2019 Том 3, №2

Keynote speech
Natalya Pavlovna Mitkovskaya
Learn as if you constantly feel a lack of your knowledge, and as if you are constantly afraid to lose your knowledge. Confucius (Kun Tzu).
Requirements for the design of scientific articles
The presented requirements for the publication of scientific articles are based on the “Uniform Requirements for Manuscripts Submitted to Biomedical Journals” of the International Committee of Medical Journal Editors (the official version is available on the website www.ICMJE.org). For consideration, articles may be submitted that have never been previously published and not submitted for publication in other publications. The article can be presented in Belarusian, Russian, and English. Articles with violation of the “Rules and norms of humane treatment of biological research objects” are not accepted for publication.
A rare case of focal mid-ventricular form of Takotsubo syndrome
E.A. Vertinsky, L.Yu. Ushakova, M.V. Novikova
Stress cardiomyopathy, also called Takotsubo syndrome (TTS), broken heart syndrome and stress-induced cardiomyopathy, is characterized by transient regional systolic dysfunction of the left ventricle (LV) in the absence of angiographic evidence of obstructive coronary artery disease or acute plaque rupture as well as by regional wall motion abnormalities that extend beyond a single coronary vascular bed. TTS accounted for 1,7% to 2,2% of cases presenting with suspected acute coronary syndrome (ACS) or ST-elevation infarction in a systematic review. According to the International Takotsubo Registry, of 1750 patients with TTS, 89.8% were women (mean age 66,8 years). Complete recovery of LV systolic function is necessary to confirm the diagnosis of Takotsubo cardiomyopathy and can happen over a period of days to weeks. The typical and most common description of TTS is the apical type (81,7%), evident in the characteristic abnormality of a ballooned left ventricular apex with basal segmental hyperkinesis. However, atypical variants of this syndrome with mid-ventricular (14,6%), basal (2,2%) and focal (1,5%) wall motion patterns are increasingly diagnosed. We present a patient who developed a mid-ventricular dyskinetic TTS pattern.
Allergic purpura in the therapeutical practice
L. N. Romanchuk, V. M. Pyrochkin, Y. I. Karpovich, E. V. Chalaya, A. L. Belyaeva, Y. L. Karpovich, А.А. Shchetko
The article describes the clinical case of the Henoch-Schönlein disease in a patient of 53 years as an example of the relevance of the anamnestic data careful analysis, objective examination of the patient and the differential diagnosis for early detection. Polymorphism of cutaneous manifestations and visceral lesions can cause difficulties in the diagnosis of allergic purpura. Early administration of pathogenetically justified combined treatment leads to stabilization of the inflammatory process, avoidance of possible destruction of the internal organs as well as development of complications and relapses.
Nosocomial pneumonia: modern approaches to diagnosis and treatment
Zh.V. Antanovich
Nosocomial pneumonia (NP) is the second most common nosocomial infection and the main cause of death from nosocomial infections in critically ill patients. Most cases of NP are caused by aerobic gramnegative bacteria (P. aeruginosa, E. coli, K. pneumoniae, Acinetobacter spp.) and gram-positive cocci (S. aureus). From a practical point of view, in order to prescribe adequate initial antibacterial therapy (ABT) it is advisable to stratify patients depending on timing of the NP development and presence of risk factors (RF) for multidrug-resistant (MDR) pathogens. MDR pathogens are more often excreted in patients with severe chronic diseases and RF for the development of NP. Diagnostic criteria and Clinical Pulmonary Infection Score (CPIS) are used to diagnose NP and determine its severity. The outcome of treatment of patient with NP depends on the doctor’s level of knowledge and the most rapid administration of an adequate initial empiric ABT, presented in guidelines, taking into account local data on pathogens prevailing in the department and their resistance.
Chronic coronary syndromes: a review of the recommendations of the ESC-2019
A.S. Rudoy
The review summarizes the key points and main evidence of the updated modern recommendations of the European Society of Cardiology in 2019, which influenced the principles of management and treatment of patients with chronic coronary syndromes. The new concept and recognition of the importance of the multifactorial causes of angina pectoris and myocardial ischemia represents an important evolution in understanding the pathogenesis and treatment of coronary artery disease.
Personalized medicine and its role in type 2 diabetes prevention
V.V. Salukhov, B.V. Romashevskiy
Personalized medicine (PM) is a safe and effective way to prevent and treat type 2 diabetes mellitus (T2DM). The basic strategy of PM is to adapt various prevention and treatment methods to individual characteristics of patients, including their genome sequence, microbiome composition, life, case history and dietary preferences. The article highlights the prospects of personalized methods application for T2DM prevention based on the results of research in the field of genomics, metabolomics, intestinal microbiome technologies, pharmacogenetics and pharmacogenomics. The potential and advantages of mobile applications and technologies for large amounts of data assessment (“Big Data”) in the PM structure are demonstrated. The findings on the role of pharmacogenetics and pharmacogenomics in the selection of effective and safe drugs for T2DM treatment are presented. In conclusion, it was noted, that it would be feasible to conduct population –based studies confirming the effectiveness, profitability and advantages of PM compared to traditional T2DM prevention and treatment methods.
Association of HIF-1α genetic polymorphism with the risk of obstructive sleep apnea-hypopnea syndrome in atrial fibrillation patients with ischemic heart disease and/or arterial hypertension
T.I. Balabanovich, V.I. Shishko, T.L. Stepuro, V.R. Shulika
Aim: to explore the relationship between hypoxia inducible factor-1α (HIF-1α) (С1772T) gene polymorphism and the risk of obstructive sleep apnea-hypopnea syndrome (OSAHS) in atrial fibrillation (AF) patients with ischemic heart disease and/or arterial hypertension.
Wrapping of the dilated ascending aorta in patients with aortic valve pathology
D.А. Bozhko, Y.М. Chesnov, S.V. Spiridonov, S.А. Kurganovich
The method for ascending aorta wrapping developed at the “Cardiology” Republican Scientific and Practical Centre, Belarus, has been used in the treatment of 93 patients. The analysis of early and long-term treatment results was performed. A short time of ischemia and cardiopulmonary bypass, a low level of postoperative complications, including repeated operations for bleeding (3.23%) were noted. According to echocardiography data, a significant decrease in the average diameter of the ascending aorta, from 45.33 ± 3.12 mm to 36.26 ± 4.09 mm, was marked. In the long-term follow-up period no significant changes in the size of the ascending aorta at all levels were observed; rapid aorta dilatation, aneurysm formation, dissection, aorta rupture, and such complications as uterus erosion, dislocation of the wrap and aortic kinking were also not revealed.
Specific features of lipid metabolism in children with cardiac risk factors
O.N. Volkova, V.D. Yushko, N.N. Bylinskiy, V.V. Strogiy
The article presents the data on the role of lipid metabolism disorders, including fatty acid metabolism disorders, among children with cardiac risk factors: arterial hypertension, obesity and aggravated atheroselrosis heredity.
The role of endothelial dysfunction and oxidative stress in the formation of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease
N.Yu. Grigoryeva, M.V. Mayorova, M.O. Samoluk, T.P. Ilyushina
The purpose of this study was to evaluate oxidative stress and endothelial dysfunction in patients with chronic obstructive pulmonary disease (COPD) who had concomitant cardiovascular pathology.
The level of homocysteine and polymorphisms of genes of folate exchange in patients with coronary heart disease and diabetes mellitus type 2
E.V. Davydchyk, V.A. Snezhitskiy, T.L. Stepuro, E.M. Doroshenko, V.Yu. Smirnov
The aim of the study is to investigate the level of homocysteine (Hcy), distribution of frequencies of alleles and genotypes of polymorphic options С677Т, А1298С of gene MTHFR, A66G of gene MTRR, А2756G of gene MTR in patients with chronic coronary heart disease (CHD) in combination with diabetes mellitus (DM) type 2.
Adipose tissue metabolic activity in chronic obstructive pulmonary disease patients in case of chronic nonspecific inflammation
D.V. Lapitski, A.N. Ryapolov, V.A. Pupkevich, T.V. Chirikova, I.B. Butyanovskaya, R.F. Ermolkevch, A.A. Arabey, A.V. Goncharik, G.A. Ibragimova, N.P. Mitkovskaya
The article addresses the dynamics of adipose tissue hormones leptin (LN) and adiponectin (AN) depending on nonspecific inflammation (NI) degree, as well as relations between adipokin and glucose/lipids metabolic disorders, adipose tissue capacity with different NI degrees in patients with chronic obstructive pulmonary disease (COPD). NI is associated with a high AN degree and a low LN degree which promotes the increase in metabolic substrata intake for immunity caloric supply. NI decrease is associated with a low AN degree and a highLN degree which promotes increase in adipose tissue capacity and worsening of glucose/lipids metabolic disorders. Nebivolol administration is associated with increase in AN level. Statins administration results in decrease in AN level and increase in LN level, due to reduced NI. Thus, treatment strategy in COPD patients should include some measures to prevent adipose tissue capacity increase and glucose/lipids metabolic disorders when NI is reduced.
Evaluation of health-related quality of life in patients with avascular necrosis
N.А. Martusevich, К.V. Gudkevich
Aim: to evaluate Health-Related Quality of Life (HRQL) in patients with avascular necrosis (AN) and to identify the most significant risk factors, which lead to low HRQL in patients with AN.
Results of factor analysis of laboratory resistance markers to acetylsalicylic acid in patients with stable angina
T.P. Pronko, V.A. Snezhitskiy, V.R. Shulika
The aim of the study was to assess the markers influencing the development of acetylsalicylic acid (ASA) laboratory resistance in patients with stable angina.
Non-sjögren syndrome dry eye in general medical practice: causes, outcomes, treatment tactics
G.R. Semak, V.A. Zaharava, S.K. Kletsky, T.A. Liatkovskaya, I.Yu. Zherko
Recently, non-Sjogren’s eye disease (DED) has become increasingly frequent in the therapeutic practice. In the Republic of Belarus, about 17–25% of the population over 40 years old suffer from corneal conjunctival xerosis of various severity. DED can develop both as an outcome of eye diseases and on the background of somatic pathology (diabetes mellitus, systemic atherosclerosis, menopausal syndrome, arterial hypertension, thyroid disease and metabolic syndrome) and is often associated with the systemic and topical use of medications (β-blockers, diuretics, analgesics, antidepressants, etc.). With the progression of corneal dystrophy and albugo formation, various types of donor cornea keratoplasty are used. In the best clinics, a 5-year transplant survival associated with the tear film deficiency is less than 50%.
Prevention of cardiovascular complications in the long-term period of initial percutaneous coronary intervention
N.L. Tsapaeva, S.F. Zolotuhina, E.V. Mironova, N.V. Tarashkevich, N.I. Egorova
The aim of present study investigate the clinical, instrumental and biochemical markers of the risk of cardiovascular complicated in long-term of initial percutaneous coronary intervention.
Radical correction of Fallot’s tetralogy in children after right ventricle outflow stenting
P.F. Charnahlaz, Y.I. Linnik, A.V. Bashkevich, E.V. Korolkova, A.I. Savchuk, N.S. Shevchenko, K.V. Drozdovski
The aim is to compare the results of radical correction of Fallot’s tetralogy in children after endovascular stenting of the outflow tract of the right ventricle and Blalock-Taussig shunt.
New technique for surgical left atrial appendage closure during mitral valve surgery
A.Р. Shket, E.Е. Stepanova, M.V. Zimina, T.V. Hlybouskaya, A.A. Komarovsky, O.I. Kozlov, S.I. Kozlov, Y.V. Vasilevich, V.A. Tokunov, D.I. Krachak, O.V. Lubimova, V.D. Krachak
The aim of work is to demonstrate the new surgical approach of left appendage closure from inside the left atrium during open heart surgery on mitral valve and early results of this method.
Possibilities of the volume sphygmography method in identification of atherosclerotic arterial damage markers in elderly and senile people
E.А. Siamushina, L.A. Zhilevich, L.M. Sychik
The article describes the potential of the method of volume sphygmography (VS) using the VaSera VS-1500N apparatus (Fukuda Denshi, Japan) in identifying a combination of markers of atherosclerotic arterial lesions in centenarians. For this purpose, we conducted a survey of 36 centenarians at the Republican Clinical Hospital for Disabled Veterans of the Great Patriotic war named after P. M. Masherov.
Psychometric analysis of the questionnaire «the quantification inventory for somatoform syndromes» (QUISS)
Т.Е. Tomashchyk
Somatoform disorders represent a group of psychiatric disorders manifested primarily in physical symptoms, which are clinically unexplained. Diagnosis of somatoform disorders requires taking into account not only the somatic symptoms and their severity, but also additional emotional, cognitive, behavioral and psychosocial aspects. The questionnaire “The quantification inventory for somatoform syndromes” (QUISS) meets the above-mentioned requirements. The questionnaire exists in the English version and requires standardization for the Belarusian population of patients, as well as compliance with current psychometrics.
Structural features of the valvular apparatus of the human heart in early embryogenesis
A.R. Rombalskaya
The article presents the data on the structural features of the development of atrioventricular valves (tendon chords, papillary muscles) in early embryogenesis and shows the development of fleshy trabeculae as structures from which papillary muscles are formed. The stages of development of these structures are described. It has been found that fleshy trabeculae in the form of a reticular plexus are the first to be visualized the first in the ventricles of the heart of embryos of 6 mm parietal-coccygeal length (TCD), and some of them, protruding into the ventricular cavity, form papillary muscles. As the size of the human embryo heart increases, the leaflets of atrioventricular valves and papillary muscles move away from each other and strands with a muscular component appear between them – future tendon chords (in embryos 18–19 mm TCD). Gradually, the muscle tissue in the tendon chords and atrioventricular valves is replaced by connective tissue and intraventricular formations approach the definitive structure (in embryos 65–70 TCD).
History of telemedicine in the Russian Federation
P.N. Shepel, A.V. Kutcher, T.V. Vakhovskaya, O.M. Drapkina
In the article the authors conducted a retrospective analysis of the periodization of the history of telemedicine in the Russian Federation by evaluating the data presented in scientific publications, Internet publications and monographs. In the process of writing the article the information resources of the library were used cyberleninka.ru. Тhe analysis of the existing normative-legal acts of the Russian Federation, defining the concept of “telemedicine”, the development of telemedicine in the Russian health care at the present stage and the concept of telemedicine technologies. Generalization and systematization of the revealed facts in the history of telemedicine allowed to determine the degree of development of telemedicine technologies in health care, both in Russia and abroad.