop a system for their coding.

Material and methods. Macroscopic anatomical layer-by-layer and macro-microscopic intratubular dissection of 121 brachial plexus preparations were performed in 105 cadavers of men and women aged 40–100 years. A database was formed from the obtained indicators in the MS Excel 2012 program, and their processing was carried out using Statistica for Windows 12. All indicators were tested for the normal distribution using the Shapiro–Wilco criterion. When describing the studied indicators, the median (Me) and interquartile intervals [Q1, Q3] were determined, as well as the significance of intergroup differences according to the Mann–Whitney test.

Results. It was established that the farther from the spinal cord, the more variants of the macroscopic and macro-microscopic structure of the brachial plexus elements exist: roots — 3, trunks — 7, divisions — 3, bundles — 12–16, and a total of 20 variants of the general structure were identified. The roots of spinal nerves C6 (66.1%), C7 (66.4%) and C8 (64.2%) take the greatest part in the formation of brachial plexus bundles, 2 times less often — C5 (34.8%) and Th1 (33.3%), very rarely — C4 (2.5%) and Th2 (0.8%). Reverse coding of variants of the brachial plexus structure in the direction: bundle ← division ← trunk (root) allows to briefly and clearly display the entire morphological diversity of the nervous system of the human upper limb. The results obtained should be taken into account when diagnosing injuries, performing regional anesthesia, reconstructive operations, rehabilitation measures, creating neurosimulators, neurochips, and nerve conductors.

Conclusion. 20 different variants of the general structure of the human brachial plexus have been identified and a reverse coding system has been developed.

Kazan medical journal. 2023;104(1):62-71
pages 62-71 views

Experimental medicine

New derivatives of phosphorus-containing compounds with amino acid and triazolethione ­fragments are potential drugs that improve memory and cognitive functions
Nikitina A.V., Semina I.I., Baychurina A.Z., Vivolaneс A.A., Akhmedieva D.V.
Abstract

Background. Cognitive disorders are often the main symptom of neurological and mental diseases. Given the variety of mechanisms for the development of these changes, it is necessary to search for and develop new drugs.

Aim. An experimental study of the behavioral effects of new derivatives of phosphorus-containing compounds with amino acid and triazolethione fragments as potential agents that improve memory and cognitive functions.

Material and methods. A computer prediction of the activity of 43 compounds (the Prediction Activity Spectral of Substances and Pharma expert programs) and the selection of 5 active compounds were carried out. The compounds were studied on 140 outbred male mice (14 groups, n=10) and 100 male Wistar rats (10 groups, n=10) in the “T-maze” and “Morris water maze” behavioral tests when administered intraperitoneally in doses 1/100 and 1/50 LD50 for 14 days. A comparative analysis with memantine (10 mg/kg), piracetam (100 mg/kg) and the structural analogue of the 2-chloroethoxy-para-N-dimethylaminophenylphosphorylacetohydrazide compounds (10 mg/kg) was carried out. Statistical processing was performed using the GraphPad prism 8.0.1 program with the calculation of Student's t-test.

Results. The mnemotropic activity of N-substituted ammonium salts of arylphosphinic acids and phosphorylated derivatives of thiosemicarbazides was shown, the most effective representatives of which, 2-ethoxy-2-oxoethanammonium salt (2-ethoxy-2-oxotyl)(4-tolyl) of phosphinic acid (AH15) and 2-[(diphenyl phosphoryl)acetyl]-N-phenylhydrazine-1-carbothioamide (T8), reduced the time of searching for a feeder in the “T-maze” by 2.0 and 4.3 times, respectively (p <0.05). A similar effect was observed in the Morris Water Maze, where the use of substances T8 and 2-ethoxy-2-oxoethanammonium salt (2-ethoxy-2-oxotil)(4-chlorophenyl) of phosphinic acid (B3) on the 4th day of administration led to an increase in the time spent by rats in the platform area by 1.8 and 1.6 times (p <0.05), respectively, and on the 14th day — by 1.5 times (p <0.05). Memantine and piracetam were only effective after 14 days of administration.

Conclusion. Compounds of the series of N-substituted ammonium salts of arylphosphinic acids and phosphorylated derivatives of thiosemicarbazides improve memory and learning processes in experimental rodents with a single and 14-day application, showing significant advantages over memantine and piracetam.

Kazan medical journal. 2023;104(1):72-80
pages 72-80 views
The effect of ethyl alcohol solution with a reduced content of deuterium on the development of chronic alcohol intoxication in the experiment
Popov K.A., Ermakova G.А., Bykov I.M., Tsymbalyuk I.Y., Ustinova E.S.
Abstract

Background. Protium/deuterium isotope exchange reactions can have a significant effect on the metabolic systems of cells and the whole organism. An imbalance in isotope homeostasis can have both a protective and a negative effect under various pathological conditions.

Aim. To determine the nature of the influence of an ethyl alcohol solution with a reduced content of deuterium on the development of chronic alcohol intoxication in rats.

Material and methods. The study was performed on five groups of rats, 10 animals in each: the first group — control, the second and third groups — alcoholization for 1 month, the fourth and fifth groups — alcoholization for 2 months. At the same time, rats of the third and fifth groups received a solution of ethyl alcohol with a reduced content of deuterium. For the development of alcohol intoxication, the animals received a 10% ethanol solution in the 1st week, a 20% solution in the 2nd week, and a 30% ethanol solution starting from the 3rd week. Water with a reduced content of deuterium was obtained using an installation developed at the Kuban State University by the method of electrolytic separation. In the blood plasma of laboratory animals, markers of cytolysis (activity of alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase) and oxidative stress (content of thiol groups, glutathione concentration, activity of catalase, glutathione peroxidase, and glutathione reductase) were determined. To analyze the data, nonparametric Kruskal–Wallis and Mann–Whitney tests were used, which were calculated using the StatPlus program.

Results. As a result of the studies, it was found that the activity of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase against the background of ethyl alcohol introduction to animals in water with a reduced content of deuterium during 2 months of the experiment was increased to the level of median values of 51.7; 65.7 and 174.8 U/l, respectively. These indicators statistically significantly exceeded the values of similar parameters of the groups of rats treated with alcohol solution in ordinary distilled water by 22% (p=0.0129), 45% (p=0.0236) and 55% (p=0.0123), respectively. In the study of the SH-groups level (0.29 u.o.d.×100/g of protein) in blood plasma and the concentration of glutathione (1.46 μmol/ml) in the erythrocyte suspension in animals of the fifth group, values that were reduced relative to the fourth groups by 12–17% were determined.

Conclusion. Isotopic modification of an ethanol solution, aimed at reducing the level of deuterium, is accompanied by a more severe course of chronic alcohol intoxication; this is confirmed by the greater severity of the cytolytic syndrome and the imbalance of the antioxidant system.

Kazan medical journal. 2023;104(1):81-88
pages 81-88 views

Reviews

Possibilities of computed and magnetic resonance imaging of the heart in patients with ­atrial fibrillation
Galyautdinov G.S., Ibragimova K.R., Galeeva S.S.
Abstract

Computed and magnetic resonance imaging of the heart has been widely used in recent years in patients with atrial fibrillation. They are used to determine the morphology of the heart, the presence of intracardiac thrombi, quantify the structures of the heart, thrombosis of intracardiac devices, determine tactics for surgical interventions, and other purposes. These methods of instrumental diagnostics can be used as an alternative to transesophageal echocardiography, which has a number of limitations and disadvantages compared to computed tomography and magnetic resonance imaging. Computed and magnetic resonance imaging of the heart are used to avoid invasiveness in the study of the heart, to improve the accuracy of measuring heart structures, to reduce the number of diagnostic methods used before various surgical interventions in patients with atrial fibrillation, and also, according to epidemic indications, as part of the prevention of the spread of coronavirus infection. In addition, magnetic resonance imaging allows to avoid radiation exposure to the patient. The review presents the results of studies, meta-analyses of pooled samples, as well as a description of the clinical possibilities of computed and magnetic resonance imaging of the heart in patients with atrial fibrillation. Publications on the use of these methods for visualization of thrombi in the left atrium and its appendage, in pulmonary vein ablation and occlusion of the left atrial appendage, as well as data on visualization of the residual flow around the occlusive device and thrombosis of intracardiac devices are presented. According to the results of a literature review, computed tomography and magnetic resonance imaging of the heart have similar or higher imaging capabilities compared to transesophageal echocardiography, as well as some advantages over it, primarily the non-invasiveness of the procedure. The works demonstrating the possibilities of computed tomography of the heart for the diagnosis of coronary heart disease in patients with atrial fibrillation are presented. In preparing the review, the literature search method in PubMed databases for the period 2013–2022 was used.

Kazan medical journal. 2023;104(1):89-98
pages 89-98 views
Epidemiological studies of the prevalence of the oral mucosa and the red lip border lesions
Yatsenko A.K., Trankovskaya L.V., Pervov Y.Y., Gritsina O.P., Zagudaeva I.O.
Abstract

The problems of diagnosis, treatment and prevention of diseases of the oral mucosa and the red lip border remain one of the most relevant in modern dentistry. The review analyzes clinical and epidemiological studies of pathological conditions on the oral and lip mucosa. The role of risk factors in the occurrence of certain nosological groups of diseases of the mouth and lips is indicated according to the literature. The relationship between age-related regenerative features of the oral mucosa, as well as the presence of somatic diseases and the development of oral pathology is shown. The influence of local risk factors on the occurrence of lesions on the mucous membrane of the mouth and lips is described, among which injuries with dentures and poor oral hygiene come to the fore. The significance of social and behavioral determinants, such as smoking and alcohol consumption, in the occurrence of precancerous processes on the mucous membrane of the mouth and lips is reflected. Changes in the structure of the mucous membrane of the mouth and lips depending on the age and sex characteristics of patients are highlighted. In young people, glossitis (folded tongue, geographic tongue) and cheilitis (chronic lip cracks, meteorological cheilitis) occupied the leading positions among oral lesions. A high proportion of lesions in middle-aged people accounted for precancerous (lichen planus, leukoplakia) and neurogenic (glossalgia) processes. Prosthetic stomatitis and dermatosis (erythema multiforme exudative, lupus erythematosus, lichen planus) were more often noted in elderly, senile patients and centenarians. The importance of studying the incidence structure of the oral mucosa and lips in each age and sex group is emphasized in order to identify and assess the impact of potential risk factors, as well as to develop and improve regional preventive programs for maintaining dental health.

Kazan medical journal. 2023;104(1):99-107
pages 99-107 views
Kimura's disease
Matchin A.A., Matz E.G.
Abstract

The analysis of published clinical observations on the diagnosis and treatment of patients with Kimura's disease, which is a rather rare chronic inflammatory disease of human soft tissues of unknown etiology, is presented. The onset of Kimura's illness is hardly noticeable. The disease proceeds sluggishly, with a varied clinical picture, most often with the formation of single or multiple subcutaneous nodules or tubercles and swelling in the head and neck on one or both sides. Other localizations of lesions are also described: limbs, orbit, eyelids, palate, pharynx, armpit, chest, inguinal region. The affected areas gradually increase in size over many months or years. Other clinical manifestations of Kimura's disease are presented in the form of edema of the extraocular muscle, juvenile temporal arteritis, sleep apnea in cases of damage to the larynx, and life-threatening coronary artery spasm in children. There are reports of other rare systemic clinical signs of Kimura's disease in the form of pruritus, eczema and rash. The disease is often associated with regional lymphadenopathy and/or salivary gland involvement, eosinophilia, and an increase in serum immunoglobulin E from 800 to 35,000 IU/mL. The disease may be accompanied by kidney damage in the form of glomerulonephritis and nephrotic syndrome. Most reported cases of Kimura's disease occur in young Asian men in their 20s and 30s, sporadically the disease is diagnosed in Europeans, North Americans, Caucasians, and Africans. Diagnosis of Kimura's disease is often clinically difficult. It is primarily based on excisional biopsy of the lesion or regional lymph nodes, and the histopathological findings are consistent regardless of the location of the lesion. Morphologically, Kimura's disease is characterized by the presence in biopsy specimens of such histological features as reactive follicular hyperplasia with prominent follicles surrounded by fibrous tissue. Interfollicular infiltrates are rich in plasma cells and eosinophils, which form diffuse eosinophilic microabscesses associated with granulomatous inflammation. The vessels are numerous, with an increase in postcapillary venules. At the same time, the blood vessels remain thin-walled, with cuboidal endothelial cells. Treatment issues are highlighted, and differences between Kimura's disease and angiolymphoid hyperplasia with eosinophilia are presented.

Kazan medical journal. 2023;104(1):108-119
pages 108-119 views

Social hygiene and healthcare management

The share of influence of factors determining the state of public health in the context of the COVID-19 pandemic
Fomin V.V., Korshever N.G., Sidelnikov S.A., Royuk V.V., Reshetnikov V.A.
Abstract

Background. The relevance of the study is explained by insufficient knowledge of the determinants of health in the context of the COVID-19 pandemic.

Aim. To study the share of influence of factors that determine the state of public health in the context of a pandemic of a new coronavirus infection (COVID-19).

Material and methods. A sociological research method was used — in 2021, an anonymous survey of 42 expert healthcare managers, who were asked to determine the share of influence of determinants on the state of public health in the context of the COVID-19 pandemic, was conducted. After the completion of the survey, its results were compared with those obtained without a pandemic in 2017. Since the data distribution corresponded to the Gauss–Newton binomial curve, the significance of differences was assessed using the parametric Student's t-test.

Results. It has been established that the structure of the influence of health determinants in the context of the COVID-19 pandemic differs significantly from that without it. During a pandemic, the share of factors in the “Lifestyle” group decreases by 1.75 times, and it is no longer a priority, but occupies the third ranking place. Out-of-group determinants, which were in second position, take the first place. The second ranking place with a growth of 1.60 times is occupied by the “Conditions of life and work” group. The share of influence of each of the considered 37 determinants of health was assessed — multidirectional changes, for example, an increase in the responsibility of the authorities for actions and equity in relation to the health of the population from the “General Factors” group and a decrease in six of the seven determinants of the “Lifestyle” group, were identified. Continuation of the study is possible with regard to the formation of a separate block in the design of the appropriate optimization technology.

Conclusion. A significant change in the structure of the influence of the public health determinants during the COVID-19 pandemic in comparison with the data obtained before the onset of this pandemic, has been established.

Kazan medical journal. 2023;104(1):120-128
pages 120-128 views

Clinical experiences

New method of surgical treatment of glaucoma
Kurbanov S.A., Gabdrakhmanova A.F., Gaynutdinova R.F.
Abstract

Background. Fistulizing operations are the most commonly used types of surgery for both primary and secondary glaucoma. The development of cicatricial blockade in the area of surgical intervention is considered one of the reasons for the decrease in the hypotensive effect of surgical treatment of glaucoma, for which antiglaucoma drainages are widely used.

Aim. To evaluate the hypotensive efficacy of sinustrabeculectomy with implantation of drainage from collagen hemostatic sponge using Maklakov tonometry and quality of life indicators in patients with primary open-angle glaucoma in the course of surgical treatment.

Material and methods. The study involved 52 people (52 eyes) (mean age 64.1±4.4 years) with a diagnosis of primary open-angle glaucoma. The inclusion criteria were the age of 40–80 years, the diagnosis of glaucoma for more than 6 months, the ineffectiveness of local drug therapy, and the absence of severe concomitant ophthalmic pathology. All patients underwent surgical treatment of glaucoma: sinustrabeculectomy with posterior scleral trepanation and implantation of drains in the form of 4×2.5 mm strips from a collagen hemostatic sponge under the scleral flap in three zones: in the distal and lateral zones of the flap. In the postoperative period, the level of intraocular pressure was assessed on the 30th, 90th and 180th days. The patients' quality of life was assessed using the GQL-15 questionnaire. Statistical processing of materials was carried out using the Statistica 8.0 software package (Statsoft, Inc., USA), comparison in dynamics was carried out using Student's parametric t-test. The normality of the sample distribution was controlled using the Shapiro–Wilk test. Significance of differences in indicators was considered established at a significance level of p <0.05.

Results. The surgical treatment of patients contributed to a decrease in intraocular pressure from 42.4±6.5 to 13.4±4.9 mm Hg (p=0.0000) and improved quality of life according to the GQL-15 questionnaire from 28.6±4.3 to 19.3±1.9 points (p=0.0224) on day 30 after surgery. During the observation period, the level of intraocular pressure remained within the normal range, amounting to 16.9±4.3 mm Hg on the 90th day, and 18.1±4.6 mm Hg on the 180th day.

Conclusion. The modified method for the treatment of glaucoma leads to a long-term (6 months) effective reduction in intraocular pressure in patients and an improvement in their quality of life.

Kazan medical journal. 2023;104(1):129-133
pages 129-133 views
Neurotization of the facial nerve as an effective way to treat paralysis of mimic muscles
Skaliitchouk B.V., Gaivoronsky A.I., Vinogradov V.V., Svistov D.V.
Abstract

Pathologies of the facial nerve are one of the most common types of pathology of the peripheral nervous system. In the structure of lesions of the cranial nerves, this pathology occupies the first place. The clinical picture of facial nerve damage of various genesis is rather monotonous and manifests itself as persistent paresis or paralysis of the facial muscles. The literature describes a large number of different highly effective techniques aimed at restoring the function of the facial nerve and mimic muscles, examples of which are numerous conservative and surgical methods for the treatment of facial nerve neuropathy. The review presents the most common method of mimic muscles paralysis surgical treatment — facial nerve neurotization. The essence of this surgical intervention is in suturing to the affected facial nerve the trunk or a portion of individual fibers of the intact nerve-neurotic, which can be the hypoglossal, masticatory, phrenic, accessory, glossopharyngeal nerves, as well as the descending branch of the hypoglossal nerve and the anterior branches of the C2–C3 cervical nerves. Currently, options for the combined use of various donor nerves and autoextensions are gaining popularity among neurosurgeons, due to more favorable results in restoring the function of the facial nerve, as well as with an individual approach to each patient. The main stages of neurotization of the facial nerve include the isolation and intersection of the facial nerve, the isolation and intersection of the trunk or individual fibers of the neurotizer, the execution of the suture of the nerve in the “end to end” or “end to side” method. Particular attention should be paid to the most innovative method of facial nerve neurotization — facial nerve cross-plasty, during which an anastomosis between the damaged and intact facial nerves using autotransplants from the gastrocnemius nerve or a free muscle graft, including the tender muscle and the anterior branch of the obturator nerve is performed. The process of restoring facial nerve function and regressing characteristic symptoms takes a long period of time and requires specialized restorative treatment.

Kazan medical journal. 2023;104(1):134-143
pages 134-143 views

History of medicine

Evolution and interdisciplinary interaction of early childhood cardiac surgery in the Republic of Tatarstan
Mirolyubov L.M.
Abstract

Surgical treatment of congenital heart defects is one of the most difficult tasks. The article shows the way of development of this direction in Kazan and in the Republic of Tatarstan. The benefits of using the ways and methods adopted in cardiac surgery for the treatment of patients in difficult clinical situations are described. The positive influence of the scientific study of medical activity on the development of the general situation is reflected.

Kazan medical journal. 2023;104(1):144-151
pages 144-151 views
Kazan Trachomatous Institute in historical retrospective: background and circumstances of its opening
Khusainova D.C., Ivanov A.Y., Ivanova R.G.
Abstract

The article is devoted to the study of the prerequisites and circumstances of the first trachomatous institute establishment in Russia, designed to stop the spread of a dangerous infectious eye disease in one of the key regions of the RSFSR — the Republic of Tatarstan. The initial period of the spread of trachoma in the Russian Empire, dating back to the first quarter of the 19th century, is characterized, and the first steps in the study and treatment of trachoma in the Kazan province are defined. On the basis of archival documents, many of which were not previously introduced into scientific circulation, the authors analyze a significant layer of historical information that sheds light on a number of facts that have not been previously published or studied. The prerequisites that characterize the formation of the attitude of the Kazan scientific community to the need to organize the fight against a new spreading disease — trachoma — on a large scale, have been identified. For the first time, prosopographic data on the first leaders of the institute were clarified, it was convincingly proved that, contrary to popular belief, it was not V.V. Chirkovsky, but A.G. Agababov who became the first director of the Trachomatous Institute in Kazan. Materials on the circumstances and conditions of the actual opening of the trachomatous institute in 1922 are given. The features of the fight against trachoma in the period preceding the opening of the trachomatous institute, starting with the activities of E.V. Adamyuk, representatives of the Kazan Governorate and special medical commissions, ending with the formation of a specialized scientific and clinical infrastructure, are identified.

Kazan medical journal. 2023;104(1):152-158
pages 152-158 views

Cochrane Review Summaries

Thoracic imaging tests for the diagnosis of COVID-19 (Russian Translation of Cochrane Plain Language Summary)
Abstract

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Syste¬matic Review: Islam N, Ebrahimzadeh S, Salameh J-P, Kazi S, Fabiano N, Treanor L, Absi M, Hallgrimson Z, Leeflang MMG, Hooft L, van der Pol CB, Prager R, Hare SS, Dennie C, Spijker R, Deeks JJ, Dinnes J, Jenniskens K, Korevaar DA, Cohen JF, Van den Bruel A, Takwoingi Y, van de Wijgert J, Damen JAAG, Wang J, McInnes MDF, Cochrane COVID-19 Diagnostic Test Accuracy Group. Thoracic imaging tests for the diagnosis of COVID-19. Coch¬rane Database of Systematic Reviews. 2021. Issue 3. Art. No.: CD013639. DOI: 10.1002/14651858.CD013639.pub4.

Kazan medical journal. 2023;104(1):159-160
pages 159-160 views


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