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Vol 29, No 2 (2023)

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Original Research Articles

Neuromuscular electrophonopedic stimulation of the larynx after surgical treatment of patients with differentiated thyroid cancer

Vyazmenov E.O., Polunin M.M., Slashchuk K.Y., Beltsevich D.G., Katsobashvili I.A., Shotik J.V., Sardaeva D.G., Mokrysheva N.G.


BACKGROUND: Thyroid cancer is the most common endocrine malignancy, accounting for 3.4% of all cancers diagnosed annually. Differentiated thyroid cancer (DTC) is primarily treated with surgery, which can often involve complications such as postoperative pareses or reversible laryngeal nerve (RLN) paralysis. Currently, rehabilitation possibilities for patients with postoperative RLN pairs are relevant. In this study, we used neuromuscular electrostimulation with vocaSTIM in combination with drug therapy and evaluated the effectiveness of the rehabilitation.

AIMS: To determine the possibility of using neuromuscular electrophonopathic laryngeal stimulation (NMELS) in restoring laryngeal function after surgical treatment of DTC complicated by pareses/paralysis of thr RLN.

MATERIALS AND METHODS: Seventy-six patients with DTC who have undergone surgical treatment, complicated by paresis of RLN, were enrolled in this study.

RESULTS: The study analyzed the treatment results of these 76 patients. The age of the patients ranged from 6 to 78 (average age, 47) years, the female-to-male ratio was 59 to 17 (women, 77.6%; men, 22.4%). Postoperative unilateral laryngeal paresis was present in 56 patients (73.68%) and bilateral lesions in 20 (26.32%). Phonation violation was found in all patients: dysphonia, 76 (100%); dysphagia, 28 (36.84%); and respiratory failure, 11 (14.47%), and 2 patients (2.63%) were tracheotomized postoperatively. All patients underwent neuro-phonic rehabilitation with mandatory assessment and video fixation of laryngeal function. As a result of neuromuscular electrophonopathic stimulation of the larynx, 69 out of 76 patients (90.79%) had improved larynx function.

CONCLUSIONS: Based on our experience, NMELS with vocaSTIM can be used for restoring the functions of the larynx in patients with RLN paresis of varying severities, after surgical treatment for DTC.

Medical Journal of the Russian Federation. 2023;29(2):83-90
pages 83-90 views

Human heart rate variability under the influence of aromatherapy with sweet orange and pine oils

Semiletova V.A., Gubina O.I., Kozlova A.D., Popov M.V.


BACKGROUND: Aromatherapy is one of the simplest and most effective methods of influencing the functional state of a person. It is applicable both for therapeutic purposes in adults and children, and for restoring the psychoemotional and physical state of a person, which requires a detailed study of the psychophysiological mechanisms of the impact of individual aroma oils on the patient. Moreover, a wide choice of oils allows you to determine the necessary spectrum of action of a particular smell, and the activation of the olfactory sensory system causes a number of physiological reactions and affects the body in a complex way.

AIM: To study the human heart rate variability under the influence of aromatherapy with sweet orange and pine oils.

MATERIALS AND METHODS: The aromatherapy session was conducted for 25 minutes. Before and after the aroma session, the simple visual-motor reaction (sVMR) of the subjects was determined and the heart rate was recorded on the VNS-Micro hardware-software complex (Neurosoft, Russia) in lead II, at rest, sitting, for 5 minutes. Statistical processing of the obtained data was carried out using Excel and IBM SSPS Statistics 26 programs.

RESULTS: Maximal R–R intervals after rest were significantly higher than at rest before rest. The net regulatory effect (SDNN) increased significantly. The activity of the autonomous regulation circuit (RMSSD), the total wave power (TP), the power of the low-frequency component of the spectrum (LF), the power of the high-frequency component of the spectrum (HF) increased significantly. The centralization index (IC) increased after the rest.

Under the influence of the smell of pine, changes in heart rate variability and spectral power are insignificant. Significant changes in the power of the HF component of the spectrum were observed under the influence of the smell of orange — it significantly decreased. The centralization index (IC) has increased.

After the aroma sessions with pine and orange oil, the time of the subjects' MTMR and their error increased, after the aroma session with pine oil, the error increased to a greater extent. Aromatherapy with sweet orange and pine oils eliminated the significant changes in the parameters of heart rate variability of the subjects, which were observed after a 25-minute rest in the control group.

CONCLUSION: After rest, the activity of the sympathetic nervous system decreased, the activity of the autonomous regulation circuit increased, the influence of the vagus and the influence of subcortical and cortical centers of regulation increased. Aroma session with oils of pine or sweet orange reduces the effectiveness of the sVMR of the subjects, while a 25-minute inhalation of pine aroma oil reduces the effectiveness of the sVMR to a greater extent.

Medical Journal of the Russian Federation. 2023;29(2):91-98
pages 91-98 views

Influence of drugs with hyaluronidase activity on the survival of animals with a purulent-inflammatory process in the abdominal organs

Kukushkin G.V., Zhuravleva M.V., Yurov D.E.


BACKGROUND: The optimization of the pharmacokinetics of antibiotics is an important aspect in improving the effectiveness of therapy for intra-abdominal infections. Thus, studying the survival of experimental animals with a simulated purulent-inflammatory process in abdominal organs using the combined use of antibacterial agents with endolymphatic agents is worthwhile.

AIMS: To examine the effect of the co-administration of cefotaxime and hyaluronidase or bovgyaluronidase azoximer on the survival of mice with a purulent-inflammatory process of the abdominal organs.

MATERIALS AND METHODS: The purulent-inflammatory process of the abdominal organs, which was simulated by the intraperitoneal administration of a lethal dose of Staphylococcus aureus microbial suspension to mice, was evaluated. Four study groups were formed, with 28 animals each. Group 1 did not receive treatment, group 2 was administered with cefotaxime, and groups 3 and 4 received antibiotics after preliminary administration of hyaluronidase or bovgialuronidase azoximer. For the statistical analysis of animal survival, the Kaplan–Meier multiple assessment method was used, and a univariate analysis using a log-rank test was employed to identify significant differences between the groups.

RESULTS: During the study, a single injection of cefotaxime alone and in combination with other studied drugs promoted the survival of some mice with a simulated purulent-inflammatory process of the abdominal organs compared with the untreated group, and at the end of the experiment (day 7), 100% of the animals died. Moreover, the best results were achieved with the initial administration of hyaluronidase or bovhyaluronidase azoximer. Thus, on day 7 of observation, >70% of the animals in groups that received both an antibiotic and hyaluronidase or bovgyaluronidase azoximer survived. No statistically significant differences were found in the effect of these drugs on animal survival in the presence of an experimental purulent-inflammatory process.

CONCLUSION: A single injection of cefotaxime alone or in combination with other studied drugs ensures the survival of some mice with a simulated purulent-inflammatory process of the abdominal cavity compared with the control group, in which 100% of the animals died by the end of the experiment (day 7). Moreover, the best results were achieved in groups initially administered with hyaluronidase or bovgialuronidase azoximer.

Medical Journal of the Russian Federation. 2023;29(2):99-105
pages 99-105 views

Results of monitoring diabetic retinopathy in patients after simultaneous pancreas and kidney transplantation

Vorobyeva I.V., Bulava E.V., Balkarov A.G., Dmitriev I.V.


BACKGROUND: Very few studies have focused on the state of the fundus and visual functions before and after simultaneous transplantation of the pancreas and kidney. In addition, the results and conclusions of authors on this topic are contradictory.

AIMS: To evaluate the ophthalmological status of patients with diabetic retinopathy before and after kidney and pancreas transplantation.

MATERIALS AND METHODS: The patients were divided into three groups: group 1 included patients on the transplant waiting list receiving hemodialysis, group 2 were kidney transplant recipients, and group 3 included patients who had undergone simultaneous pancreas and kidney transplantation. The ophthalmological status of patients was assessed through standard ophthalmic diagnostic methods and measurements of photosensitivity, central retinal thickness, choroid thickness, density perfusion of the superficial and deep retinal capillary plexus, choriocapillary layer, and deep choroidal layer in the foveal and parafoveal zones of the macular region.

RESULTS: The study involved 76 patients (152 eyes) (group 1, n=30 patients undergoing dialysis; group 2, n=24 kidney transplant recipients; group 3, n=22 kidney and pancreaticoduodenal post-transplant recipients). Signs of the active phase of the proliferative stage of diabetic retinopathy (group 1, 54.1%; group 2, 53.3%; and group 3, 25.9%, p <0.05) and diabetic macular edema (group 1, 26.4%; group 2, 31.8%; and group 3, 12.8%, p <0.05) were more common in groups 1 and 2 than in group 3. Moreover, group 3 needed laser therapy (group 1, 45.3%; group 2, 43.2%; and group 3, 20.5%, p <0.05) and antiangiogenic therapy to a lesser extent (group 1, 18.9%; group 2, 25.0%; and group 3, 5.1%, p <0.05) than patients undergoing dialysis and kidney recipients. The eyes of patients after simultaneous pancreas and kidney transplantation were characterized by the smallest retinal thickness, highest retinal and choroidal perfusion, and highest visual acuity and photosensitivity (p <0.05).

CONCLUSIONS: A surgical method for restoring euglycemia through transplantation of physiologically active pancreatic tissue favorably affects the morphological and histological state of the retina and retinal and choroidal hemoperfusion and reduces the frequency of the active phase of proliferative diabetic retinopathy and diabetic macular edema.

Medical Journal of the Russian Federation. 2023;29(2):106-115
pages 106-115 views

Adaptation of the hearing analyzer under vibration noise exposure in volunteers: Ways of prevention

Korkmazov M.Y., Dubinets I.D., Lengina M.A., Korkmazov A.M., Koroleva A.N., Fastakovskaya K.S., Romanyugo G.D., Bidzhiev A.S.


BACKGROUND: The negative effect of impulse noise and vibration when using small arms on the auditory analyzer in athletes is less investigated and justifies the need for an extended study of volunteers with normal hearing. The study of the initial characteristics of the impulse noise and vibration effects of sports weapons on the auditory analyzer will make it possible to determine the early risk factors for the occurrence of high-frequency hearing loss in shooters by the number of shots from sports weapons and the recovery time of auditory function.

AIMS: To conduct a comparative analysis of the effect of impulse noise and vibration exposure depending on the technical characteristics of small arms on volunteers with normal hearing and, based on the results obtained, unify the methods of forecasting and prevention.

MATERIALS AND METHODS: At the Department of Otorhinolaryngology of the South Ural State Medical University of the Ministry of Health of Russia, 30 fifth-year students were examined following continuous recruitment of volunteers between September 2022 and November 2022. All interviewed participants gave voluntary written consent to participate in the survey and to the test level of impulse noise. Based on the current regulatory documents, all volunteers were surveyed and underwent audiological and vestibulometric studies, the technical characteristics of noise and vibration exposure as a risk factor for the early development of presbycusis were determined, and ways of preventing hearing loss through lifestyle were proposed.

RESULTS: The comparative analysis of the influence of impulse noise and vibration effects showed a dependence on the weight of the small arms cartridge, number of shots, and adaptation time of the auditory analyzer in volunteers with normal hearing considering the changes in the high-frequency spectrum of increasing audiometry thresholds from the average value of indicators.

CONCLUSIONS: The use of active explanatory propaganda among young people on a careful attitude to the physiological state of the cochleovestibular apparatus avoids the risk of early presbycusis development.

Medical Journal of the Russian Federation. 2023;29(2):116-126
pages 116-126 views


Diagnostic and therapeutic aspects of neuregulin-1: A review

Alieva A.M., Teplova N.V., Reznik E.V., Strangul E.I., Baikova I.E., Kotikova I.A., Shikhova Y.A., Khachirova E.A., Valiev R.K., Nikitin I.G.


In recent decades, the prospect of using a biomarker strategy for early personalized diagnosis of cardiovascular pathologies has been actively explored. The use of new markers appears promising, and the search for an “ideal” marker is actively ongoing, which will make it possible to understand various mechanisms of cardiovascular diseases. In recent years, scientists have actively focused on studying the role of neuregulin-1 as a laboratory biological marker in cardiac pathology. Neuregulins belong to a superfamily of epidermal growth factors that are synthesized by the vascular endothelium in response to ischemia, adrenergic stimulation, and oxidative stress.

Several studies have shown the potentially important diagnostic and prognostic value of assessing neuregulin-1 as a biological marker. Thus, further scientific and clinical studies will demonstrate the possibility of using this marker as an additional laboratory tool for diagnosing, risk stratifying, and predicting cardiovascular events in patients with cardiovascular pathology. The therapeutic effect of recombinant neuregulin-1 on reducing morbidity and mortality in patients with cardiac disorders require more detailed assessments.


Medical Journal of the Russian Federation. 2023;29(2):127-140
pages 127-140 views

Factors of oral sanitation and caries resistance of the teeth: A scientific review

Kopetsky I.S., Pobozhieva L.V., Sheveluk Y.V.


This study aimed to analyze social, clinical, and laboratory indicators that contribute to the maintenance of oral sanitation based on current literature.

This article analyzed data from foreign and domestic studies indexed in PubMed, CyberLeninka, MEDLINE, Web of Science, Embase, and Scopus.

Literature data from the last 15 years were used. Epidemiological data have shown that dental caries affects >90% of the adult populations in the Russian Federation and European countries. The most important role in maintaining oral health care is determined by the complex composition of the microbial community. To ensure caries-free oral cavity from childhood, individual oral hygiene, nature of nutrition, and mineralization of tooth enamel must be emphasized. Caries-specific markers can be saliva proteins. Caries resistance is also caused by differences in the composition of the crystal lattice of enamel apatites and is characterized by an increase in the degree of substitution of the PO4 3–group by CO3 2–.

Maintaining oral hygiene and healthy teeth is influenced by a combination of factors such as the microbial composition of saliva, peculiarities of the metabolism in biofilm, genetic factors, structure of the crystal lattice of enamel apatites, nature of nutrition and peculiarities of individual oral hygiene, local use of fluorides, and educational level.

Medical Journal of the Russian Federation. 2023;29(2):141-149
pages 141-149 views

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