Journal of Clinical Medicine of Kazakhstan

J Clin Med Kaz 2014;4(34):10-19

Authors: Gulziya Ismailova, Bakytgul Yermekbayeva, Bakhit Zhussupova, Aliya Iskakova, Zharilkasin Esmagambetov, Galiya Shaimardanova, Raushan Kumisbekova

Breast Cancer one of the most widespread cancer form in the world, and from the scientific point of view one of the most studied cancer types. The success of breast cancer treatment depends on staging of the disease, family history, and also HER2 characteristics. The analysis of qualitative characteristics of breast cancer diagnostics, staging and treatment will allow reduce recurrence risk of breast cancer using required standard treatment.

J Clin Med Kaz 2014;4(34):25-29

Authors: Zhanna Serikova, Saule Abisheva

The article is a review of the literature on a research of effectiveness of the education programs for patients with rheumatoid arthritis. The review included randomized controlled trials, systematic reviews and meta-analyzes. Various methods of teaching patients with rheumatoid arthritis, a comparative study of teaching methods, problem-based learning, the use of printed material such as leaflets, booklets, mental maps, multimedia resources, assessment tools for needs of patients with rheumatoid arthritis were used in obtaining the information. Volume 4, Number 34 (2014)

J Clin Med Kaz 2014;4(34):34-39

Authors: Valentina Delevskaya

The aim: To study the changes in connective tissue metabolism at progression of bronchoobstruction in patients with chronic obstructive pulmonary disease in combination with arterial hypertension and to determine the character of their correlations with parameters of respiratory function. Methods: We investigated the level of serum chondroitin sulfates, glycoproteins, glycosaminoglycans and their fractional composition in 62 patients with chronic obstructive pulmonary disease of II and III degree of severity of airflow limitation with concomitant arterial hypertension. Results: The patients had elevated serum levels of chondroitin sulfates, chondroitin-6-sulfates, glycoproteins and reduced levels of dermatan / chondroitin-4-sulfates and keratan- / heparan sulphates. While progression from II to III degree of severity of airflow limitation, along with increased levels of glycoproteins the patients had chondroitin-6-sulfates and chondroitin-4-sulfates increase and heparan sulphate decrease, that may indicate impaired synthesis of the latter type of glycosaminoglycans and expressed extracellular matrix degradation processes. Study revealed moderate and strong correlations between parameters of respiratory function, chondroitin-6-sulfates, heparan sulfates and glycoproteins may indicate their involvement in the pathogenesis of bronchial obstruction in chronic obstructive pulmonary disease and arterial hypertension. Conclusion: Serum levels of chondroitin-6-sulfates, glycoproteins and heparan sulfates may be used in predicting bronchoobstruction progression in patients with chronic obstructive pulmonary disease and arterial hypertension. Volume 4, Number 34 (2014)

J Clin Med Kaz 2014;4(34):46-48

Authors: Rikhsi Sabirova, Munojat Kulmanova

The aim. To study cytokines in experimental hepatitis depending on the timing of study. Methods. Experiments were carried on 60 white male rats weighing 100-120 g. Heliotrinic hepatitis (HH) was reproduced by oral injection of heliotrin solution, acidified with hydrochloric acid (pH 7.0) at the rate of 50 mg / kg (5 mg heliotrin per 100g) weight once a week for 42 days. Then animals were decapitated on the 60th, 90th and 120th days of the experiment. Interleukin (IL-1b, IL-2, IL-6) and tumor necrosis factor-alpha (TNF-α) were determined on ELISA analyzer of «Stat-Fax» (USA) firm using a set of test kits produced by LTD «Cytokine» (St. Petersburg). Results. In the dynamics of the development experimental heliotrinic hepatitis set of induction of cytokines IL-1b, IL-2, IL-6, the most increase these cytokines in comparison with intact animals was on the 90th day of the experiment. Conclusion. Immune dysfunction plays an important role in progression of pathophysiological processes, in course, severity and outcome of the disease in heliotrinic hepatitis. Volume 4, Number 34 (2014)

J Clin Med Kaz 2014;4(34):54-57

Authors: Timur Omarov, Liliya Omarova

The aim. To study the influence of intestinal Candidiasis on immune status and severity of clinical implications in patients with nonspecific ulcerative colitis. Methods. The patients with nonspecific ulcerative colitis (NUC) infected by Intestinal Candidiasis, were divided into 2 groups depending on the severity. The first group – 15 patients with moderate NUC severety, the second - 15 patients with mild severity. The state of the immune status, depending on the severity of nonspecific ulcerative colitis was studied. Cell-bound immunity was assessed by uniform method, the main classes of immunoglobulins (G, A, M) by radial immunodiffusion according to Mancini. The identification of gram-positive cocci and Gram-negative rods pure cultures was performed by microbiological computer analyzer “Microtax” of firm “Sy-Lab” (Austria). Results. A significant decrease in the number of To lymphocytes, the increase of immunoregulatory index Tx/Ts by reducing the amount of Tc and functional activity of Tx, reduction of killer suppressor T- lymphocytes in the peripheral blood, increase in CIC, decrease in В19+ and increase in IgG and decrease in IgA and IgM were identified in patients with moderate NUC severity infected by Candidiasis. In 89 % of patients with NUC colonic bacteria associated not only with a significant reduction of obligate bifidobacteria, but also with active growth of opportunistic bacteria. More marked impairment of microbial spectrum was observed in first group. Conclusions. In patients with moderate NUC severity on the background of a violation of the microbial spectrum of the large intestine showed significant changes in cell-bound and humoral immunity and led to worse clinical severity. Volume 4, Number 34 (2014)

J Clin Med Kaz 2014;4(34):61-65

Authors: Tuba Tulay Koca, Aydın Arslan

Spinal meningioma is a benign tumor, with a slow but severe course of symptoms, demonstrating different neurological deficits according to the anatomic region. Diagnosis is generally made with magnetic resonance imaging (MRI). A 74-year-old female presented with chronic atypical low back pain spreading bilaterally to the thighs and progressive difficulties in walking with a history of onset after surgery for gallbladder stones. There was no neurological deficit in the physical examination. MRI revealed a spinal intramedullary mass at T8-9 level, 1.5 cm in size. Laminectomy and instrumentation were applied. Post-operative histopathological examination reported the case as ‘psammomatous’ and ‘meningothelial’ Grade I. The lower back pain and difficulty in walking improved rapidly postoperatively. The aim of this paper was to emphasise the importance of early investigation with MRI and differential diagnosis of spinal tumors in patients presenting with complaints of persistent atypical low back pain and sciatica. Volume 4, Number 34 (2014)

J Clin Med Kaz 2014;4(34):70-74

Authors: Sahipzhamal Idrissova, Galiya Shaimardanova, Saltanat Abdraimova, Karlygash Kuzembayeva, Assem Tuleyeva

This article is a clinical report about supervision of 2 patients with Konovalov-Wilson’s disease, Hepatolenticular degeneration. The disease started when they were young; in one of the cases patient was diagnosed incorrectly as Myasthenia and was observed for quite a long time. In both cases there was no evidence of positive family history. Both patients have a diverse severe damage of the liver. In one of the cases cirrhosis led to severe coagulopathy with marked decrease in coagulation factors, platelets and increased bleeding time of the hemostasis system with decreasing the level of platelets, lengthening of indicators of coagulogram was diagnosed. Both patients have a severe damage of nervous system with combination of extrapyramidal and cerebellar signs. Cognitive function was affected as well creating diverse presentation of symptoms. Volume 4, Number 34 (2014)

J Clin Med Kaz 2014;4(34):77-79

Authors: Aigul Syzdykova

The main factor, which defines the level of patient risk of fall in hospitals is age. The highest risk is among people older than 60 years. This is due to age related loss of muscle strength, reduced coordination and impaired vision. Volume 4, Number 34 (2014)