We are glad to welcome you on the pages of our scientific journal «Bulletin of the Medical Institute of Continuing Education». This time we chose dermatovenereology as the topic of our new issue.
Throughout the history of mankind, much attention has been paid to the skin. It is the largest organ in the human body. The skin protects the body and internal organs from external influences, and also participates in thermoregulation, metabolic and other important processes. It is directly related to most of the functions of the body: absorption, excretion, excretion, pressure regulation, thermoregulation, protection, etc. Dermatology is the science of the skin, one of the oldest areas of medicine, which arose from the practical experience of various countries and peoples, primarily China, India and Greece.
In Russia, dermatology has long had the character of traditional medicine. Until the 18th century, skin diseases were considered through a direct connection with the nervous system and internal organs. Dermatovenereology as a separate discipline was formed in the 70s of the XIX century, when departments of skin and venereal diseases were opened in Moscow and St. Petersburg.
Domestic dermatovenereology has always developed as an independent school, independent of Western European schools. Soviet dermatologist V.V. Ivanov said: «Russian dermatologists have always been distinguished by their desire to associate skin lesions with various diseases of other organs, the nervous system and the whole organism».
Today in Russia, dermatovenereology has confidently reached a high level of development. In our country, the relationship of dermatology with other related areas of medicine is being actively studied.
The Department of Skin and Sexually Transmitted Diseases with the course of cosmetology of MINO preserves and enhances scientific and educational traditions. In recent years, the interest in scientific work on the part of young doctors, residents and graduate students has noticeably increased. Every year the department presents a large number of scientific and practical reports, conducts fascinating and informative analyzes of unique clinical cases. Reports and discussions at scientific and practical conferences with the participation of the faculty of the department testify to the high level of scientific work, the use of the latest research methods.
The Department of Skin and Venereal Diseases with the course of cosmetology of the Ministry of Education and Science maintains close ties and constantly interacts with the departments of medical higher educational institutions in Moscow, Russia and abroad, with leading research centers and the Russian Society of Dermatovenerologists.
Dear colleagues, the Bulletin of the Medical Institute of Continuing Education is a platform where original research papers, reviews, practical recommendations, unique and didactic clinical cases devoted to the problems of medicine and healthcare and relevant both in Russia and abroad are constantly published. The journal is interdisciplinary in nature, and we hope that it will be of interest to doctors of various specialties.
Best regards, Editor-in-Chief, MD, PhD, Prof. V.V. Gladko
1 Medical Institute of Continuing Education of the Moscow State University of Food Production 2 Institute of Medicine, Ecology and Physical Culture of Ulyanovsk State University 3 Moscow State University named after M.V. Lomonosov
Summary
The choice of treatment tactics for atopic dermatitis depends on the severity of the disease, which is assessed on the SCORAD scale. The question of its significance in clinical outpatient practice is debated. The aim of the study was a multifactorial analysis of the dependence of the severity of atopic dermatitis on the SCORAD scale on various factors and a quantitative assessment of their occurrence in children, taking into account the age periods of the disease (infancy, childhood, adolescence). A retrospective analysis of data from 60 case histories and 266 outpatient records of children with atopic dermatitis (2019–2022) was carried out: the infancy period of 149 patients; children – 151, adolescents – 26. For statistical processing of the material, the Pearson criterion (X2) and Spearman correlation analysis were used. The criteria that play a role in the formation of a severe process were identified: 6 or more relapses per year (30%); clinical forms with pronounced lichenification (70.4%); hereditary predisposition to allergic diseases (72.7%); the presence of complications (81.4%), especially represented by bacterial mycotic infection (18.9%); atopic march (43.2%), with clinical manifestations of allergic rhinoconjunctivitis (47.4%); three or more concomitant diseases of various genesis (26.3%); sensitization to 7 or more allergens (25%). A multifactorial analysis of the severity of atopic dermatitis made it possible to qualitatively and quantitatively assess the criteria that play a role in the formation of a severe process. Timely elimination of most of them is the key to successful therapy. The use of the SCORAD scale in scientific research makes it possible to objectify the data obtained.
Key words: atopic dermatitis, severity of the disease, multifactorial analysis, SCORAD scale
For citation: Sokolova T.V., Kafarova A.I., Panchenko L.A., Smirnova V.A. Atopic dermatitis in children: focus on the severity of the disease on the SCORAD scale. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 8–12. DOI 10.46393/27821714_2022_4_8
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Тихомиров А.А. Клинико-патогенетическое обоснование дифференцированного подхода к терапии тяжелых форм атопического дерматита у детей: автореф. дис. ... д-ра мед наук. М., 2014. 40 с.
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Согласительный документ ассоциации детских аллергологов и иммунологов «Атопический дерматит у детей» (на правах руководства). М.: АДАИР, 2019; Самара: ООО «Полиграфическое Объединение «Стандарт», 2019. 222 с.
Федеральные клинические рекомендации «Дерматовенерология 2015. Болезни кожи. Инфекции, передаваемые половым путем». 5-е изд., перераб. и доп. М.: Деловой экспресс, 2016. 768 с.
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1 Medical Institute of Continuing Education of the Moscow State University of Food Production 2 Consultative and Diagnostic Center of the General Staff of the Armed Forces of the Russian Federation 3 Moscow State University named after M.V. Lomonosov
Summary
In accordance with the Federal Law of November 21, 2011 No. 323-FL (as amended on June 25, 2012) «About the Fundamentals of Protecting the Health of Citizens of the Russian Federation», a clinical diagnosis includes: the underlying disease, complications of the underlying disease, concomitant diseases. The existing classification of demodicosis does not meet these requirements. Demodicosis against the background of concomitant pathology can't be considered a secondary process. In accordance with dermatological propaedeutics, the primary process is an early stage of the disease, and the secondary is a later one with the same etiological factor. The purpose is to substantiate a new approach to the classification of demodicosis with an illustration of clinical cases from the personal medical practice of the authors. The analysis of the data of 39 articles reflecting the approach to the classification of demodicosis was carried out and a description of two clinical cases of demodicosis was given. For its diagnosis, the author's methods for detecting tick-borne invasion were used. The analysis of the literature and the results of a personal examination of patients indicate that demodicosis can be an independent nosological form; concomitant disease; complication of dermatoses associated with it, drug therapy complication; demodectic hyperinvasion; intact demodectic hyperinvasion. Revision of the classiRcation of demodicosis based on the characteristics of pathogen parasitism in the skin is the basis of a rational approach to the choice of adequate therapy. Insufficient knowledge of the biocenotic relationships of mites of the genus Demodex and other representatives of the skin microbiome indicates the need for further research.
For citation: Sokolova T.V., Golitsina M.V., Malyarchuk A.P., Lopatina Yu.V. Classification of demodicosis as the basis for diagnosis and rational therapy. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 13–23. DOI 10.46393/27821714_2022_4_13
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MEANS OF EXTERNAL THERAPY IN THE TREATMENT OF PSORIASIS
E.G. Sanakoeva1, E.V. Vvedenskaya2, O.Yu. Ivanishko3
24-29
1 Medical Institute of Continuing Education of the Moscow State University of Food Production 2 Yaroslavl State Medical University 3 City Polyclinic No. 36 of the Department of Health of the City of Moscow
Summary
Modern principles of external therapy of psoriasis are focused on direct therapeutic measures and basic care using topical adjuvant agents, which are currently widely represented. Patients with psoriasis, together with dermatovenereologists or independently, can choose skin care products, and also have the opportunity to combine them with each other. The article provides a brief description of the main drugs for the treatment of psoriasis and improving the quality of life of patients, describes their mechanism of action and side effects.
For citation: Sanakoeva E.G., Vvedenskaya E.V., Ivanishko O.Yu. Means of external therapy in the treatment of psoriasis. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 24–29. DOI 10.46393/27821714_2022_4_24
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REVIEW OF TOPICAL DRUGS FOR THE CORRECTION OF HYPERPIGMENTATIONS: COMPARATIVE CHARACTERISTICS OF THIAMIDOL
D.Z. Tlostanova1, S.A. Masyukova1, I.V. Ilina1, J.A. Sokolovskaya2
30-36
1 Medical Institute of Continuing Education of the Moscow State University of Food Production 2 Beiersdorf
Summary
The color of human skin is determined by a combination of various factors: the thickness of the entire epidermis and its stratum corneum, the number and location of blood vessels and the number and distribution of pigments. Normal skin pigmentation is formed by the following basic pigments of the epidermis and dermis: oxygenated hemoglobin in the arteries and capillaries, deoxygenated hemoglobin in the veins, carotenoids, and melanin [1].
The behavior of melanocytes in the skin is largely due to signals from neighboring keratinocytes, autocrine signals and environmental factors. Melanocytes receive both positive and negative paracrine signals that modulate melanocyte proliferation and diPerentiation [2].
The most prominent target in hyperpigmentation is tyrosinase – a key regulator of melanin production. Many substances have been described in the literature as tyrosinase inhibitors. The results of these studies cannot be fully applied to human tyrosinase [3].
In this regard, in the article, based on the literature data, various topical preparations used for the treatment of hyperpigmentation are analyzed.
For citation: Tlostanova D.Z., Masyukova S.A., Ilina I.V., Sokolovskaya J.A. Review of topical drugs for the correction of hyperpigmentations: comparative characteristics of thiamidol. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 30–36. DOI 10.46393/27821714_2022_4_30
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1 Medical Institute of Continuing Education, Moscow State University of Food Production 2 FSBI «NMRC of HMT named after A.A. Vishnevsky» Russian Ministry of Defense
Summary
The article presents the clinical observation and experience of treating patients with atherosclerotic aortic lesion by the vascular method. Endovascular treatment of atherosclerotic lesions of the abdominal aorta using stents is recognized as safe and ebjective, with a high percentage of immediate technical success and good long-term results.
For citation: Ivanov A.V., Shabaev R.M., Lischuk A.N., Koltunov A.N. The first experience of endovascular treatment for atherosclerotic lesions of the abdominal aorta. Retrospective. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 38–40. DOI 10.46393/27821714_2022_4_38
Literature
Önder H., Oğuzkurt L., Gür S. et al. Endovascular treatment of infrarenal abdominal aortic lesions with or without common iliac artery involvement. Cardiovasc Intervent Radiol. 2013; 36 (1): 56–61.
Ritter J.C., Ghosh J., ButterMeld J.S. et al. Chimney stent technique or treatment of severe abdominal aortic atherosclerotic stenosis. J. Vasc. Interv. Radiol. 2011; 22 (3): 391–394.
Гавриленко А.В., Скрылев С.И. Хирургическое лечение больных с критической ишемией нижних конечностей, обусловленной поражениями артерий инфраингвинальной локализации. Ангиология и сосудистая хирургия. 2008; 14 (3): 111–117.
Базылев В.В., Тунгусов Д.С., Микуляк А.И. Результаты коронарного шунтирования у пациентов с крайне низкой фракцией выброса. Вестник Медицинского института непрерывного образования. 2022; (1): 62–65.
Сусанин Н.В., Чернявский М.А., Чернова Д.В., Ванюркин А.Г. Эндоваскулярная коррекция синдрома Лериша у пациентов пожилого возраста с высоким хирургическим риском. Эндоваскулярная хирургия. 2021; 8 (4): 392–397
TREATMENT OF ARTERIOVENOUS FISTULA BY ENDOVASCULAR METHOD TO A PATIENT WITH POLYTRAUMA. DESCRIPTION OF THE CLINICAL CASE
R.M. Shabaev1,2, A.V. Ivanov1,2, A.N. Lischuk2
41-45
1 Medical Institute of Continuing Education, Moscow State University of Food Production 2 FGBU «NMITs VMT them. A.A. Vishnevsky» of the Ministry of Defense of Russia
Summary
Patients with polytrauma are at high risk for vascular complications. The article presents a clinical case of treatment of a 23-year-old patient with multiple blind splinter wounds of the neck and upper third of the left shoulder with the formation of an arteriovenous fistula, spinal cord injury, who underwent surgery to install an endoprosthesis in the subclavian artery by X-ray endovascular method. The described case shows the importance of high-tech X-ray endovascular minimally invasive techniques for patients with polytrauma, as this method improves the results and outcomes of treatment of patients with polytrauma.
For citation: Shabaev R.M., Ivanov A.V., Lischuk A.N. Treatment of arteriovenous fistula by endovascular method to a patient with polytrauma. Description of the clinical case. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 41–45. DOI 10.46393/27821714_2022_4_41
Literature
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REVIEW OF STUDIES IN EXTERNAL FACTORS AND GENETIC BACKGROUND TO COMBAT PTSD
A.M. Reznik
46-54
Medical Institute of Continuing Education of the Moscow State University of Food Production
Summary
Post-traumatic stress disorder (PTSD) is the most common consequence of combat mental trauma, which has a high degree of comorbidity and a significant impact on social functioning. At the same time, conflicting views remain on the risk of its occurrence, the dificulties of differential diagnosis, prevention and treatment, which is largely due to a lack of knowledge about the biological mechanisms of stress disorders. Based on the analysis of publications available in scientific medical databases of the last twenty years, it has been shown that combat stress has a complex nature with the total effect on the individual of many pathogenic factors that are superimposed on individual vulnerability, in the development of which, most likely, genetic variations identiffied in recent years are important. Most PTSD-associated polymorphisms are related to the risk loci of other mental disorders, which makes it difficult to assess their role in the development of reactive states. Rerefore, it is of interest to elucidate how the genetic risk is realized. In this regard, it was interesting to find a feedback between traumatic stress and environmentally sensitive mechanisms of DNA methylation and histone modification. The chains of neurobiological disorders triggered by epigenetic changes can persist after the end of the action of psychological traumatic stressors.
For citation: Reznik A.M. Review of studies in external factors and genetic background to combat PTSD. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 46–54. DOI 10.46393/27821714_2022_4_46
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LEGAL REGULATION OF SANATORIUM TREATMENT AND MEDICAL REHABILITATION
A.D. Fesyun1,2, M.Yu. Yakovlev2
56-59
1 Medical Institute of Continuing Education of the Moscow State University of Food Production 2 National Medical Research Center of Rehabilitation and Balneology of the Ministry of Health of Russia Federation
Summary
The article highlights the problems of legal regulation in the Meld of medical rehabilitation and sanatorium treatment. The areas requiring improvement of the legislative framework for effective functioning are marked. The main legal and regulatory acts, providing work in this sphere at all levels from more to less, are provided.
Key words: legal regulation, medical rehabilitation, sanatorium treatment, public health, quality of life
For citation: Fesyun A.D., Yakovlev M.Yu. Legal regulation of sanatorium treatment and medical rehabilitation. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 56–59. DOI 10.46393/27821714_2022_4_56
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Ушаков И.Б., Бобровницкий И.П. Воздействие факторов внешней среды на здоровье человека: методы оценки и профилактики заболеваний. Russian Journal of Rehabilitation Medicine. 2016; 2: 3–31.
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EXPERIENCE IN SURGICAL TREATMENT OF DAMAGE TO THE STRICTURES OF EXTRAHEPATIC BILE DUCTS
I.R. Nabiullin1, A.S. Kataev2
60-63
1 National Medical and Surgical Center named after N.I. Pirogov 2 Medical Institute of Continuing Education of the Moscow State University of Food Production
Summary
The article discusses the problems of treating patients with injuries and strictures of extrahepatic bile ducts. The general and particular factors of biliary tract damage are analyzed. The issues of the technique of surgical interventions are outlined. The results of treatment are interpreted.
Key words: stricture of extrahepatic bile ducts, transfusion of extrahepatic bile ducts, hepaticoejunostomy, biliodigestive anastomosis, persistent cholangitis, biliary hypertension, functional liver tests
For citation: Nabiullin I.R., Kataev A.S. Experience in surgical treatment of damage to the strictures of extrahepatic bile ducts. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 60–63. DOI 10.46393/27821714_2022_4_60
Гальперин Э.И., Чевокин А.Ю., Дюжева Т.Г., Гармаев Б.Г. Выбор метода операции в зависимости от типа высокой рубцовой стриктуры печеночных протоков. Анналы хирургической гепатологии. 2003; 8 (2): 86–87.
DOCTORS' CRIMINAL LIABILITY IN CASE PATIENT'S DEATH DUE TO MASSIVE OBSTETRIC BLEEDING
I.Yu. Breslav
64–67
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Summary
Obstetricians and gynecologists occupy leading positions among doctors of surgical specialties brought to criminal responsibility. The article presents improper provision examples of medical care in obstetrics: similar acts resulting in death or serious bodily harm were qualified under various articles of the Criminal Code of the Russian Federation (part 2 of article 109, part 2 of article 118, p. "c" part 2 of article 238 of the Criminal Code of the Russian Federation). The problem of the complexity of qualification of the acts of medical workers under Art. 238 of the Criminal Code of the Russian Federation and delimitations from the general norm, Part 2, Art. 109 of the Criminal Code of the Russian Federation. The most frequent defects in the provision of medical care, leading to massive obstetric bleeding and maternal mortality, are analyzed. Evidence of a different approach of the law enforcement officer to the qualification of such acts of medical workers is presented.
Key words: criminal liability, professional offenses, medical care, improper provision of medical care, service that does not meet security requirements, causing death, obstetrician-gynecologist, pregnancy, delivery, fetus
For citation: Breslav I.Yu. Doctors' criminal liability in case patient's death due to massive obstetric bleeding. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 64–67. DOI 10.46393/27821714_2022_4_64
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Приговор Заволжского районного суда г. Ульяновска от 5 марта 2020 г. по делу № 1-19/2020. [Электронный ресурс] URL: https://bsr.sudrf.ru/bigs/portal.html
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Игонина Е.О. Квалификационные казусы применения ст. 238 УК РФ при расследовании ятрогенных преступлений. Вестник Московского университета МВД России. 2022; 1: 128–134.
Канунникова Л.В., Морозова Н.А. Уголовное преследование за ненадлежащее оказание медицинской помощи по ст. 238 УК РФ: обзор судебной практики. Медицинское право. 2021; 6: 51–56.
Быкова Е.Г., Яшков С.А. Медицинская услуга как предмет преступления, предусмотренного ст. 238 УК РФ. Вестник Московской академии СК РФ. 2019; 1: 62–65.
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THE RELEVANCE OF VITAMIN D IN THE GENESIS OF WOMEN’S HEALTH DISORDERS
T.F. Yumatova, I.V. Budnik
68-74
Medical Institute of Continuing Education of the Moscow State University of Food Production
Summary
The relevance of vitamin D in the genesis of women health disorders remains relevant. The relevance is associated with high insufficiency and defecit of vitamin D in women of different ages. Based on the results of studies vitamin D insufficiency revealed in 38,1% of cases and defecit in 50,4% in women of different ages. Modern correction in women of vitamin D status improves health indicators.
Key words: vitamin D, insufficiency, defecit
For citation: Yumatova T.F., Budnik I.V. Тhe relevance of vitamin D in the genesis of women's health disorders. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 68–74.
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Federal State Budgetary Educational Institution of Higher Education «Moscow State University of Food Production – Russian Biotechnology University»
Summary
The Food Safety Department of the Federal State Budgetary Educational Institution of Higher Education «Moscow State University of Food Production – Russian Biotechnology University» has developed a training program on the design of food safety management systems. The program includes six modules containing theoretical materials on Hazard Analysis and Critical Control Points (HACCP) systems and their audit, collections of practical works for the enterprises of the main food industry profiles, intermediate and final tests. The results obtained during the training of students made it possible to create a professional development program for food industry specialists.
Key words: Hazard Analysis and Critical Control Points system (HACCP), safety management systems, food safety, training program, food industry
For citation: Tulyakova T.V., Kryukova E.V., Paramonov G.V. et al. Training in the basics of safety management system design in a food university is an urgent industry requirement. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 80–83. DOI 10.46393/27821714_2022_4_80
Literature
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Тулякова Т.В., Крюкова Е.В., Парамонов Г.В. Проблемы обеспечения биологической безопасности пищевых продуктов. Вестник Медицинского института непрерывного образования. 2022; 2: 52–54.
Доктрина продовольственной безопасности Российской Федерации. Утверждена Указом Президента Российской Федерации от 21.01.2020 No 20. М.: ФГБНУ «Росинформагротех», 2020. 23 с.
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THE ROLE OF GOST R ISO 9001-2015 IN THE IMPLEMENTATION OF AN INTEGRATED MANAGEMENT SYSTEM FOR THE FOOD INDUSTRY
T.N. Kolomnikova, E.D. Goryacheva
84-87
Federal State Budgetary Educational Institution of Higher Education «Moscow State University of Food Production – Russian Biotechnology University»
Summary
The article deals with the possibility of implementing integrated management systems based on the standard GOST R ISO 9001-2015, as well as methods of implementing an integrated management system in the food industry enterprises. As a result of the study, it was found that GOST R ISO 9001-2015, being the basis for an integrated management system at such enterprises, establishes a minimum set of requirements for a quality management system to ensure confidence in the stable production of products in accordance with the requirements of consumers, society and other stakeholders.
Key words: international standard, integrated management system, food safety management system, Hazard Analysis and Critical Control Points (НАССР), quality management system, documented information, analysis, effectiveness, efficiency
For citation: Kolomnikova T.N., Goryacheva E.D. The role of GOST R ISO 9001-2015 in the implementation of an integrated management system for the food industry. Bulletin of the Medical Institute of Сontinuing Education. 2022; (4): 84–87. DOI 10.46393/27821714_2022_4_84
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