2020 Том 4, №1
 



Requirements for the design of scientific articles
The requirements for submitting scientific articles are based on the "Unified 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).
Adult-onset Still’s disease in pregnancy complicated by macrophage activation syndrome
N.I. Artishevskaia, T.G. Rayeuneva, S.E. Aliakseitshik, E.A. Mikhnevich, A.M. Malyuta
Adult-onset Still’s disease is a rare polygenicautoinflammatory disease characterized by the classic triad of persistent high spiking fevers, joint pain (arthritis), and a distinctive salmon-colored bumpy rash. In the past decade, some pathophysiological mechanisms of the disease have been clarified and some sensitive and specific diagnostic criteria have been suggested. The disease is considered a diagnosis of exclusion. The course of the disease can be either relatively favorable or severe and disabling. Treatment is based on the use of glucocorticoids, immunosuppressive therapy and monoclonal antibodies. In the early 21 st century, descriptions of isolated cases and small series of adult-onset Still’s disease in pregnancy appeared in literature.
Inherited coagulation disorders in newborns in the early neonatal period
T. N. Voitovitch, O.A. Platonova, E.N. Alferovich, I.N. Evstigneev, E.A. Sarzhevskaya, V.V. Dmitriev
The article presents a rare case of a hereditary coagulation disorder (factor VIII deficiency). Тhe reported rare case of hemophilia A manifestation in a child in the early neonatal period emphasizes the need for an accurate collection of a family history of bleeding, as well as an assessment of specific clinical and laboratory data and a differential diagnosis with other disorders of the blood coagulation system. The clinical manifestations of hemorrhagic syndrome were not specific; they allowed us to determine the direction of the laboratory search for violations of primary and secondary hemostasis. Clarification of the diagnosis and the choice of gemostatic therapy were performed after a laboratory study of blood coagulation. The presented studies reflect the most typical errors at the stages of diagnosis and correction of blood coagulation disorders, which will improve the quality of medical care for newborns in the future.
Giant left ventricular aneurysm: sonographer’s view
N.V. Zatoloka, A.A. Popova, E.G. Komarovskaya
Aneurysm of the left ventricle is a well-defined area of a thin scar deprived of the muscle layer that develops after myocardial infarction with systolic akinesia or dyskinesia, which impairs its normal geometry and contractility and, as a result, reduces the ejection fraction. There are two strategies for treating left ventricular aneurysm, i.e. medication and surgery. Surgical treatment is absolutely indicated for patients with dyskinetic (akinetic) aneurysms with an increase in the endsystolic index > 80 ml/m 2 and in the end-diastolic index > 120 ml/m 2 , as well as with the threat of rupture or the development of a false aneurysm. A clinical case of a 72-year-old patient is presented. After myocardial infarction there developed a giant aneurysm of the left ventricle filled with a large thrombus. Due to the ineffectiveness of conservative treatment and the impossibility of surgical remodeling of the left ventricle using standard methods, the patient will have to undergo an orthotopic heart transplantation. This case is of interest due to the rare occurrence of such a clinical scenario of this pathology.
Elimination of post-puncture arteriovenous femoral fistula
N.A. Rogovoy, V.A. Yanushko, I.P. Klimchuk, V.V. Komisarau, Y.A. Melnichuk
This article presents clinical cases of successful surgical treatment of arteriovenous fistula is formed after angiographic examination by transfemoral access. This pathology is quite rare and was identified as a random finding when we were examining patients with complaints of intermittent claudication and an angiographic exemiation in history. Treatment approaches of these patients are not completely clear. As a result, there are no generally accepted recommendations. The optimal treatment methods for these patients search for many reseachers. Surgical treatment of patients gave a positive clinical result. It is consistent with most literature data showing the advantage of surgical treatment.
Double lung transplantation for primary pulmonary arterial hypertension under extracorporeal membrane oxygenation support
Sh.Z. Sharipov, E.V. Kotov, V.A. Shilo, E.A. Vilkotski, M.Ju. Gurova, V.V. Erohov, M.V. Kachuk, A.V. Sherbo, D.V. Korchemkin, A.M. Dziadzko, O.O. Rummo, N. P. Mitkovskaya, S.V. Golovinskiy
The surgical procedure of choice for treatment of patients with end stage of primary pulmonary arterial hypertension is double lung transplantation. Adequate systemic hemodynamics and gas exchange during the perioperative period of lung transplantation for such patients can be effectively and safely provided by venoarterial extracorporeal membrane oxygenation. The article presents a case report of successful lung transplantation under veno-arterial extracorporeal membrane oxygenation (central cannulation) to 22-year old patient with idiopathic pulmonary arterial hypertension complicated by right-ventricular heart failure with cardiomegalia due to expansion of the right chambers and congestive hepatopathy. This clinical case is the first one in the practice of Belarusian transplantology.
COVID-19 coronavirus infection (overview of international research data)
N.P. Mitkovskaya, I.A. Karpov, G.P. Arutyunov, Ye.A. Grigorenko, D.Yu. Ruzanov, T.V. Statkevich, Е.I. Tarlovskaya
COVID-19 coronavirus infection is a previously unknown acute respiratory viral infection caused by the zooanthroponous RNA-containing SARS-CoV-2 virus, first reported and described in December 2019 in the Chinese city of Wuhan. On 30 January 2020, WHO declared an international emergency and upgraded the risk assessment for COVID-19 at the global level from high to very high. The epidemic was recognized as a pandemic, in which the simultaneous infection of many people with the virus in a number of countries led to overloaded healthcare systems, an avalanche of hospitalizations and deaths.
The causative agents of viral myocarditis
T.V. Amvrosieva, N.P. Mitkovskaya, Z.F. Bohush, A.S. Arinovich, E.M. Balysh
The article describes the algorithm of virological examination of patients with clinically suspected viral myocarditis and presents the results of its use in a group of 49 patients with respect to 12 causative agents of viral infections - cytomegalovirus, Epstein-Barr virus, varicella-zoster virus, human herpes virus type 6, herpes viruses types 1 and 2, enteroviruses, parvovirus B 19, hepatitis C virus, influenza A and B viruses, rhinoviruses and adenoviruses. The presence of serological markers of viral infections (antiviral IgM) was detected in 42.1% of patients, the genetic material of pathogens (RNA / DNA) in the blood serum in 16.0% of patients, in heart tissues – in 75.0%. Among the viral pathogens revealed in the biological material, adenoviruses, parvovirus B 19, and human herpes virus type 6 dominated. According to serodiagnosis IgM to enteroviruses was most often detected in blood serum.
Comorbid status of patients with chronic obstructive pulmonary disease
N.Yu. Grigoryeva, M.E. Korolyova, E.M. Yashina
Aim: to study the frequency of occurrence of comorbid pathology in hospitalized patients with chronic obstructive pulmonary disease (COPD). Material and methods. We conducted a retrospective analysis of 688 “inpatient medical records” of patients undergoing treatment from September 2016 to February 2017 in City Hospital No.5 of Nizhny Novgorod, of which 142 (20.6%) patients were diagnosed with COPD. As the main disease, COPD was found in 79.6% of cases, and as a concomitant disease in 20.4% of cases. Of 142 cases, the majority of patients were men – 58.5% (83 patients), whose mean age was 67.8±12.4 years and who had a long history of smoking. 41.5% (59 patients) were women, whose mean age was 73.9±11.8 years.
Pain syndrome in the postoperative period after elimination of oropharyngeal obstruction in patients with obstructive sleep apnea syndrome
Ya.E. Yaromenka, V.A. Кarnialiuk, L.E. Makaryna-Kibak, K.S. Tsishkevich
One of the components characterizing the course of the postoperative period is pain. The article analyzes the severity of pain in the postoperative period in patients with uncomplicated snoring and obstructive sleep apnea of varying severity after the surgical treatment of upper respiratory tract obstruction at the oropharyngeal level. Significant differences were found in the severity of pain in patients with uncomplicated snoring and severe obstructive sleep apnea on the 3rd, 7th, 10th and 14th days of the postoperative period. It was found that in patients with obstructive sleep apnea of moderate to severe degree, the severity of pain and dysphagia in the postoperative period and the duration of pain medication use is the greatest (p < 0.05).
Differential diagnosis of arterial hypertension syndrome in young men
A.N. Zayats, V.I. Shyshko
Aim: Development of a model for the early diagnosis of arterial hypertension (AH) in men aged 18-29 years based on risk factors and structural and functional parameters of the circulatory system.
Prediction of the development of renal dysfunction in patients with chronic heart failure
U.K. Kamilova, Z.D. Rasulova, N.A. Nuritdinov, D.R. Tagaeva
Aim. To identify prognostic factors for the development of renal dysfunction (RD) and to develop a method for assessing and predicting RD in patients with chronic heart failure (CHF). Methods. Totally, 101 patients with I-III functional class (FC) CHF were examined (according to the classification of the New York Heart Association). Additionally, the patients were distributed depending on the glomerular filtration rate determined by the calculation method according to the formula CKD-EPI (eGFR) into two groups: patients with eGFR ≥ 90 ml/min (n = 20), with eGFR < 90 ml/min (n = 81). In all patients there were determined: creatinine (Cr), eGFR according to the formula SKD-EPI, albumin/creatinine (Al/Cr) (mg/mmol) in morning urine, specific gravity in the morning urine (SG). We also studied renal blood flow according to Doppler ultrasonography readings at the level of the common left and right renal arteries.


Effectiveness and safety of coronary arteries chronic total occlusions recanalization by retrograde approach
V.I. Stelmashok, O.L. Polonetsky, N.P. Strygo, M.G. Tsybulski, O.V. Zotova
Aim. To study effectiveness and safety of coronary arteries chronic total occlusions (CTO) recanalization by retrograde approach.
Correlation of left ventricular hypertrophy with impaired filtration and tubulointerstitial kidney function in patients with hypertension
A.I. Chernyavina, N.A. Koziolova
Aim: to identify the correlation of left ventricular hypertrophy (LVH) with the development of early renal dysfunction in patients with uncomplicated HT without CKD.
Clinical and epidemiological profile of outpatient venous thromboembolic complications
V.Ya. Khryshchanovich, S.S. Kalinin, I.P. Klimchuk, N.A. Rogovoy
To determine the demographic and clinical structure of venous thromboembolic (VTE) complications in the population of a large industrial center.
The pathogenesis of cell aging: gene polymorphism and renin-angiotensin-aldosterone system activity
O.S. Pavlova, I.Yu. Korobko, M.M. Liventseva, O.A. Barbuk, I.I. Russkikh, M.G. Kaliadka, A.M. Gorkavaya, S.E. Ogurtsova
The aim of the study was to determine the correlation of genetic polymorphism and renin-angiotensin-aldosterone system (RAAS) components with the relative leukocyte telomere length (TL) in individuals with normal or optimal blood pressure.
Cholin and its metabolite feasibilities in hyperhomocysteinemia correction and cardiovascular pathology decrease
O.V. Panasiuk, E.V. Mogilevets, А.V. Naumov
Homocysteine is a cyto- and neurotoxic amino acid. The raise of its level in blood plasma is called hyperhomocysteinemia. This pathological state leads to the development and progressive course of cardiovascular diseases. Homocysteine utilization involves its transulfurization to cysteine or remethylation to methionine. Choline and its metabolite (betaine) increased intake leads to enhanced processes of remethylation and decreased homocysteine level in blood plasma. Thus, choline and betaine may be considered as substances capable of influencing hyperhomo-cysteinemia and lowering the level of cardiovascular disease development.
Risk assessment and venous thromboembolism prophylaxis strategy in neurosurgical patients
L.N. Gavrilenko, I.S. Romanova, I.N. Kozhanova, O.G. Sadovskaya, A.E. Baranovsky
Venous thromboembolism (VTE) causes 25,000 in-hospital deaths every year in the United Kingdom. Approximately one-third of the total of 150,000 to 200,000 of VTE-related deaths per year in the United States occur following surgery. The VTE risk varies widely in neurosurgical patients depending on the type of intervention, the patient’s condition, comorbidity, and methods of thromboprophylaxis used. Neurosurgical patients’ characteristics (high prevalence of hypovolemia and hemoconcentration, paralysis and paresis, the use of high doses of glucocorticoids, the long duration of surgical interventions), high bleeding risk associated with pharmacological prophylaxis, and relatively few high-quality studies require development of a uniform decision-making approach regarding thromboprophylaxis in neurosurgery. This article presents a VTE prophylaxis strategy in neurosurgical patients developed on the basis of the latest international guidelines.
Modern opportunities for diagnosis and treatment of systemic vasculitis with kidney involvement in children: review of literature (part 1)
I.A. Kazyra, A.V. Sukalo
The article presents current literature data on the problem of systemic vasculitis (SV) with kidney involvement in children. SV is rare in childhood, but is characterized by a severe progressive course, ultimately leading to early disability. This is a group of diseases with a wide range of clinical manifestations, the most important pathomorphological sign of which is inflammation of the blood vessel wall with the development of thrombosis, necrosis, and sclerotic lesions.
Sepsis in children: clinical and laboratory diagnosis
E.N. Serhiyenka, O.N. Romanova
Diagnosis of sepsis in intensive care requires an interdisciplinary approach. There is no doubt that the clinical picture is also important when making a diagnosis. However, signs such as fever, tachypnea, tachycardia, etc. are not specific. This is why the use of integrated diagnostic and prognostic scales and monitoring of metabolism, hemodynamics, microcirculation, and specific biomarkers are more important for practitioners.