Journal «MEDICINA» 1/2022

The aim of the study is to analyze the spatial distribution of the prevalence of tuberculosis, HIV infection and combined pathology in the Altai Territory. Materials and methods. The statistical data provided by the Department of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the Altai Territory, the Ministry of Health of the Altai Territory, Center for the Prevention and Control of AIDS and Other Infectious Diseases, Altai Tuberculosis Dispensary on the incidence of tuberculosis and HIV infection were used. The ranking was carried out by the method of sigma deviations for all administrative territories of the Altai Territory for 2019, and the cartogram was plotted. Statistical processing and graphical representation of the data obtained was carried out using the programs Statistica 13.0, Microsoft Excel 2014, and ArcGIS. The preparation of the text of the work was carried out using the Microsoft Word 2014 program. Results. A territorial analysis of TB prevalence, HIV infection and the incidence of combined pathology indicated the spread of the zone characterized by an average incidence rate. The zones of high TB prevalence are defined as 5 territories (from 270.5 to 479.4.0 per 100 thousand population). Also, Barnaul, Biysk, Belokurikhinskaya and Rubtsovskaya were defined as zones of high prevalence of HIV infection (from 843.2 to 1158.3 per 100 thousand population). The territorial distribution of the incidence of combined pathology (Tuberculosis + HIV) mirrors the zoning of HIV prevalence in 4 main zones, and the fifth zone (Slavgorod) is set. Conclusion. The zones of high prevalence of HIV infection and tuberculosis were determined by the negative socio-economic conditions of the region's development. The involvement of young people in drug addiction at a low socio-economic level of the region ensured the rapid development of the epidemic process of this infection. Modern conditions characterized by the development of resort business and tourism have determined the formation of new zones with a high incidence rate.

Key words: HIV infection, tuberculosis, combined pathology, ranking, cartogram

We compared the difficulty of letter recognition in ETDRS charts for English-speaking (according to literature) and Russian-speaking (own data) subjects. In both cases, the proportion of incorrect recognitions was calculated for each letter by dividing the total number of times that letter was read incorrectly on discriminant lines by the total number of times that letter appeared on discriminant lines. Comparison of recognition difficulty for each letter was performed by Fisher's exact test. Among the letters, that significantly differ in recognition difficulty and absent in the Russian alphabet, symbol S was recognized better by Russian speakers, and symbol Z was better recognized by native English speakers. At the same time, the symbol H (common to both alphabets) was significantly easier to recognize by English speakers. Obtained results indicate that native language may affect the ability to recognize optotypes. This may present some difficulty in comparing the results of visometry in different populations, even if charts with letters common to different alphabets are used.

Key words: visometry, visual acuity, ETDRS tables, complexity of optotypes

The article presents the results of the elaboration of techniques for identification and assay of a new active pharmaceutical substance (API) – 3- (1H-benzimidazol-2-yl) -1,2,2-trimethylcyclopentane-carboxylic acid. To identify the API, the method of IR spectroscopy was used, the assay was carried out using the method of direct acidimetric titration in a medium of glacial acetic acid. Methods were validated in accordance with the requirements of the State Pharmacopoeia of the Russian Federation and are suitable for further use in quality control in the production of 3- (1H-benzimidazol-2-yl) -1,2,2-trimethylcyclopentane-carboxylic acid.

Key words: active pharmaceutical substance (API), 3-(1h-benzimidazol-2-yl) -1,2,2-trimethyl cyclopentancarbonic acid, quality control, identification, assay

COVID-19 is a potentially severe acute respiratory infection caused by the SARS-CoV-2 coronavirus. The aim of the study is to describe a case of COVID-19 infection, proceeding with the addition of a bacterial infection and the development of abscess pneumonia in a young adult patient. Material and research methods. The accompanying medical documentation was studied, clinical and morphological analysis was carried out using the description of macro- and micropreparations. Research results. Patient A.E., 31 was hospitalized with a diagnosis of New coronavirus infection, severe course. Community-acquired bilateral pneumonia. Was admitted with complaints of shortness of breath, cough, fever up to febrile levels. Laboratory and instrumental tests were carried out and treatment started. However, the patient's condition worsened, respiratory failure increased, ending in lethal outcome. The postmortem examination revealed signs of bilateral pneumonia with areas of abscess formation. Histological examination revealed focal hemorrhages in the pulmonary parenchyma, merging in places and areas of necrosis of the lung tissue with the formation of «abscesses» (microabscesses). On the periphery of the area of necrosis, a well-defined shaft of granular leukocytes and congested vessels with erythrocyte sludge was noted. Signs of edema were observed in the brain; histological examination revealed perivascular, pericellular optical voids with vascular congestion, erythrocyte sludge and minor hemorrhages. Viral pneumonia caused by coronavirus and the addition of a bacterial infection, in this case staphylococcus, led to abscessed pneumonia and severe respiratory failure. Conclusion. The presented case of SARS-CoV-2 infection in a young adult patient is of particular importance and relevance, as it demonstrates an unfavorable outcome of the disease despite a young age and the absence of concomitant pathology.

Key words: COVID-19, pneumonia, microabscesses, cerebral edema

The article examines the trends in the change of the patient’s role in the treatment process, associated with the development of home telemedicine, as well as the problems arising in this case. The methodological basis of the research was the analysis of scientific publications and generalized practical experience. It has been shown that the development of home telemedicine causes a wider involvement of patients in taking care of their own health and an increase in their role in the treatment process. They are turning from objects of medical services into full subjects of treatment. However, the active participation of patients in the implementation of the methodology of responsible self-care implies increased requirements for the level of their medical literacy. Therefore, special preparation of patients for the use of home telemedicine is necessary. In addition, patients should have access to information that facilitates making responsible decisions in the process of monitoring their condition and the necessary self-treatment.

Key words: patients, home telemedicine, treatment process, responsible self-care, patient education

The article describes the international regulatory framework fixing the definition of reproductive rights. The list of these rights has been identified and analyzed. The incompleteness of fixing human rights in the aforementioned area in the national constitutional and sectoral (medical) legislation is stated, the necessity of introducing the definition of reproductive rights into domestic legislation is formulated. The problem of compliance of the national legal framework in the field of medical legislation with international standards in this area is presented.

Key words: reproductive rights, reproductive violence, international human rights standards, personal rights, positive human rights

Hereditary retinal dystrophies are clinically and genetically heterogeneous group of conditions, many of which have similar symptoms and functional findings, making correct diagnosis difficult. Bietti corneoretinal dystrophy is a rare form of hereditary retinal dystrophy with an autosomal recessive mode of inheritance. With this dystrophy, yellow-white crystals are visualized on the retina and progressive atrophy of the retinal pigment epithelium, pigment accumulation, and sclerosis of the choriocapillaries are observed. A mutation in the CYP4V2 gene leads to the development of the disease. Currently, 50 different CYP4V2 mutations have been described, most of which are missense mutations. The article presents a clinical case of genetically confirmed Bietti corneoretinal dystrophy with a description of the clinical and functional signs that should be considered when making a diagnosis and taken into account in the differential diagnosis of other hereditary retinal dystrophies. Molecular genetic analysis is necessary in doubtful clinical cases, as well as for genetic counseling of relatives at risk and prenatal testing of high-risk pregnancies.

Key words: Bietti corneoretinal dystrophy, genetic analysis, whole exome sequencing, CYP4V2 gene, hereditary retinal dystrophies, missense mutations