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Vol 26, No 4 (2020)

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Oxidative stress and inflammation in COVID-19 pathogenesis

Kukes V.G., Parfenova O.K., Sidorov N.G., Olefir Y.V., Gazdanova A.А.


This study discusses the role of oxidative stress and inflammation in the development of severe acute respiratory syndrome (SARS) associated with COVID-19 caused by the novel SARS-CoV-2 coronavirus. An analysis of the literature revealed that the development of respiratory viral infections, including COVID-19, is usually accompanied by the accumulation of acidic metabolic products in the blood and tissues and, accordingly, oxidative stress and increased levels of cytokines. In this regard, it seems appropriate to use the second-generation low-toxic antioxidant Ethoxidol, manufactured in Russia, which reduces the intensity of inflammation, and also improves blood oxygen saturation.

Medical Journal of the Russian Federation. 2020;26(4):244–247
pages 244–247 views

Iatrogenic (drug induced) cognitive disorders

Damulin I.V., Strutsenko A.A.


This article discusses the clinical and pathogenetic aspects of iatrogenic (drug induced) cognitive disorders. It is emphasized that in most cases the etiology of these disorders is multifactorial in nature. In some cases, iatrogenic disorders are caused by the intake of an inadequately large dose of the drug, while in other cases, they are caused by the side effect of drugs. Disorders such as cerebral homeostasis, impaired permeability of the blood–brain barrier and the neurochemical properties of a certain drug are important. Side effects of drug therapy in elderly patients are much more common than in patients of a younger age, which is due to a number of causes, namely the poly-pragmasy characteristic of the elderly patients, erroneous prescription of certain drugs, drug interactions, altered pharmacokinetics and pharmacodynamics, and increased sensitivity to medications. Various groups of drugs are considered, during the intake of which, neuropsychiatric disorders may occur. In this case, special attention is paid to drugs with cholinolytic properties. Neurological disorders arising from radiation therapy were analyzed separately. It was concluded that it is necessary to assess the possible adverse effect of previously prescribed drug therapy for various indications in patients with cognitive impairment.

Medical Journal of the Russian Federation. 2020;26(4):248-254
pages 248-254 views

Aspects of examination of patients with diabetes mellitus type 1 and 2 in the office of sociomedical assessment

Stolov S.V., Ugleva E.M., Yamshchikova T.Y., Makarova O.V.


When examining citizens in federal state medical and social examination institutions when recognizing a person as disabled, it is necessary to apply the criteria for determining disability set out in Order of the Ministry of Labor of Russia dated August 27, 2019 No. 585н. The conditions for recognizing a citizen as a disabled person are persistent violations of body functions, which lead to a limitation in various categories of life, the need for social support. A quantitative assessment of the severity of persistent dysfunctions of the human body is determined in percent. Certain clauses of the Order regulate the examination of citizens with diabetes. The article sets out the generally accepted criteria for assessing the severity of diabetes and its complications, the main research methods to determine the dysfunction of the target organs for a timely and reasonable referral for examination at the bureau of medical and social examination.

Medical Journal of the Russian Federation. 2020;26(4):255–262
pages 255–262 views

Clinical medicine

Sternum separation in the postoperative period: analysis of risk factors

Skorobogachev R.V., Belekhova D.A., Belov D.V., Naymushina Y.V.


This study aimed to assess the main risk factors contributing to postoperative separation of the sternum and to substantiate the recommendations on the optimal number of sternal polyspast and multi-twist knots based on data from international literature and our own experience.

In this study, the indicators such as gender, age, height, body weight, body mass index, diabetes mellitus, chronic obstructive pulmonary disease, bronchial asthma, separation during the surgery of the internal thoracic artery, and re-exploration were evaluated. A key indicator was the sutures applied on the sternum after sternotomy, precisely the suture type (polyspast and multi-twist) and number. The study was conducted in the Federal Cardiovascular Surgery Center of the Ministry of Health of Russia (Chelyabinsk). The final sample was 1 051 patients in 2019. The patients were distributed into two groups; those without separation of the sternum in the postoperative period (n = 1 038) and those with sternum separation (n = 13). In the course of this study, we found that the most significant factors were the height and weight of patients. The multivariate analysis of variance showed that for multi-twist sutures, an additional sternal knot was required for every 4 cm of height, starting from 163 cm, and for every 7 kg of body weight, starting from 81 kg. For polyspast sutures, one additional sternal knot was required for every 5 cm of height, starting from 165 cm, as well as for every additional 5 kg of body weight, starting from 76 kg. When planning the number of sternal sutures, the height and weight of the patient’s body should be taken into account in aggregate, and the number of knots should be formed according to a more significant indicators.

Medical Journal of the Russian Federation. 2020;26(4):217–223
pages 217–223 views

Rehabilitation of patients with motor development retardation using reflector gymnastics by the Vojta method

Kiselev D.A., Levkov V.Y., Gubanov V.V., Kozlovsky I.V., Timonin E.M., Laysheva O.A., Panyukov M.V.


The study aimed to demonstrate the significance and effectiveness of the Vojta rehabilitation technique, which leads to activation of human motor performance and to the pronounced potentiation of numerous functions of the nervous system in children with a diagnosis of motor development retardation.

Medical Journal of the Russian Federation. 2020;26(4):224–227
pages 224–227 views

Research of blood viscosity in patients with purulent and inflammatory diseases of the maxillofacial region during wound healing

Khelminskaya N.M., Kravets V.I., Goncharova A.V., Krasnov N.M.


The article presents the study of changes in blood viscosity during purulent wound healing in patients with purulent and inflammatory diseases of the maxillofacial region.

Medical Journal of the Russian Federation. 2020;26(4):228–231
pages 228–231 views

Clinical pharmacology and pharmaceuticals

Study of the pharmacokinetics of levofloxacin when combined with st. John’s wort preparations in healthy volunteers and in patients with lower respiratory tract infection

Krasnyk L.M., Goroshko O.A., Tsyganko D.V., Berdnicova N.G., Krasnyanskaya V.G., Menshov V.A.


In patients with pneumonia and concomitant diseases, the administration of antimicrobial agents together with other medications accompanied by the risk of side effects and drug-drug interactions. We studied the pharmacokinetics (PK) of levofloxacin when combined with a herbal preparation (common St. John’s wort extract) in healthy volunteers and in patients with community-acquired pneumonia on the days 1 and 5 of the drugs intake. Individual differences in the average concentrations (AUC analog) of the antibiotic before and after the course of administration of the St. John’s wort extract within each group were quite significant; however, the group-average differences were statistically insignificant. Intergroup differences in PK with St. John’s wort intake were also statistically insignificant. To search for factors that make a significant contribution to the variations observed in PK indices, we used a statistical multivariate analysis of variance which included factors such as gender, age, body mass index, smoking history, and cardiovascular system parameters. We found that smoking only and, to a lesser extent, the patient’s gender had an effect on levofloxacin PK, while the intake of St. John’s wort completely eliminated this effect. Other factors played an insignificant role in the antibiotic PK regardless of the St. John’s wort administration.

Medical Journal of the Russian Federation. 2020;26(4):232–238
pages 232–238 views

Neurochemical study of the mechanism of action of thymus peptides in emotional stress

Novoseletskaya A.V., Kiseleva N.M.


A comparative study of the effect of the thymus hormone thymulin and thymus peptides (thymosin fraction 5) on the content of monoamines and their metabolites in the frontal cortex, striatum, adjacent nucleus, hypothalamus, hippocampus of the brain of Wistar rats, by high performance liquid chromatography, was performed. The hormone and peptides of the thymus were found to reduce emotional stress during functional impairment of the avoidance reaction and improved adaptation under stressful conditions in rats, which indicates the anti-stress effect of thymus hormones. The positive effect of the hormone and peptides of the thymus were manifested in a change in the balance of serotonin and norepinephrine in favor of the former in the hypothalamus and frontal cortex.

Medical Journal of the Russian Federation. 2020;26(4):239–243
pages 239–243 views

Health care organization and public health

Vaccination approach for children born with very low and extremely low body weight

Mironova A.K., Potyanova O.I., Osmanov I.M.


Annually, more than 1 million premature infants die of infectious diseases due to the failure of the mechanisms of antiviral and antibacterial protection. In this regard, immune build up with timely vaccination to prevent severe infections is a particularly important factor. This study presents a retrospective analysis of the results of vaccination of extremely premature infants. The results of immunization were analyzed, and the vaccination scheme for children born with very low and extremely low body weight are presented.

Medical Journal of the Russian Federation. 2020;26(4):198-204
pages 198-204 views

Monitoring the opinions of resident physicians on the state of healthcare system, quality of medical care, and readiness for professional activity in current conditions

Kasimovskaya N.A.


Despite the ongoing reforms, the staff shortage in the healthcare system and the loss of medical personnel in the field still negatively affect the quality of medical care. The article presents the results of monitoring the opinions of future resident physicians of the current organization and the quality of medical care and their readiness for professional activity, as well as their views to the healthcare system needs. It has been established that every third graduate was not ready for the profession before entering the residency, 36.7% considered their future profession to be nonprestigious, only half of the residents (50.3%) considered the medical profession to be highly paid, and personal aptitude (53%) and abilities (40%) were considered the leading factors in choosing the profession. The residents evaluated the quality of medical care at a high level only in a clinical setting (69.7%), and they do not plan to work in regional health care but prefer to stay in Moscow (60.3%). To preserve the healthcare system human resources, it is advisable to develop a program for managing risk factors for the professional environment, starting with training of personnel at the institute of higher education.

Medical Journal of the Russian Federation. 2020;26(4):205-210
pages 205-210 views

Analysis of gynecological morbidity and the trend of development of stationary gynecological care in the Russian Federation

Fomina A.V., Dzidzarija F.G., Bivol E.V.


Background: Due to a quantitative decrease in the demographic reserve and a qualitative decrease in the reproductive potential of the country, protecting the reproductive health of women in Russia has now become an emergency situation. The obstetric and gynecological service is of major importance in maintaining reproductive health and conducting a comprehensive demographic policy. This study aimed to assess the dynamics of gynecological morbidity in the Russian Federation, the Central Federal District, the city of Moscow, and the organization of stationary gynecological care. Material and methods: The official statistics of the Federal State Statistics Service and the Ministry of Health of Russia for 2009–2018, as well as data from copies of the medical records (medical history, records of patients discharged from the hospital) of patients who received treatment in a gynecological day patient facility between 2015 and 2017. Results: A decrease in the number of gynecological beds by 32.2% over 10 years was noted. At the same time, the level of primary and general incidence of inflammatory diseases of the female pelvic organs did not decrease; between 2014 and 2018, there has been an increase in the incidence of primary female infertility. Non-inflammatory diseases of the female genital organs prevail (76.6%) as reason for admission in the day patient facility. Conclusion: The gynecological day patient facility manages female health; however, the nationwide and regional incidence rate of gynecological morbidity follows a negative trend and is increasing annually.

Medical Journal of the Russian Federation. 2020;26(4):211–216
pages 211–216 views

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