Vol 97, No 1 (2016)
- Year: 2016
- Articles: 29
- URL: https://kazanmedjournal.ru/kazanmedj/issue/view/128
Theoretical and clinical medicine
24-hour arterial stiffness monitoring in comorbid patients with cardiovascular pathology
Abstract
Aim. To evaluate 24-hour dynamics of the arterial stiffness main indicators in patients with arterial hypertension associated with metabolic syndrome, coronary heart disease and type 2 diabetes mellitus.
Methods. The study included 54 patients with hypertension, who formed main groups: the first group - 17 patients with hypertension amid the metabolic syndrome, the second - 21 patients with metabolic syndrome and coronary heart disease, the third group - 16 patients with hypertension and type 2 diabetes mellitus. All patients underwent the vascular stiffness parameters study using a multifunctional complex for the 24-hour monitoring and office measurements of blood pressure and vessels condition. At the same time blood pressure, cardiac function and vascular stiffness indicators were examined: PWVao - pulse wave velocity in the aorta (m/s); PWTT - the pulse wave transit time (m/s); Aix - augmentation index (%); Asi - the arterial stiffness index. (mmHg).
Results. When comparing the 24-hour arterial stiffness dynamics indicators, changes were found in all main patients groups compared to the healthy group. Thus, a statistically significant increase in the pulse wave velocity in the aorta (PWVao) in all groups of patients compared with the control group, a decrease in the index of the pulse wave transit time (PWTT) in all main groups of patients and a significant increase in arterial stiffness index (Asi) were found. When assessing the results of arterial stiffness monitoring at night time significantly larger values of the pulse wave velocity in the aorta were observed in patients with the metabolic syndrome and combination of metabolic syndrome and coronary heart disease. The obtained data are indicative of improvement in vascular stiffness indicators at night time in healthy individuals group, as well as maintaining a high degree of the vascular wall stiffness both in the night and in the daytime in a group of examined patients, especially in groups with the metabolic syndrome, and a combination of metabolic syndrome and coronary heart disease.
Conclusion. 24-hour monitoring of vascular stiffness indicators in comorbid patients have revealed variability of the main indicators during the day; such arterial stiffness indicators as the pulse wave transit time, pulse wave velocity in the aorta, the arterial stiffness index, augmentation index can be used to assess early signs of the major arteries remodeling.



Comorbid cardiovascular system disorders in patients with cryoglobulinaemia
Abstract



Gender differences of response to various options of drug therapy in patients with chronic heart failure after suffered myocardial infarction
Abstract
Aim. To evaluate gender features of treatment in patients with chronic heart failure who suffered myocardial infarction, determine the effect of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers II, as well as antidepressants in the clinico-functional and psycho-emotional status, morphological and functional parameters of the heart in the treatment of men and women with this pathology.
Methods. The study included 205 men and 185 women with chronic heart failure after suffering a myocardial infarction. Patients were randomized into three groups. Patients of the first group (80 men and 70 women) received background treatment (cardiac glycosides, diuretics, aldosterone antagonists, prolonged nitrates if necessary, acetylsalicylic acid, atorvastatin and perindopril 5-10 mg/day. The patients of the second group (80 men and 70 women) received valsartan 80-160 mg/day in addition to the above-noted background treatment. In the therapeutic regimen of the third group of patients (45 men and 45 women) sertraline in a dose of 50 mg/day was included in addition to background treatment. All the patients underwent usual methods of general clinical examination, the 6-minute walk test, clinical status evaluation, the anxiety syndrome severity assessment using a Hamilton scale, echocardiography. The patients dynamic monitoring was carried out for 6 months.
Results. The study results showed that provided therapy has comparable clinical effect in both men and women in all three groups. Statistically significant improvement in clinical condition indicators was reported and as a result, exercise tolerance increased. At the same time the quality of life improvement was more pronounced (p <0.001) in patients of the third group, amid the perindopril and sertraline use. According to the results of our study in patients of all three groups provided therapy has a comparable positive effect on echocardiography indicators, including those which characterize left ventricular hypertrophy.
Conclusion. Amid the provided treatment in all three groups positive dynamics of clinical status indicators and intracardiac dynamics was reported; in addition to that the dynamics of both clinical status and linear and volumetric heart parameters was more pronounced amid the treatment with perindopril in combination with sertraline.



Ways to prevent complications in endoscopic transpapillary interventions
Abstract
Aim. To assess the effectiveness of preventive measures in endoscopic interventions on the major duodenal papilla.
Methods. 1028 transpapillary interventions related to benign and malignant diseases were performed on 575 patients from 2007 to 2015. The analysis of complications rate and structure in different time intervals, taking into account the changing of patients management tactics and the use of different preventive technologies, was performed.
Results. During 2007-2015, 30 cases of post-manipulational complications were registered (2.9% of patients) with a mortality rate of 0.09%. In the period from 2007 to 2008 post-manipulational complications rate was 8.5%. The main causes of complications were surgery long duration (up to 2 hours) and the lack of endoscopist experience. During this period, there was only one death, which was caused by acute cardiovascular insufficiency. From 2009 to 2011, the complications number decreased to 3.4% due to the careful patients selection for elective surgery, including the endosonography in diagnostic algorithm, octreotide, and hyoscine butylbromide use, the expansion of indications for the bile ducts stenting, exclusion the main pancreatic duct contrast, nasobiliary drainage in obstructive jaundice and suppurative cholangitis. In the period from 2012 to 2015, in the presence of a high risk of post-manipulational pancreatitis, every fifth intervention was completed by the main pancreatic duct stent placement with reducing of manipulations duration to 25-35 minutes, and increasing the surgery phases number. During this period, post-manipulational complications rate was 1.2%.
Conclusion. Analysis of post-manipulational complications allowed to identify the most important measures to enhance the transpapillary interventions safety, thereby reducing the number of complications from 8.5% in the period of 2007-2008, to 1.2% in the period of 2014-2015.



Treatment compliance in patients with gastrointestinal diseases: role of certain factors
Abstract
Aim. To study the influence of socio-psychological factors, factors associated with the disease, the patient, and psychopathological disorders on the treatment compliance.
Methods. Structured interviews were conducted with 151 patients (57 patients with irritable bowel syndrome, 57 - gastroesophageal reflux disease, 37 - peptic gastric ulcer and duodenal ulcer). Compliance was assessed using Morisky-Green validated test. Patients were divided into three groups: the first group - compliant patients, the second - risk group, the third group - non-compliant patients.
Results.Negative effect on compliance had the following socio-psychological factors: employment, lack of higher education, age from 40 to 49 years, non-constructive model of parent-child relationships, conflict relationships in their own family. Overprotective parenting was mentioned more often in the third group than in the first (20.7 and 42.3%, p
Conclusion. The influence of certain socio-psychological factors, factors associated with the disease, the patient and the psychopathological disorders presence on the treatment of patients with gastrointestinal diseases was identified, and therefore comprehensive gastroenterologist and psychiatrist monitoring with the subsequent treatment of psychopathological syndromes is necessary.



Minilaparotomy cholecystectomy in elderly and senile patients
Abstract
Aim. To evaluate the efficacy of minilaparotomy access and programmed treatment of cholecystectomy complications in elderly and senile patients.
Methods. 160 patients (113 women and 47 men), who underwent surgery in the period from 2010 to 2012 in the departments of surgery at the Municipal clinical hospital №1 (Bishkek), were followed-up. Patients mean age was 68.4±3.5 years. Cholecystectomy and biliodigestive anastomoses were performed using mini-access in all patients. In addition to clinical and laboratory diagnostic methods, ultrasound examination with gallbladder projection detection on the anterior abdominal wall to select surgical approach was used.
Results. The surgery results of 160 elderly and senile patients with acute cholecystitis who underwent minilaparotomy cholecystectomy are presented. In 12 (7.5%) patients after cholecystectomy, choledochotomy (or choledochoduodenostomy) was performed to remove stones from the common bile duct; external drainage of the common bile duct by Ker or A.V. Vishnevskiy was performed on 10 of them, and in 2 cases choledochoduodenoanastomosis by Yurash-Vinogradov was imposed. Complications were registered in 9 (5.6%) patients. 1 patient died as a result of pulmonary embolism developed on the 5th day after the surgery. Conversion rate was 5% (8 patients). Treatment of complications was performed by developed and implemented in the clinic algorithm (regional lymphostimulation, breathing exercises, infrared laser irradiation). The average hospital stay of patients without complications was 7.8±0.87 bed-days, and patients with complications - 9.4±0.14 bed-days.
Conclusion. Our observations showed the possibility to perform surgery for acute cholecystitis in elderly and senile patients by the minilaparotomy access in case of taking into account patients general condition, following the surgical technique and the active management of the postoperative period.



Modern possibilities of homeostatic reserves indication in bronchitis in children
Abstract
Aim. To study the homeostatic reserves indicators in children with bronchitis by assessment of colonization resistance indicators and oxidative stress processes in the oral cavity.
Methods. Clinical and instrumental examination of 115 children aged 5 to 14 years admitted to hospital with different variants of bronchitis was performed. The patients (main group) were divided into two subgroups according to the diagnosis: the first subgroup included 70 children with recurrent bronchitis, the second subgroup consisted of 45 children with acute bronchitis. The control group included 33 apparently healthy children of the same age. The examination complex included, in addition to conventional clinical and laboratory methods, special methods of examination - the oral cavity colonization resistance indicators identification (buccal epithelial cells colonization index and saliva anti-adhesive activity). In addition, oxidative stress indicators on oral neutrophils model - spontaneous and induced luminol-dependent chemiluminescence, were measured.
Results. It was found that colonization index and saliva anti-adhesive activity was significantly lower in children of the main group than in control group. The lowest rates were characterstic for the first subgroup of patients. In children with acute bronchitis higher values of the induced and the spontaneous luminol-dependent chemiluminescence were registered as compared to control, whereas in recurrent bronchitis, by contrast, they were lower than in control (p
Conclusion. Patients with recurrent bronchitis extremely «vulnerable» in relation to recurrent bacterial infections (diseases) in connection with the mucosal protection system severe defects; they need to undergo aimed preventive and rehabilitation measures, the effectiveness control of which can be performed using the proposed non-invasive methods.



The modern non-injecting mesotherapy use in treatment of patients with inflammatory periodontium lesions
Abstract
Aim. To perform clinical reasoning and evaluation of non-injection mesotherapy use in complex treatment stages in patients with periodontitis.
Methods. The current study included treatment results of 46 patients with generalized periodontitis who received out-patient treatment at a clinical site of the therapeutic dentistry department of Azerbaijan Medical University. The mean age of patients was 25±3.1 years (from 17 to 49 years).
Results. The use of «TEAQRIP» applications on treatment stages in addition to conventional measures, as well as mesotherapy sessions (2 times a week) contributed to the sooner and stable clinical effect by the end of 2-week treatment course. Procedures («TEAQRIP» application + mesotherapy) were continued for the next 2 weeks (2 times a week). All patients noted subjective improvement in their general condition amid the accelerated remitting of the inflammation developed in periodontal tissues. At the end of treatment, there were no complaints of bleeding, discomfort, itching in 14 (87.5%) patients. Hyperemia, cyanosis and edema disappeared or decreased in all patients, tooth mobility decreased in 6 patients (37.5%). Acquired data showed that all patients well tolerated mesotherapy sessions.
Conclusion. The clinical effect is associated with regenerative processes acceleration, enhanced (by mesotherapy sessions) action of used traditional drugs and «TEAQRIP» applications; combined ultrasound and photon irradiation of periodontal tissue contributed to a deeper effect of the used remedies.



Electron microscopic analysis of regional lymph nodes in the process of cancer development
Abstract
Aim. To study regional lymph nodes ultrastructure at different cancer stages, determine the reactive changes dynamics and identify the factors contributing to the inadequate local immune response and spread of tumor.
Methods. The regional lymph nodes obtained from 149 cancer patients during surgery for cancer of various localization were studied. Lymph nodes obtained from 32 apparently healthy individuals who died of accidental causes were used as a control. One part of lymph node, cut in two parts along the major axis, was used for the histological sections preparation, the second - for electron microscopy. A comparative study of the following groups of preparations was conducted: (1) lymph nodes of the control group; (2) lymph nodes without metastases in stage I cancer; (3) lymph nodes without metastases in stage II cancer; (4) the affected lymph nodes in the II and III stages with various volume metastasis.
Results. Ultrastructural changes in the regional lymph nodes in the process of cancer development have a certain dynamics: amid increasing microcirculation disorders and sclerotic processes, redistribution of immune cells and the immune reactions shift to B-cell humoral immunity occurs, resulting in the later stages to inactivation of T-cell-mediated immune reactions and macrophage-monocyte system, while maintaining plasmacytic reaction with high antibody-producing ability of the cells.
Conclusion. Factors, contributing to inadequate local immune response are: (a) a progressive decrease in the number of activated (immune) lymphocytes - main cytotoxic anticancer elements, in cancer development; (b) high amount of antibody-producing plasma cells, which can block T-cell cytotoxic effect by humoral antibodies, at all stages of cancer development; (c) decrease of the number of migrated (free) macrophages of monocytic origin and the fixed macrophages - sinuses reticular cells, phagocytic activity decrease; (d) the sclerotic processes and microcirculatory disorders that impede tumor cells and cytotoxic lymphocytes contact.



The role of doppler ultrasound and multislice spiral computed tomography angiography in the common form of stomach cancer diagnosis
Abstract
Aim. To evaluate the results of Doppler ultrasound and multislice computed tomography angiography in patients with gastric cancer and the sensitivity of these diagnostic methods for the detection of the abdomen great vessels lesions.
Methods. The study included 32 patients aged 37 to 82 years who had histologically confirmed gastric adenocarcinoma diagnosis. The control group consisted of 30 apparently healthy people of the same age. Transabdominal ultrasonography of the abdominal cavity organs and stomach in gray-scale mode (B-mode before and after the stomach filling with degassed liquid), Doppler ultrasound of the abdomen and the stomach wall vessels, multislice spiral computed tomography angiography were performed in all patients at the preoperative stage. The analysis of the study results and their comparison with intraoperative data were conducted.
Results. In patients with gastric cancer a statistically significant increase in peak systolic velocity in the celiac trunk, superior mesenteric artery, left gastric artery and resistive index decrease in these blood vessels (p <0.05) with the presence of atypical vascularization in the affected stomach walls were registered. The data obtained during the multislice spiral computed tomography angiography were analyzed. The sensitivity of Doppler ultrasound in the preoperative detection of abdominal cavity great vessels affection in patients with gastric cancer was 77.8%, multislice spiral computed tomography angiography - 88.9%, the combination of these two methods - 96.3%.
Conclusion. The analysis of used diagnostic methods of examination of patients with stomach cancer showed that Doppler ultrasound should be included in the patients examination standard to assess the abdominal cavity great vessels condition, what is important in deciding on the possibility of operative intervention; the sensitivity of the combination of dopplerography and multislice spiral computed tomography angiography in the diagnosis of great vessels affection is 96.3%.



Comparative characteristics of bronchial obstruction formation trigger mechanisms in children with bronchial asthma and recurrent obstructive bronchitis
Abstract
Aim. To study the comparative characteristics of the causative significant factors involved in the bronchial obstruction development in children with bronchial asthma and recurrent obstructive bronchitis.
Methods. A cross-sectional (transversal) study of 50 children with bronchial asthma, 38 children with recurrent obstructive bronchitis was conducted. The differences and similarities of etiopathogenetic factors of the bronchial obstruction occurrence were revealed. According to medical history, in all patients regardless of the severity and duration of the disease at the time of examination, the impact of the factors, acting as triggers of bronchial asthma, according to patients, such as infectious agents, infectious allergens and aeroallergens, nighttime, climatic conditions deterioration, physical and/or emotional stress, was registered.
Results. The main triggers that influence the bronchial obstruction occurrence in children with asthma were infectious factors impact, allergens and aeroallergens, and in patients with recurrent obstructive bronchitis more important in the bronchial obstruction development were infectious agents and weather conditions worsening (high humidity, fog, rain). However, unlike the other factors involved in the bronchial obstruction development in asthma, nighttime, allergens and aeroallergens did not have significant impact on the bronchial obstruction occurrence in children with recurrent obstructive bronchitis. In both groups, physical stress (jogging, gymnastics) and emotional stress (loud laugh, crying) contributed to the bronchial obstruction syndrome development with the corresponding clinical picture, but in the second group of children with recurrent obstructive bronchitis duration of cough lasted 2 times less (1-1,5 h) than in children with bronchial asthma (over 3 hours).
Conclusion. Conducted comparative characteristics showed that there is a clear link with the trigger mechanisms of bronchial obstruction occurrence in bronchial asthma and recurrent obstructive bronchitis, and triggers, regardless of the severity and duration of disease, have the same effect on the recurrent obstructive bronchitis outcome.



Experimental medicine
Dependence of clot contraction (retraction) on the molecular and cellular blood composition
Abstract
Aim. To study the effect of the blood components on clot contraction dynamics in vitro.
Methods. The original method based on the optical detection of changes in the blood clot volume over time was used. Whole blood, as well as reconstructed samples using washed platelets, erythrocytes, purified fibrinogen, platelet-poor and platelet-rich plasma were studied.
Results. Blood clot contraction has a non-linear kinetics, reflecting the complexity of the underlying mechanisms. Platelets increase the blood clot contraction, while the red blood cells have an inhibitory effect. Blocking the fibrin and platelets interaction using the RGDS peptide, an integrin αIIbβ3 antagonist, reduces the extent and rate of clot contraction. The exogenous Ca2+ is not required for contraction, but its addition stabilizes clots by inhibiting the erythrocytes. Thrombin has a dose-dependent effect and increases the rate and extent of contraction. In blood samples of patients taking warfarin, blood clot contraction was delayed.
Conclusion. The blood clot contraction is a process which depends on many factors, including the blood cell composition, amount of fibrinogen, the endogenous thrombin activity and platelets interaction with fibrin; understanding the mechanisms of the blood clot contraction could form the basis for the development of novel approaches to the hemostatic disorders treatment.



Electron microscopy study of antibacterial effect of selimakcid against salmonella and escherichia
Abstract



Reviews
Prevention of compartment syndrome after abdominal surgeries
Abstract



Serotonergic mechanisms of regulation of the systemic circulation vessels lumen
Abstract



Modern surgical approaches in treatment of simple solitary, multilocular, multiple cysts and polycystic kidney disease in children
Abstract



Modern concepts of celiac disease
Abstract



Social hygiene and healthcare management
Modern ethical, legal and institutional framework of biomedical cell technologies development in the People’s Republic of China
Abstract



Epidemiological features and risk factors of non-scpecific low back pain in petrochemical enterprise workers
Abstract
Aim. To study the prevalence and incidence of new cases, and the role of risk factors such as PARK2 gene polymorphism and mechanical loads in non-specific low back pain development in workers of a large petrochemical enterprise.
Methods. On a cross-sectional study by continuous sampling method (all factory workers - 580 people, the participation rate 87.6%) the prevalence of problems with the musculoskeletal system, including low-back pain was studied. Russian version of the Nordic questionnaire and the analysis of medical records were used. 228 people without any musculoskeletal system problems (the participation rate 82.4%) were selected for the 6-month prospective study. PARK2 gene rs926849 A/G polymorphism has been identified in 177 workers; epithelial cells of the oral cavity served as material for genetic analysis. The severity of the work process was evaluated in all workplaces. Multivariate statistical analysis was conducted by logistic regression method.
Results. The prevalence of low back pain reached 38.7%; the incidence of new cases at 6 months was 13.3%. In case of genotype AA of PARK2 gene rs926849 polymorphism (compared with protective genotypes AG and GG) the low back pain was more common (OR=1.68, p=0.047). Another risk factor was age (OR=1.06, p=0.005). The presence of the «work severity» variable in the model increased the level of statistical significance of the «genotype» variable from p=0.055 to p=0.047, i.e. the association with the risk of low back pain increased.
Conclusion. Hereditary predisposition and age play a significant role in the development of non-specific low back pain among workers; mechanical loads may increase the effect of a genetic predisposition, but do not have an independent etiologic importance.



Ethnic variability of bladder cancer in the Republic of Kazakhstan
Abstract
Aim. To study the bladder cancer incidence in ethnic groups of the Republic of Kazakhstan.
Methods. The study, covering the period from 2004 to 2013, included patients with newly diagnosed and registered cases of bladder cancer. Statistical methods of cancer incidence descriptive epidemiology were used. Besides, age-specific, crude and standardized indices of bladder cancer incidence were calculated.
Results.In total in 10 years 4887 patients with bladder cancer were registered in Kazakhstan. Crude incidence rate of bladder cancer among the Kazakh ethnic group was the highest in Akmola (2.2) and Kostanay (2.2) regions, as well as in Almaty (2.1 per 100 thousand population). The lowest incidence rate among indigenous ethnic groups was registered in South Kazakhstan region - 0.8 per 100 thousand population. The highest average annual incidence of bladder cancer among Russians was registered in Almaty - 11.4 per 100 thousand population. The same high figures were registered in West Kazakhstan (11.0), North Kazakhstan (10.5), Kyzylorda (10.5) and Aktobe (10.0 per 100 thousand population) regions. The lowest incidence was observed among persons of Russian nationality in the Atyrau region (4.0 per 100 thousand population). In general, the incidence among the Kazakh ethnic group was 1.59±0.41 per 100 thousand, that was significantly less than among Russians - 8.25±1.88 per 100 thousand population (p
Conclusion. There is considerable ethnic variability in bladder cancer incidence in Kazakhstan: the incidence among Russians 5 times higher than among Kazakhs.



Medico-demographic situation in prisons of Volga federal district in the period of the penal system reforming
Abstract
Aim. To assess tendency in medico-demographic indicators of persons held in prisons of Volga Federal District in the period of the penal system modern reforming (2006-2014).
Methods. Assessment of the studied contingent quantitative and qualitative medico-demographic indicators dynamics, the most relevant for the prisons for the 2006-2014. Forecasting of studied indicators for the period up to 2017 was conducted. Intensive and extensive indicators calculation and their dynamic comparison were performed.
Results. Changes of demographic indicators for the 2006-2014 period involve the total number of prisoners reduction, the proportion of women increase and the proportion of teenagers decrease, reduction the punishment serving duration, migration processes intensification. The studied contingent, which was held in the prisons of the Volga Federal District, in the vast majority (91.0%) was presented by male persons. The mean age of convicted is 30.9 years. The mean term of punishment in prisons is 7.6 years. During the 2006-2014, the constant tendency of the studied contingent mortality increase due to the continuing increase in the number of patients with socially significant diseases amid decrease of the total number of persons held in prisons was registered. In 2014, the mortality rate was 7.1‰, which is 36.5% higher than in 2006 (5.2‰). The leading causes of death were infectious and parasitic diseases (37.1%). Studied medico-demographic indicators changes had significant regional features.
Conclusion. Revealed significant changes in the medico-demographic indicators of studied contingent, definitely affecting the penalty system medical service activity, dictate the necessity of considering them when adopting the strategy of medical care organization in prisons.



Analysis of surgical care delivery to gynecological patients
Abstract
Aim. To analyze surgical care delivery to patients with urgent gynecological diseases in Kazan hospitals for the period of 2010-2014.
Methods. The data on incidence, its structure, performed interventions, types of surgical approaches, obtained from eight Kazan hospitals, serving the urban population over the last 5 years (2010-2014) were analyzed.
Results. During this period, 86 165 women were treated in gynecological departments, 13 863 (16%) of them were provided with surgical care. During the analyzed period, the number of gynecological patients increased by 7000: from 12 374 to 19 548 people. Abdominal surgical interventions prevailed. When analyzing the surgical approaches types ratio in elective abdominal interventions, the prevalence of abdominal laparoscopic approach was revealed. The increase in the use of endoscopy at urgent conditions from 73% in 2010 to 83.7% in 2014 was observed. The downward trend of the laparoscopic approach use during elective surgery, observed in recent years, to some extent may be due to reprofiling of departments and hospitals. The tendency to increase the ectopic pregnancy frequency - from 48.1 to 55.2%, ovarian apoplexy - from 20.8 to 31.7% in 2010 and 2014 respectively, was revealed. The laparoscopy use increase by almost 20% both in ectopic pregnancy and in ovarian apoplexy was observed.
Conclusion. Adequate provision of city gynecological departments with endoscopic equipment, the possibility of its round-the-clock use, increase in the number of gynecologists mastered laparoscopic technology allow to increase the proportion of mini-invasive methods of surgical treatment.



To the 40th anniversary of Pharmaceutical Faculty of Kazan State Medical University
P2-receptors as promising target for future drugs
Abstract



Intermacromolecular interactions with Eudragit® copolymers as a new principle of the microparticulate oral drug delivery systems development
Abstract



Development of new potential drugs with psychotropic activity among phosphorylacetohydrazides and other phosphorylated carboxylic acids derivatives - priority area of Kazan school of psychopharmacologists
Abstract



Clinical observations
Two clinical cases of nonspecific aortoarteritis
Abstract



Experience of Fournier’s gangrene clinical diagnostics
Abstract



History of medicine
Medical detachments activities during the 2nd battle of Geok Tepe
Abstract



Obituary
Professor Andrey Nikolaevich Mayanskiy


