Saratov JOURNAL of Medical and Scientific Research

2019, volume 15

Periodontal disease at cardiovascular pathology

Year: 2019, volume 15 Issue: №2 Pages: 246-251
Heading: Stomatology Article type: Review
Authors: Eremin A.V., Lepilin A.V., Lipatova T.E.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

The purpose of the systematic literature review was to characterize existing problem of the relationship between cardiovascular diseases and periodontal diseases on the basis of information analysis of the Russian and English original studies and metanalyses published in open access bibliographical databases such as eLibrary and PubMed the past ten years as a methodological basis for future clinical and experimental studies

Keywords: cardiovascular disease, periodontal diseases, risk factors

Clinical and neurological features in patients with venous cerebral dysfunction

Year: 2019, volume 15 Issue: №2 Pages: 241-245
Heading: Neurology Article type: Original article
Authors: Gafurov B.G., Nazarova Zh.A.
Organization: Tashkent Institute of Postgraduate Medical Education,
Summary:

Objective: to study the clinical and neurological features in patients with chronic cerebral ischemia, depending on the presence of venous cerebral dysfunction. Material and Methods. 168 patients sufering from chronic cerebral ischemia took part in the study (mean age 61.2±3.8 yrs; 45.2 % — men). The control group comprised 20 healthy subjects comparable in age and sex distribution. All patients with chronic cerebral ischemia underwent rheoencephalographya for detection of cerebral venous dysfunction, as well as standard clinical and neurological examination (patient»s complaints, past history, neurological status assessment). Clinical features of headache were evaluated using the original questionnaire. The intensity of headache were determined using a ten-point visual-analog scale. Cognitive function was assessed in all study groups by means of evoked potential method with using P300 technique. Results. In patients with chronic cerebral ischemia in 46.4 % of cases revealed venous cerebral symptoms. In such patients, headache syndrome is most pronounced, both by clinical criteria and by visual-analog scale score: 6.8 points against 5.1 points in patients with chronic cerebral ischemia without venous cerebral dysfunction (p<0.05). In patients with chronic cerebral ischemia with concomitant cerebral palsy revealed more pronounced comorbid background and cognitive defcits, manifested in violation of sensory integration, diferentiation of stimuli, memory and decision-making as compared with patients with chronic cerebral ischemia without venous cerebral dysfunction and healthy subjects. Conclusion. Venous cerebral dysfunction aggravated the course of chronic brain ischemia predominantly due to the presence of cognitive defciency.

Keywords: headache, venous cerebral dysfunction

Twin-to-twin transfusion syndrome: A clinical case

Year: 2019, volume 15 Issue: №2 Pages: 236-240
Heading: Pediatrics Article type: Case report
Authors: Nechaev V.N., Chernenkov Yu.V.
Organization: Saratov State Medical University
Summary:

At the heart of the development of twin-to-twin transfusion syndrome (TTTS) is the presence of pathological anastomoses in the placental vascular network. The article presents a clinical case of TTTS development in monochorionic twins with placental vessel abnormality with a diagnostic search and a plan of further management.

Keywords: donor, monochorionic twins, recipient, twin-to-twin transfusion syndrome

Features of blood lipid profile in low birth weight infants with different types of feeding

Year: 2019, volume 15 Issue: №2 Pages: 232-236
Heading: Pediatrics Article type: Original article
Authors: Kadymova I.I., Bochkova L.G., Eiberman A.S., Gumeniuk O.I., Kirilochev O.K.
Organization: Astrakhan State Medical University, Saratov State Medical University
Summary:

The research goal is to study of blood lipid profile for different types of feeding in infants with low birth weight (LBW), very low birth weight (VLBW) and extremely low birth weight (ELBW) at birth, receiving breast milk or special mixes, to determine whether correction of their food. Material and Methods. The dynamic study of cholesterol (CS), triglycerides (TG), high-density lipoproteins (HDL) and low-density lipoproteins (LDL) was carried out depending on the type of feeding in low-weight infants of different weight categories. The concentration of these lipid components was determined using the test of Liquick Cor-CHOL; Liquick Cor-TG; CORMAY HDL DIRECT systems. Results. This study showed that newborns with extremely low birth weight with intrauterine growth retardation and newborns with very low birth weight had significantly lower levels of lipid profile than infants with low birth weight (CS — by 11-17%, TG — by 18-27%, HDL — by 33-47%, LDL— by 14%). Conclusion. Extremely low birth weight newborns with intrauterine growth retardation (IGR) and very low birth weight newborns need early correction of lipid metabolism throughout the neonatal period.

Keywords: lipoproteins, premature birth

Eradication therapy in children: the choice of the optimal treatment regimen

Year: 2019, volume 15 Issue: №2 Pages: 225-231
Heading: Pediatrics Article type: Review
Authors: Zryachkin N.I., Ananyeva O.V.
Organization: Saratov State Medical University
Summary:

The review is devoted to the choice of the optimal treatment regimen of eradication therapy in children. Main tasks in the treatment of children with gastroduodenal pathology associated with Helicobacter pylori are eradication of the pathogen, restoration of the damaged mucosa and prevention of recurrence of the infection. A particular importance in the composition of eradication schemes is the choice of antibacterial drugs. The main requirements for anti-Helico-bacter therapy regimens used in pediatric practice are: eradication rate of at least 80 %, economic accessibility, good tolerability with minimal severity of adverse reactions, optimal frequency of admission. An analysis of a number of domestic and foreign studies has shown that insufcient adherence of the patient to therapy, the presence of antibacterial resistance, pathogenicity factors in a number of strains of H. pylori have a negative efect on the efectiveness of treatment and should also be taken into account when choosing therapeutic tactics. Successful eradication of H. pylori in most cases depends on the optimal treatment regimen also has an impact on the result.

Keywords: Helicobacter pylori, proton pump inhibitors, resistance

Balloon pulmonary angioplasty — an efective method of treatment for patients with pulmonary arterial hypertension

Year: 2019, volume 15 Issue: №2 Pages: 222-224
Heading: Cardiology Article type: Case report
Authors: Starodubtseva I.A.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

The article presents the clinical case of patient with chronic thromboembolic pulmonary hypertension. It is describes the classical course of the disease with use of full spectrum of diagnostic procedures. Pulmonary endarterectomy (PEA) is a gold standard of treatment. Nevertheless, performance of PEA is possible in only 60 % of patients with chronic thromboembolic pulmonary hypertension. Balloon pulmonary angioplasty and drug therapy with a stimulator of soluble guanylate cyclase are alternative treatment strategy.

Keywords: balloon pulmonary angioplasty, chronic thromboembolic pulmonary hypertension, stimulator of soluble guanylate cyclase

Cardiac remodeling in patients with chronic kidney disease

Year: 2019, volume 15 Issue: №2 Pages: 217-221
Heading: Internal Diseases Article type: Review
Authors: Sedov D.S., Rebrov А.Р.
Organization: Saratov State Medical University
Summary:

The duration and quality of life of patients undergoing extracorporeal renal replacement therapy are largely dependent on concomitant diseases and conditions. Cardiovascular disease is a significant complication of chronic kidney disease and a major cause of death in patients undergoing hemodialysis. Cardiovascular remodeling is an independent predictor of the risk of cardiovascular events in patients with chronic kidney disease (CKD), including those in the dialysis stage. This paper analyzes the literature on left ventricular myocardial remodeling in the late predialysis stages of CKD and in patients receiving treatment with chronic hemodialysis.

Keywords: cardiac geometry, chronic kidney disease, hemodialysis, left ventricular myocardial remodeling,

Clinical case of the manifestation of Parkinson's disease in a patient with neuro-leptic-induced parkinsonism

Year: 2019, volume 15 Issue: №1 Pages: 199-202
Heading: Neurology Article type: Case report
Authors: Yudina V.V., Makarov N.S., Yudina G.K.
Organization: Saratov State Medical University
Summary:

The article presents data on the mechanisms of development of drug-induced parkinsonism in patients taking neu-roleptic drugs, as well as on specifics of the development of Parkinson's disease in these patients. A clinical case of Parkinson's disease development in a patient with drug-induced parkinsonism who has been taken antipsychotics for a long time is described.

Keywords: drugs for Parkinson's disease treatment, neurolepticinduced parkinsonism, neuroleptics, Parkinson disease

Carotid arteries ultrasound screening in asymptomatic patients

Year: 2019, volume 15 Issue: №1 Pages: 190-199
Heading: Neurology Article type: Original article
Authors: Shchanitsyn I.N., Shvarts E.Yu., Ishmukhametova R.A., Vozdeeva A.S.
Organization: Saratov State Medical University
Summary:

Objective: to reveal the most important predictors of carotid artery stenosis in ambulatory patients of Saratov and Saratov Region with the help of multivariate analysis and to define an ideal patient for ultrasound screening. Material and Methods. In 2014-2018 off-site consultations and ultrasound screening were performed for asymptomatic patients with suspected carotid artery disease in outpatient clinics of Saratov and Saratov Region. Those patients were referred for screening by neurologists and general practitioners. The study used 470 medical charts. The multivariate regression analysis was performed to identify independent predictors of carotid artery stenosis (>50%). Results. The >30% carotid artery stenosis was detected in 24.5% (115/470) of participants, >50% stenosis — in 10.2% (48/470) of participants, >70% stenosis — in 2.9% (14/470) of participants. The multivariate analysis revealed that the odds of finding >50% stenosis in patients chosen by neurologists and general physicians for screening was significantly higher in the presence of following factors: age older then 72, male sex, acute cerebrovascular event more than 6 months ago, atherosclerosis in arteries of lower extremities, episodes of speech disorder. The point scale for risk assessment has been created. In the absence of prognostic factors the absolute risk of >50% stenosis was only 3%. In the presence of 1 point it was 16% and more than 50% in the presence of 4 points. Conclusion. The analysis we conducted allowed to specify major predictors of atherosclerosis in patients followed in outpatient clinics of Saratov and Saratov Region and to create the patient model which allows to optimize selection for ultrasound screening.

Keywords: asymptomatic stenosis, carotid stenosis

Specific features of rehabilitation potential in adult patients with cerebral palsy

Year: 2019, volume 15 Issue: №1 Pages: 187-190
Heading: Neurology Article type: Original article
Authors: Shulyndin A.V., Antipenko Е.А.
Organization: Privolzhskiy Research Medical University
Summary:

Objective: to determine the specific features of rehabilitation potential in adult patients with cerebral palsy (CP). Material and Methods. Fifty patients with a confirmed diagnosis of cerebral palsy established in childhood were studied. Level of development of gross motor skills according to GMFCS classification was evaluated in all patients; functions were assessed using the International Classification of Functioning (ICF, version 2.1a, clinical form). Results: In patients with level 2 GMFCS, dysfunctions of muscle tone, muscle strength, implementation and capacity for raising and transferring objects of moderate and severe degree (p<0.05) were more common. The frequency of restricted implementation of precise manual movements is comparable in patients with GMFCS levels 1 and 2 Restricted non- assisted walking was significantly more common in patients with 2nd functional level. The moderately significant positive impact of personal mobility assistive products is more common among level 2 patients, while the importance of communication tools was greater for level 1 GMFCS patients. Conclusion. In adult patients with cerebral palsy it is necessary to assess the rehabilitation potential using ICF. Indicators of activity and participation are of key importance to the rehabilitation potential of adult cerebral palsy patients and should be considered in terms of the possibility of full or partial recovery to a level at which the performance of a certain task will meet the needs of the patient.

Keywords: adults, cerebral palsy, International Classification of Functioning, rehabilitation