RUDN Journal of Medicine

Editor-in-Chief: KOBALAVA Zhanna D., Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of Department of Propaedeutics of Internal Medicine, RUDN University, Moscow, Russia

ISSN: 2313-0245 (Print) ISSN: 2313-0261 (online)

Founded in 1997. Publication frequency: quarterly.

Open Access: Open Access. APC: no article processing charge

Peer-Review: double blind. Publication language: Russian, English

PUBLISHER: Peoples’ Friendship University of Russia (RUDN University)

Journal History

Indexation: Russian Index of Science Citation, Google Scholar, Ulrich's Periodicals Directory, WorldCat, East View, Dimensions, DOAJ, Lens, Research4Life, EBSCOhost, ResearchBib, JournalTOCs, British Library, Bodleian Libraries (University of Oxford), Ghent University Library 

 

RUDN journal of Medicine is published since 1997 with a periodicity of 4 issues per year. Publishing mission - to make the results of scientific researches of Russian scientists available for foreign academics. The editorial board includes recognized in the medicine and health care professionals in Russia and abroad.

Themes of articles are largely varied. They reflect the results of scientific work in the performance of master's and doctoral theses, as well as other relevant research, including search and reflecting the improvement and expansion of existing preventive, diagnostic, treatment and rehabilitation methods.

The journal publishes articles both university staff and authors from other medical schools and medical faculties of universities in the country, as well as various medical institutions in Russia, CIS and far abroad.

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Current Issue

Vol 26, No 1 (2022): PHYSIOLOGY

Physiology

Carboxypeptidase A3 in the structure of the protease phenotype of mast cells: cytophysiological aspects
Atiakshin D.A., Kostin A.A., Trotsenko I.D., Shishkina V.V., Tiemann M., Buchwalow I.B.
Abstract

Carboxypeptidase A3 (CPA3) is a specific protease of mast cells (MC) with variable expression and appears to be one of the preformed components of the secretome. CPA3 is involved in regulation of the state of a specifi tissue microenvironment and components of the integrative-buffer metabolic environment in adaptive and pathological processes; it affects implementation of the innate immunity, mechanisms of angiogenesis, processes of the extracellular matrix remodeling, etc. CPA3 identification using protocols of multiplex immunohistochemistry allows specifying details of the organ-specific mast cell population features, including the protease phenotype, mechanisms of biogenesis with cytoand histotopographic criteria, and features of secretory pathways. Numerous biological effects of CPA3, including participation in the regulation of the pulmonary parenchyma and systemic blood flow, in biogenesis and remodeling of the fibrous component of the extracellular matrix, in epigenetic reprogramming, determine the importance of fundamental investigation of the physiological activity of protease and its involvement in the implementation of pathological processes. Further studies will contribute to the detection of the translational value of the mast cell CPA3 expression features as a prognostic factor and a promising molecular target for treatment of socially significant diseases.

RUDN Journal of Medicine. 2022;26(1):9-33
pages 9-33 views
Physiological features of cells and microvasculature under the local hypothermia influence
Guseynov N.A., Ivashkevich S.G., Boyko E.M.
Abstract

Hypothermia or cold therapy is the local or systemic application of cold for therapeutic purposes. Local application of cold is used to control inflammation: pain and swelling, hematoma and trismus reduction. Despite the frequent use of cooling in prosthodontic rehabilitation and in physical therapy, as evidenced by many reports in the literature, there is scientific documentation that suggests disadvantages of using this treatment in maxillofacial surgery and oral surgery. Also the clinical studies that have been carried out in maxillofacial surgery and oral surgery have been conducted in an empirical manner, which casts doubt on the results. In view of this, it is relevant to study the mechanisms of microcirculatory preconditioning and hypothermia. This physiological process is so interesting for the development of medical devices of controlled hardware hypothermia to prevent inflammatory symptoms at the stage of rehabilitation by targeting the vascular and cellular component of the inflammatory process in different areas of the human body. To date, the use of local hardware controlled hypothermia in various pathological conditions in humans is a topical trend in medicine. Microcirculatory bloodstream is directly related to temperature factors. Although there are concepts of vascular spasm or dilatation in the microcirculatory bloodstream during systemic hypothermia, there are no reliable data on the cellular and vascular reactions during local hypothermia. In this paper, a search for fundamental and current scientific work on the topic of cellular and vascular changes under the influence of hypothermia was conducted. The search for data revealed that the mechanisms of intracellular hypothermia are of particular interest for the development of therapeutic treatments after surgical interventions in areas with extensive blood supply. With this in mind, it is relevant to investigate several areas: the role of endothelium, glycocalyx and blood cells in microcirculatory-mediated preconditioning and intracellular hypothermia, and in the molecular mechanism that regulates these processes, whether they occur in the same way in all tissues.

RUDN Journal of Medicine. 2022;26(1):34-41
pages 34-41 views
Trace elements content in the hair of patients at the maxillofacial surgery department
Gedulyanov M.T., Kiyaeva E.V.
Abstract

Relevance. The urgency of the problem of traumatism is constantly increasing, which is associated with an increase in road accidents, an increase in the number of interpersonal conflicts, the availability of firearms and cold steel weapon, etc. In addition, the proportion of victims with injuries of the maxillofacial region in a state of alcoholic intoxication is constantly growing. The aim of the study is to conduct a comparative analysis of trace elements in hospitalized patients with maxillofacial trauma, intoxicated, acute traumatic stress and the study of the effect of trauma on the balance of trace elements in patients of the Department of Maxillofacial Surgery with various alcohol history. Materials and Methods. The study involved 30 male patients of the department of maxillofacial surgery of the Moscow «city clinical F.I. Inozemtseva hospital located in the city of Moscow. All patients were joined to the department for trauma of the maxillofacial tract and were divided into two groups: 15 of them regularly took alcohol and were in a state of alcoholic intoxication at the time of injury (group 1), 15 - without alcohol history (comparison group 2). All patients carried a general clinical blood test, a biochemical blood test, and the content of essential and conditionally essential elements in the hair were also determined. Results and Discussion. As a result, significant differences were revealed in the content of micro elements between the groups of patients: the content of copper (p = 0.013) and zinc (p = 0.000) in the hair examined of the first group was 1.4 lower than in the comparison group 2. The manganese content (p = 0.05), on the contrary, was also increased by 1.4 times in the hair of group 1 patients. Besides, leukocytosis was detected in the blood in patients with a history of alcohol and an increase in AST levels. Conclusion. The study showed an increase in the content of manganese and a decrease in the content of selenium, zinc and copper in the hair of patients with an alcoholic history. Diselementosis was accompanied by a significant increase in aspartate aminotransferase activity, as well as leukocytosis and lymphocytosis. Such an imbalance of chemical elements, together with a changes of peripheral blood and an increase in the activity of ASaT, can be reflected on the period the timing and peculiarities of the course of the reparative process.

RUDN Journal of Medicine. 2022;26(1):42-50
pages 42-50 views
Auto-antibodies to cardiomyocyte proteins dynamics at different stages of simulated muscle loads
Belyaev N.G., Levochkina E.D., Baturin V.A., Rzhepakovsky I.V., Abasova T.V., Piskov S.I.
Abstract

Relevance. Early diagnosis of chronic overstress among athletes remains an important problem for coaches and specialists in the field of sports physiology and medicine. The goal is to study in an animal model the dynamics of autoimmune response to physical activity of different duration and intensity and to establish the prospects of the method of determining autoantibodies to cardiomyocyte proteins as an indicator of the morphofunctional state of the heart in the conditions of adaptation to muscle loads. Materials and Methods. The study was conducted in male white rats. Animals were subjected to 9 weeks of training simulated with treadban. The intensity of the load changed the angle of inclination and the speed of the tape. The amount of cardiospecific autoantibodies (auto-AB) to troponin I, to alpha-actin 1, to the human cardiac beta-myosin heavy chain MYH7 was determined in the blood by enzyme immunoassay. The relative heart mass was measured. Histomorphological assessment of cardiomyocyte condition was carried out. Statistical processing was carried out using the Student and Mann-Whitney criteria. Results and Discussion. Animal training was accompanied by moderate cardiac hypertrophy of pathological changes in cardiomyocytes. Heart weight increased by 6.9 %; 10.6 %; 12.9 % in the dynamics of 6-8-9 weeks of training. Concentrations of auto-AB to troponin I and to alpha-actin 1 were characterized by cyclicity, manifested by an increase in week 2 and a decrease by the 8th and 9th weeks of training. In the dynamics of 0-2-8-9 weeks of the experiment, the amount of auto-AB to troponin I was: 3.1±0.3; 4.2±0.9; 2.1±0.2; 2.0±0.04 ng/ml. For auto-AB to actin: 26.7±1.2; 31.3±1.4; 13.7±1.8; 12.1±1.6 ng/ml, respectively. The level of auto-AB to beta-myosin was manifested by a decrease in the dynamics of 0-6-9 weeks of training and amounted to: 16.3±0.9; 10.9±1.5; 8.2±0.8; 9.6 ±0.9 ng/ml. Conclusion. The results of determining cardiospecific auto-AB demonstrate a clear response of the immune system to the processes taking place in cardiomyocytes, which makes it possible to recommend further study of the method of determining auto-AB to cardiomyocyte proteins as a diagnostic test of the functional state of the heart muscle during the period of adaptation to physical activity.

RUDN Journal of Medicine. 2022;26(1):51-61
pages 51-61 views
The rabbits retina functional state after exposure to low-frequency ultrasound: electroretinogram indicators analysis
Vafiev A.S.
Abstract

Relevance. Currently, several groups of scientists are working on the implementation of low-frequency ultrasound in surgery of the retina and vitreous body. But there are not enough articles on the study of the functional activity of the retina when exposed to this type of energy. Electrophysiological research methods make it possible to analyze and evaluate the safety, effectiveness of surgical interventions, the effect of new drugs at the level of neurons and visual pathways. The electroretinography method makes it possible to record the bioelectrical activity of retinal neurons during light stimulation during dark and light adaptation. The aim of the study is to carry out a comparative analysis of the aand b-wave indices of the rabbit electroretinogram after experimental removal of the vitreous body using low-frequency ultrasound and mechanical action. Materials and Methods. Experiments were carried out in two groups of Chinchilla rabbits (n = 40). In the experimental group, surgery to remove the vitreous body was performed using low-frequency ultrasound, in the control group a fragmentator with guillotine mechanism was used. Before and after the surgery (1, 7, 14, 30 days) an electroretinogram was recorded, the parameters of the amplitude and latency of the aand b-waves were measured. Results and Discussion. In both groups, a sharp decrease in all parameters was observed on day 1. Later, on the 7th day, the dynamics of the latency of aand b-waves slightly decreased than the preoperative values. On the 14th day after the exposure, the amplitude and peak latency of the aand bwaves in both groups remained at the same level as on the 7th day. On the 30th day, the indicators increased, which indicates the restoration of the functions of photoreceptors and Mueller cells in both groups. There were no statistically significant differences between the study groups at all periods of the study. Conclusion. The use of low-frequency ultrasound for vitreous removal can be considered safe and has prospects for further development and application.

RUDN Journal of Medicine. 2022;26(1):62-68
pages 62-68 views
Astragalus membranaceus infusion effect on rats learning in the radial maze
Karetnikova A.Y., Matvienko U.A., Savinova D.A., Denikaeva E.A., Durnova N.A.
Abstract

Relevance. Treatment of cognitive impairment is a serious problem for modern medicine. Alzheimer’s disease and Parkinson’s disease are chronic progressive neurodegenerative diseases and the most common cause of progressive dementia in the elderly. There is no effective therapy for these diseases, so it is necessary to search for integrated therapies, including herbal medicine. The aim was to study a short-term and long-term memory of rats in the test «eight-arm radial maze» under the infl of repeated administration of an aqueous extract of the herb Astragalus membranaceus (Fisch.) Bunge. Materials and Methods. The experiment was carried out on 18 non-linear rats, divided into 3 groups - control and 2 experimental. For 21 days, the animals received daily intragastric caffeine at a dose of 5 mg/kg, infusion an aqueous extract of Astragalus membranaceus (Fisch.) Bunge at a dose of 100 mg/kg. The control was injected with drinking water by weight. To study the cognitive functions of the maze, performing two series of tests - at 2-7 and 16-21. Results and Discussion. In the course of the study, it was found that when the animals were tested for 2-7 days, there were no signifi changes between the groups. With an increase in the duration of administration of the test substances by the 16-21 days of the experiment, in the second test series, an increase in memory points was observed both in the second (caffeine, 5 mg/kg) and in the third ( Astragalus membranaceus (Fisch.) Bunge, 100 mg/kg) of the experimental groups. Conclusion. The introduction of caffeine at a dosage of 5 mg/kg infl d the activation of short-term and long-term memory with a duration of more than 17 days of administration - at the 2nd stage of testing. Astragalus membranaceus (Fisch.) Bunge (100 mg/kg) caused the activation of working and long-term spatial memory from the 16th day of the experiment - on the 2nd series of tests.

RUDN Journal of Medicine. 2022;26(1):69-78
pages 69-78 views

SOCIAL HEALTH AND HEALTH PROTECTION

Nursing process application in Nepal teaching hospital
Katel K.
Abstract

Relevance. Nursing process is a scientific method of organizing and providing nursing care. Due to imbalance of nurse patient ratio, application of nursing process in actual clinical setting is very limited which reduces the quality nursing care. Despite the importance of application of nursing process, there is no standard nursing process protocol available in the hospital where study was carried out. The governments set a standard nurse patient ratio in Nepal, UK and USA is 1:10, 1:8, and 1:5 respectively. However, global statistic has been revealed due to improper nurse patient ratio which cannot implement the nursing process for patient caring which are being for leading cause of mortality of patient in hospitals. Aim of the study. The study was conducted to assess the application of the nursing process among nurses working in teaching hospital. Additionally, this study explores the association between status of application of nursing process and selected variables. Materials and Methods. Based on a descriptive cross-sectional study design. A simple random sampling technique was applied for nurses working in tertiary hospital of Chitwan, Nepal. The data was collected using structured questionnaire among 182 nurses. The statistical analysis tool chi-square was used to find out the association and logistic bivariate to find out the odds ratio. Results and Discussion. The result indicates that only 23,1 % of nurses have moderate level of application of nursing process. Majority of nurses did not follow standard ways of nursing process. This study also explored the infl ncing variable for barriers related to nurses and profession. Age (p=0.001), professional qualification (p=0.001) and learning approach (p=0.022) were the significant influencing variable for barriers related to nurses whereas practical skill (p= <0.001), cooperation among nurses (p=0.008) and diffi in diagnosis characteristic (p=0.010) were the barrier related to profession. Conclusion. It was concluded that the majority of nurses working in teaching hospital of Nepal did not follow the standard ways of nursing process so that barriers for the application of nursing process are identifi The overall ratio of nurses to patients in the teaching hospital is 1:16, that is in the lower range than the standards set by the government. Therefore, special attention must be paid to adherence to a standardized nursing process protocol for quality medical care.

RUDN Journal of Medicine. 2022;26(1):79-87
pages 79-87 views
Diagnostics errors as the reasons for the discrepancy between clinical and pathoanatomical diagnoses
Lebedeva A.M., Bereznikov A.V., Berseneva E.A., Onufriychuk Y.O., Shkitin S.O., Makarets N.V.
Abstract

Relevance. The development of medical science has made it easier for clinicians to diagnose specific diseases, often leading to the reduction of traditional diagnostic methods, including differential diagnosis. As a result, there is an increase in medical errors in diagnosis, the choice of treatment tactics, including in cases with the development of an unfavorable outcome. The aim of the study was to identify typical errors in the differential diagnosis of diseases in cases with a fatal outcome in the departments of both therapeutic and surgical profiles. Materials and Methods. At the first stage of the retrospective cohort study, fatal cases were analyzed for the correctness of the final post-mortem clinical diagnosis and the results of its comparison with the pathoanatomical diagnosis based on the results of the examination of the quality of medical care in compulsory health insurance. Errors in the formulation of the post-mortem clinical diagnosis were identified, and their causes were determined. At the second stage, the scenario method determines three variants of risk realization in the case of divergence of the final clinical and pathoanatomical diagnoses, with an assessment of the frequency of risk variants realization in the surgical and therapeutic profiles . Results and Discussion. When analyzing cases of fatal outcomes with a discrepancy between the final clinical and pathoanatomical diagnoses, the main errors in the formulation of the final clinical diagnosis were identified. In the first variant of risk realization, the reason for the discrepancy is the incorrect formulation of the final post-mortem diagnosis. In the case of the second scenario, violations relate to incorrect diagnostic tactics when a new disease or exacerbation of a chronic disease occurs. In the third scenario, violations are associated with incorrect differential diagnosis: the initial restriction of the range of nosologies for diagnostic search. Conclusion. Typical violations of diagnosis and differential diagnosis leading to a discrepancy between the final clinical and pathoanatomical diagnoses are identified. As part of the provision of medical care in surgical specialties, the second scenario is more often identified: incorrect diagnostic tactics when a new disease appears or a chronic disease worsens. When providing medical care in therapeutic specialties, violations are more often detected in the third scenario: incorrect differential diagnosis, initial restriction of the range of nosologies for diagnostic search. The second and third scenarios create legal risks for the doctor and the medical organization when evaluated by the relevant authorities.

RUDN Journal of Medicine. 2022;26(1):88-95
pages 88-95 views

SURGERY. ANDROLOGY

Reproductive potential repair in men with varicocele
Roitberg G.E., Dorosh Z.V., Tarasova T.V., Saushev I.V., Tyurina E.P., Shuligina I.V.
Abstract

Relevance. In majority of men, varicose veins of the testicle - varicocele - does not cause discomfort and is asymptomatic, and scrotal pain only bothers 10 % of patients. In 2/3 of cases, varicocele is a clinical finding. In this case, varicocele is the most common cause of male infertility. Aim of the study. Recovery of the reproductive potential of patients with varicocele. Materials and Methods. In 219 patients with varicocele, we’ve carried an ejaculate study out (WHO, 2010) 3, 6, 12 months after surgical treatment of varicocele. We considered the reproductive function restored by normozoospermia in the ejaculate and the onset of pregnancy in the spouse during the follow - up period of 12 months. Results and Discussion. The 2/3 men of the 219 patients with varicocele had ejaculate abnormalities. The age of patients who were diagnosed with pathospermia was 31+11 years. 66 (39.5 %) patients with varicocele had spermatozoa with reduced mobility. After surgical treatment (varicocelectomy according to Marmara), normozoospermia was present almost in every second man. Nevertheless, the number of pregnancies in a married couple was higher than 6 months after varicocelectomy - 24(32.8 %). The surgical method of treatment of varicocele allows to restore the reproductive function of a man in 30 %. In our study, normozoospermia after varicocelectomy was recorded in almost every second patient. Ultrasound changes in the testicle with varicocele are an unfavorable prognosis for the restoration of male fertility. Conclusion. Surgical treatment of varicocele can recover the reproductive potential of almost every second man of reproductive age. Moreover, a greater number of pregnancies six months right after the operation were registered in spouses.

RUDN Journal of Medicine. 2022;26(1):96-102
pages 96-102 views

PSYCHIATRY

Depression prevalence in cancer patients: a cross sectional study
Jahagirdar R.
Abstract

Relevance. Depression has substantial effects on cancer patients’ quality of life. Estimates of its prevalence vary widely. Aim of the study was to evaluate the prevalence and severity of depression in cancer patients. Materials and Methods . All cancer patients admitted at tertiary care Dr. Vithalrao Vikhe Patil Foundation’s Medical College Hospital (Dahod, Gujarat, India) between December 2015 to December 2016 were included in this study. All subjects gave informed consent to participate in the investigation and personal data processing. Depression in cancer patients was screened using the Mini International Neuropsychiatric Interview (MINI) questionnaire and administered the Hamilton Depression Rating Scale for severity of depression. Results and Discussion. Out of 128 cancer patients screened, 44 (34 %) patients were identified to have depression using MINI. Among them mild to moderate depression was seen in 60.4 % depressed patients, and severe to very severe depression was present in 39.4 % patients. Further analysis showed that the marital status, monthly income and literacy had an impact on the level of depression. Conclusion . The psychological impact of cancer is considerable. The failure to detect and treat elevated levels of psychological distress might jeopardize the result of cancer therapies, decrease patient’s quality of life and increase health care cost. The lack of identifiable risk factors makes the task of diagnosing psychiatric conditions in cancer patients a difficult one. Early recognition of psychiatric distress for the identification of depression is an integral part in the comprehensive management of cancer patients.

RUDN Journal of Medicine. 2022;26(1):103-108
pages 103-108 views

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