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Vol 102, No 2 (2021)

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Theoretical and clinical medicine
Quantitative and qualitative changes in blood cells associated with COVID-19
Evtugina N.G., Sannikova S.S., Peshkova A.D., Safiullina S.I., Andrianova I.A., Tarasova G.R., Khismatullin R.R., Abdullaeva S.M., Litvinov R.I.

Aim. To establish the relationship of hematological disorders with the pathogenesis, course and outcomes of COVID-19.

Methods. We examined 235 hospitalized patients with moderate and severe forms of acute COVID-19 receiving anticoagulants and immunosuppressive drugs. We studied the full blood cell counts and morphology along with the platelet function by flow cytometry in comparison with the clinical features and synthesis of inflammatory markers. To assess platelet contractility, blood clot contraction (retraction) kinetics was used in combination with scanning electron microscopy of platelets and blood clots.

Results. Hemolytic anemia, neutrophilia and lymphopenia were associated with immature erythrocytes and leukocytes, indicating activation of hematopoiesis. Contraction of blood clots in COVID-19 was impaired, especially in severe and lethal cases, as well as in the presence of comorbidities, including myeloproliferative and coronary heart diseases and acute cerebrovascular disease. In male patients, the changes in clot contraction were more pronounced. Suppression of clot contraction correlated directly with anemia and coagulopathy, including a high D-dimer level, which confirms the pathogenetic significance of blood clot contraction in COVID-19. A decrease in platelet contractility was due to moderate thrombocytopenia in combination with chronic platelet activation and secondary platelet dysfunction. The structure and cellular composition of blood clots depended on the extent of contraction; clots with impaired contraction were porous, had a low content of deformed polyhedral erythrocytes (polyhedrocytes) and an even distribution of fibrin.

Conclusion. Blood cells undergoing both quantitative and qualitative changes are involved in the pathogenesis of COVID-19; the suppressed platelet-driven contraction of intravital blood clots may be a part of the prothrombotic mechanisms.

Kazan medical journal. 2021;102(2):141-155
Psychosocial adaptation to chronic heart failure in patients with coronary heart disease
Zhidyaevskij A.G., Galyautdinov G.S., Mendelevich V.D., Gataullina A.G., Kuzmenko A.O.

Aim. To assess the effects of acquired social status, neurotic conditions, type D personality, cognitive functions, quality of life and adherence to treatment on psychosocial adaptation of patients with coronary heart disease (IHD) to chronic heart failure (CHF), depending on the severity of decompensation.

Methods. 87 patients with coronary artery disease and chronic heart failure aged between 55 and 72 years were ­examined. All patients were divided into two groups depending on the functional class of chronic heart failure [New York Heart Association (NYHA) class I–IV]. The first group included 41 patients with NYHA functio­nal class I–II, the second group — 46 patients with NYHA functional class III–IV. For a comprehensive study of the psychosocial adaptation of patients, a set of standardized questionnaires was used: the abridged variant of the Minnesota Multiphasic Personality Inventory (SMOL), a clinical questionnaire for identifying and assessing neurotic condition, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 36-Item Short Form Health Survey Questionnaire (SF-36), the Mini Mental State Examination (MMSE), 14-question test “Type D Scale-14” (DS14), Morisky–Green test, the short version of the AUDIT questionnaire (AUDIT-C). We collected data on the patient's social status: gender, education, income level. The results obtained were analyzed.

Results. Based on the SMOL personality profiles, patients of the second group were classified as neurotic — an increase was noted in three neurotic scales: hypochondria (U=541; p=0.030), hysteria (U=579; p=0.048), and autism/schizoid (U=577.5; p=0.047) compared with patients of the first group. According to the results of the clinical questionnaire for the identification and assessment of neurotic condition, the greatest differences were found between patients of first and second groups on the scale of autonomic disorders (U=571; p=0.039) and neurotic depression (U=576; p=0.046). Comparing the groups according to the MLHFQ score, quality of life in patients of the second group was markedly reduced (U=447.5; p <0.001). According to the SF-36 questionnaire, a decrease in the quality of life was also found in patients of the second group on the scale “Physical functioning” (U=554; p=0.032) and “Physical component of health” (U=573.5; p=0.044). The cognitive status in patients of the second group was significantly decreased compared with the first group (U=427; p <0.001). No significant differences were found in adherence to treatment between the two groups (U=757; p=0.666). Also, there were no patients with type D perso­nality on both subscales (U=717.5; p=0.483, U=784; p=0.933) and according to the AUDIT-C scores, there are no significant differences between men (U=681.5; p=0.257) and women (U=728.5; p=0.425) in both groups of patients.

Conclusion. Signs of social maladjustment in patients with more severe NYHA functional class of the disease are expressed by significantly more pronounced social isolation (autism), a tendency to avoid communicating with ­others, isolation on their own problems and hypochondriacal attention to the somatic manifestations of chronic heart failure; probably, the main reason that reduces the level of social adaptation is a high score in neuroticism, which leads to a functional decrease in cognitive abilities and a significant deterioration in quality of life.

Kazan medical journal. 2021;102(2):156-166
Impact of gender and age on long-term outcomes of isolated coronary bypass surgery
Poteev M.A., Yakubov R.A., Khaisanov A.G.

Aim. Search for predictors of death and analysis of long-term survival after coronary bypass surgery.

Methods. The study included 1742 patients who underwent isolated coronary bypass surgery in Emergency Hospital (Naberezhnye Chelny) between 2011 and 2019, of whom 345 (19.8%) women and 1397 (80.2%) men. The women were older: their average age was 65.89±6.98 years — versus 61.29±7.71 years for men (p <0.001). The primary end point was death from any cause in the long-term postoperative period.

Results. The primary end point occurred in 170 patients (9.8% of the total sample), including 19 women and 151 men (11.2 vs. 88.8%). The average follow-up period was 43.65±27.55 months, the median follow-up period — 41 months. Both the 5-year survival rate (89% for women against 76% for men; p=0.042) and overall survival rate for the entire observation period were higher in women (86% versus 74%; p=0.042). Multivariate Cox regression analysis revealed that the long-term survival statistically significantly associated with age: up to 59 years [hazard ratio (HR) 0,43; confidence interval (CI) 0,28–0,65; р <0,001] and aged between 60 and 69 years (HR 0,62; CI 0,41–0,9; р <0,018), with gender: for female (HR 0,46; CI 0,29–0,77; р <0,002) and with factor of aortic occlusion during extracorporeal circulation (HR 2,42; CI 1,13-5,17; р <0,022) as well as the number of used internal thoracic arteries: one (HR 0,12; CI 0,02–0,65; р <0,015) or two (HR 0,08; CI 0,01–0,95; р <0,045).

Conclusion. Both 5-year and overall survival in women was higher; factors such as female gender and young age significantly influence survival in the long-term follow-up period after coronary bypass surgery, increasing it.

Kazan medical journal. 2021;102(2):167-175
Assessing the effectiveness of prevention of mother-to-child HIV transmission
Khamidulina R.M., Katyagina M.G., Zolotova I.S., Ziganshina L.E.

Aim. To analyze the outcomes of a set of interventions to prevent vertical transmission of the human immunodeficiency virus (HIV) in the Republic of Mari El.

Methods. A retrospective analysis of temporary registration forms “Notifications of the termination of pregnancy in an HIV-infected woman” and “Notifications of a newborn born by an HIV-infected mother”, case histories and outpatient medical records of HIV-infected women who gave birth in 2000–2018 was carried out. The study included all children born in the Republic of Mari El to HIV-positive women registered with the Republican Center for the Prevention and Control of AIDS and Infectious Diseases, as well as children whose HIV status is detected after birth as a result of epidemiological investigations. The assessment of the risks of transmission as an outcome of the three-step preventive interventions has been carried out. A comparative analysis of the results of perinatal prevention of HIV transmission in the Republic of Mari El and other regions of the Russian Federation was performed.

Results. A total of 299 HIV-infected pregnant women and 368 children born to these women during the study period were registered in the region; 63 (21.7%) of these women had more than one child. Over the entire study period, 18 (4.8%) children with confirmed HIV infection were registered. The most common factor associated with infant HIV infection is late maternal HIV diagnosis: (1) several years after childbirth in the absence of antiretroviral (ARV) prophylaxis and the infants were breastfeeding (11 cases, 64.7%); (2) during or shortly after childbirth, when the patient did not receive entire three-step antiretroviral prophylaxis during pregnancy and childbirth (6 cases, 29.4%); (3) in the third trimester of pregnancy (1 case, 5.5%). An important limitation for the successful prevention of vertical transmission of HIV was the lack of routine HIV testing, which is required by women and their partners before and at various stages during pregnancy. A single case of self-infection indicates the need to introduce preventive measures from early adolescence among children.

Conclusion. Due to the late maternal HIV diagnosis, during or after delivery, HIV transmission events occurred either with limited or no limited antiretroviral prophylaxis.

Kazan medical journal. 2021;102(2):176-184
Analysis of the intestinal microbiome in colorectal cancer
Gataullin B.I., Gataullin I.G., Nga N.T., Kolpakov A.I., Ilinskaya O.N.

Aim. To conduct a comparative analysis of the microbiome of biopsies of a tumor and normal intestinal epithelium of patients diagnosed with colorectal cancer and to identify of functional activities of the obtained bacterial isolates that affect the development of the tumor.

Methods. The study included 50 patients with malignant neoplasms of the colon: 36 men and 24 women. The mean age of the patients was 64.1±10.2 years. To analyze the microbiota of the biopsies, DNA samples were obtained from the tissue of the unaffected colon mucosa and tumor of the patients. Bacterial 16S rRNA genes fragments were amplified using bar-coded primer bakt_341f. Metagenomic next-generation sequencing was performed using the MiSeq platform (Illumina, USA). The obtained data were processed by bioinformatic methods using the QIIME package. Recognition of microorganisms depending on the morphotype and gram staining of the microflora was carried out using combination differential media and biochemical tests. Statistical analysis was carried out using Microsoft Excel, Service Pack 2 for Office XP, Statistica 6.0 (StatSoft). A comparative analysis was performed with the Student's t-test and the Mann–Whitney test in case of unmet conditions of validity. Alpha diversity of bacterial communities was quantified by the Shannon diversity index and the UniFrac distance for beta diversity analysis.

Results. In patients with colorectal cancer, 5 bacterial phyla were isolated, the predominant of which were Firmicutes and Bacteroidetes, while the content of Actinobacteria was low. In addition, a higher number of representatives of Fusobacteria was observed in the tumor tissue compared to the tissue of a healthy mucosa, at a distance of 5 centimeters proximal to the tumor. The results of this study indicate that the microbiome of a tumor and a healthy mucosa fundamentally differ from each other not only in morphotype and gram staining but also in antagonistic, hemolytic and ribonucleolytic activities.

Conclusion. Colonization of the tumor by dominant aggressive Gram-negative bacteria leads to significant changes in the tumor microbiome composition compared with normal mucosa, whose representatives are displaced from the damaged epithelium by more aggressive strains.

Kazan medical journal. 2021;102(2):185-191
Features of the clinical course of nephrolithiasis in patients with hyperparathyroidism
Baranova I.A., Zykova T.A., Baranov A.V.

Aim. To assess the incidence of kidney stone disease and to identify its clinical course in patients with primary hyperparathyroidism.

Methods. 48 medical records of patients hospitalized with primary hyperparathyroidism were retrospectively analyzed. The average age of the patients was 57 [53; 61] years. The medical history, complaints upon admission, the clinical presentation, the results of laboratory test and instrumental examination were studied in evaluating the medical records. The patients were divided into the group with nephrolithiasis (n=33) and the group without nephrolithiasis (n=15). The differences between the two groups were tested for statistical significance by the Mann–Whitney U test.

Results. Among patients with primary hyperparathyroidism, nephrolithiasis was detected in 69% of patients, of which 90% were women in the postmenopausal period. The course of the kidney stone disease in these patients was characterized by frequent recurrence with a predominance of bilateral renal impairment (62%). The duration of nephrolithiasis before the diagnosis of primary hyperparathyroidism was 6 [1; 19] years, and this complication was often the first manifestation of the disease. According to the instrumental examination of kidney in patients with nephrolithiasis, small stones up to 5 mm in diameter were detected in 42% of cases, asymptomatic kidney stones — in 15% of cases. A severe complication of primary hyperparathyroidism — staghorn calculi were found in 2 (10%) patients. The patients in the group with nephrolithiasis showed higher serum calcium (p=0.022) and parathyroid hormone (p=0.007) levels compared with patients in the group without nephrolithiasis.

Conclusion. Nephrolithiasis is a common complication of primary hyperparathyroidism; the presence of nephrolithiasis is associated with more significant changes in calcium and phosphate metabolism and is also characterized by a frequent asymptomatic course, thus requiring attention of specialists to this type of complications in primary hyperparathyroidism.

Kazan medical journal. 2021;102(2):192-198
Experimental medicine
The glutathione system in bone tissue under the action of copper-zinc ore components and antioxidants administration
Kuramshina G.R., Kamilov F.K.

Aim. To study changes in the glutathione system in bone tissue during chronic intoxication with elements contained in copper-zinc pyrite ore and antioxidant vitamin administration.

Methods. 36 mature male white rats were divided into three groups (control, comparison, experimental). The rats of the experimental and comparison groups received intragastrically copper-zinc pyrite ore powder in a 2% starch solution as a suspension at a dosage of 60 mg/100 g bodyweight daily for three months. During the last month, the experimental group received an antioxidant vitamin preparation (the complex of vitamins with a trace element) containing α-tocopherol, β-carotene, ascorbic acid and selenium. The content of reduced glutathione, free thiol groups in proteins, the activity of glutathione peroxidase, glutathione transferase, glutathione reductase, gamma-glutamyl transferase, and glucose-6-phosphate dehydrogenase were determined in homogenates derived from femoral epiphysis. The statistical analysis of the results was performed using Statistica 6.0 software. The median (Me) and percentiles (Q1 and Q2) were calculated, a non-parametric Mann–Whitney U test was carried out to compare study groups.

Results. Chronic intoxication with elements contained in copper-zinc pyrite ore causes impairment of the glutathione system in bone tissue. Intoxicated rats showed a decrease in the reduced glutathione content to 71.9% (р=0.014) and free sulfhydryl groups of proteins to 77.8% (р=0.0143), inhibition of glutathione-dependent antioxidant enzymes activities, and disruption of the glutathione reduction system in tissues, compared to the control group. Antioxidant vitamin administration increased the levels of reduced glutathione and free thiol groups of proteins, activated the enzymes involved in the glutathione system: the reduced glutathione content increased to 94.8% (p=0.2132), glutathione peroxidase activity to 85.7% (p=0.0432), glutathione transferase — up to 94.3% (p=0.5251), glutathione reductase — up to 86.1% (p=0.0442) compared to the control group.

Conclusion. Chronic intoxication with metals contained in copper-zinc pyrite ore leads to decreasing the content of reduced glutathione and free thiol groups of proteins in bones along with reducing glutathione reductase and glucose-6-phosphate dehydrogenase activities, inhibition of glutathione peroxidase and glutathione transferase; an antioxidant vitamin administration increases the activity of glutathione reduction enzymes in bone tissue, the content of reduced glutathione and free sulfhydryl groups of proteins, the activities of glutathione peroxidase and glutathione transferase.

Kazan medical journal. 2021;102(2):199-205
Outpatient management of endocrine conditions during the COVID-19 pandemic
Ziganshina A.P., Gosmanov A.R.

Still very active COVID-19 pandemic demands continuous adjustment of our regular practices of delivering patient care. The aim of this manuscript is to provide practical suggestions for the management of the most common endocrinological conditions during ongoing COVID-19/SARS-CoV2 pandemic. We have conducted a literature review and present our own experience of treating endocrinology patients during the months of full COVID-19 lockdown and then phased partial reopening. The results of the literature review have demonstrated the utmost importance of excelling in a challenging task of maintaining the best possible control of such endocrinological conditions as diabetes mellitus and adrenal insufficiency, while also maintaining the universal social distancing and isolation. In the patients with diabetes mellitus Hemoglobin A1C level correlates with the risk of unfavorable outcomes of COVID-19 which makes optimization of diabetes mellitus control an even more significant during the pandemic. It is important to provide the patients with the specific instructions on self-titration of insulin and on the use of non-insulin antidiabetic medications, examples of which are shown in the manuscript. For the patients with adrenal insufficiency, it is essential to discuss the rules of dose increase of the glucocorticosteroids in case of development of COVID-19 or any other acute illness. The diagnosis and management of other endocrinological conditions as for example thyroid nodules and osteoporosis (with the exclusion of secondary osteoporosis associated with diseases requiring timely treatment) can be delayed for the sake of everybody’s safety and partially also for prioritization of healthcare recourses utilization during these uneasy times. Since the beginning of the pandemic a considerable amount of new information regarding theoretical and practical aspects of connection of SARS-CoV2 and endocrinology is emerging almost weekly. In this manuscript, we have tried to gather the most clinically relevant data on the outpatient management of the patients with endocrine pathology.

Kazan medical journal. 2021;102(2):206-215
Distension methods of surgical correction of hypospadias in boys
Akramov N.R., Kagantsov I.M., Khaertdinov E.I.

Difficulties in the treatment of hypospadias in boys persist to this day. After surgical correction of hypospadias, fistulas, strictures, urethral diverticula, retraction of the meatus, glans dehiscence and other complications occur. At the same time, it is quite difficult to understand the whole variety of proposed methods for correcting hypospadias, which creates confusion for specialists and negatively affects the results of treatment. The literature describes more than 300 different methods of correcting hypospadias, but none of the methods is perfect, and there are no generally accepted treatment standards. Despite this, it is an established fact that the choice of the surgery procedure depends on the type of hypospadias. A successful technique of hypospadias repair should be completed with a good cosmetic and functional result. The article presents an overview of the distension techniques of urethroplasty. For the first time, the experience of urethral advancement was presented at the end of the XIX century, but the technique was unpopular and did not have significant success. However, by the end of the XX century, more effective distension techniques of urethroplasty began to be developed, which were widely used around the world (Koff S.A., Ti-Seng Chang, Belman A.B., MAGPI, LUM, etc.). According to scientific literature, urethral advancement is a safe and reliable way to correct distal hypospadias, and it is considered as an alternative to creating a “neourethra”. This technique has many competitive advantages, such as the short operation time, the absence of urethral tubularization, excellent functional and cosmetic results, and a small number of complications. It, therefore, follows that distension techniques of urethroplasty are considered a good option for correcting distal hypospadias, which should be in the arsenal of every pediatric surgeon and urologist.

Kazan medical journal. 2021;102(2):216-227
Social hygiene and healthcare management
Epidemiological aspects of central serous chorioretinopathy
Agliullin D.R., Khasanova G.R., Abdulaeva E.A., Agliullina S.T., Amirov A.N., Kuskov A.N., Kim A.A., Rascheskov A.Y., Lipinskiy D.A.

Aim. To analyze the incidence of central serous chorioretinopathy among the Kazan’s population between 2009 and 2018.

Methods. A descriptive epidemiological study of the incidence of Central serous chorioretinopathy of the population of Kazan between 2009 and 2018 was conducted. It included an analysis of long-term changes in the incidence of male and female population and an assessment of the structure of morbidity by sex for the entire period and in dynamics. Testing for differences was performed using the nonparametric Mann–Whitney U test and Chi-square test with Yates correction.

Results. 831 new cases of central serous chorioretinopathy were registered in Kazan during 2009–2018, the ratio of men and women was approximately 1:1. In the dynamics of morbidity, the proportion of men increased from 24.2% in 2009 to 60.7% in 2018 (р=0.000002), while the proportion of women decreased from 75.8% in 2009 to 39.3% in 2018 (р=0.000002). The long-term dynamics for 2009–2018 is characterized by a statistically significant increase in the incidence rate of central serous chorioretinopathy in men (p=0.004) from 3.2 per 100 000 in 2009 to 14.8 per 100 000 in 2018. During the study period, the incidence rate in women remains at the same level, varying from 5.4 per 100 000 to 8 per 100 000 (p=0.663). Men are more likely to have central serous chorioretinopathy at a younger age (р=0.0001). The median age at the time of diagnosis in women was 55 years (Q25–Q75 45–65 years), in men — 45 years (Q25–Q75 37–56 years).

Conclusion. From 2009 to 2018, the incidence rate of central serous chorioretinopathy among men in Kazan significantly increased in both intensive (p=0.004) and extensive indicators (p=0.000002); сentral serous chorioretinopathy in men develops at an earlier age compared with women (median age of women at the time of diagnosis was 55 years, median age of men — 45 years, p=0.0001).

Kazan medical journal. 2021;102(2):228-233
Clinical observations
Clinical case of intussusception of the jejunum into gastroenteroanastomosis after gastric ­resection
Akhmetzyanov F.S., Egorov V.I., Daminov A.N., Sirazitdinov N.D.

Intussusception is one of the varieties of mixed (strangulation and obturation) mechanical intestinal obstruction. It arises as a result of the introduction of the adducting segment of the intestine into the abducting one. Gastroduo­denal intussusception is an extremely rare type of high intestinal obstruction. It most often occurs after surgery on the stomach and much less often in non-operated patients. Intussusception of the jejunum into the stomach can occur soon after surgery, but most often, this complication occurs 5–15 years after the intervention. This paper describes a case of retrograde intussusception that arose 9 years after the Billroth II gastric resection with Braun anastomosis. This clinical case acquaints specialists with the possibility to encounter this pathology in clinical practice and demonstrates the appropriateness of differential diagnostics in cases with similar clinical symptoms.

Kazan medical journal. 2021;102(2):234-237
A case report of psoriasis exacerbation following COVID-19
Khaliullina D.R., Abdrakhmanov R.M.

The article presents a clinical case of severe exacerbation of psoriasis after a novel coronavirus infection. A 60 years old patient who has recovered from Corona Virus Disease 2019 (COVID-19) was admitted to the Republican Skin and Venereal Disease Dispensary of the Republic of Tatarstan for inpatient treatment with a diagnosis “Large plaque psoriasis involving palms and soles. Progressive stage. Scalp psoriasis. Nail psoriasis”. This was the first time the patient had experienced psoriasis exacerbation of this severity in his medical history. Presumably, exacerbation of psoriasis was due to the use of hydroxychloroquine. The exacerbation of psoriasis during the pandemic outbreak of Coronavirus disease can be explained by the following reasons: use of hydroxychloroquine, excessive inflammatory response to COVID-19, psychological stress, anxiety, depression, the decline in household income, limited outdoor activities. It is necessary to focus attention of physicians to the fact that patients who have suffered from COVID-19 may develop exacerbation of psoriasis.

Kazan medical journal. 2021;102(2):238-242
Clinical experiences
The effectiveness of kinesio taping in edema-reducing treatment for fractures of the lower jaw
Gasimzade D.K., Takhavieva F.V., Ksembaev S.S., Ivanov O.A.

Aim. To assess the effect of Kinesio taping on edema reduction among the patients with fractures of the mandible (lower jaw) in the early postsurgical period of osteosynthesis.

Methods. Patients with unilateral mandibular angle fractures with displacement of fragments (49 men at the age of 18–50 years), divided into 2 groups: the main group — 26 patients (with the inclusion of Kinesio taping in the complex of treatment) and the control group — 23 patients (the traditional complex of treatment). All patients underwent splinting of the jaw and miniplate osteosynthesis. Kinesio tapes were applied the next day after surgery to the skin above and below the surgical wound. Three out of five standard landmarks were used to measure edema on the 1st and 5th days after osteosynthesis. Data were analyzed by using descriptive statistics and Student's test. In all cases, the level of statistical significance was 5% (p ≤0.05).

Results. On the day after osteosynthesis, the patients of the main group showed a statistically significant (р <0.003) increase in the measured length for all three landmarks compared with the intact side due to pronounced postoperative edema. On the 5th day after the inclusion of Kinesio taping in the complex of treatment, there was a reduction in edema — the indicators of the fractured and intact sides did not differ significantly from each other (р >0.05). In patients of the comparison group, the decrease in the parameters of postoperative edema on the 5th day of observation was negligible and insignificant in all measurements (р >0.05).

Conclusion. The results indicate the effectiveness of using Kinesio taping for mandibular fractures in the early postoperative period of osteosynthesis, which makes it possible to achieve a significant reduction in postoperative edema; Kinesio taping is a promising, easy-to-perform method that can be used to reduce inflammatory edema in fractures of the mandible.

Kazan medical journal. 2021;102(2):243-248
History of medicine
On the history of management of the third stage of labor in Kazan (to the 155th anniversary of the birth of Professor V.S. Gruzdev)
Kozlov L.A.

The article aims to show the experience of the Kazan Obstetrics and Gynaecology Clinic named after V.S. Gruzdev for replacing the obstetric operation “manual removal of the placenta” with other techniques to prevent serious postpartum complications. Research methods — the historical study of primary literature sources. Manual removal of the placenta always associated with the risk of infection and developing puerperal sepsis. That is why obstetricians are constantly looking for a replacement for this operation. In 1895, even in the pre-Kazan period of work, professor Gruzdev successfully performed a method of inserting saline into the umbilical vessels to speed-up placental separation in the third stage of labor. While working in Kazan, on his proposal, doctor L.S. Sidorova (1936), and then Professor P.V. Manenkov (1942, 1948, 1955) and doctor M.V. Korotkova (1958) thoroughly studied and implemented the method of Budimilich in the work of the maternity ward of the clinic. This method involves replacing the saline solution with the crude alum solution. The second measure, preventing hemorrhage in the third stage of labor and avoiding manual removal of the placenta, was the successfully testing intravenous pituitrin (oxytocin) injection by Z.N. Yakubova, completed with the defense of her doctoral dissertation (1962). The high efficiency of these methods allowed us to recommend to them for widespread obstetric practice.

Kazan medical journal. 2021;102(2):249-257
The contribution of Kazan scientists to the success of the fight against child mortality
Baranov A.A., Albitsky V.Y., Zakirov I.K.

The work aims to analyze and present the contribution of scientists from Kazan medical universities and their pupils to the success of combat child mortality in Russia in the twentieth century using the historical and medical method. The most important results of the works of Kazan scientists can be considered the following: (1) the finding of underestimation of infant mortality; (2) development of methods for its statistical analysis; (3) identification of medical-statistical and social hygienic patterns of child mortality; (4) scientific substantiation of the methodology and strategy for reducing infant mortality in the USSR; (5) a comprehensive study of the problems of child mortality and substantiation of ways to reduce it in the Russian Federation in the late 20th — early 21st centuries. Measures are proposed to further reduce child mortality, including a regional approach, reduction of the population's genetic load, priority implementation of antenatal and neonatal prophylaxis, prompt and full provision of treatment by the state for children with rare diseases, further development of specialized and rehabilitation assistance provided to children, intensive development of medical and social assistance.

Kazan medical journal. 2021;102(2):258-263
80 years to Professor Valeriy Yurevich Albitsky
Kazan medical journal. 2021;102(2):264-266
80 years to Associate Professor Valeriy Petrovich Nefedov
Kazan medical journal. 2021;102(2):267-269
Cochrane Review Summaries
Aspirin and other non-steroidal anti-inflammatory drugs for the prevention of dementia

Деменция — глобальная проблема здравоохранения. В настоящее время не существует лекарств, для которых доказано, что они задерживают или предотвращают наступление деменции. Патофизиология деменции всё ещё плохо изучена. Тем не менее, есть основания полагать, что частичная ответственность за некоторые изменения мозга, наблюдаемые при деменции, лежит на воспалении. Существует множество лекарств, обладающих противовоспалительными свойствами, включая аспирин и НПВС, которые часто продаются как обезболивающие средства. Мы хотели выяснить, влияют ли как-нибудь эти лекарства на развитие деменции или нет.

Kazan medical journal. 2021;102(2):270-271
Cognitive training interventions for dementia and mild cognitive impairment in Parkinson’s disease

В этом обзоре мы рассмотрели, является ли когнитивный тренинг эффективным в улучшении таких исходов, как общие когнитивные навыки («глобальное познание»), память, внимание или способность осуществлять повседневную деятельность у людей с БП и либо с деменцией, либо с ЛКР.

Kazan medical journal. 2021;102(2):271
Aromatherapy for dementia

Лекарства, назначенные для лечения слабоумия, не всегда эффективны в облегчении симптомов заболевания, таких как проблемы с мышлением, поведением, настроением и сном. Натуральная терапия, включая ароматерапию (использование ароматных эфирных масел из растений), является привлекательным вариантом лечения этих мучительных симптомов слабоумия, так как часто полагают, что она имеет низкий риск возникновения побочных эффектов.

Kazan medical journal. 2021;102(2):272

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