Сибирское медицинское обозрение. 2019. № 5 View full textКоличество просмотров : 2256
Vaiman E., Shnayder N.A., Neznanov N., Nasyrova R.F.
DIAGNOSTIC METHODS OF ANTIPSYCHOTIC-INDUCED EXTRAPYRAMIDE DISORDERS
Vaiman EE, Shnayder NA, Neznanov NG, Nasyrova RF. Diagnostic methods of antipsychotic-induced extrapyramide disorders. Siberian Medical Review.2019;(5):5-13. DOI 10.20333/2500136-2019-5-5-13
Vaiman E.E. ; V.M. Bekhterev National Medical Research Center of Psychiatry and Neurolog; firstname.lastname@example.org
Shnayder Natalya Alekseevna MD, PhD, Prof., Head of the Department of Medical Genetics and Clinical Neurophysiology of Institute of Postgraduate Education; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; 660022, г. Красноярск, ул. Партизана Железняка, д. 1; тел.: 8(391) 2212449; e-mail: email@example.com
Neznanov N.G. ; V.M. Bekhterev National Medical Research Center of Psychiatry and Neurology; firstname.lastname@example.org
Nasyrova Regina Faritovna MD, PhD, Dr.Med.Sci., Leading Researcher, Department of biological therapy mental disorders; St. Petersburg V.M. Bekhterev Psychoneurological Research Institute; Адрес: 192019, Санкт-Петербург, ул. Бехтерева, д.
Drug-induced dyskinesia is a serious, oft en undesirable, adverse reaction. In clinical practice, it is important to diagnose adverse reactions in time for further correction of patient treatment. Th is article discusses scales and questionnaires for assessing antipsychotic-induced tardive dyskinesia, parkinsonism and akathisia in dynamics
Keywords: drug-induced dyskinesia, antipsychotics, extrapyramidal disorders, scales, questionnaires, diagnostics
Barbarash O.L., Zhidkova I.I., Shibanova I.A., Ivanov S.V., Sumin A., Samorodskaya I.V.
GENDER AND AGE CHARACTERISTICS OF COMORBID PATHOLOGY IN PATIENTS UNDERGONE CORONARY BYPASS GRAFTING
Barbarash OL, Zhidkova II, Shibanova IA, Ivanov SV, Sumin AN, Samorodskaya IV. Gender and age characteristics of comorbid pathology in patients undergone coronary bypass graft ing. Siberian Medical Review.2019;(5):14-22.. DOI 10.20333/2500136-2019-5-14-22
Barbarash O. L. Dr. Med. Sci., Professor; Kemerovo State Medical University; Scientific Research Institute of Complex Problems of Cardiovascular Diseases; email@example.com
Zhidkova Irina Igorevna Research Associate of the Blood Circulation Pathology Laboratory; Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases; Irina04046@yandex.ru
Shibanova Irina A. Cand. Med. Sci.; Research Institute for Complex Problems of cardiovascular disease; firstname.lastname@example.org
Ivanov Sergey Vasiljevich ; Research Institute for Complex Issues of Cardiovascular Diseases; Кемерово, ул. Сосновый бульвар, 6; тел.: +7(384)2341902; e-mail: email@example.com
Sumin A.N. Dr.Med.Sci; Research Institute for Complex Issues of Cardiovascular Diseases; firstname.lastname@example.org
Samorodskaya Irina V. Dr.Med.Sci.; National Medical Research Center for Preventive Medicine; email@example.com
The aim of the research is to study gender and age characteristics of the main factors of cardiovascular risk and comorbid pathology in patients who underwent coronary artery bypass grafting. Material and methods. In order to detect comorbid pathology gender and age analysis was performed in 680 patients (CABG registry of Federal State Budget Scientifi c Institution Research Institute of Complex Problems of Cardiovascular diseases) who were hospitalized for coronary artery bypass graft ing (CABG) during 2011. Modifi ed Charlson Comorbidity Index (1992) was calculated. Statistical analysis was performed by SPSS 20.0.1 program. Results. In males, comorbid conditions such as chronic cystitis / prostatitis, chronic lower extremities ischemia (CLLI 2B-III stage), myocardial infarction (MI), and also smoking risk factor are more oft en. Among females’ comorbid pathology are: chronic heart failure (CHF) and high functional class angina (FC); III stage of obesity, diabetes mellitus of type 2, impaired glucose tolerance, chronic pancreatitis and / or cholecystitis, hyper / hypothyroidism. Charlson index values did not signifi cantly diff er in male and female groups. Th e most adverse in relation to cardiovascular and comorbid pathology is a group of patients aged > 61 ≤ 70 years, both among males and females. Conclusion. Patients referred to CABG are characterized by high background of cardiovascular comorbidity in both males and females. However, the structure of comorbidity has gender diff erences.
Keywords: comorbid pathology, coronary artery bypass graft ing, age and gender characteristics, Charlson index, cardiovascular disease, coronary heart disease
Skorodumova E.G., Kostenko V.A., Skorodumova E.A., Pivovarova L.P., Osipova I.V., Siverina A.V., Александр Васильевич A.V.
EXOGENOUS MOLECULAR PATTERN IN PATIENTS WITH HEART FAILURE DECOMPENSATION АND INTERMEDIATE LEFT VENTRICULAR EJECTION FRACTION
Skorodumova EG, Kostenko VA, Skorodumova EA, Pivovarova LP, Osipova IV, Siverina AV, Rysev AV. Exogenous molecular pattern in patients with heart failure decompensation and intermediate left ventricular ejection fraction. Siberian Medical Review. 2019;(5):23-28. DOI 10.20333/2500136-2019-5-23-28
Skorodumova Elizaveta Gennadievna Budapeshtskaya Street 3St-Petersburg, Russian Federation, 192242; Phone: +7(921)339676; e-mail:firstname.lastname@example.org; MD. GBU «Saint-Petersburg Research Institute of Emergency Care II Janelidze», St. Petersburg, 192242, Russian Federation;
Kostenko Viktor Avenirovich Budapeshtskaya Street 3St-Petersburg, Russian Federation, 192242; Phone: +7(921)9456921; e-mail: email@example.com; MD, PhD. GBU «Saint-Petersburg Research Institute of Emergency Care II Janelidze», St. Petersburg, 192242, Russian Federation;
Skorodumova Elena Andreevna Budapeshtskaya Street 3 St-Petersburg, Russian Federation, 192242; Phone: +7(921)3276510; e-mail: firstname.lastname@example.org; MD, PhD. GBU «Saint-Petersburg Research Institute of Emergency Care II Janelidze»;
Pivovarova Lyudmila P. Dr.Med.Sci.; St. Petersburg I. I. Dzhanelidze Research Institute of the Emergency medicine; email@example.com
Osipova Irina V. Cand.Med.Sci.; St. Petersburg I. I. Dzhanelidze Research Institute of the Emergency medicine; firstname.lastname@example.org
Siverina Anna Viktorovna Budapeshtskaya Street 3St-Petersburg, Russian Federation, 192242; Phone: +7(911)7100152; e-mail: Gudkovanna_09@mail.ru; MD, GBU «Saint-Petersburg Research Institute of Emergency Care II Janelidze»;
Александр Васильевич Alexander V. Cand.Med.Sci.; St. Petersburg I. I. Dzhanelidze Research Institute of the Emergency medicine; email@example.com
Th e aim of the research is to determine the relationship of latent infections with each other on the basis of cross-analysis of correlation between infectious agents and antibodies in patients with intermediate left ventricular function. Material and methods. Exogenous molecular pattern was studied, which included phagocytic indices of 30% and 60%, phagocytic numbers for 30 and 60 minutes, phagocytosis completion index, levels of lipopolysaccharide of gram-negative bacteria wall, antistreptolysin-O, interleukin-6, classes M and G immunoglobulins to Ebstein-Barr viruse, cytomegalovirus, Candida and Aspergillus fungi, intracellular microorganisms: Toxoplasma gondi, Mycoplasma gondi, Mycoplasma pneumonia, in 195 patients with heart failure on the background of intermediate function of the left ventricle aft er the relief of acute heart failure decompensated. Th e average age of the observed was 65.2 ± 3.6 years. Th ere were 64.3 % of males and 25.7 % of females. In all patients, classes M and G of immunoglobulins to viruses, bacteria and intracellular parasites were determined. Th e results are statistically processed. Results. Th e article provides cross-analysis between infectious agents and antibodies in patients with intermediate function of the left ventricle, and exogenous molecular pattern is determined in all studied groups for the fi rst time. It was shown that patients with acute heart failure decompensation on the background of intermediate function of the left ventricle had latent infection with a large number of bacterial, viral and fungal agents, as well as intracellular parasites, leading to the development of systemic infl ammatory reaction. Conclusion.The results of this work allow us to determine several antibodies to pathogens in clinical practice without using entire diagnostic panel in acute heart failure decompensation.
Keywords: acute heart failure decompensation, intermediate function of the left ventricle, systemic infl ammatory reaction, exogenous molecular pattern, ejection fraction, systolic function of the left ventricle.
Klochkova E.V., Tolmacheva A.A., Chernova N.N., Nikolskaya I.N.
DIABETIC NEPHROPATHY AND CHRONIC KIDNEY DISEASE IN TYPE 2 DIABETES
Klochkova EV, Tolmacheva AA, Chernova NN, Nikolskaya IN. Diabetic nephropathy and chronic kidney disease in type 2 diabetes. Siberian Medical Review.2019;(5):29-32. DOI 10.20333/2500136-2019-5-29-32
Klochkova Elena V Cand.Med.Sci.; Novosibirsk State Medical University; firstname.lastname@example.org
Tolmacheva Anastasia A. resident; Novosibirsk State Medical University; email@example.com
Chernova Nina N head of endocrinology department; Railway Clinical Hospital on the station Novosibirsk-Glavniy; firstname.lastname@example.org
Nikolskaya Inna N Cand.Med.Sci.; Novosibirsk State Medical University; email@example.com
Th e aim of the research is to analyze the incidence of diabetic nephropathy (DN), chronic kidney disease (CKD) in patients having treatment at endocrinology department of NIH RWCH, the causes of CKD and ongoing glucose-lowering, nephroprotective therapy in this category of patients. Material and methods. While analyzing histories of 1476 patients with type 2 diabetes, DN and CKD were diagnosed in 283 patients (19.2 %) who were admitted to NIH RWCH for the period from 01.01.2014 to 09.01.2017. Th e average age of patients was 66.7 ± 9.9 years, the debut age of type 2 diabetes was 53.2 ± 9.9 years, and the duration of type 2 diabetes was 13.5 ± 7.1 years. The average age of DN debut is 64.7 ± 9.2 years. When assessing the stages of CKD due to GFR, stages 2 and 3a prevailed in 45 % and 21.2 % of cases, respectively, due to albuminuria of the 2nd and 3rd category, in 75.3 % and 13.4 %, respectively. Results. Correlation analysis showed an inverse correlation of GFR with the age of patients, duration of type 2 diabetes, level of albuminuria, total cholesterol and uric acid; correlation of albuminuria with the duration of type 2 diabetes, with the level of HBA1c and uric acid. As a result of causes analysis, formulated diagnosis in the medical history, DN was determined in 60.4 % of patients, from non-diabetic causes, chronic pyelonephritis – 25.1 % comes fi rst, then goes urolithiasis – 12 %, arterial hypertension – 1.8 %, acquired kidney cysts – 0.7 %. But hypertension rate in this group of patients was 97.8 %, the debut of hypertension was recorded at 50.4 years, i.e. 2.8 years earlier than the debut of type 2 diabetes, this confi rms the role of hypertension in the development of CKD in the analyzed group of patients. When GFR decreases, the incidence of coronary heart disease, MI, and stroke increased. Conclusion. Most of the patients did not reach the target indicators of carbohydrate and lipid metabolism, and they needed therapy correction. Nephroprotective therapy was not carried out in full.
Keywords: type 2 diabetes mellitus (type 2 diabetes), diabetic nephropathy (DN), chronic kidney disease (CKD), arterial hypertension (AH), cardiovascular pathology, hypoglycemic therapy, nephroprotective therapy
Bersenyeva O.A., Ageeva E.S.
ETHNO-POPULATION NUTRITION FEATURES OF PATIENTS WITH METABOLIC SYNDROME
Bersenyeva OA, Ageeva ES. Ethno-population nutrition features of patients with metabolic syndrome. Siberian Medical Review.2019;(5):38-46.. DOI 10.20333/2500136-2019-5-38-46
Bersenyeva O. A. ; Khakas State University of N.F. Katanov; firstname.lastname@example.org
Ageeva E. S. ; Federal State Budgetary Institution of higher education «Khakassia State University named N. F. Katanov», Abakan; Ageevaeliz@iamblei.iu
Th e aim of the research is identifi cation of nutrition patterns and eating behavior in patients with metabolic syndrome from the Republic of Khakassia. Material and methods. 2 groups – the Khakass and the Caucasians of Khakassia (n = 100) were examined. Verifi cation of the metabolic syndrome was carried out taking into account the criteria of JIS (2009). Nutrition assessment was carried out on the basis of 24-hour registration of food consumption and frequency of meals. Analysis of dietary intake and eating behavior was carried out using Nutrition Analytics program and the DEBQ questionnaire. Statistical processing of the results of the study was carried out using BioStat package. Results. Regardless of ethnicity, nutritional structure of patients with metabolic syndrome is characterized by insuffi cient consumption of dairy products, fish and seafood, vegetables and fruits amid excessive consumption of sugar, confectionery, fat and bakery products. Th ere is an unbalanced diet with violation of proteins, fats, carbohydrates ratio: regardless of gender and ethnicity. The most characteristic violations of chemical composition of the diet are excessive calorie and fat intake, insuffi cient intake of protein, complex carbohydrates and dietary fiber, signifi cantly higher consumption of sodium, potassium, phosphorus. All these is amid a defi ciency of magnesium intake. Diet imbalance for the consumption of certain groups of macronutrients had ethnic differences. The leading type of food addiction in the Khakases with metabolic syndrome was restrictive eating behavior, while in the Caucasians – emotional one. Conclusion. The analysis of nutritional structure of patients with metabolic syndrome indicates pronounced deviations in the consumption of individual nutrients from the recommended values, as well as eating disorder
Keywords: metabolic syndrome, factors affecting metabolism, nutrient imbalance, diet, eating behavior, the Khakasses.
Sorokin E.P., Kohno V.N.
SIGNIFICANCE OF INTEGRAL SCALES FOR PREDICTION OF INFECTIOUS COMPLICATIONS IN VICTIMS WITH THORACOABDOMINAL INJURIES
Sorokin EP, Kohno VN. Signifi cance of integral scales for prediction of infectious complications in victims with thoracoabdominal injuries. Siberian Medical Review. 2019;(5):47-51. DOI 10.20333/2500136-2019-5-47-51
Sorokin Eduard Pavlovich Cand.Med.Sc., Associate Professor of the Department of surgical pathology assistant with the course of anesthesiology and intensive-care medicine; Izhevsk State Medical Academy; email@example.com
Kohno Vladimir N Dr.Med.Sci.; Novosibirsk State Medical University; firstname.lastname@example.org
Th e aim of the research is to assess the possibility of using integrated scales in predicting infectious complications in victims with thoracoabdominal injuries. Material and methods. Based on the study of data from 244 medical records of inpatients with thoracoabdominal injuries, the effi cacy and possibility of using generally accepted ISS, TRISS, RAPS, APACHE II scales, as well as the developed and proposed SHORI and SHORI 2 scales, were evaluated. Results. Evaluation due to ISS and TRISS scales did not have a reliable correlation with the development of infectious complications. When examining RTS scale, its eff ectiveness was revealed at the stages of admitting department and on the fi rst day of inpatient treatment, since the value less than 7.84 was combined with an increased chance of developing infectious complications. RAPS scale showed positive results in predicting infectious complications, starting from the first day of inpatient treatment. Value which is higher than 10, due to APACHE II scale, also increases the chances of infectious complications development. The assessment of the areas under ROC-curves revealed the fact that in admitting department SHORI scale is the most eff ective one; and on the first day of inpatient treatment – SHORI 2 scale. Conclusion. SHORI and SHORI 2 scales can be used in admitting department and on the fi rst day of inpatient treatment to predict infectious complications in patients with thoracoabdominal injuries. Th ese scales can be used in practical health care system and their eff ectiveness is highly competitive with generally accepted scales.
Keywords: thoracoabdominal injury, infectious complications, integral scales, SHORI, SHORI 2.
Byvaltsev V.A., Kalinin A.A., Aliyev M.A., Yusupov B.R.
RESULTS OF LAMINECTOMY WITH LATERAL MASSES FIXATION IN TREATMENT OF MULTILEVEL CERVICAL DEGENERATIVE DISEASES
Byvaltsev VA, Kalinin AA, Aliev МА, Yusupov BR. Results of laminectomy with lateral masses fi xation in treatment of multilevel cervical degenerative diseases. Siberian Medical Review.2019;(5):52-58.. DOI 10.20333/2500136-2019-5-52-58
Byvaltsev Vadim Anatolyevich Professor, Head of the Neurosurgery Course of the Irkutsk State Medical University, the Chief Neurosurgeon of the Health Department of «Russian Railways», Leading Researcher at the Laboratory of boron-neutron capture therapy, Institute of Nuclear Physics SB RAS, Professor of the Department of Traumatology, Orthopaedics and Neurosurgery, Irkutsk State Academy of Postgraduate Education, Leading Researcher of the Irkutsk Scientific Center of Traumatology and Surgery.; Irkutsk State Medical University; Department of «Russian Railways»; Irkutsk State Academy of Postgraduate Education; email@example.com
Kalinin Andrey A Cand.Med.Sci.; Irkutsk State Medical University; firstname.lastname@example.org
Aliyev Marat A Cand.Med.Sci.; Irkutsk State Medical University; email@example.com
Yusupov Bobur R graduate student; Irkutsk State Medical University; firstname.lastname@example.org
Th e aim of the research is to analyze the results of laminectomy with lateral masses fi xation in treatment of patients with multilevel cervical spine degenerative diseases. Material and methods. A prospective study included 57 patients who underwent decompression-stabilizing neurosurgical interventions in CIII-CVII segments in the period from 2013 to 2016. Gender characteristics, anthropometric data, technical parameters of intervention, specifi city of postoperative management, presence of perioperative complications were analyzed. Furthermore, pain level in cervical spine and in upper extremities according to visual analogue scale (VAS), functional status according to Neck disability index (NDI), result of surgical treatment according to subjective Macnab scale were studied before surgery, at the discharge from hospital, in 12 and 24 months. Results. A signifi cant decrease in pain intensity was observed both in cervical spine from 71 (67; 78) mm to 23 (21; 33) mm (p < 0.001) and in the upper extremities from 84 (80; 87) mm to 18 (10 ; 29) mm (p > < 0.001); positive dynamics of functional status from 47 (42; 48) to 21 (18; 26) (p > < 0.001) was revealed. Due to subjective Macnab scale, excellent and good outcomes of 75.4% were obtained in the long-term period. Th e total number of perioperative complications was 10.5 %. Conclusion. Performing cervical vertebrae laminectomy with lateral masses screw fixation according to Anderson – Sekhon method has high clinical effi cacy and a low risk of adverse eff ects development when performing multilevel decompression-stabilizing interventions in patients with cervical spine degenerative diseases.
Keywords: cervical spine, multilevel degenerative diseases, spinal stenosis, dorsal surgical interventions, laminectomy, lateral masses screw fixation
Shimansky V.N., Shevchenko K.V., Odamanov D.A., Tanyashin S.V., Poshataev V.K., Karnaukhov V.V., Gasparyan S.S., Abdurakhimov F.D., Gvazava G.I.
RESULTS COMPARISON OF SURGICAL TREATMENT OF PATIENTS WITH NEURINOMA OF THE AUDITORY NERVE, OPERATED IN «LYING» AND «SITTING» POSITION ON THE OPERATING TABLE
Shimansky VN, Shevchenko KV, Odamanov DA, Tanyashin SV, Poshataev VK, Karnaukhov VV, Gasparyan SS, Abdurakhimov FD, Gvazava GI. Results comparison of surgical treatment of patients with neurinoma of the auditory nerve, operated in «lying» and «sitting» position on the operating table. Siberian Medical Review.2019;(5):59-65. DOI 10.20333/2500136-2019-5-59-65
Shimansky Vadim N. ; Academician N.N. Burdenko National Medical Research Center of Neurosurgery; email@example.com
Shevchenko Kirill V. ; Academician N.N. Burdenko National Medical Research Center of Neurosurgery; firstname.lastname@example.org
Odamanov Dzhemil’ A. ; Academician N.N. Burdenko National Medical Research Center of Neurosurgery; email@example.com
Tanyashin Sergey V. ; Academician N.N. Burdenko National Medical Research Center of Neurosurgery; firstname.lastname@example.org
Poshataev Vladimir K. ; Academician N.N. Burdenko National Medical Research Center of Neurosurgery; email@example.com
Karnaukhov Vasily V. ; Academician N.N. Burdenko National Medical Research Center of Neurosurgery; firstname.lastname@example.org
Gasparyan Sergey S Dr.Med.Sci.; N.N. Burdenko National medical research center of neurosurgery; email@example.com
Abdurakhimov Firuz D resident; N.N. Burdenko National medical research center of neurosurgery; firstname.lastname@example.org
Gvazava Giorgi I resident; N.N. Burdenko National medical research center of neurosurgery; email@example.com
Th e aim of the research is to compare the results of surgical treatment of patients with auditory nerve neurinomas, operated in diff erent positions on the operating table, «sitting» and «lying» to be exact. Material and methods. In the period from 2015 to 2016 200 patients were operated on, there were 107 females (69 %) and 93 males (31 %) aged 15-75 years (average age is 46 years). Patients were divided into 2 groups («sitting» and «lying» positions), each group included 100 people. Retrosigmoid suboccipital access was performed in all operations. Average size of the extrameatal tumor part was 30 mm and it was the same in both groups. Results. The function of trigeminal and abducent nerves, as well as the severity of nystagmus in the early postoperative period, is worse in case of patient’s lying position (p < 0.05). In the late postoperative period, this dependence is lost. Th e function of facial, auditory, bulbar group of nerves and the severity of ataxia in the early and late postoperative periods does not depend on patient’s position on the operating table (p > 0.05). Surgery nature does not depend on patient’s position on the operating table (p < 0.05). Th e frequency of venous air embolism, orthostatic hemodynamic disorders and postoperative pneumocephalus is significantly lower in case of patient’s lying position (p < 0.05). Conclusion. Operations on posterior cranial fossa on removal of the auditory nerve neurinoma, in particular, are more appropriate if a patient is lying, as far as this eliminates the risks of venous air embolism and hemodynamic disturbances and does not worsen neurological function aft er surgery
Keywords: auditory nerve neurinoma, vestibular schwannoma, sitting position, lying position, surgical treatment, venous air embolism, retrosigmoid suboccipital access, posterior cranial fossa
Shchudlo N.A., Анастасия Юрьевна A.Y.
DYNAMICS OF HISTOLOGICAL CHANGES IN SPINAL CORD THE FIRST DAY AFTER COMPLICATED SPINE FRACTURE (EXPERIMENTAL STUDY)
Shchudlo NA, Kirsanpva AYu. Dynamics of histological changes in spinal cord the fi rst day aft er complicated spine fracture (experimental study). Siberian Medical Review.2019;(5):66-71. DOI 10.20333/2500136-2019-5-66-71
Shchudlo N A Dr.Med.Sci.; ; firstname.lastname@example.org
Анастасия Юрьевна A Yu Cand.Biol.Sci.; Russian Ilizarov Scientifi c Center «Restorative Traumatology and Orthopaedics; email@example.com
The aim of the research is to study the dynamics of morphological changes in spinal cord in the fi rst day aft er complicated spine fracture. Material and methods. In experiments, a complete transverse LIV osteotomy of vertebra was performed in 6 dogs with the displacement of its fragments in sagittal and frontal planes and a decrease of spinal canal diameter by 50-70%. For histological examination of spinal cord, the animals were withdrawn from the experiment in 2, 4, and 24 hours aft er the injury. Serial paraffi n cross sections of spinal cord at LIV-LVII level were stained by hematoxylin and eosin, thionine and by Masson’s three-color method. Results. In 2 hours aft er injury, hemorrhages in central channel were detected mainly at LVII level, intramedullary hemorrhages, reactive changes in neurons (nucleoli fuchsinophilia, nucleus edema, cytoplasm vacuolization), appearance of amoeboid gliocytes, signs of neuronophagy of small neurons. In 4 hours aft er the injury, edema and reactive changes in vessels of spinal cord are pronounced. By the end of the fi rst day, destructive processes and neurons death prevail over vascular disorders. Conclusion. Interaction of vascular disorders and infl ammatory response start the mechanism of secondary damage of spinal cord tissues, leading to rapid irreversible changes.
Keywords: spinal cord, trauma, experiment, early period, morphology, secondary damage
Bensman V.M., Savtchenko J.P., Sahakyan E.A., Malyshko V.V.
PERITONEUM VISCERA-PARIETAL ADHESIVE DISEASE AND LAPAROTOMY WOUND HEALING FOR PERITONITIS
Bensman VM, Savchenko YuP, Saakyan EA, Malyshko VV. Peritoneum viscera-parietal adhesive disease and laparotomy wound healing for peritonitis. Siberian Medical Review.2019;(5):72-79. DOI 10.20333/2500136-2019-5-72-79
Bensman Vladimir Mihajlovich ; Kuban State Medical University; г. Краснодар, ул. Седина, д. 4; тел.:+7(918)4737691; e-mail: firstname.lastname@example.org
Savtchenko Jurij Pavlovich ; Kuban State Medical University; г. Краснодар, ул. Седина, д. 4; тел.:+7(861)2528559; e-mail: email@example.com
Sahakyan Edgar A surgeon; Ust-Labinsk Central Regional Hospital; firstname.lastname@example.org
Malyshko Vadim Vladimirovich ; Kuban State Medical University; г. Краснодар, ул. Седина, д. 4; тел.:+7(952)8187872; e-mail: Introemail@example.com
The aim of the research is correlation study of peritoneum viscera-parietal adhesions with laparotomy wound purulence. Material and methods. 149 patients with purulent peritonitis were operated and studied. In the observation check group, laparotomy wound was closed with a traditional layer-by-layer suture in 99 patients. In 50 patients from the main group, laparotomy wound was closed with a removable draining muscle-aponeurotic suture. In 19 patients, separate cytological analysis of subcutaneous and preperitoneal cellular spaces healing process was performed. Results. In the check group, laparotomic wounds purulence occurred in 34 (34,7 %) patients. In 19 (19,4 %) patients among the mentioned group, adhesive disease developed in the long-term, in this connection four patients underwent surgery. In the main group of the observed, purulence occurred in two patients (4,0 %), and infl ammatory infi ltrate appeared in one patient. These three patients in the long term got peritoneal adhesion disease that was treated conservatively. Cytologically parallel one-way dynamics of both infl ammatory-regenerative and degenerative-necrotic processes that occur simultaneously in subcutaneous and in peritoneal cellular space of laparotomy wound was revealed. Conclusion. Laparotomic wound purulence is the cause of viscera-parietal adhesions, which are formed as abdominal cavity protection from purulent preperitoneal tissue infection. At the same time, such planar viscera-parietal adhesions most oft en cause peritoneum adhesive disease. Removable drainage muscle-aponeurotic suture for peritonitis reduces the risk of purulent complications and the development of adhesive disease signifi cantly. Purulence or «smooth» laparotomy wound healing for peritonitis proceeds one-way, and simultaneously in both preperitoneal and subcutaneous tissue, regardless of apparent of infectious lesion depth.
Keywords: viscera-parietal adhesions, peritonitis, laparotomy wound healing
Borisov R.N., Zdzitovetsky D.E., Kasparov E.V., Savchenko A.A., Borisov S.A., Berdnikov D.S., Govorukha E.S., Boldyrev P.N.
TYPES OF IMMUNE SYSTEM REACTIONS AND THEIR CHARACTERISTIC IN PATIENTS WITH GENERALIZED PURULENT PERITONITIS
Borisov RN, Zdzitovetskii DE, Kasparov EV, Savchenko AA, Borisov SA. Berdnikov DS, Govorukha ES, Boldyrev PN. Types of immune system reactions and their characteristic in patients with generalized purulent peritonitis. Siberian Medical Review.2019;(5):80-87. DOI 10.20333/2500136-2019-5-80-87
Borisov R. N. ; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; firstname.lastname@example.org
Zdzitovetsky Dmitry Eduardovich Cand.Med.Sc., Professor, Head of the Department and Ginic Surgical Diseases named after Prof. Y.M. Lubensky; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; email@example.com
Kasparov E. V. ; Scientific Research Institute of medical problems of the North; firstname.lastname@example.org
Savchenko Andrey Anatolievich Dr. Med.Sc, Professor, Head of the Department of Physiology named after Prof. A.T. Pshonik; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; email@example.com
Borisov Sergei A graduate student; Research Institute of medical problems of the North; firstname.lastname@example.org
Berdnikov Dmitrii S. Surgeon; N. S. Karpovich Krasnoyarsk Interdistrict Clinical Hospital of Emergency Medical Care; email@example.com
Govorukha Egor S Surgeon; Krasnoyarsk Interdistrict Clinical Hospital №4; firstname.lastname@example.org
Boldyrev Pavel N Surgeon; Krasnoyarsk Interdistrict Clinical Hospital №4; email@example.com
The aim of the research is the assessment of initial immune system state in patients with generalized purulent peritonitis (GPP) according to hemogram. Material and methods. A retrospective analysis of the results of 109 patients with GPP examination and treatment was carried out. The main causes of peritonitis were acute appendicitis, intestinal perforations, perforated gastroduodenal ulcers and postoperative peritonitis. Immune system reaction types and their characteristics were determined with the help of computer program “RAKI” (“complete blood count, immunology”) according to the complete blood count. Statistical analysis of the data was carried out by methods of variation statistics Results. Initially, before the fi rst operation four types of immune system reactions, from fi ve possible, were identifi ed in patients with GPP; the main of which were «activation of innate immunity” and “immune system suppression”. It was established that “immune system areactivity” as a type of reaction is one of the factors of unfavorable outcome. A signifi cant correlation was found between some ratios of immune system reaction types and their characteristics with patient’s gender. In postoperative peritonitis, such reaction as “immune system suppression” is more common than other causes of peritonitis. Correlation analysis revealed a signifi cant relationship between the initial immune system reaction type and pathological process phase with peritonitis and the severity of multiple organ failure (MOF). Conclusion. Th e proposed method of GPP patients’ stratifi cation, depending on initial immune system state, based on interpretation of complete blood count indicators, can be used as a simple routine method for predicting the disease, planning the volume of surgical intervention, further surgical tactics, deep immunological examination and personifi ed immune-correction.
Keywords: generalized purulent peritonitis, multiple organ failure, immune system reaction type, characteristic of immune system reaction type, disease prognosis, planning of surgical tactics.
Koshel’ A.P., Klokov S.S., Drozdov E.S., Dibina T.V., Vorobyev V.M.
PANCREATIC CYSTIC FORMATIONS: SELECTION OF TREATMENT TACTICS
Koshel AP, Klokov SS, Drozdov ES, Dibina TV, Vorob’ev VM. Pancreatic cystic formations: selection of treatment tactics. Siberian Medical Review.2019;(5):88-96. DOI 10.20333/2500136-2019-5-88-96
Koshel’ Andrey Petrovich ; City Clinical Hospital №3 by B.I. Alperovich: Siberian State Medical University;; Томск, ул. Нахимова, 3; Московский тракт, 2; тел.: +7(382)2414785; e-mail: firstname.lastname@example.org
Klokov Sergey Sergeyevich ; The Medical Center of G. K. Zherlov; Siberian State Medical University; Томская обл., г. Северск, переулок Чекист, 3; Томск, Московский тракт, 2; тел.: +7(382)2414785; e-mail: email@example.com
Drozdov Eugeny S oncologist; Tomsk Regional Oncology Hospital; firstname.lastname@example.org
Dibina Tatyana V Cand.Med.Sci.; The medical center of G. K. Zherlov; email@example.com
Vorobyev Vladimir M Cand.Med.Sci.; The medical center of G. K. Zherlov; firstname.lastname@example.org
Th e aim of the research is improving short- and long-term results of patients with pancreatic cysts treatment. Material and methods. Analysis of treatment results of 79 patients with pancreatic cysts is presented, among them there were 38 (48.1 %) males and 41 (51.9 %) females aged 26 to 76 years. Th e average age of patients was 48.9 ± 1.9 years. Th e criteria for exclusion from the study were verifi ed solid pancreatic formations (cancer, pseudotumor pancreatitis, neuroendocrine tumors), parasitic cysts, congenital polycystic pancreas, post-necrotic cysts developed less than 3 months ago, complications of acute pancreatitis (sequestration, abscess). Cysts associated with chronic pancreatitis occurred in 58 (73.4 %) patients, in the outcome of acute pancreatitis – 12 (15.2 %) and in 9 (11.4 %) patients’ treatment was carried out for cystic tumors. Short- and long-term results of conservative, minimally invasive (puncture) and surgical methods of treatment are compared. Results. It was shown that long term results of surgical treatment were the best (there was no relapse in 80.6 %), however, the number of complications in this group of patients was maximum. Th e eff ectiveness of puncture treatment depended directly on the connection of cyst with Wirsung duct (positive eff ect was obtained in 43.8 %). Finally, long-term results of conservative therapy were the least favorable, the eff ectiveness was 37.5 %. Conclusion. According to the study results, algorithm for cystic formations of the pancreas diagnosis and treatment based on etiology of the disease, cyst connection with the ductal system of pancreas, formation, as well as the previous treatment, is proposed.
Keywords: pancreas, cysts, treatment, surgery, algorithm, pseudocyst, cystic neoplasia
METHODICAL APPROACHES TO THE TECHNOLOGY FOR PEROTID SALIVARY GLAND REMOVAL WITH PREPARATION OF FACIAL NERVE BRANCHES
Levenets AA. Methodical approaches to the technology for parotid salivary gland removal with preparation of facial nerve branches. Siberian Medical Review.2019;(5):97-103. DOI 10.20333/2500136-2019-5-97-103
Levenets Anatoliy Aleksandrovich Doct.Med.Sc., Professor of maxillo-surgery Department; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; email@example.com
The aim of the research is analysis of methodological changes in the operation for parotid salivary gland removal with benign neoplasms and chronic parotitis with preservation of facial nerve branches. Material and methods. Th e features of tumors clinical course and frequency of patients’ hospitalization with parotid salivary glands tumors in three separate periods from 1966 to 2016 were evaluated. Methodological approaches to the technology of patients’ surgical treatment and treatment results in three separate periods from 1966 to 2016 are described. A total of 261 medical records were subjected to expert evaluation. Th e technology of parotid salivary gland extirpation in a single unit with preparation and preservation of facial nerve branches is presented. Methodological approaches and patients with parotid gland neoplasms surgical treatment results were evaluated. Results. Removal of pleomorphic adenomas with partial and even subtotal resection of parotid salivary glands is not always a radical operation that relieves relapses. The operation of complete parotid salivary gland removal contributes to the prevention of recurrence of parotid salivary glands pleomorphic adenomas, but the operation requires certain technological approaches related to the preparation of the main trunk and facial nerve branches as well as elimination of postoperative complications, deformations and defects of soft tissues. This technique has been successfully applied for extirpation of parotid salivary glands in chronic parotitis with severe damage to the parenchyma and frequent exacerbations of the purulent infl ammatory process. Conclusion. Th e proposed additions and technical methods to previously developed ones provide a stably positive result of operation for complete removal (extirpate) of parotid salivary gland both in tumors and in chronic infl ammatory processes that are not amenable to conservative treatment
Keywords: parotid salivary gland, pharyngeal process of parotid salivary gland, pleomorphic adenoma, clinical course features, differential diagnosis, chronic parotid, surgical treatment methods, prevention of complications.
Gareeva D.F., Zagidullin N.S., Zagidullin S.Z.
CLINICAL CASE OF REVERSE REMODELING OF MYOCARDIUM IN A PATIENT WITH MYOCARDITIS AND HEART FAILURE DECOMPENSATION ON THE BACKGROUND OF SERELAXIN INTRODUCTION
Gareeva DF, Zagidullin NSh, Zagidullin ShZ. Clinical case of reverse remodeling of myocardium in a patient with myocarditis and heart failure decompensation on the background of serelaxin introduction. Siberian Medical Review.2019;(5):104-107. DOI 10.20333/2500136-2019-5-104-107
Gareeva Diana F Assistant; Bashkir State Medical University; firstname.lastname@example.org
Zagidullin Naufal Sh Dr.Med.Sci.; Bashkir State Medical University; email@example.com
Zagidullin Shamil Z Dr.Med.Sci.; Bashkir State Medical University; firstname.lastname@example.org
Acute heart failure leads to signifi cant damage of target organs and brings unfavorable outcome, but the medications used till present day (diuretics, vasodilators, etc.) have not reduced mortality during hospitalization and in long term period. Serelaxin is a recombinant form of the human hormone relaxin-2, produced in female body in the fi rst trimester of pregnancy. For the first time in RELAX-AHF study the drug showed a decrease in cardiovascular and overall mortality in 180 days aft er infusion and a positive trend in symptoms of heart failure in patients with acute heart failure, compared with standard therapy. Th is article describes a clinical case of treating a patient with myocarditis and heart failure decompensation by serelaxin
Keywords: serelaxin, heart failure, mortality, hemodynamic eff ects
Zyuzyukina A.V., Chavkunkin F.P., Boyakova N.V.
THE CASE OF SIMULTANIOUS ACUTE APPENDICITIS AND CHOLECYSTITIS
Zyuzyukina AV, Chavkunkin FP, Boyakova NV. Th e case of simultaneous acute appendicitis and cholecystitis. Siberian Medical Review.2019;(5):108-110. DOI 10.20333/2500136-2019-5-108-110
Zyuzyukina A. V. ; Krasnoyarsk state medical univeraty named afteг Prof. V. F. Voyno-Yusenetsky, Scientific Research Institute of medical problems of the North; email@example.com
Chavkunkin Fedor Petrovich Cand.Med.Sc., Associate Professor, Department of General Surgery; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; firstname.lastname@example.org
Boyakova Nina Vasilievna Assistant, Department of General Surgery named after Prof. M.I. Gulman; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; email@example.com
Acute appendicitis (AA) is one of the most common surgical diseases. Mortality is 0.1-0.3%, while complications occur in 5-9% of cases. Th e most common cause of AA is enterogenic pathway of infection; certain role in genesis belongs to hematogenous and lymphogenous pathways. Diagnosis of typical AA forms is of no diffi culty. Th ere are various vermiform appendix (VA) locations, that infl uence clinical picture of the disease. Subherpatic location of VA complicates the diagnosis of AA signifi cantly. Tenderness, muscle tension in the right hypochondrium, positive Shchotkin-Blumberg symptom makes it possible to exclude acute cholecystitis (AC). Th erapeutic tactics in AA is early removal of VA. Among acute diseases of the abdominal organs, acute cholecystitis takes the second place aft er AA. Timely diagnosis of AC, eff ective treatment, in compliance with active surgical tactics principle, allowed to reduce mortality rate to 2-5 %. VA infl ammation in acute diseases of abdominal cavity is sometimes secondary problem. Among the etiological factors of AC occurrence, the leading role is taken by cholestasis and infection. AC occurs suddenly with intense abdominal pains that are of permanent nature, their intensity increases while the disease is in progress. Th e symptoms of AC are nausea, repeated vomiting, which does not bring relief to a patient, fever, chills. Specifi c symptoms are: Ortner, Murphy, Kera, Mussi-Georgievsky, Shchetkin-Blumberg if peritoneum is involved in the infl ammatory process. Th e frequency and dependence of these symptoms depends on morphological changes in the gallbladder. In typical cases, it is not diffi cult to diagnose AC. Timely surgical intervention, rational intensive care in postoperative period lead to a favorable surgical treatment outcome of patients with acute appendicitis and acute cholecystitis. Th e article presents clinical observation of simultaneous acute appendicitis and acute cholecystitis.
Keywords: acute appendicitis, acute cholecystitis, vermiform appendix, atypical appendix location, subhepatic appendix location, clinical observation.
Galonsky V.G., Tarasova N.V., Voroshilova K.N., Chernichenko A.A., Chernov V.N.
DENTAL ORTHOPEDIC REHABILITATION OF CHILDREN WITH SECONDARY DEFECTS OF THE UPPER LIP AND THE PALATE
Galonsky VG, Tarasova NV, Voroshilova KN, Chernichenko AA, Chernov VN. Dental orthopedic rehabilitation of children with secondary defects of the upper lip and the palate. Siberian Medical Review.2019;(5):111-116. DOI 10.20333/2500136-2019-5-111-116
Galonsky V. G. ; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; firstname.lastname@example.org
Tarasova Natalya Valentinovna PhD, Docent; Professor V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University; email@example.com
Voroshilova Ksenia N. ; Professor V. F. VoinoYasenetsky Krasnoyarsk State Medical University; firstname.lastname@example.org
Chernichenko Andrei A. Can.Med.Sci.; Professor V. F. VoinoYasenetsky Krasnoyarsk State Medical University; email@example.com
Chernov Vladimir N Can.Med.Sci.; Professor V. F. Voino-Yasenetsky Krasnoyarsk State Medical University; firstname.lastname@example.org
Rehabilitation measures were carried out for children with secondary defects of the upper lip and the palate aft er repeated surgical treatment. Obturator prostheses were made using Titanide dental casting alloy. Adaptation to obturator prostheses lasted in average 10-30 days, aft er which satisfactory functional state of dentoalveolar apparatus was observed, the patients used prostheses constantly. Intelligibility and level of speech disturbance depended on topography of the defect, nasal anastomosis size, ranged from 31.68% to 60.74%.
Keywords: children, lips and palate cleft , defects of the upper jaw, obturator prostheses, shape memory materials, “Titanide” alloy, rehabilitation.