¹ Aesthetic Medicine Center of Dr. Shumskaya, Moscow, Russia
² Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH), Moscow, Russia

Summary

The article considers the classification of cutaneous vasculitis, the main clinical manifestations, differential diagnostics and treatment principles.

Key words: angiitis, dermal vasculitis, viral and bacterial infections, classification, clinical forms.

For citation: Maksimovich V.O., Masyukova S.A., Lamotkin I.A., Ilyina I.V., Gladko O.V. Skin-limited vasculitis. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 10-15. – DOI 10.36107/2782-1714_2023-3-1-10-15.

Literature

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Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH), Moscow, Russia

Summary

Demodicosis is a parasitic skin disease caused by mites of the genus Demodex, the most common conditionally pathogenic parasite in the human skin microbiocenosis. An increase in their number aggravates the course of dermatoses of facial localization, which indicates the expediency of determining the degree of tick-borne invasion and the need to use antiparasitic drugs. In clinical practice, for the treatment of demodicosis, not only antiparasitic drugs (benzylbenzoate, permethrin, ivermectine), but also drugs with a different mechanism of action (metronidazole, ornidazole, ketoconazole, isotretinoin) are used. The results of comparing their effectiveness are contradictory. An analysis of the literature data allows us to identify several reasons that confirm this and justify the need for a personalized rational approach to the choice of tactics for the treatment of demodicosis.

Key words: demodicosis, treatment, efficiency, expert opinion.

For citation: Sokolova T.V., Golitsyna M.V., Malyarchuk A.P., Ilyina I.V. Treatment of demodicosis: traditions and reality. // Bulletin of the Medical Institute of Continuous Education. – 2023. – V. 3. – No 1. – P. 16-23. – DOI 10.36107/2782-1714_2023-3-1-16-23.

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Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH), Moscow, Russia

Summary

The majority of patients with hereditary connective tissue diseases have cutaneous signs, joint hypermobility and sometimes pathology of other organs and systems. The review of the major symptoms of this syndrome is given in the article.

Key words: hereditary connective tissue diseases, cutis hyperelastica, joint hypermobility.

For citation: Mordovtseva V.V., Gladko V.V. Chernogubov — Ehlers — Danlos syndrome at the intersection of clinical specialties. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 24-28. – DOI 10.36107/2782-1714_2023-3-1-24-28.

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¹ Medical Institute of Continuing Education, Russian Biotechnological University, Moscow, Russia
² Branch No. 2 of The National Medical Research Center of High Medical Technologies, The Central Military Clinical Hospital named after A.A.Vishnevsky, Russian Ministry of Defense, Moscow, Russia
³ Branch of Military Medical Academy, Moscow, Russia

Summary

The article analyzes the diagnostic results of 245 patients with coronary heart disease after coronary angioplasty. Obstructive sleep apnea was detected in 35.7% of patients. According to the rehabilitation programs, the patients were divided into two groups of 30 people in each one, comparable in age, severity of coronary artery disease, number of surgical interventions, severity of OSA and pharmaseutical treatment. The patients of the main group were prescribed CPAP therapy along with the standard therapy. The effectiveness of CPAP therapy use in the medical rehabilitation of patients with ischemic heart disease with OSA syndrome after coronary angioplasty has been studied. The inclusion of the technique in the comprehensive program of medical rehabilitation in this category leads to a decrease in the number of complaints, improvement of the functional and psychological state, stabilization of the cardiorespiratory system and increased tolerance to physical activity.

Key words: Coronary heart disease, OSA, CPAP therapy, medical rehabilitation, coronary angioplasty.

For citation: Yudin V.E., Klimko V.V., Shchegolkov A.M. [et al.] The use of C-PAP therapy in the medical rehabilitation of patients with coronary heart disease with obstructive sleep apnea after coronary angioplasty. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 30-33. – DOI 10.36107/2782-1714_2023-3-1-30-33.

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Russian Biotechnological University, Moscow, Russia

Summary

The article presents a clinical case of rehabilitation of a young patient in the third trimester of pregnancy who had a severe form of coronavirus disease. The case demonstrates the importance of timely specialty medical rehabilitation care, which may be crucial in preserving health, improving life quality of patients with pneumonia associated with the new coronavirus infection COVID-19.

Key words: new coronavirus infection, the third trimester of pregnancy, medical rehabilitation.

For citation: Yudin V.E., Klimko V.V., Chursina T.V. [et al.] Features of the coronavirus disease course of a patient in the third trimester of pregnancy: clinic, treatment and approaches to rehabilitation. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 34-38. – DOI 10.36107/2782-1714_2023-3-1-34-38.

Literature

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8. Методические рекомендации: Организация оказания медицинской помощи беременным, роженицам, родильницам и новорожденным при новой коронавирусной инфекции Сovid-19. Версия 4 (05.07.2021)
9. Шмонин А.А., Мальцева М.Н., Мельникова Е.В., Мишина И.Е., Иванова Г.Е. Медицинская реабилитация при коронавирусной инфекции: Новые задачи для физической и реабилитационной медицины в России. Вестник восстановительной медицины No 3 (97). 2020 — С. 14–19.
10. Юдин В.Е., Щегольков А.М., Ярошенко В.П., Будко А.А., Климко В.В., Калинина С.В. Физические методы медицинской реабилитации пациентов, перенесших новую коронавирусную инфекцию COVID-19. Учебное пособие — М. : МГУПП, 2021. — 40 с.

Russian Biotechnological University, Moscow, Russia

Summary

The article analyzes the literature data on the problem of diagnostic assessment, prevention, treatment and medical rehabilitation of the victims with the phantom limb pain. According to the various authors, the phantom limb pain occurs in 35-85% of the cases. There are different views on the pathogenesis of phantom pain syndrome, modern approaches of the treatment choice and rehabilitation methods. The analysis of the Russian and foreign literature data showed that the study of pain syndrome, the development of modern prevention and treatment techniques of patients with phantom limb syndrome is a relevant medical objective nowadays.

Key words: phantom limb syndrome , chronic pain, diagnostic assessment, medical rehabilitation.

For citation: Yudin V.E., Yaroshenko V.P., Kosukhin E.S. [et al.] Phantom limb syndrome: clinic, diagnostic assessment and treatment (literature review). // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 39-43. – DOI 10.36107/2782-1714_2023-3-1-39-43.

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¹ Infectious Clinical Hospital No. 2, Moscow, Russia
² Medical Institute of Continuing Education, Russian Biotechnological University, Moscow, Russia

Summary

Objective: Improve the quality of treatment for HIV-infected patients with heart attacks and splenic abscesses by optimizing the diagnosis of these pathological processes.

Material and Methods: From 2004 to 2019, 14,405 HIV-infected patients, including 34 patients with suspected splenic abscesses, were treated in the surgical department of the Infectious Clinical Hospital State Budgetary Healthcare Institution (ICH SBHI) No.2. The average age was 34.9 years, 22 males and 12 females. Three patients had stage 3, ten people had stage 4A, ten patiens had stage 4B, and eleven people had stage 4B HIV infection. Patient management followed the generally approved algorithms of the Ministry of Health of the Russian Federation for surgical patients (taking into account the HIV-infection co-morbidity). The following was done: complaints and anamnesis were collected, the duration of HIV-infection, adherence to ART, presence of opportunistic and concomitant diseases were carefully determined, an abdominal ultrasound imaging and an abdominal CT scan were performed. Four patients were diagnosed with splenic infarction; they were treated conservatively and discharged in a satisfactory condition. Surgical treatment was performed in 30 out of 34 patients in the period from 1 to 57 days from admission to the hospital, usually on day 9. 26 of them were discharged and 4 patients died. All 30 surgical patients received antibiotic therapy, surgical material was examined histologically, the cause of the splenic process was determined and therapy was adjusted (if tuberculosis had been diagnosed, patients were moved to an anti-TB hospital, if lymphoma had been diagnosed, patients were moved to an oncohematology department).

Results: When examining HIV-infected patients with complaints of abdominal pain and hyperthermia, a detailed history of HIV infection, adherence to ART, viral load and immune status (if the patient knows these data), the presence of concomitant pathological conditions should always be clarified, as wells as abdominal ultrasound and abdominal CT scan should be performed as early as possible. All surgical materials should be examined histologically to verify the cause of the splenic process. Patients in stages 4B-4B, not adhering to ART, with a high viral load and low immune status, suffering from drug addiction and HCV infection, more often get complicated forms of the disease.

Key words: HIV, abscess, spleen.

For citation: Puchkov S.S., Faller A.P.Challenges in diagnosing splenic abscesses in HIV-infected patiens. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 44-51. – DOI 10.36107/2782-1714_2023-3-1-44-51.

Literature

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¹ Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH), Moscow, Russia
² JSC "Family Doctor", Moscow, Russia

Summary

The article provides a brief literature review of the problem of gynecomastia, diagnostics and treatment of this disease, the relation between the frequency of detection of gynecomastia and oncological processes in the breast. It has been shown that gynecomastia is detected in male patients of different age groups, different in BMI, body type. The correlation of complaints and body type in patients with gynecomastia is shown, as well as the connection of clinical types of gynecomastia which depend on the patient's constitution. The article discribes the necessity of further studies of the relation between gynecomastia and body types in order to find the optimal surgical treatment for this problem.

Key words: breast, gynecomastia, diagnosis, treatment.

For citation: Pakhomova R. A., Sergeev D. I., Drobiazgo S. V. [et al.] Gynecomastia: the relation of patient complaints, type of constitution and clinical type of a disease. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 52-55. – DOI 10.36107/2782-1714_2023-3-1-52-55.

Literature

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¹ Medical Institute of Continuing Education, ROSBIOTECH, Moscow, Russia
² Central Military Clinical Hospital named after A.V. Vishnevsky, Russian Ministry of Defense, Department of endovascular surgical methods of diagnosis and treatment (with an operating unit and a group of anesthesiology-resuscitation) of the Center of Cardiac Surgery, Krasnogorsk, Novy, Russia
³ Military Medical Academy named after S.M. Kirov, Russian Ministry of Defense (Moscow branch)
⁴ Peoples' Friendship University of Russia, Moscow, Russia

Summary

Vascular injuries of the extremities have a predominant majority in the structure of combat injuries. In case of suspected damage to the vessel with various injuries, instrumental research methods are used for clarification, such as MRI, MSCT, ultrasound, selective angiography, which all victims with vascular injuries need. Due to contraindications for MRI due to the presence of metal fragments in the tissues and the presence of metal structures for osteosynthesis, as well as the presence of artifacts and "highlights" on CT angiography, which do not allow to accurately determine the size of the affected area of the vessel, selective angiography (SA) was used for subsequent diagnosis of vascular damage, and in some cases, simultaneous closure was performed arterial wall defect with special tools.

Key words: angiography, selective angiography, CT angiography, X-ray endovascular method, a vascular injury, a vascular injury, arteriovenous fistula, a stent graft.

For citation: Shabaev R.M., Ivanov A.V., Ivanov V.A., Lishchuk A.N. The use of X-ray endovascular angiography for the diagnosis of damaged vessels with low-informative visualization on CT angiography. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 56-62. – DOI 10.36107/2782-1714_2023-3-1-56-62.

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ta.0000220372.85575.e2. PMID: 16766960

¹ Medical Institute of Continuing Education, Russian Biotechnological University, Moscow, Russia
² Clinical Hospital of Ministry of Internal Affairs of the Russian Federation, Moscow, Russia

Summary

Objective: to evaluate the long-term results of mastoidoplasty with bone chips in patients with chronic suppurative otitis media. Materials and methods: Surgical treatment of 38 patients with chronic suppurative otitis media and sclerotic type of mastoid structure was performed. Anatomical and functional results were assessed according to otoscopy, audiometry, CT of the temporal bones.

Results: a satisfactory anatomical result was obtained in 84% (32 patients), unsatisfactory in 16% (6 patients), among them 1 recurrence of cholesteatoma, 3 cases of partial lysis of the osteoplastic material with the formation of retraction pockets, 2 cases of formation of partial fibrous atresia of the external auditory passage. According to audiometry after 1 year, in 16 patients (42%) the air-bone interval was at the level of 0–10 dB, in 14 (36%) patients it was 10–20 dB, in 4 (11%) patients it was 20–30 dB, more than 30 dB in 4 patients (11%). The mean value of the air-bone interval before surgery was 26.7 ± 10.9 dB, after surgery 20.8 ± 10.8 dB (P < 0.05).

Conclusion: the technique of mastoidoplasty using bone chips during primary operations in patients with chronic suppurative otitis media with cholesteatoma and sclerotic structure of the mastoid process, showed high efficiency and allows achieving satisfactory anatomical and functional results in 84%.

Key words: mastoidoplasty, mastoidectomy, chronic suppurative otitis media, cholesteatoma.

For citation: Morozov I.I., Grachev N.S., Gorbunova N.V. Experience of the surgical treatment of chronic suppurative otitis media with mastoidoplasty. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 64-67. – DOI 10.36107/2782-1714_2023-3-1-64-67.

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¹ Medical Institute of Continuing Education, Russian Biotechnological University, Moscow, Russia
² Clinical Hospital of Ministry of Internal Affairs of the Russian Federation, Moscow, Russia

Summary

The reasons for unsuccessful functional outcomes of ossiculoplasty are poor aeration of the middle ear, cicatricial deformity, adhesive process in the tympanic cavity, incorrectly selected length of the prosthesis, which ultimately leads to dislocation or extrusion of the implant with deformation of the neotympanic membrane in 1-6% of cases. The article presents a clinical case of dislocation of a partial prosthesis after ossiculoplasty with tympanoplasty, the cause of dislocation of which is not a widespread one. Patient K., 42 years old, previously underwent tympanoplasty with ossiculoplasty with a partial prosthesis for left-sided mesotympanitis with destruction of the ossicular chain. Despite the improvement in hearing in the early postoperative period, the patient began to notice a gradual decrease in hearing in 6 months. The examination revealed left-sided conductive hearing loss of the 3rd degree with a air-bone gap (ABG) of 40 dB, cicatricial deformity of the anterior meatotympanic angle, according to computed tomography of the temporal bones (CT), lateralization of the neotympanic membrane with cicatricial deformity of the anterior meatotympanic angle, diastasis between the head of the stapes and leg of a partial prosthesis. The head plate of the prosthesis is adjacent to the inner surface of the neotympanic membrane together with the cartilaginous plate. During an intraoperative detailed examination of the extracted prosthesis, it was revealed that the head plate of the prosthesis was fixed to the cartilage with three interrupted sutures with a thread of non-absorbable material, the nodes were located on the side of the prosthesis stem. A repeated ossucoloplasty was performed with a longer partial prosthesis, eliminating atresia in the anterior meatotympanic angle. ABG was less than 10 dB, on the control CT of the temporal bones, the tympanic cavity was airy, the partial denture was in the correct position in 10 months. This clinical case is of particular interest, since the unsuccessful outcome of tympanoplasty with ossiculoplasty was due to the peculiarities of fixing the denture plate with suture material combined with the peculiarities of the reparative process.

Key words: tympanoplasty, ossiculoplasty, tympanoplasty complications, prosthesis dislocation in tympanoplasty.

For citation: Morozov I.I., Grachev N.S., Gorbunova N.V. Analysis of the unsuccessful outcome of ossiculoplasty due to the peculiarities of prosthesis fixation. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 68-71. – DOI 10.36107/2782-1714_2023-3-1-68-71.

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6. Грачев Н.С., Полев Г.А., Морозов И.И., Самарин А.Е., Ворожцов И.Н., Щербаков Д.А. Опыт применения эндоскопической техники в отохирургии у детей. Вестник оториноларингологии. 2020;85(1):59–63. https:// doi.org/10.17116/otorino20208501159 [Grachev N.S., Polev G.A., Morozov I.I., Samarin A.E., Vorozhtsov I.N., Shcherbakov D.A. Our first experience with endoscopic ear surgery. Vestnik otorinolaringologii. 2020;85(1):59–63. (In Russ.) https://doi.org/10.17116/otorino20208501159]
7. Mardassi A., Deveze A., Sanjuan M., Mancini J., Parikh B., Elbedeiwy A., Magnan J., Lavieille J.P. Titanium ossicular chain replacement prostheses: prognostic factors and preliminary functional results. Eur Ann Otorhinolaryngol Head Neck Dis. 2011 Apr;128(2):53-8. doi: 10.1016/j.anorl.2010.11.005
8. Schlemmer K., Qingsong L., Linder T. Tympanoplasty with an Intact Stapes Superstructure in Chronic Otitis Media. J Int Adv Otol. 2021 Jul;17(4):282–287. doi: 10.5152/iao.2021.9267

¹ Medical Institute of Continuing Education, Russian Biotechnological University, Moscow, Russia
² Clinical Hospital of Ministry of Internal Affairs of the Russian Federation, Moscow, Russia

Summary

Balloon Eustachian tube dilatation (BET) is a promising treatment for Eustachian tube dysfunction (ETD). The incidence of isolated ETD of the Eustachian tube (ET) in adults is 4.6%, therefore, the literature data present a few studies of BET in this pathology.
Objective: Evaluation of the effectiveness of BET in isolated ETD in adult patients.
Materials and methods: 14 adult patients with isolated ETD (total 18 cases of ETD) and clinical manifestations were treated for at least 3 months , in the absence of the effect of conservative therapy. In 7 cases (50%), patients had previously undergone tympanostomy surgery. Pre- and postoperative examination included otoscopy, tympanometry, audiometry and ETDQ-7 questionnaire. The control periods for examining patients were 2, 6 and 12 months after BET. Results: in all 18 cases, a type A tympanogram was recorded and there was no air-bone interval on the audiogram in 2 months after BET. ETDQ-7 results were within the normal range in 14 out of 18 cases (77.7%) in 2 months after BET, 6 months later they were in 16 out of 18 (88.9%), 12 months later they were in 17 out of 18 (94.4%) %). The difference between the results before and after surgery was statistically significant (P < 0.05). Only 1 patient noted no change in their condition. Complications of BET were not noted. Conclusions: BET demonstrated efficiency of 94.4%. Isolated ETD is an indication for BED in the absence of the effect of conservative therapy for more than 3 months, in the presence of objective signs of negative pressure in the middle ear and according to the ETDQ-7 questionnaire, as well as in case of negative results of ETD treatment by tympanostomy.

Key words: Eustachian tube, balloon Eustachian tuboplasty, Eustachian tube dysfunction.

For citation: Morozov I.I., Grachev N.S., Gorbunova N.V. [et al.] Balloon dilatation of the Eustachian tube in patients with isolated Eustachian tube dysfunction. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 72-75. – DOI 10.36107/2782-1714_2023-3-1-72-75.

Literature

1. Tucci D.L., McCoul E.D., Rosenfeld R.M., Tunkel D.E., Batra P.S., Chandrasekhar S.S., Cordes S.R., Eshraghi A.A., Kaylie D., Lal D., Lee J., Setzen M., Sindwani R., Syms C.A. 3rd, Bishop C., Poe D.S., Corrigan M., Lambie E. Clinical Consensus Statement: Balloon Dilation of the Eustachian Tube. Otolaryngol Head Neck Surg. 2019 Jul;161(1):6–17. doi: 10.1177/0194599819848423
2. Plaza G., Navarro J.J., Alfaro J., Sandoval M., Marco J. Consensus on treatment of obstructive Eustachian tube dysfunction with balloon Eustachian tuboplasty. Acta Otorrinolaringol Esp (Engl Ed). 2020 May-Jun;71(3):181–189. English, Spanish. doi: 10.1016/j. otorri.2019.01.005
3. Shan A., Ward B.K., Goman A.M., Betz J.F., Reed N.S., Poe D.S., Nieman C.L. Prevalence of Eustachian Tube Dysfunction in Adults in the United States. JAMA Otolaryngol Head Neck Surg. 2019 Oct 1;145(10):974– 975.
4. Siow J.K., Tan J.L. Indications for Eustachian tube dilation. Curr Opin Otolaryngol Head Neck Surg. 2020 Feb;28(1):31–35. doi: 10.1097/MOO.0000000000000601
5. Cheng H., Saxby A., Jufas N., Kong J., Patel N. Balloon dilation eustachian tuboplasty for dilatory dysfunction: Safety and efficacy analysis in an Australian cohort. ANZ J Surg. 2021 Jul;91(7–8):1480–1484. doi: 10.1111/ans.16980
6. Luukkainen V., Vnencak M., Aarnisalo A.A., Jero J., Sinkkonen S.T. Patient satisfaction in the long-term effects of Eustachian tube balloon dilation is encouraging. Acta Otolaryngol. 2018 Feb;138(2):122-127. doi: 10.1080/00016489.2017.1384568
7. Грачев Н.С., Полев Г.А., Морозов И.И., Самарин А.Е., Ворожцов И.Н., Щербаков Д.А. Опыт применения эндоскопической техники в отохирургии у детей. Вестник оториноларингологии. 2020;85(1):59-63. https:// doi.org/10.17116/otorino20208501159 [Grachev N.S., Polev G.A., Morozov I.I., Samarin A.E., Vorozhtsov I.N., Shcherbakov DA. Our first experience with endoscopic ear surgery. Vestnik otorinolaringologii. 2020;85(1):59-63. (In Russ.) https://doi.org/10.17116/otorino20208501159]
8. Meyer T.A., O'Malley E.M., Schlosser R.J., Soler Z.M., Cai J., Hoy M.J., Slater P.W., Cutler J.L., Simpson R.J., Clark M.J., Rizk H.G., McRackan T.R., D'Esposito C.F., Nguyen S.A. A Randomized Controlled Trial of Balloon Dilation as a Treatment for Persistent Eustachian Tube Dysfunction With 1-Year Follow-Up. Otol Neurotol. 2018 Aug;39(7):894-902. doi: 10.1097/MAO.0000000000001853
9. Kourtidis S., Hempel J.M., Saravakos P., Preyer S. Diagnostic value of computed tomography in Eustachian tube dysfunction. Auris Nasus Larynx. 2022 Jun;49(3):352– 359. doi: 10.1016/j.anl.2021.09.001

¹ Russian Biotechnological University (ROSBIOTECH), Moscow, Russia
² National Medical and Surgical Center named after N.I. Pirogov, Moscow, Russia
³ International Law Institute, Moscow, Russia

Summary

The article examines the issue of a potential danger to the life and health of all participants of the emergency liquidation in railway transport, and also suggests an algorithm for cooperative actions.

Key words: emergency, video recording, inspection of the scene, graphic fixation method, search and rescue.

For citation: Kataev A.S., Suvorov A.S., Belavin A.V. Some safety organizing issues of medical and other workers while performing employment duties at the scene of a railway emergency. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 76-78. – DOI 10.36107/2782-1714_2023-3-1-76-78.

Literature

1. Инновационные аспекты и тенденции тактики производства осмотров с использованием беспилотных авиационных средств. Современный ученый. 2019. No 6. С. 269–279;
2. Ильин Н.Н. Применение видеозвукозаписи в ходе осмотра места происшествия и ее роль при назначении транспортно-технической судебной экспертизы. Юридическая наука и правоохранительная практика. 2020. No 1 (51). С. 82–90.;
3. Некоторые вопросы криминалистического исследования места чрезвычайного происшествия на железнодорожном транспорте. Шуваева М.С., Белавин А.В. В книге: криминалистика — наука без границ: традиции и новации. материалы всероссийской научно-практической конференции. Санкт-Петербург, 2022. С. 362–365.

¹ Medical Institute of Continuing Education, ROSBIOTECH, Moscow, Russia
² Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST)of the Department of Health of Moscow, Moscow, Russia

Summary

Relevance. All over the world environmental protection issues are taken into great consideration. A serious threat of environmental pollution exists from medical waste in case of improper organization of their collection, movement, disinfection, transportation and disposal. The requirements set out in the sanitary rules and regulations for the management of medical waste are not fully understood by the responsible people and require clarifications and commentary.
Objective. Determination of the organizing features of medical waste in a medical organization of an emergency pediatric profile.
Summary. Strict organizing rules following of medical waste management in a medical organization plays an important role in the prevention of infections associated with medical care provision and allows to fully avoid nosocomial infection for both patients and employees of a medical organization. To carry out the correct collection, accounting, movement, disinfection and transportation of medical waste, a number of administrative, organizational and anti-epidemic measures need to be done in a medical organization.

Key words: medical waste, hazard class, epidemiologically hazardous waste, disinfection of medical waste, temporary storage of medical waste, transportation of medical waste, production control, medical waste management site, CRIEPST.

For citation: Gladko V.V., Maev E.Z., Vlasenko A.V. [et al.] Organizing of medical waste management in a pediatric emergency medical organization. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 79-83. – DOI 10.36107/2782-1714_2023-3-1-79-83.

Literature

1. Власенко, А. В. Организация работы участков по обеззараживанию медицинских отходов в городских поликлиниках департамента здравоохранения города Москвы / А. В. Власенко, Ю. Е. Вязовиченко, Л. Р. Батыршина // Инфекционные болезни. — 2017. — Т. 15, No S1. — С. 58-59. — EDN ZRHFCN.
2. Федеральный закон от 21.11.2011 No 323-ФЗ (ред. от 26.03.2022) «Об основах охраны здоровья граждан в Российской Федерации», статья 49. Медицинские отходы.
3. Постановление Правительства РФ от 04.07.2012 No 681 «Об утверждении критериев разделения медицинских отходов на классы по степени их эпидемиологической, токсикологической, радиационной опасности, а также негативного воздействия на среду обитания».
4. Постановление Главного государственного санитарного врача РФ от 28.01.2021 No 3 (ред. от 14.02.2022) «Об утверждении санитарных правил и норм СанПиН 2.1.3684-21 "Санитарно-эпидемиологические требования к содержанию территорий городских и сельских поселений, к водным объектам, питьевой воде и питьевому водоснабжению, атмосферному воздуху, почвам, жилым помещениям, эксплуатации производственных, общественных помещений, организации и проведению санитарно-противоэпидемических (профилактических) мероприятий"» (вместе с «СанПиН 2.1.3684-21. Санитарные правила и нормы...») (Зарегистрировано в Минюсте России 29.01.2021 No 62297). Глава X. Требования к обращению с отходами.

¹ Medical Institute of Continuing Education, ROSBIOTECH, Moscow, Russia
² he National Medical Research Center of High Medical Technologies, The Central Military Clinical Hospital named after A.A.Vishnevsky, Russian Ministry of Defense, Moscow, Russia

Summary

The article considers the problematic issues of ensuring communication of military medical organizations in the unified state medical information system. It is shown that a military medical institution is an integral part of the military organization of the state, which is integrated into the nationalheathcare system. Improving the efficiency of military medical institutions is limited by the possibilities of information support for business processes, the speed of information analysis for any period, in any context, and also the ability to establish full management accounting for making reasonable management decisions.

Key words: medical information system, a military medical organization, information analysis.

For citation: Sukhorukov A.L., Abushinov V.V., Maev E.Z. Medical information systems in modern conditions of military medical organizations' activity (Regulatory framework and literature review). // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 84-87. – DOI 10.36107/2782-1714_2023-3-1-84-87.

Literature

1. Федеральный закон от 21.11.2011 No 323-ФЗ «Об основах охраны здоровья граждан в Российской Федерации».
2. Федеральный закон от 25 ноября 2013 г. No 317-ФЗ «О внесении изменений в отдельные законодательные акты Российской Федерации и признании утратившими силу отдельных положений законодательных актов Российской Федерации по вопросам охраны здоровья граждан в Российской Федерации» (с изменениями и дополнениями).
3. Приказ Министерства здравоохранения РФ от 29 декабря 2014 г. No 930н «Об утверждении Порядка организации оказания высокотехнологичной медицинской помощи с применением специализированной информационной системы» (Зарегистрирован в Минюсте РФ 31 декабря 2014 г. Регистрационный No 35499).
4. Приказ Минздрава России от 30.12.2014 No 956н «Об информации, необходимой для проведения независимой оценки качества оказания услуг медицинскими организациями, и требованиях к содержанию и форме предоставления информации о деятельности медицинских организаций, размещаемой на официальных сайтах Министерства здравоохранения Российской Федерации, органов государственной власти субъектов Российской Федерации, органов местного самоуправления и медицинских организаций в информационно-телекоммуникационной сети Интернет» (вместе с «Информацией, предоставляемой медицинскими организациями, необходимой для проведения независимой оценки качества оказания услуг медицинскими организациями») (Зарегистрирован в Минюсте России 20.02.2015 No 36153).
5. Методические рекомендации по обеспечению функциональных возможностей медицинских информационных систем медицинских организаций (МИС МО) (утв. Министерством здравоохранения РФ 1 февраля 2016 г.).
6. Есипов А.В., Алехнович А.В., Мешков А.В., Абушинов В.В. Технологии оптимизации управления многопрофильным стационаром/А.В. Есипов, А.В. Алехнович, А.В. Мешков, В.В. Абушинов. М.: Буки-Веди, 2019. — 244 с.
7. Абушинов В.В., Есипов А.В., Алехнович А.В. Новые требования к внутреннему контролю качества и безопасности медицинской деятельности: пути и инструменты их реализации в многопрофильном стационаре (сообщение второе)/ В.В. Абушинов, А.В. Есипов, А.В. Алехнович //Госпитальная медицина: наука и практика. 2021. Т. 4. No 2. С. 64–71.
8. Есипов А.В., Абушинов В.В., Алехнович А.В. Новые требования к внутреннему контролю качества и безопасности медицинской деятельности: пути и инструменты их реализации в многопрофильном стационаре (сообщение первое)/А.В. Есипов, В.В. Абушинов, А.В. Алехнович //Госпитальная медицина: наука и практика. 2021. Т. 4. No 1. С. 45–53.
9. Есипов А.В., Алехнович А.В., Абушинов В.В. Новые требования к внутреннему контролю качества и безопасности медицинской деятельности: пути и инструменты их реализации в многопрофильном стационаре. Содержание и основные результаты производственных процессов военного госпиталя (сообщение четвертое)/ А.В. Есипов, А.В. Алехнович, В.В. Абушинов, Р.В. Зенин, А.А. Агапитов //Госпитальная медицина: наука и практика. 2021. Т. 4. No 4. С. 71–79.
10. Интеллектуальный и информационный потенциал системы поддержки принятия решений по противодействию биологическим и химическим угрозам в республике Адыгея/ А.Х. Агиров, С.А. Завгородний, А.П. Мурзин, Б.П. Белашев, В.А. Захаров, И.С. Конышев, В.М. Гукасов, А.В. Алехнович, И.Б. Феткевич, А.А. Ермакова //Медицина и высокие технологии. 2015. No 3. С. 11–18.

¹ National Medical Research Center of Surgery named after A.V. Vishnevsky, Moscow, Russia
² Peoples' Friendship University of Russia, Moscow, Russia
³ Central Military Clinical Hospital named after A.V. Vishnevsky, Moscow, Russia
⁴ 4 Medical Institute of Continuing Education, Russian Biotechnological University, Moscow, Russia

Summary

The article describes a rare clinical case of prostate cancer with a high initial level of prostate-specific antigen — 4000.0 ng/ml. In the diagnostics prosess of drug and subsequent surgical treatment, there was a consistent dynamics of a decrease in the PSA level and an improvement in the clinical picture. Currently, the relapse-free follow-up period is 36 months. The presented clinical observation emphasizes the importance of a personalized approach to the treatment of patients with prostate cancer, and also confirms the need to continue fundamental research in the field of the molecular genetic nature of this disease.

Key words: prostate cancer, prostate-specific antigen, prostate-specific antigen level dynamics, combined treatment (hormonal and surgical), prostate cancer chemotherapy

For citation: Gritskevich A.A., Kochetov A.G., Baytman T.P. [et al.] The prognostic role of prostate-specific antigen level in hormonesensitive prostate cancer: a clinical case. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 88-92. – DOI 10.36107/2782-1714_2023-3-1-88-92.

Literature

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11. Ayala G., Tuxhorn J.A., Wheeler T.M., Frolov A., Scardino P.T., Ohori M., Wheeler M., Spitler J., Rowley D.R. Reactive Stroma as a Predictor of Biochemical-Free Recurrence in Prostate Cancer. Clin. Cancer Res. 2003; 9: 4792-4801.

¹ Russian Scientific Center of Roentgenoradiologyof the Ministry of Healthcare of the Russian Federation, Moscow, Russia
² Scientific Research Institute of Urology and Interventional Radiology named after N.A. Lopatkin, Branch of the National Medical Research Radiological Centre of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

Summary

Transurethral botulinum toxin type A (BT) injections to the external urethral sphincter are the most effective and safe method of treating detrusor-sphincter dyssynergia (DSD) in patients with a spinal cord injury. The technique requires special logistics and anesthetic support and is difficult to reproduce in the conditions of rehabilitation centers. This article presents comparative data on the treatment of detrusor-sphincter dyssynergy with injections of botulinum toxin type A into the men external urethral sphincter with minimally invasive transperineal administration under ultrasound guidance (main group, N = 36) and transurethral administration (control group, N = 41). Evaluation of the treatment results of patients in both groups showed that the incidence of postoperative complications was significantly lower in patients of the main group (11.1% and 53.7%, respectively, p < 0.05) with a shorter duration of intervention (26 and 42 minutes, respectively, p < 0.05). There were no statistically significant differences in the incidence of autonomic dysreflexia and urodynamic parameters after 3 and 6 months of follow-up. The clinical effect with the transperineal technique was achieved in 55.6% by the 3rd month after injection, and in 66.7% of men by the 6th month after the treatment, with an expected decrease in efficiency to 35.7% by 12 months of observation. Transperineal injections of BT into the zone of the external urethral sphincter in the treatment of DSD in patients with traumatic spinal cord disease are comparable in their effectiveness to transurethral endoscopic administration of BT, however, it is accompanied by a lower incidence of perioperative complications.

Key words: detrusor-sphincter dyssynergia, botulinum toxin, spinal cord injury, neurogenic dysfunction of the lower urinary tract.

For citation: Salyukov R.V., Pavlov A.Yu., Kotlyarov P.M., Tsallagova Z.S., Kasatonova E.V. Efficacy of ultrasound-guided transperineal botulinum toxin injections for the detrusor-sphincter dyssynergia treatment. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 93-97. – DOI 10.36107/2782-1714_2023-3-1-93-97.

Literature

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¹ Medical Institute of Continuing Education, ROSBIOTECH, Moscow, Russia
² National Medical Research Center for High Medical Technologies, Central Military Clinical Hospital named after A.V. Vishnevsky, Moscow, Russia
³ State Research Center of the Russian Federation, Federal Medical Biophysical Center named after A.I. Burnazyan, Moscow, Russia
⁴ Medical Research and Educational Center, Moscow State University named after M.V. Lomonosov, Moscow, Russia
⁵ National Medical Research Center for Surgery named after A.V. Vishnevsky, Moscow, Russia
⁶ Peoples' Friendship University of Russia, Moscow, Russia

Summary

Cystitis cystica et glandularis (CCEG) and intestinal metaplasia are benign diseases indistinguishable from a bladder tumor on cystoscopy. Despite the benign nature, these pathological changes can be underlying in adenocarcinoma of the bladder. One more unsolved problem is the recurrent glandular cystitis. The article considers the modern classification of benign bladder diseases and clinical examples of recurrent cases of glandular cystitis.

Key words: Cystitis cystica et glandularis (CCEG), intestinal metaplasia, cystoscopy, transurethral resection of the bladder, benign urothelial tumors.

For citation: Plekhanova O.A., Kochetov A.G., Martov A.G., Gvasalia B.R., Gritskevich A.A., Baikov N.A. Endoscopic diagnosis of benign tumors of the bladder. The Features of clinical management of patients with cystitis cystica et glandularis and intestinal metaplasia. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 98-102. – DOI 10.36107/2782-1714_2023-3-1-98-102.

Literature

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¹ "Russian Biotechnological University", Moscow, Russia
² International Law Institute, Moscow, Russia
³ National Medical and Surgical Center named after N.I. Pirogov, Moscow, Russia

Summary

The article deals with the issues of forensic and criminalistic research of the traces of a bullet and additional factors of the shot, formed on the obstacle from firing with a 12-gauge hunting weapon equipped with a polymer wad-container at a distance of 100 cm.

Key words: firearms, muzzle attachment, a polymeric wad-container, ammunition, traces of a shot, damage, forensic science, criminalistics

For citation: Kataev A.S., Suvorov A.S., Belavin A.V., Einstein V.K. Some issues of forensic and criminalistic research of general and special signs in the traces of a shot from a 12-gauge hunting weapon using a cartridge equipped with a wad-container at a distance of 100 cm. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 103-106. – DOI 10.36107/2782-1714_2023-3-1-103-106.

Literature

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International Institute of Management and Business, Russian Biotechnological University (ROSBIOTECH). Moscow, Russia

Summary

One of the promising and developing areas of modern technology is the production of plant foods. Many people, due to medical reasons or because of their lifestyle, refuse to consume cow's milk and replace it with plant-based drinks. In this regard, the demand for alternatives of dairy products, which are presented in a wide range, is growing. The nutritional properties of such drinks depend on the source of plant raw materials and fortification. The purpose of this article was to study plant-pased beverages and the possibility for its production in our country. A systematic research was conducted on the basis of data from scientific articles. This review includes the materials from the database of Google Scholar dated from 2018 to 2023. The article examines the raw materials used in the production of drinks and the technology of their prosessing. The chemical composition of oats was studied, and also a SWOT-analysis was compiled. The data of this review show the beneficial properties of plant-based drinks, their difference from cow's milk and the trends of alternative production in the world.

Key words: milk, dairy products, plant-based drink, oatmeal drink, production technology, allergens, SWOT-analysis.

For citation: Tulyakova T.V., Buravova N.A., Kolesnikova A.A. Plant-based milk alternatives. // Bulletin of the Medical Institute of Continuing Education. – 2023. – V. 3. – No 1. – P. 107-112. – DOI 10.36107/2782-1714_2023-3-1-107-112.

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