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Actual Problems of Theoretical and Clinical Medicine

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No 4 (2022)
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ORIGINAL ARTICLES

12-16 783
Abstract

   The creation and publication of an article in a peer-reviewed foreign scientific journal is one of the leading indicators of effective scientific activity of both an individual employee and the organization as a whole (educational or scientific). The publishing process requires a certain amount of effort. You can minimize such efforts by following professional advice when compiling (creating) your intellectual written product. Following the recommendations given in the article and avoiding common mistakes, you can simplify the publishing process.

   The purpose of this article is to tell about the methodology of writing a scientific article in foreign publications and to help avoid common mistakes.

17-25 1144
Abstract

   This article analyzes the neurophysiological mechanisms of the occurrence and occurrence of stress and depression, their influence on the physiological state of the body, examines the studied and effective methods of dealing with stress and depression, which can be used in practice by both psychotherapists and the person. Stressful situations occur in the life of each of us. In order to minimize the negative of them, change your life for the better, change the way of thinking and world perception, you need to change your brain.

25-34 245
Abstract

   In patients with coronary artery disease (CAD), renal failure which can result in hemodialysis use is seen during the percutaneous coronary intervention (PCI) performed with contrast agents with iodide. This injury is more particularly in patients with diabetes with lower estimated glomerular filtration rate (eGFR) compared to the patients who have not diabetes.
   Aims: The aim of this study is to investigate the alterations in the renal glomerular filtration rate after the implantation of the drug-eluting stents (DESs) in the patients with Type-2 insülin-treated diabetes mellitus (ITDM) and CAD.

   Study Design: Prospective study.
   Methods: In total, 463 patients with ITDM in which one or more drug-elution stents under PCI were inserted successively for last 5 years (last uptated to December 2015) were included into the study. Patients in both groups were followed with eGFR with laboratory tests and with other cardiologic parameters by the Departments of Cardiology and by the Department of Internal Medicine for 24 months with 3-month periods.
   Results: The patients being included into the study were separated into two groups according to the eGFR as Group 1 including 351 patients (75,8 %) with eGFR > 90 ml/min/1,73m2 and Group 2 including 112 patients (24,2 %) with eGFR between 60 and 89 ml/min/1,73m2. Patients in both groups were followed for 24 months with 3-month periods. At the end of the study, no statistically significant change was found in both groups in eGFRs. But, a tendency to decrease in the eGFR(s) in Group 2 was found. Furthermore, when three-month eGFR measurements were compared with the first eGFR before PCI, no significant difference was found.

   Besides, the frequency of contrast agent-induced nephropathy (CIN) was seen more common in significant level in Group 2 when compared to Group 1 (p < 0.01). In the 24-month cardiologic follow-up, the incidence of restenosis and revascularization, the incidence of major cardiac complications and the relative risk of death were seen more commonly significantly in Group 2 compared to Group 1 (p < 0.01).

35-41 274
Abstract

   Background: Coronary artery ectasia (CAE) is the diffuse or localized enlargement of the epicardial coronary arteries without any particular symptoms. Cell-free DNA (cfDNA) is defined as the DNA originating from nucleated cells which circulates freely in circulatory system. In our study, we aimed to measure the cfDNA levels, an indicator of ischemia at cellular level, which is shown to be elevated in non-invasive exercise tests and perfusion scintigraphies.
   Methods: 41 patients with isolated CAE and 39 patients with normal coronary angiograms (NCA) were included in the study. Coronary angiography was performed in case of typical angina or a positive exercise test. The amount of cfDNA was determined by centrifugation of peripheral blood samples from both groups.
   Results: Plasma cfDNA levels were 5.86 ± 4.41 ng/µl in isolated CAE patients and 2.36 ± 1.32 ng/µl in NCA group (p=0.000). When angiographic types were evaluated based on Markis Classification, cfDNA levels were found as follows: type I (n=7) 10.15±5.25, type II (n=5) 6.42±3.91, type III (n=4) 5.15±3.74 and type IV (n=25) 4.66±3.78. The level of cfDNA was found significantly higher in type I CAE group when compared to other groups based on the Markis Classification (p=0.028).
   Conclusion: High levels of cfDNA in patients with CAE suggest that impaired myocardial perfusion and the resulting ischemia cause myocardial cell lysis or rapid apoptosis that leads to earlier programmed cell death. High levels in cfDNA in these patients might be used as a marker of increased cardiovascular risk.

42-45 235
Abstract

   In Kazakhstan, male infertility accounts for 30 % to 45 % of cases. The pathogenesis of fertility decline in patients with varicocele is based on thermal exposure, which is often accompanied by oligozoospermia and asthenozoospermia. One of the most frequently used methods of treatment in the postoperative period in patients with impaired fertility and varicocele, antiestrogens are used, since they enter into the feedback of sex steroids at the level of the hypothalamus and pituitary gland, increasing the production of endogenous gonadotropin-releasing hormone by the hypothalamus and, respectively, LH and FSH by the pituitary gland.

45-50 228
Abstract

   The article presents the results of the use of electroactivated sodium chloride solutions in the treatment of inflammatory diseases of the urethra, as well as after reconstructive plastic surgery on the urethra in men, an assessment of the effectiveness of the use of therapeutic electroactivated aqueous solutions of sodium chloride "anolyte" and "catholyte" is given. Clinical observations have shown the special effectiveness of the consistent use of therapeutic solutions, contributing to the rapid sanitation of the urethra due to their antiseptic, biostimulating, regenerative effect. A necessary condition for persistence is certain biological properties of the microorganism and the defectiveness of the host's protection, which causes bacterial carrier (persistence of pathogens) and chronization of the inflammatory process (frequent relapses of the disease). By reducing virulence or isolating themselves in foci of local immunodeficiency, bacteria can evade human protection factors. The suppression of host defense factors is due to an increase in the virulent properties of bacteria or as a result of dissemination in an immunocompromised organism. The high adaptability of microorganisms to constantly changing conditions of existence is especially evident in antibiotic therapy – whole classes of antibiotics are devalued due to the selection of resistant strains of microorganisms.

51-55 240
Abstract

   The use of innovative methods, digital technologies in the educational process for the purpose of high-quality training of future doctors are relevant. The article presents comparative methods of teaching dental students and proves the effectiveness of their teaching using active methods. There is a growing interest in learning, obtaining practical skills, the formation of logical and clinical thinking, professional adaptation to digital technology and the creative approach to obtaining professional skills.

56-62 351
Abstract

   Infant mortality is the mortality of children in the first year of life. Reducing the mortality of the child population is an important State task.
   Objective: to analyze infant mortality rates, to assess the dynamics of the main trends for the development of medical and organizational measures aimed at reducing mortality.
   Methods. Statistical method of research. Official statistics.
   Results. The infant mortality rate was 8.3 per 1,000 live births. The indicator by region varied from 6.1 to 12.3. In the structure of the causes of infant mortality, the leading place is occupied by conditions of the perinatal period, congenital malformations and controlled diseases. The main problematic issues and solutions are identified.
   Conclusions. The infant mortality rate in the Republic of Kazakhstan has a steady downward trend. In order to further reduce the infant mortality rate and preserve every life, constant monitoring of indicators is necessary, taking into account the structure of infant losses.

62-67 261
Abstract

   Orthokeratology is a method of correcting refractive errors, based on the night wearing of special gas-permeable reverse geometry contact lenses that temporarily change the shape of the cornea. The influence of OK-therapy on the progression of myopia deserves a detailed study. Within 3-4 weeks, diagnostics and selection of orthokeratological lenses were carried out in 18 children (36 eyes) aged 8 to 14 years with progressive myopia. There were 7 girls (38.9 %), boys - 11 (61.1 %). The control group consisted of 22 children with myopia aged 8 to 14 years who underwent contact and spectacle correction. As a result of a comprehensive ophthalmological examination, it was found that the use of refractive therapy leads to a decrease in the spherical and cylindrical component of the refractive error when used for 3-4 weeks. In the future, it is planned to continue monitoring in a longer period (1 and 2 years) from the start of refractive therapy. The obtained results of the work carried out allow us to recommend the use of OK lenses in the practice of ophthalmologists for the optical correction of mild and moderate myopia in children and adolescents.

CLINICAL CASE

67-71 262
Abstract

   Chronic heart failure (CHF) is one of the most common, rapidly progressive diseases of the cardiovascular system with the most unfavorable prognosis in many countries. In the world, approximately 2 % of the adult population suffer from heart failure; in most cases, these are people over 70 years old and approximately half of them have a left ventricular ejection fraction (LVEF) of less than 50% [1; 2]. According to the results of large epidemiological and randomized studies, one-year mortality in this population remains high, reaching 60% among patients with functional classes III-IV (FC). According to various data, from 1 to 4% of cases of emergency hospitalization among adults occur due to heart failure and, undoubtedly, in each case, an underestimation of the condition is possible due to difficulties in diagnosis [3; 4]. Dilated cardiomyopathy (DCMP) is one of the diseases that leads to severe forms of heart failure; it can be asymptomatic for a long time, despite the presence of objective (echocardiographic) signs of ventricular dilation and impaired function [9]. Most often, the first clinical manifestations of the disease are associated with cardiac decompensation, stagnation of blood in the small and then in the large circulatory circles and a decrease in cardiac output [10; 11]. This report describes a clinical case of declatational cardiomyopathy in a 39-year-old young patient. Observation of repeated recurrences of circulatory insufficiency, complexity of diagnostic search.

71-74 236
Abstract

   The article describes a clinical case of detection of bladder and cervical cancer during pregnancy, with a rapidly progressive course and local lesion of several body systems. Despite the availability of various diagnostic methods (computed tomography, overview excretory urography, ultrasound-controlled punctures, MRI), recognition of this pathology is very difficult due to the absence of pathognomonic signs. Further measures to improve diagnostics, apparently, should have an in-depth nature of oncological alertness.

75-79 341
Abstract

   This article will present a clinical case of a patient with hereditary spinocerebellar ataxia type 2 (SCA-type 2). Spinocerebellar ataxia is a group of hereditary progressive cerebellar ataxias, numbering over 40 subspecies, manifested in the form of cerebellar, oculomotor and speech disorders.

80-83 280
Abstract

   Retroperitoneal sarcoma (RPS) is a heterogeneous group of malignant tumors with an incidence of approximately 1 case per 100,000 population per year, which includes leiomyosarcoma. Leiomyosarcoma is a malignant neoplasm with smooth muscles differentiation. It is the second most common sarcoma affecting the retroperitoneal space. In this article, we describe a case of fatal hematoma of the retroperitoneal space, caused by spontaneous rupture of leiomyosarcoma. A 65-year-old woman presented with severe pain in her left side and hypovolemic shock. After an additional examination of hemodynamic stabilization, she was operated on an emergency basis. The tumor was removed and the bleeding was stopped. The patient was transferred to the intensive care unit (ICU) after surgery, despite the ongoing intensive therapy, the condition remained extremely serious, against which the deterioration result from cardiac arrest and death is occurred. In the world literature, spontaneous rupture of retroperitoneal leiomyosarcoma is described in isolated cases. Moreover, the main publications are aimed at managing patients with tumors of the retroperitoneal space only in a planned manner. Thus, this case could be of clinical interest among emergency medical practitioners as well as in the scientific community. Literature search for a review of the problem was carried out in the following scientific databases and search engines: PubMed, Web of Science, Scopus, Google Scholar, eLIBRARY.

REVEWS

84-88 357
Abstract

   One of the main problems in the field of demography is the process of population aging. In Kazakhstan, this issue is still new and requires reflection in state documents and legal acts. The aging process can be prevented and slowed down naturally. To this end, it is necessary to pay special attention to the technology of geriatric care in the Republic of Kazakhstan, the CIS countries and the allocation of a separate doctor - gerontologist for the elderly. In many CIS countries, the issue of population aging requires attention, while in other "young" countries, time helps to solve this problem in a timely manner. The solution to the issue of population aging was proposed by the UN and a number of other international organizations. In this regard, many countries are taking actions aimed at introducing or improving the system of long-term assistance.

88-91 313
Abstract

   The results of the analysis, the study of clinical and morphological features in resistant hypertension. Hypotheses of clinical and morphological features of resistant hypertension are described. The problems of arterial hypertension (AH) are determined by its high frequency in the population, its impact on the health, working capacity and life expectancy of the population. The prevalence of hypertension is 15-30 %, and in people over 65 it exceeds 60 % [URL: https://moluch.ru/archive/236/54737/]. The presence of elevated blood pressure (BP), especially systolic, is associated with an increased risk of coronary heart disease, strokes, heart and kidney failure, that is, complications. In patients with hypertension, an increase in total mortality was revealed by 2-5 times, and mortality from cardiovascular diseases by 2-3 times [URL: https://moluch.ru/archive/236/54737/ ]. Therefore, the development of tactics for the diagnosis and prevention of complications of hypertension is one of the important problems of modern cardiology. A large number of antihypertensive drugs of various groups creates certain difficulties in choosing the optimal medication for blood pressure correction and prevention of complications. According to the literature and recent studies, a high incidence of hypertension has been found in individuals with complications of target organs [URL: https://moluch.ru/archive/236/54737/ ]. Thanks to the doctor's attentiveness and the method of specific and sensitive diagnostics, we can prevent complications during hypertension. With age, this pathology becomes resistant to standard therapy, and this threatens to undesirable consequences in the introduction of the patient, which can lead to complications, disability, and also fatal outcomes for patients are not excluded.



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ISSN 2790-1289 (Print)
ISSN 2790-1297 (Online)