In this section you can check out Belarusian author’s publications in foreign periodicals which are accessible in RSML. To order a full text, use Electronic medical library or the Electronic document delivery service.
Марченко, С. В. Сравнительная характеристика эффективности и безопасности оригинальной алтеплазы и ее биоаналога при лечении ишемического инсульта в реальной клинической практике / С. В. Марченко (Минск), В. В. Гиль (Гродно), И. Г. Гиль (Минск) // Журнал неврологии и психиатрии имени С. С. Корсакова [Москва]. – 2024. – Т. 124, № 3, вып. 2. – С. 49–54.(Comparative characteristics of the efficacy and safety of the original alteplase and its complete biosimilar in the treatment of ischemic stroke in real clinical practice) |
Objective: To conduct a comparative analysis between the original alteplase and its biosimilar in terms of efficacy and safety in real clinical practice in the Republic of Belarus. Material and methods: The cohort study included 420 patients. All included patients underwent thrombolytic therapy with alteplase within 4.5 hours of the onset of stroke symptoms according to the approved tactics of the Republic of Belarus and international recommendations. The patients were divided into 2 groups: 215 received the drug Revelisa, 205 – Actilyse. Results: The patients were comparable in gender, age, ASPECTS assessment, but had statistically significant difference in NIHSS was found, due to the large number of patients with NIHSS=16-25 in the Actilyse group. The assessment of premorbid disability also showed a statistically significant difference: there were more patients in the Revelisa group who had functional limitations of varying degrees before the disease, 83 (38.6%) versus 62 (28.3%) patients in the comparison group. Clinical outcomes were comparable, the proportion of patients achieving mRS=0-1 at discharge was 41.5% in group A and 42.8% in group P. The Revelisa demonstrated a statistically significant lower number of deaths in 15 (7.0%) and 29 (14.1%) in the comparison group. The development of a greater number of clinically insignificant petechial hemorrhages was noted after the use of Actilyse. Conclusion: The analysis demonstrated a high level of safety in the use of alteplase preparations in routine practice. The compared fibrinolytics had comparable effectiveness in achieving functional independence after ischemic stroke, despite the more premorbid disability of patients who received a biosimilar. |
Клиническое значение экспрессии мРНК сурвивина (BIRC5) при колоректальном раке / А. В. Орехва (Витебск), Е. А. Шляхтунов (Витебск), В. М. Семенов (Витебск), И. В. Жильцов (Витебск), А. В. Ерушевич (Витебск), Г. М. Шаппо (Витебск), Я. Н. Лях (Витебск), А. В. Орехва (Витебск) // Хирургия и онкология [Москва]. – 2023. – Т. 13, № 4. – С. 17–37.(Clinical significance of survivin (BIRC5) mRNA expression in colorectal cancer) |
The aim of the study was to evaluate the clinical significance of survivin (BIRC5) mRNA expression in circulating tumor cells (CTCs) and tumor material in colorectal cancer (CRC). Materials and Methods. The study was organized as a continuous prospective non-randomized study. Survivin (BIRC5) mRNA expression in CRCs and tumor material was determined by real-time polymerase chain reaction. Results. 130 patients were included in the study: study group – 109 patients with CRC, observation group – 21 patients with colorectal adenomas. All patients underwent complete tumor removal: radical operations – 93.6%, cytoreductive – 6.4%. We found a high level of survivin (BIRC5) mRNA expression in colorectal adenocarcinoma compared to adenomas (pMann-Whitney < 0.001) M ± SD (1.678 ± 2.45 and 0.023 ± 0.07). Survivin (BIRC5) mRNA expression in CSCs both preoperatively M ± SD (1.175 ± 1.33 and 0.052 ± 0.11) and after 3 months M ± SD (1.015 ± 0.93 and 0.018 ± 0.002) was significantly different between the study and observation groups (pMann-Whitney < 0.001). Adjuvant chemotherapy was associated with a decrease in survivin expression level in CTCs (p < 0.0001). In 6 and 9 months after surgery, CTCs persisted in the bloodstream despite adjuvant chemotherapy (p = 0.015 and p = 0.012). Survivin overexpression in CTCs preoperatively correlates with regional lymph node involvement (p = 0.03, r = 0.21), stage of tumorigenesis (p = 0.01, r = 0.25), and degree of tumor differentiation (p = 0.03, r = 0.21). Survivin overexpression in CSCs 9 months after surgery significantly affects recurrence-free survival, hazard ratio (HR) (95% confidence interval (CI): OR 3.1 (95% CI 1.56-6.08, p = 0.0012) and overall patient survival: OP 6.8 (95 % CI 2.65-17.33, p = 0.0001). Conclusions. Survivin mRNA overexpression in CRC is a negative prognostic factor of the disease, directly depends on tumor involvement of regional lymph nodes, stage of the disease, degree of tumor differentiation, contributes to the development of disease recurrence, and can be used to diagnose minimal residual disease and estimate the prognosis of patients’ overall survival. |
Практика работы медицинской сестры по организации помощи детям, больным сахарным диабетом: учебные программы «от инноваций – к качеству жизни» в условиях Союзного государства / Е. Е. Петряйкина, К. И. Григорьев, Т. В. Матвейчик (Минск), О. Ф. Выхристюк (Минск) // Медицинская сестра [Москва]. – 2024. – Т. 26, № 3. – С. 3–11.(Practice of work of a nurse in organizing care for patients with diabetes mellitus: training programs «from innovation to quality of life» in the conditions of the Union State) |
Help and treatment of children and adolescents with diabetes is an important part of the health care system. A socially oriented state is obliged to provide this category of patients with the development and application of the latest methods in the field of preventive diabetology and medical demography, and is obliged to form and educate the correct behavior of children and adolescents, which must be implemented in the family, school, and educational organizations. Of great importance is the use of standards/algorithms for specialized medical care for patients with diabetes, educational programs designed not only to provide knowledge about the disease, but also to teach patients the skills of self-monitoring of the disease, the principles of independent decision-making on treatment and prevention. The article outlines the modern principles of organizing work in “Health Schools” and “Schools of Diabetes Mellitus”, educational programs used by medical workers, and the achieved results of activities in the field of preventing exacerbations of diabetes mellitus in parallel mode both in Russia and Belarus. |
Цервикогенная дисфагия: случай из практики / А. Б. Перминов (Минск), С. Л. Кабак (Минск), Н. О. Жижко-Михасевич (Минск), Ю. М. Мельниченко (Минск), А. Р. Сакович (Минск) // Вестник оториноларингологии [Москва]. – 2024. – Т. 89, № 2. – С. 109–112.(Cervicogenic dysphagia: a case report) |
The article presents a case of pharyngeal dysphagia and obstructive sleep apnea syndrome caused by degenerative-dystrophic changes in the cervical spine with the formation of large cervical osteophytes at the C3-C6 level. Osteophytes caused deformation of the posterior wall of the hypopharynx and narrowing of its lumen by 20-25% from the level of the arytenoid cartilages to the upper parts of the epiglottis. CT scan also showed the intervertebral disc heights lost, as well as osteophytes at the posterolateral margins of the vertebral bodies (disc osteophyte complex). Osteosclerosis in combination with facet arthrosis caused spinal and foraminal stenosis. |
Пальцев, Ю. П. Опасность инфракрасного лазерного излучения для органа зрения / Ю. П. Пальцев, Л. В. Походзей, Г. И. Желтов (Минск) // Медицина труда и промышленная экология [Москва]. – 2024. – № 3. – С. 158–163.(The danger of infrared laser radiation to the organ of vision) |
The article tells about the widespread use of infrared lasers in the fields of human activity. The constantly increasing power of laser installations leads to an increased risk to the health of large groups of workers. Current hygiene standards do not provide adequate eye protection from the harmful effects of this factor. The study aims are a scientific justification for improving the maximum permissible level (MPL) of infrared laser radiation. Materials and methods. To generalize and systematize the results of experimental studies and mathematical modeling to determine the threshold values of the harmful effects of infrared laser radiation on eyeball tissue, the authors used analytical methods. Results. Far infrared laser radiation can pose a danger not only to the cornea, but also to the retina. One of the important indicators affecting the depth of penetration of laser radiation into the structures of the eye and the severity of lesions is the absorption coefficient of the medium. Based on mathematical modeling of the thermochemical destruction of eye tissues, the researchers determined the threshold values of the harmful effects of far-infrared laser radiation, confirmed by the results of experimental studies. The scientists justified the need to introduce a higher coefficient of hygienic reserve in determining the maximum permissible level and recommended new proposals for the hygienic regulation of far-infrared laser radiation. Conclusion. The introduction of new maximum permissible levels will provide more reliable eye protection from far infrared laser radiation. |
Байко, С. В. Атипичный гемолитико-уремический синдром у детей в Республике Беларусь: первый опыт комплементблокирующей терапии / С. В. Байко (Минск), М. Д. Чередниченко (Минск) // Педиатрия. Журнал имени Г. Н. Сперанского [Москва]. – 2024. – Т. 103, № 3. – С. 70–78.(Atypical hemolytic-uremic syndrome in children in Belarus and the first use of complement blocking treatment therapies) |
Atypical hemolytic uremic syndrome (aHUS) is one of the most complex and severe forms of thrombotic microangiopathy with an unfavorable outcome in its natural course. The purpose of this research was to study the epidemiology, demographics, course and outcomes of aHUS in comparison with patients with typical hemolytic uremic syndrome (tHUS) as well as to conduct a personal analysis of all cases of aHUS and evaluate the response to therapy, including complement-blocking with Eculizumab. Materials and methods used: the study was longitudinal, observational and included all 349 cases of HUS in children in Belarus in 2015–2023. A comparative analysis of demographic and clinical data, laboratory results and outcomes was performed in patients with HUS hospitalized at the Center for Pediatric Nephrology and Renal Replacement Therapy of the Republic of Belarus (Minsk, Belarus). Results: of 349 HUS cases, the proportion of aHUS was 3,7% (13). Children with aHUS were older (4,6 (1,6; 6,7) v. 2,7 (1,7; 4,8) y/o with tHUS) due to the portion of patients older than 5 y/o (46%). In aHUS, severe central nervous system disorders were more often observed (62% v. 14%, p=0,002), the development of critical conditions requiring transfer to mechanical ventilation (39% v. 9%, p=0,006), prolonged anuria with the need for dialysis therapy in 100% of cases and severe adverse outcomes (death or end-stage renal disease) during natural course (53,8% v. 2,7%, p<0,001). The most common trigger for aHUS was acute intestinal infections in 54% of cases. A genetic study was performed in 9 (69%) children with aHUS and in 8 (89%) of them the CFHR3/CFHR1 deletions were detected: in 4 cases (3 hetero- and a single homozygous) and heterozygous pathogenic and probably pathogenic gene mutations, CFHR5 in 2 cases, CFH in a single case and combined CD46 and CFI in a single case as well. Antibodies to complement factor H were detected in 5 patients, 3 of which had a CFHR3/CFHR1 deletion. Therapy with a biosimilar of the original Eculizumab showed its effectiveness in aHUS: in 3 (100%) children it was possible to prevent the return of the disease in the kidney graft, in single patient who did not receive prophylaxis it was able to block the recurrence of aHUS in the transplanted kidney while preserving its function, in 3 (100%) patients with late administration of treatment the urine output was restored after prolonged anuria (24, 33 and 59 days); in a single child with the antibody variant of aHUS, with early administration of the drug, renal function was preserved. No complications of complement blocking therapy were noted. Conclusions: the introduction into clinical practice of a biosimilar of the original Eculizumab in children in Belarus has significantly improved the outcomes and prognosis of the disease. |
Применение мезенхимальных стромальных клеток при остром экспериментальном панкреатите / О. А. Куделич (Минск), Г. Г. Кондратенко (Минск), М. П. Потапнев (Минск), О. В. Клименкова (Минск) // Трансплантология [Москва]. – 2024. – Т. 16, № 1. – С. 74–87.(Application of mesenchymal stem cells in severe acute experimental pancreatitis) |
The significance of the problem of acute pancreatitis is due to an increase in the incidence with an increase in the number of common forms of pancreatic necrosis, accompanied by a high incidence of severe complications. Aim. To determine the effect of regional application of mesenchymal stromal cells on the systemic manifestations of severe acute experimental pancreatitis. Material and methods. This experimental study was carried out on 42 adults Wistar rats. Acute pancreatitis was induced by administering 0.3 ml of 5% solution of non-ionic polyethylene glycol octylphenol ether detergent into the caudal part of the pancreas. The animals were randomly divided into 4 groups: Group I (n=6) consisting of intact animals, Group II (control group) (n=12) of rats with untreated pancreatitis, Group III (n=12) of rats with pancreatitis treated:
anesthesia + infusions of 0.9% sodium chloride solution (saline), and Group IV (n=12) of rats with pancreatitis treated: anesthesia + infusions of saline + regional application of mesenchymal stromal cells. Animals were taken out of the experiment by euthanasia on the 3rd and 7th day. The hematological parameters, markers of systemic manifestation of the pathological process (pancreatic amylase, aspartate aminotransferase, alanine aminotransferase, urea, creatinine), markers of endogenous intoxication (lipid peroxidation activity, nitric oxide level), markers of systemic inflammatory response (C-reactive protein, tumour necrosis factor-alpha, interleukin-6) have been evaluated. Results. The application of mesenchymal stromal cells in the early stages of acute pancreatitis made a favourable effect on the platelet count, the level of glycemia, helped to reduce the content of endogenous intoxication elements (malonic dialdehyde, nitric oxide) and of those of the systemic inflammatory response (interleukin-6, tumor necrosis factor-α, C-reactive protein), which are key links in the pathogenesis of severe acute pancreatitis. Conclusion. Comparison of different treatment regimens for acute experimental pancreatitis has shown that the early use of mesenchymal stromal cells has a systemic positive effect and confirms the therapeutic efficacy of the method in
the treatment of this disease |
Возможности ультразвукового метода исследования в диагностике отека легких у пациентов в критическом состоянии, обусловленном печеночной недостаточностью / Д. Н. Марцинкевич (Минск), П. С. Прилуцкий (Минск), А. М. Дзядзько (Минск), Т. А. Севрук (Минск), С. А. Точило (Могилев) // Трансплантология [Москва]. – 2024. – Т. 16, № 2. – С. 186–196.(The potential of the ultrasound method in diagnosing pulmonary edema in critically ill patients with liver failure) |
Pulmonary edema is a common complication in critically ill patients. The liberal tactics of fluid therapy and pathological accumulation of extravascular lung water increase the risks of mortality in Intensive Care Unit patients. Timely and non-invasive diagnosis of pulmonary edema is a primary goal in the intensive care of patients in the Critical Care Unit. We prefer to use lung ultrasound with the registration of B-lines to diagnose lung edema. However, in our country, this method is not validated due to the lack of a sufficient number of clinical studies and necessary regulatory framework. Objective. To assess the potential of diagnostic ultrasonography for pulmonary edema in critically ill patients. Material and methods. A retrospective study was conducted on 27 patients, including 15 males and 12 females aged from 43 to 67 years old (mean age 45.05±17.2 years). All patients were in critical condition due either to acute liver failure, or acute-on-chronic liver failure, or early post-transplant liver graft failure, or posthepatectomy liver failure. Some patients had a systemic inflammatory response syndrome with the development of multiple organ failure and clinical signs of redistribution shock. All patients underwent ultrasound examination of the lungs, and had hemodynamic parameters measured using the transpulmonary thermodilution technique. The data obtained by the two diagnostic modalities were compared. Results. A significant correlation (p<0.05) was found between the extravascular lung water index and the presence of lung edema. We identified a significant correlation (p<0.05) between the number of B-lines and the presence of pulmonary edema. In assessing the relationship between the “B-line” parameter and the “EVLWI” parameter, a strong positive correlation was identified. The area under the ROC curve (AUC) was 0.9±0.06 with a 95% CI [0.77–1.00]. Conclusions. Ultrasound data in diagnosing pulmonary edema have a significant correlation with the level of extravascular pulmonary water. Lung ultrasound is an accurate, non-invasive method for assessing extravascular lung water. It can be used for the rapid and accurate diagnosis of pulmonary edema. |
Оценка вероятности прогрессирования фиброза легких у пациентов с интерстициальными болезнями легких для определения дальнейшей тактики лечения / А. А. Лукашевич (Минск), О. А. Юдина (Минск), Л. С. Богуш (Минск), Е. И. Давидовская (Минск), М. И. Дюсьмикеева (Минск), А. Ф. Белько (Минск) // Туберкулез и болезни легких [Москва]. – 2024. – Т. 102, № 3. – С. 34–40.(Assessment of the probability of lung fibrosis progression in patients with interstitial lung diseases to determine further treatment tactics ) |
Purpose of the study: to develop a method of assessing the probability of lung fibrosis progression in patients with interstitial lung diseases to determine further treatment tactics. Materials and methods. Clinical examination: morphologic and immunohistochemical studies of lung biopsy specimens were performed among 80 patients with ILD. The group with progressive fibrosis consisted of 42 patients. The prognostic model was built using the method of binary logistic regression. Results. A statistical model in the form of regression equation including 3 indicators was developed: presence of morphological pattern of interstitial fibrosis; intensity of CTGF expression; intensity of TGF-β expression. This mathematical model allows predicting with sensitivity 83.3% and specificity 84.2% the progression of pulmonary fibrosis in patients with interstitial lung disease. |
Проблема антибиотикорезистентности: пробиотики как возможный путь решения у детей / Н. В. Скрипченко, С. Е. Украинцев, К. Д. Ермоленко, Т. Н. Самаль (Минск) // Вопросы детской диетологии [Минск]. – 2024. – Т. 22, № 2. – С. 39–46.(The problem of antibiotic resistance: probiotics as a possible solution in children) |
The article gives a brief review of the history of antibacterial drugs and the formation of resistance to them in microorganisms. The data on the main mechanisms of antibiotic resistance formation and the reasons leading to the wide spread of this phenomenon among microorganisms are discussed. The data on the possibility of using probiotics as a factor in reducing the risk of prescribing unjustified antibiotic therapy are presented. Special attention is paid to strain-specificity of probiotics effects and their role in the therapy of children with acute intestinal infections. |
Грудницкая, Е. Н. Недифференцированная дисплазия соединительной ткани у женщин репродуктивного возраста: одномоментное исследование / Е. Н. Грудницкая (Минск), Л. М. Небышинец (Минск) // Акушерство и гинекология [Москва]. – 2024. – № 5. – С. 100–106.(Undifferentiated connective tissue dysplasia in women of reproductive age: cross sectional study) |
Objective: The aim of the study was to identify the prevalence of undifferentiated connective tissue dysplasia (UCTD) and association with a burdened obstetric history (BOH) of miscarriage in women of reproductive age, who residents of the Minsk region (the Republic of Belarus). Materials and methods: From March 2022 to May 2022, a cross sectional study was carried out. It included 384 women aged 22–46 years, who were admitted to healthcare facility “Maternity hospital of the Minsk region” (the Republic of Belarus) with purpose of pregravid preparation. According to the results of comprehensive evaluation, the presence of UCTD, prevalence of clinical signs of UCTD and association of UCTD with BOH were identified. Results: Among women of reproductive age in the Minsk region, UCTD was identified in 35.7% of women (95% CI 30.9–40.7). In the group of patients with UCTD, BOH of miscarriage was 3.5 times more often – in 19/137(13,4%) women compared to women who had no UCTD – in 11/247 (4.5%); OR 3.5 [1.6; 7.5]. Conclusion: High prevalence of UCTD and association with BOH of miscarriage was identified in women of reproductive age, who are residents of the Minsk region. Based on the results of this study, formation of a comprehensive program for identifying UCTD at the stage of pregravid preparation needs to be determined. |
Побиванцева, Н. Ф. Факторы риска развития болезней системы кровообращения по итогам STEPS -исследования в Беларуси в 2016-2017 гг. и в 2019-2020 гг.: что удалось изменить? / Н. Ф. Побиванцевам (Минск, Брест), М. Ю. Сурмач (Гродно) // Проблемы социальной гигиены, здравоохранения и истории медицины [Москва]. – 2024. – Т. 32, № 3. – С. 408–414.([The risk factors of development of circulatory system diseases according the results of STEPS-study in Belarus in 2016-2017 and 2019-2020: what was succeeded to change?) |
The article for the first time analyzes and compares data of STEPS-studies in 2016-2017 and 2019-2020 in Belarus. It demonstrates impact of organizational measures and management decisions at level of the Ministry of Health of the Republic of Belarus on monitoring indicators of main risk factors of development of non-communicable diseases based on results of the study. The prospects of impact of risk factors of development of diseases of circulatory system on levels of population morbidity is demonstrated. The STEPS-studies of 2016-2017 and 2019-2020 were carried out by the authors as coordinators for the Brest region. In Belarus, the study was part of set of the UN measures implemented by the WHO targeted to ensuring increase in standard of living and well-being of population of Belarus. In 2016-2020, Belarus implemented project “Prevention of noncommunicable diseases, promotion of a healthy lifestyle and modernization of the healthcare system in the Republic of Belarus” (BELMED), funded by the EU as international technical assistance project. Within this project with the support of the WHO, national study was organized on prevalence of main risk factors of development of non-communicable diseases (NCDs) in population of the Republic of Belarus aged 18-69 years. The article compares and demonstrates dynamics of indicators of main risk factors of development of diseases of circulatory system (BSC) according STEPS-studies of 2016-2017 and 2019-2020. It is demonstrated that organizational and managerial decisions made on the basis of large-scale studies can affect further prevalence of risk factors of NCDs in population. The problems of prospects for further increasing of incidence of BSC in the Republic of Belarus and their relationship with cardiovascular risks are also highlighted. |