Сибирское медицинское обозрение. 2022. № 5 View full textКоличество просмотров : 832
Гончарова Е. А., Волкова Л. В., Пашов А. И., Рачковская В. В.
Chronic endometritis: current problems of diagnosis
Goncharova EA, Volkova LV, Pashov AI, Rachkovskaya VV. Chronic endometritis: current problems of diagnosis. Siberian Medical Review. 2022;(5): 5-11. DOI: 10.20333/25000136-2022-5-5-11. DOI 10.20333/25000136-2022-5-5-11
The review deals with the relevant problems of chronic endometritis diagnostics, which is the cause of infertility, unsuccessful attempts of in-vitro fertilisation and miscarriage. The frequency of this pathology varies within 2.8-56.8% in women with infertility and 9.3-67.6% in patients with recurrent miscarriages and amounts to 57.8% in missed pregnancies in medical history. The analysis of modern publications predominantly from E-library and PubMed databases for the period 2012-2021 was carried out. The key points of etiopathogenesis, diagnostic methods, their possibilities and limitations were analysed. The issues of the “gold standard” and new biomarkers for morphological verification of chronic endometritis were considered. An analysis of the literature has shown that, despite complex diagnostic approaches, many aspects of the pathogenesis of this pathology are not completely clear, and pathoanatomical diagnostic standards do not fully meet modern requirements.
Keywords: chronic endometritis, infertility, miscarriage, endometrium, histological analysis of endometrium, immunohistochemical markers
Fomina NV, Utkina EV. Modern methods of sarcopenia diagnostics. Siberian Medical Review. 2022;(5):12-23.. DOI 10.20333/25000136-2022-5-12-23
Sarcopenia is the loss of muscle strength and mass due to the natural ageing process of the body (primary) or a combination of sarcopenia with various diseases (secondary). Despite its clinical significance, sarcopenia often remains unrecognised and aggravates the course of comorbid diseases. The review presents analysis of scientific literature on sarcopenia diagnostic methods. Literatures from the E-Library.ru and PubMed databases published within the period of 1998- 2021 were used. The search was performed using the “sarcopenia” and “methods for diagnosing sarcopenia” keywords. Patients with sarcopenia have similar symptoms with cachexia, fatty infiltration and inflammatory lesions of muscle tissue, which complicates differential diagnosis of this disease. The screening methods for sarcopenia diagnosis include MSRA-7, MARS-5 questionnaires, Shinya Ishii method, SARC-F. The diagnosis of sarcopenia is established based on instrumental methods (bioelectrical impedance analysis, computer and magnetic resonance imaging, dual-energy X-ray absorptiometry).
Keywords: sarcopenia, muscle strength, muscle mass, bioelectrical impedance analysis, magnetic resonance imaging, computed tomography, dual-energy X-ray absorptiometry
Дунаевская С. С., Сергеева Е. Ю., Деулина В. В., Доморацкая Е. А
The role of single nucleotide polymorphisms of pro-inflammatory factor genes as predictors of risk of development and severity of acute pancreatitis
Dunaevskaya SS, Sergeeva EYu, Deulina VV, Domoratskaya EA. The role of single nucleotide polymorphisms of pro-inflammatory factor genes as predictors of risk of development and severity of acute pancreatitis. Siberian Medical Review. 2022;(5):24-27.. DOI 10.20333/25000136-2022-5-24-27
A literature review has been conducted examining the role of single nucleotide polymorphisms of pro-inflammatory factor genes as predictors of risk of developing and severity of acute pancreatitis. The review was conducted on the following databases: Pub Med, Scopus for the period from 2009 to 2021 according to the following keywords: acute pancreatitis, hereditary pancreatitis, severe acute pancreatitis, gene polymorphism, single nucleotide genes, proinflammatory factors. A number of mutations and single nucleotide polymorphisms have been identified, which are the main triggers or cofactors of the initiation of both acute and chronic hereditary pancreatitis. The percentage of cases of idiopathic recurrent acute pancreatitis and idiopathic chronic pancreatitis associated with genetic mutations is 30-60% and 12-43%, respectively. The following genetic variants of the cationic trypsinogen (PRSS1) gene - CFTR, SPINK1 and chymotripsin C (CTRC) - are most often associated with the development of pancreatitis. Inherited pancreatitis associated with gene mutations has SPINK1 autosomal recessive inheritance pattern. When the mutant gene is expressed, the synthesis of a strong trypsin inhibitor prevents premature activation of immature trypsinogen. Data are obtained that IL-6, IL-8, FNOα can activate NF kB transcription factor, inducing, thus, increase in an expression 2 DRIED. It has been found that some COX 2 polymorphisms characterized by increased expression of this enzyme create prerequisites for the progression of the inflammation process, and are possibly predictors of the development of severe acute pancreatitis.
Keywords: acute pancreatitis, hereditary pancreatitis, severe acute pancreatitis, gene polymorphism, single nucleotide genes, proinflammatory factors.
Джинджихадзе Р. С., Поляков А. В., Зайцев А. Д., Ермолаев А. Ю., Одаманов Д. А.
Quality of life of patients after surgical treatment of unruptured brain aneurysm: a literature review
Dzhindzhihadze RS, Polaykov AV, Zaitsev AD, Ermolaev AYu, OdamanovDA. Quality of life of patients after surgical treatment of unruptured brain aneurysm: a literature review. Siberian Medical Review. 2022;(5):28-32. DOI 10.20333/25000136-2022-5-28-32
The problem of high disability and mortality after aneurysmal hemorrhages has led to the fact that preventive exclusion of unruptured aneurysms has been the standard of care for many years. Indications for complex operative intervention are equated to the possibility of functional independence loss. The relevance of this study is due to the lack of data on the quality of life of patients after surgical treatment of unruptured cerebral aneurysms in Russian literature. Using the PubMed, Web of Science, Google Scholar databases and the terms “quality of life and unruptured intracranial aneurysm”, articles from 1998 to 2019 were analysed. Patients’ awareness of the presence of cerebral aneurysms often impairs the quality of life, causes anxiety and depression, limits their work and daily activities, and leads them to the choice of surgical intervention. Cultural-linguistic adaptation and validation of scales and questionnaires on the quality of life after the treatment of unruptured brain aneurysms is a necessary measure for domestic research. This article outlines the modern ideas about the epidemiology and natural course of the disease, approaches to treatment of unruptured cerebral aneurysms. Particular attention is devoted to the quality of life of patients after surgery.
Keywords: unruptured intracranial aneurisms, brain aneurisms, aneurysmal hemorrhages, microsurgical clipping, quality of life
Цеймах А. Е., Лазарев А. Ф., Секержинская Е. Л., Куртуков В. А., Мищенко А. Н., Теплухин В. Н., Кореновский Ю. В., Жарикова Г. В., Сузопов Е. В., Шойхет Я. Н.
Palliative surgical treatment of malignant tumours in the pancreatobiliary area complicated by obstructive jaundice using local and systemic photodynamic therapy
Tseimakh AЕ, Lazarev АF, Sekerzhinskaya EL, Kurtukov VА, Mitshenko АN, Teplukhin VN, Korenovskij YuV, Zharikova GV, Suzopov EV, Shoykhet IaN. Palliative surgical treatment of malignant tumours in the pancreatobiliary area complicated by obstructive jaundice using local and systemic photodynamic therapy. Siberian Medical Review. 2022;(5):33-41. DOI 10.20333/25000136-2022-5-33-41
The paper analyses the tactics of managing patients with malignant neoplasms in the pancreatobiliary area complicated by obstructive jaundice in two nosologically and clinically comparable groups of patients. The aim of the research. To evaluate the effectiveness of complex palliative treatment with the use of photodynamic therapy in patients with malignant neoplasms in the pancreatobiliary area complicated by obstructive jaundice. Material and methods. In the main group, which consisted of 41 patients, palliative complex treatment was carried out using local and systemic photodynamic therapy of neoplasms in the pancreatobiliary area complicated by obstructive jaundice, purulent cholangitis. In the comparison group, which consisted of 165 patients, palliative complex treatment of complications was carried out without the use of photodynamic therapy. Complex palliative treatment in both groups included the following surgical interventions: percutaneous transhepatic mono- and bilobar drainage of the bile ducts, stenting of the bile ducts under ultrasound and X-ray control as well as bypass biliodigestive anastomoses. Symptomatic conservative treatment included infusion, detoxification, analgesic, hepatoprotective and antibacterial therapy. Results. Against the background of local and systemic photodynamic therapy in the main group, a decrease in the largest size of the neoplasm in patients with malignant neoplasms of the pancreas from 42.5 mm to 38 mm within a week after treatment was established according to the data of multispiral computed tomography of abdominal organs with intravenous bolus contrast. The largest neoplasm size decreased from 40.5 mm to 31 mm within a month after treatment according to the ultrasound examination of the abdominal cavities. Restoration of bile excretion into the intestine in 100% of patients with malignant neoplasms of the bile ducts and the head of the pancreas was registered, as well as an increase in life expectancy of patients by more than 1 year, a decrease in the risk of complications due to a slowdown in the growth of neoplasms associated with a decrease in the concentration of the cytokine TNF-α. Conclusion. Complex treatment with the use of photodynamic therapy of malignant neoplasms of the pancreatobiliary area allows reducing the largest size and rate of neoplasm invasion and to increase the survival rate of patients.
Keywords: malignant neoplasms, pancreatobiliary area, obstructive jaundice, photodynamic therapy, systemic proteolysis, systemic inflammation
Ярощук С. А., Баранов А.И., Короткевич А.Г., Каташева Л. Ю., Кузнецов В. В.
Obstructive intestinal resection in the treatment of traumatic intestinal injuries under peritonitis
Yaroshchuk SA, Baranov AI, Korotkevich AG, Katasheva LYu, Kuznetsov VV. Obstructive intestinal resection in the treatment of traumatic intestinal injuries under peritonitis. Siberian Medical Review. 2022;(5):42-49.. DOI 10.20333/25000136-2022-5-42-49
Treating bowel injuries is challenging. Although the failure of anastomosis or suture of the intestine remains a dangerous complication and multiplies in conditions of peritonitis, multistage tactics before the tactics of maintaining intestinal continuity during the first operation is becoming an increasingly preferred strategy. The aim of the research. To evaluate the treatment results for delayed formation of the inter-intestinal anastomosis in patients with bowel injury complicated by peritonitis. Material and Methods. A total of 69 patients were enrolled in the study, among which 40 were included in the retrospective group and 29 were included into the prospective group. All included patients underwent surgery for bowel injuries at the NCHKH 29 and at the NCHKH 1 within the period from 2011 to 2019. The patients’ mean age amounted to 33.4±9.2 years. A total of 35 patients were admitted with blunt trauma and 34 had stab wounds. The retrospective group received treatment with bowel resection with application of anastomosis during the initial surgery while patients of the prospective group had their anastomosis formation delayed to the time after peritonitis management. The postoperative course was analysed in regard to the frequency and severity of postoperative complications and mortality. Results. Among the 69 patients, 78% had a small bowel injury and 47% had a colon injury. A total 39.1% of the lesions in the small intestine and 21.7% of the lesions in the colon were treated with wound closure or bowel resection with primary anastomosis, regardless of the site of injury (p = 0.381). Mortality was 33%, of which 47.5% in the control group and 13.8% in the comparison group. A severe course of the disease was noted in 32% and complications in the abdominal cavity occurred in 32% of patients. The risk factors for severe course of the disease were formed intestinal stomas (p = 0.036), massive blood loss (p = 0.005) and delayed seeking medical care (p = 0.023). The incidence of intestinal suture incompetence was 28.2%. All failures occurred in the early postoperative period. Conclusion. Multi-stage surgical tactics in treatment of patients with intestinal injury complicated by peritonitis should be the preferred option, regardless of the site of injury – small or large intestine. The imposition of an intestinal stoma is an important factor in the development of postoperative complications, which can be compared with the risk of an intestinal suture or anastomosis in peritonitis.
Keywords: large intestine injury, small intestine injury, stomach trauma, fistula, anastomosis.
Яшнов А.А., Лобанов С.Л., Коновалова О.Г., Бурцева М.А.
A new method for predicting the nature of changes in the gallbladder wall in acute cholecystitis
Yashnov AA, Lobanov SL, Konovalova OG, Burtseva MA. A new method for predicting the nature of changes in the gallbladder wall in acute cholecystitis. Siberian Medical Review. 2022;(5):50-55. DOI 10.20333/25000136-2022-5-50-55
The aim of the research. To develop a method for predicting the degree of changes in the gallbladder wall in acute cholecystitis. Material and methods. A single-stage study was performed on 105 patients with an established diagnosis of acute cholecystitis who underwent laparoscopic cholecystectomy, comparable in age, gender and concomitant pathology. Upon admission to the hospital, the activity of creatine phosphokinase (CPK), lactate dehydrogenase (LDH), gamma-glutamiltranspeptidase (GGTP) and alkaline phosphatase was determined through the kinetic colorimetric method. Statistical processing of the obtained results was carried out using the SPSS Statistics 7.0 program in compliance with the principles of statistical analysis adopted for research in biology and medicine. Results. In patients with acute destructive cholecystitis, mean CPK values were 302.2±32.5 U/l (p <0.05) and LDH - 318.3±29.4 U/l (p <0.05), which is higher than the values obtained in the group with acute non-destructive cholecystitis: CPK – 168.7±18.3 U/l (p <0.05) and LDH – 282.6±18.3 U/l (p <0.05). Along with this, a direct correlation was revealed between an increase in the concentration of CPK, LDH and the degree of destructive process in the gallbladder wall. At the same time, in patients with non-destructive cholecystitis, mean values were 340±116.9 U/l (p <0.05) for GGTP and 160.3±34.2 U/l (p <0.05) for SCHF, which exceeds these values in the group of patients with acute destructive cholecystitis: GGTP was 70.5±18.5 U/l (p <0.05), and SCHF was 93.5±16.5 U/l (p <0.05). With progression of destructive processes in the gallbladder wall, the concentration of GGTP and alkaline phosphatase decreases. Conclusion. Based on the data obtained, we have proposed a method for predicting development of destructive cholecystitis.
Keywords: acute cholecystitis, destructive cholecystitis, gallbladder, cholelithiasis, creatine phosphokinase, lactate dehydrogenase, gammaglutamiltranspeptidase, alkaline phosphatase
Котельникова Л. П., Верещагин А. В., Перемыкина К. С.
The efficiency of extracorporeal selective endotoxin adsorption in treatment of sepsis and septic shock
Kotelnikova LP, Vereshchagin AV, Peremykina KS. The efficiency of extracorporeal selective endotoxin adsorption in treatment of sepsis and septic shock. Siberian Medical Review. 2022;(5):56-62. DOI 10.20333/25000136-2022-5-56-62
The aim of the research. The aim of the study was to evaluate the efficiency of extracorporeal selective endotoxin adsorption in complex treatment of sepsis and septic shock in patients with surgical diseases, as well as in puerperas with obstetric complications or surgical problems. Material and Methods. This pilot retrospective-prospective study without formation of a control group included 36 patients with sepsis (7) and septic shock (29) against the background of surgical pathology and/or obstetric complications. The patients underwent 67 sessions of lipopolysaccharide sorption (LPS sorption) using Alteco LPS adsorbers and the number of perfusions from one to three. The efficacy of the procedure was evaluated clinically and in the laboratory with the determination of levels of C-reactive protein, procalcitonin, presepsin and endotoxin activity assay (EAA). Results. After one-three sessions of LPS sorption, the severity on the SOFA scale reliably decreased from 12 to 7 points (p=0.000) due to improvements in cardiovascular (p=0.000), respiratory (p=0.001) and neurological indicators (p=0.041). There was a significant decrease in the percentage of rod-shaped neutrophils, the level of procalcitonin and endotoxin activity (p=0.007, p=0.000, p=0.002). The mortality rate amounted to 17 out of 36 (47.2%). A direct positive correlation was found between the lethal outcome and the timing of LPS sorption (r=0.432, p=0.024), as well as the presence of septic shock (r=0.324, p=0.050). The later the procedure was performed, the more often lethal outcomes were noted, especially in septic shock. A direct positive dependence of mortality on the need for vasopressor support before and after the procedure was established (r=0.446, p=0.007; r=0.653, p=0.000). The initial levels of procalcitonin, presepsin and endotoxin activity were not considered to be statistically significant for predicting the results of extracorporeal selective sorption of endotoxin. Conclusion. LPS sorption in sepsis and septic shock in addition to complex treatment significantly reduces the severity of multiple organ failure on the SOFA scale by improving cardiovascular, respiratory, neurological parameters and leads to a significant decrease in the level of procalcitonin and endotoxin activity. The earlier the procedure of extracorporeal selective sorption of endotoxin was initiated, the less lethal outcomes occurred.
Keywords: sepsis, septic shock, LPS sorption, Gram-negative infection, endotoxin.
Шефер Н. А., Топольницкий Е. Б.
Immediate results of organ-preserving anatomical resections and pneumonectomy in elderly and senile patients with lung cancer
Shefer NA, Topolnitskiy EB. Immediate results of organ-preserving anatomical resections and pneumonectomy in elderly and senile patients with lung cancer. Siberian Medical Review. 2022;(5):63-69. DOI 10.20333/25000136-2022-5-63-69
The aim of the research. The aim of the study was to conduct a comparative analysis of the immediate results of organ-preserving anatomical resections and pneumonectomy in elderly and senile patients with lung cancer. Material and methods. The study included 126 patients over 60 years of age, who were divided into 2 groups depending on the extent of the surgical intervention performed. Group A was represented by 63 patients who underwent organ-preserving anatomical resections and group B enrolled 63 patients after pneumonectomy. The groups were formed through retrospective analysis of prospective data obtained from the electronic registry. In all cases, the comorbid background was assessed, as well as options for preoperative correction of the concomitant pathology. In the postoperative period, the number and severity of complications were assessed using the TMM (Thoracic Morbidity and Mortality) System, and an intergroup comparative statistical analysis was performed. Results. According to the results of the study, postoperative complications among patients in group A were recorded in 22 (34.9%) cases, mortality was established in 4 (6.35%) patients. In group B, the number of complications and mortality were registered in 18 (28.6%) and 6 (9.52%) cases, respectively. Among the complications registered in group A, the most common were prolonged air discharge through the drainage and cardiac arrhythmias. In the group after pneumonectomy, complications associated with arrhythmia also prevailed, while the complication occurred statistically more often. Among the lethal outcomes in both groups, the main cause was progressive cardiovascular insufficiency against the background of arrhythmia, as well as failure of the bronchus stump and suture. Conclusion. Despite the absence of reliable differences in the total number of complications and mortality in the groups, there is a clear trend towards a higher frequency of fatal complications in the group after pneumonectomy. A feature was noted in the continuing risk of mortality, regardless of the severity of the complication. Among patients after organ-preserving anatomical resections, reversible deviations from the normal course in the postoperative period prevail. In addition, this extent of surgical intervention provides for better functionality and quality of life to elderly and senile patients.
Keywords: lung cancer, pneumonectomy, lobectomy, angioplasty, bronchoplasty, elderly and senile age, complications.
Бойко Т.В., Протопопова Н.В., Кравчук Л.А.
Analysis of infant mortality in the Irkutsk region and reserves for its reduction
Boyko TV, Protopopova NV, Kravchuk LA.Analysis of infant mortality in the Irkutsk region and reserves for its reduction. Siberian Medical Review. 2022;(5):70-75. DOI 10.20333/25000136-2022-5-70-75
The aim of the research. Determination of reserves for reducing infant mortality based on the results of its analysis. Material and methods. An analysis of infant mortality dynamics in the Irkutsk Region for 2018-2020 was made as well as of medical documentation of 51 cases of death from external causes in the postneonatal period. Results. In 2020, the structure of the causes of infant mortality has changed due to its increase from external causes, which took the first place in the postneonatal period. Infant mortality outside medical institutions has a negative trend: 19.8% in 2018, 24.5% in 2019 and 25.1% in 2020. Analysis of medical records revealed that children aged 1 to 3 months (52.9%) and 4 to 6 months (35.3%) died more often, being mostly full-term children (84.3%), among whom 27.9% were with intrauterine development delay. The largest number of deaths occurred from accidental suffocation at home – 86.3%. A total of 35 (68.6%) children were brought up in families of high social risk, while 25 (71.4%) families were not registered by social protection authorities and were deprived of the opportunity to receive social support. Conclusion. The reduction of infant mortality from external causes largely depends on organisation of interdepartmental interaction of medical organisations with bodies and institutions of the neglect prevention system for monitoring families in socially dangerous situations. For timely identification of families of high social risk and the transfer of information to the custody and guardianship authority and the social protection management authority, medical organisations must be staffed with social workers.
Keywords: infant mortality, death of infants from external causes
Овчинникова Т. В., Лопатина О. Л., Таранушенко Т. Е., Салмина А. Б., Салмин В. В., Карпова Л. С., Голубенко Н. К.
Indicators of oxytocin level in blood serum of newborns taking into account the type of feeding
Ovchinnikova TV, Lopatina OL, Taranushenko TE, Salmina A. B., Salmin VV, Karpova LS, Golubenko NK.Indicators of oxytocin level in blood serum of newborns taking into account the type of feeding. Siberian Medical Review. 2022;(5):76-80. DOI 10.20333/25000136-2022-5-76-80
The aim of the research. To analyse the level of oxytocin in the blood serum of premature and full-term newborns in various types of feeding (according to the Department of Pathology of Newborns and Premature Infants of the Krasnoyarsk Regional Clinical Center for Maternal and Child Health). Material and methods. A single-centre open-label prospective study including 24 preterm infants (at 26 to 36 weeks of gestation) and 14 full-term newborns was carried out. The levels of oxytocin in the blood serum of the examined children on various types of feeding (breastfeeding and artificial) were analysed in dynamics on days 5-6 and 11-12. Results. It has been established that among full-term children, the average values of oxytocin did not have significant differences between the subgroups of breastfeeding and artificial feeding and significantly exceeded the levels of oxytocin in premature infants. The most likely reason for the low level of OT should be considered the higher vulnerability to multiple external influences (examinations and manipulations, temperature, humidity, incubator conditions, care specifics, etc.) that accompany newborns with a small gestational age. Suppression of OT secretion at the stage of the general adaptation syndrome may be due to a pronounced activation of the sympathetic-adrenal system in premature infants in response to the stress situation with an increase in the level of adrenaline and norepinephrine. Analysis of the level of OT in premature infants in various types of feeding depending on body weight at birth in BF and AF showed an inverse relationship between the level of the studied hormone and body weight at birth (the lower the birth weight, the higher the level of OT on the 5th-6th day of postnatal life). Conclusion. In modern literature, data on the physiological effects of oxytocin and the participation of the hormone in the course of a number of pathologies are being actively updated. New findings from recent studies point to the role of oxytocin not only in labour but also in multiple effects on the fetus and newborns. Maternal oxytocin can reach fetal neurons across both the placental and blood-brain barriers. At the same time, the physiological significance of the influence of oxytocin on the brain and the dependence on the type of feeding in newborns are insufficiently studied and are a subject of discussion, but mainly in experimental studies.
Keywords: oxytocin, blood serum, premature infants, breast milk, artificial feeding
Пономарева Д.А., Нагаева Т.А., Желев В.А., Басарева Н.И., Мочалина Л.А., Рейм А.С., Ермолаева Ю.А.
Cardiac manifestations of post-COVID syndrome in children and adolescents
Ponomareva DA, Nagaeva TA, Zhelev VA, Basareva NI, Mochalina LА, Reim AS, Ermolaeva JА. Cardiac manifestations of post-COVID syndrome in children and adolescents. Siberian Medical Review. 2022;(5):81-85.. DOI 10.20333/25000136-2022-5-81-85
The aim of the research. To study the features of cardiovascular system disorders in post-covid syndrome (PCS) in children and adolescents after a mild form of coronavirus infection (COVID-19). Material and methods. From 260 children and adolescents after a mild form of COVID-19, a total of 30 patients aged 7–17 years with cardiac manifestations of PCS were selected. Therewith, 32 patients with an uncomplicated form of the disease were selected to form a comparison group. In 3 and 6 months after disease onset, a comprehensive examination of patients was performed with a questionnaire on the subjective scale for MFI-20 assessment asthenia (Multidimensional Fatigue Inventory-20), electrocardiography (ECG), echocardiography; daily monitoring of ECG and blood pressure. The biochemical blood test included assay of creatine phosphokinase-MB (CPK-MB), troponin I and lactate dehydrogenase (LDH). Results. The incidence of PCS with cardiac manifestations amounted to 11.5 %. After 3 months from the disease onset, complaints of pain and discomfort in the chest, palpitations, fatigue, and poor exercise tolerance persisted. Asthenic syndrome was diagnosed in 70 % of patients. The “general asthenia” indicator totalled14 [12; 16] points (p<0.001) and was associated with the age of patients (r=+0.5; p<0.05). Arrhythmic syndrome and conduction disorders were detected in 67% of children. Labile arterial hypertension and hypotension occurred in 23 % of the adolescents. The increase in CPK-MB remained in 17% of the children, LDH – in 10%. In the sixth month after the onset of the disease, there were no significant differences in the results of the examination in the observation groups. However, a decrease in the level of resistance within 6 months was recorded in 43.3% of the schoolchildren with PCS (p<0.001). Conclusion. The data obtained indicate the need for early verification of cardiopathies in children with COVID-19, determination of a set of therapeutic and rehabilitation measures as well as ECG monitoring.
Keywords: COVID-19, post-COVID syndrome, children, asthenia, arrhythmia, electrocardiography
Толстикова Т. В., Марчук Т. П.
The frequency of cardiac arrhythmias in children according to Holter ECG monitoring
Tolstikova TV, Marchuk TP. The frequency of cardiac arrhythmias in children according to Holter ECG monitoring. Siberian Medical Review. 2022;(5):86-91. DOI 10.20333/25000136-2022-5-86-91
The aim of the research. To study the frequency and structure of cardiac arrhythmias in children. Material and methods. Analysis of the results of 24-hour Holter ECG monitoring of 255 children who underwent outpatient and inpatient examinations at the Irkutsk State Regional Children’s Clinical Hospital was carried out. The age of the patients ranged from 2 months to 18 years. For SCM-ECG, the following devices were used: Holter-DMS (Russia), Card(X)plore (Hungary), Schiller MT-200 (Switzerland). Results. The most common rhythm disturbances were supraventricular pacemaker migration (96%), 2nd degree sinoatrial blockade (86%), a combination of supraventricular pacemaker migration, SA blockade and single supraventricular extrasystoles (21%). These arrhythmias belong to the first variant of the syndrome of weakness of the sinus node associated with disorders of the autonomic nervous system. The second variant of the syndrome of weakness of the sinus node was detected in 39.2%, the third variant was not detected in any child and variant 4 was found in 26.3% of the cases. Ectopic activity in the form of supraventricular extrasystole was detected in 66%, ventricular extrasystole – in 15% of the children. Paroxysmal supraventricular tachycardia was registered in 6% of cases, ventricular paroxysmal tachycardia – in 1.2% of the children. Atrioventricular blockade of the 1st degree was detected in 16%, 2nd degree of the 1st type – in 7.5%, 2nd degree of the 2nd type – in 3.1%, 3rd degree – in 0.8% of the examined children. The WPW syndrome occurred in 3.5% of the cases, long QT syndrome – in 1.6%, atrial fibrillation and flutter – in 0.8% of the cases. Thus, life-threatening arrhythmias were detected in 49 children (19%). Conclusion. A variety of forms of rhythm and conduction disturbances, which are often life-threatening and can lead to sudden cardiac death, is characteristic for both children and adults
Keywords: cardiac rhythm disorder, cardiac conductivity disorder, ECG, Holter ECG, children, paediatric cardiology
Сулима А. Н., Румянцева З. С., Кучеренко Ю. А., Рыбалка А. Н., Баскаков П. Н., Беглицэ Д. А., Гордейчик А. Е., Адамов А. М., Стрюкова О. В.
Rare clinical cases of ectopic pregnancies terminated in the second trimester of gestation
Sulima AN, Rumyantseva ZS, Kucherenko YuA, Rybalka AN, Baskakov PN, Beglitse DA, Gordeychik AE, Adamov AM, Stryukova OV. Rare clinical cases of ectopic pregnancies terminated in the second trimester of gestation. Siberian Medical Review. 2022;(5):92-95.. DOI 10.20333/25000136-2022-5-92-95
In Russia in 2017, according to the Rosstat data, ectopic pregnancy in the structure of maternal mortality was 8.10%, and in 2018 it decreased by 2 times, amounting to 4.18%. The frequency of rare forms of ectopic pregnancy reaches 5-8.3%, and the course is characterised by massive bleeding, often with a fatal outcome. The article describes rare cases of ectopic pregnancy that have occurred in our clinical practice and were interrupted at the terms of 13 and 15-16 weeks with a favourable outcome, which will be interesting not only for practicing obstetricians and gynaecologists, but also doctors of other specialties. The difficulties in the diagnosis, as well as the tactics of management and surgical treatment of these patients are described.
Keywords: ectopic pregnancy, tubal pregnancy, rare clinical case, pregnancy second trimester, diagnosis, management.
Литвинюк Н. В, Донов И. А, Евтягин С. Е, Сидоренко А. В, Афонькин В. Ю, Каширцева И. А, Евдокимова Е. Ю, Вахрушев С. Г, Протопопов А. В.
A clinical case of simultaneous embolisation and endoscopic removal of juvenile angiofibroma at the cranial base
Litvinyuk NV, Donov IA, Evtyagin SE, Sidorenko AV, Afonkin VYu, Kashirtseva IA, Evdokimova EYu, Vakhrushev SG, Protopopov AV. A clinical case of simultaneous embolisation and endoscopic resection of juvenile nasopharyngeal angiofibroma in a young patient. Siberian Medical Review. 2022;(5):96-100. DOI 10.20333/25000136-2022-5-96-100
Juvenile nasopharyngeal angiofibroma is a benign vascular tumour, mainly in young patients. There are several theories regarding the origin of this type of tumour, but the accepted treatment tactic is radical removal. The complexity of surgical intervention is associated with pronounced vascularisation of the formation, which leads to severe intraoperative blood loss. The development of surgical techniques from open resections to endoscopic interventions made it possible to reduce the volume of blood loss and the next step was the use of preoperative arterial embolisation of the tumour. Our clinical example demonstrates the safety and efficacy of simultaneous implementation of JNA embolisation and endoscopic resection under intraoperative MSCT control.
Keywords: embolisation, juvenile angiofibroma, bleeding, resection, simultaneous surgery, otolaryngology, interventional surgery, hybrid operating room.
Polycystic ovary syndrome: pathogenetic mechanisms of the disease (part 1)
Moamar Al-Jefout. Polycystic ovary syndrome: pathogenetic mechanisms of the disease (part 1). Siberian Medical Review. 2022;(5):101-104.. DOI 10.20333/25000136-2022-5-101-104
The article presents analysis of modern literature data on risk factors and pathogenesis of polycystic ovary syndrome (PCOS). Despite numerous studies, it has not been possible so far to formulate a unified concept of the pathogenesis and etiology of PCOS. This lecture considers mechanisms of PCOS development. The role of impaired steroidogenesis in the adrenal glands and ovaries in PCOS is observed. The focus is assigned to insulin resistance that is likely involved in the development of reproductive PCOS phenotype and might m ediate on some of the changes in ovarian morphology seen in this disease. It has beenshown that not only hereditary factors lead to the development of this syndrome, but also lifestyle, physical activity and concomitant somatic diseases.
Keywords: polycystic ovary syndrome; pathogenesis; risk factors; insulin resistance; hyperandrogenis
Berezovski M. V., Veprintsev D. V.
Breast cancer-derived extracellular vesicles are the source of functional metabolic enzymes as potential targets for cancer therapy
Berezovski MV, Veprintsev DV. Breast cancer-derived extracellular vesicles are the source of functional metabolic enzymes as potential targets for cancer therapy. Siberian Medical Review. 2022;(5):105. DOI 10.20333/25000136-2022-5-105
In this work, intracellular vesicles (MVs) of breast cancer were studied. These vesicles are a source of potential targets for breast cancer therapy. This study shows that MVs carry functional metabolic enzymes and provides a framework for future studies of their biological role in BC and potential in therapeutic applications.
Keywords: microvesicles, metastatic breast cancer, ornithine aminotransferase, transaldolase, bleomycin hydrolase.
Belugin K. V., Ozerskaya A. V., Chanchikova N. G., Tokarev N. A., Volzhentsev A. A., Badmaev O. N.,. Veprintsev D. V
Aptamer-based radiopharmaceutical for PET/CT detection of lung cancer
Belugin KV, Ozerskaya AV, Chanchikova NG, Tokarev NA, Volzhentsev AA, Badmaev ON, Veprintsev DV. Aptamer-based radiopharmaceutical for PET/CT detection of lung cancer. Siberian Medical Review. 2022;(5):106. DOI 10.20333/25000136-2022-5-106
The paper describes a new radiopharmaceutical for diagnosis of lung cancer obtained on the basis of a radiolabeled 11C oligonucleotide and the study of its effectiveness in-vivo. As a result of the synthesis, an aptamer to lung cancer containing 11С in the 3'-position was obtained and remained stable for 60 minutes. Prior to xenotransplantation of human lung cancer cells, the mice were immunosuppressed. Tumour volumes and locations were monitored using PET/CT. The study of accumulation of the radiopharmaceutical in the organs of mice in vivo has shown that the 11C-labeled lung cancer aptamer specifically binds to lung cancer cells. A radiopharmaceutical based on 11C-labeled LC aptamer against lung cancer is a promising drug for lung cancer diagnosing
Keywords: radionuclide, lung cancer, aptamer, PET/CT
Starkov A. K., Titova N. M.
Targeted delivery of cisplatin conjugates with arabinogalactan to tumor using aptamers
Starkov AK, Titova NM. Targeted delivery of cisplatin conjugates with arabinogalactan to tumor using aptamers. Siberian Medical Review. 2022;(5): 107. DOI 10.20333/25000136-2022-5-107
The effectiveness of targeted delivery of cisplatin conjugate with arabinogalactan to ascitic Ehrlich carcinoma in vivo using the target ligand, the AS42 aptamer, was studied in this work. Studies conducted on male ICR mice with ascitic Ehrlich carcinoma. Antitumor therapy was carried out with cisplatin and an arabinogalactan-platinum complex (AG-Pt) and an AG-Pt complex modified with aptamers to ascitic Ehrlich carcinoma cells. The toxicity of drugs was determined on the basis of biochemical parameters of blood in healthy mice after 5-fold administration. In our studies, cisplatin treatment of Ehrlich's ascitic carcinoma for 2 weeks led to the death of 6 out of 10 animals. The toxicity of the AG-Pt complex and the AG-Pt complex modified with the aptamer was not revealed. The number of tumor cells during therapy with cisplatin conjugates decreased by 10 times compared with the control. А new promising antitumor drug based on the standard drug cisplatin, which is more effective and less toxic, was presented in the work.
Keywords: aptamers, cisplatin, arabinogalactan, targeted delivery, cancer
Vorobyeva M.A., Dymova M.A., Novopashina D.S., Kuligina E.V., Kolesnikov I.A., Taskaev S.Yu., Richter V.A., Meschaninova M.I.
Oligonucleotide aptamers as novel cell-specific delivery agents for boron neutron capture therapy
Vorobyeva MA, Dymova MA, Novopashina DS, Kuligina EV, Kolesnikov IA, Taskaev SYu, Richter VA, Meschaninova MI. Oligonucleotide aptamers as novel cell-specific delivery agents for boron neutron capture therapy. Siberian Medical Review. 2022;(5):108. DOI 10.20333/25000136-2022-5-108
Oligonucleotide aptamers seem to be promising delivery vehicles addressing boron compounds to tumour cells for boron neutron capture therapy (BNCT). Here, we report the first example of using 2'-F-RNA aptamer specific to human glioblastoma cells as a delivery agent for boron clusters, which provides cell internalisation sufficient for the BNCT model.
Keywords: cell-specific aptamers, human glioblastoma cells, boron clusters, boron neutron capture therapy, cancer treatment, drug delivery
Zamay S. S., Narodov A. A., Galeev R. G., Prokopenko V. S., Sokolov A. E., Borus A. A., Zabluda V. N., Lukyanenko A. V., Baron F. A., Garifullin V. F., Masyugin A. N., Zelenov F. V., Grek D. S., Voronkovskii I. I., Gorbushin A., Kolovskaya O. S., Lukyane
"Smart" nanoscalpel for microsurgery of glial tumors of the human brain
Zamay SS, Narodov AA, Galeev RG, Prokopenko VS, Sokolov AE, Borus AA, Zabluda VN. Lukyanenko AV, Baron FA., Garifullin VF, Masyugin AN, Zelenov FV, Grek DS, Voronkovskii II, Gorbushin A, Kolovskaya OS, Lukyanenko KA, Nikolaeva ED, Luzan NA, Kichkailo AS. "Smart" nanoscalpel for microsurgery of glial tumors of the human brain. Siberian Medical Review. 2022;(5):109-110.. DOI 10.20333/25000136-2022-5-109-110
We studied the effectiveness of magnetomechanical therapy in the treatment of brain glial tumors using magnetic nanodiscs functionalized with DNA aptamers to human brain tumor glial cells. • Materials and methods. The formation of a model of human glioblastoma was carried out by intracranial injection of tumor cells of glioblastoma obtained from a patient with glioblastoma. Antitumor therapy was carried out using nanodiscs modified with the Gli233 aptamer. The growth of the glial tumor was monitored using NMR tomography. • Results and discussion. Therapy of a glial tumor during 4 sessions of magnetomechanical therapy using a "smart" nanoscalpel in MF (10Hz, 100Oe) led to a significant reduction in its size, while glial tumors in mice that were treated with nanodiscs modified with nonspecific aptamers continued to increase in size. • Conclusion. Microsurgery using three-layer magnetic nanodisks with a quasi-dipole structure (Au/Ni/Au) modified with the specific for glial cells Gli233 aptamer (“smart” nanoscalpel) is effective for the treatment of human glial tumors in the brain.
Keywords: aptamers, glial tumor, NMR tomography, «smart» nanoscalpel, nanodiscs, magnetomechanical therapy.
Nikolaeva P.A., Moryachkov R. V., Raldugina V. N., Naumova Iu. O., Novikova T. M., Spiridonova V. A.
Structural analysis of thrombin-binding G-aptamers in presence of bivalent ions
Nikolaeva PA, Moryachkov RV, Raldugina VN, Naumova IuO, Novikova TM, Spiridonova VA. Structural analysis of thrombin-binding G-aptamers in presence of bivalent ions. Siberian Medical Review. 2022;(5):111-113.. DOI 10.20333/25000136-2022-5-111-113
The aim of this study was to examine 3D structures of DNA aptamers, thrombin inhibitors. •The main objective was to study 3D structure 15TBA, RE31, NU172 aptamers using the small-angle X-ray scattering method. The size of 15TBA was 4.5 nm, which corresponds to a partially unfolded conformation. The CD spectrum of Nu172 in the presence of 50 mM strontium ions indicates the presence of an antiparallel G-quadruplex, the concentration o f which drops at 50°C. NU172 does not have a rigid structure, apparently due to the presence of a guanine residue in the GT loop. The NU172 aptamer does not form a stable conformation in solution either without ions or with Ba2+ and Sr2+ ions. • It was shown that there is possibility of aptamers transition from one conformation to another dependently on concentration and temperature confirms that the potassium ion is a unique stabilizing ion of natural molecules containing G-quadruplexes.
Keywords: 3D structures, DNA aptamers, thrombin inhibitors, G-quadruplexes
Ibba M. L., Ciccone G., Condorelli G., de Franciscis V., Catuogno S., Moryachkov R. V., Morozov E., Esposito C. L.
Aptamer-based RNA-bio-drugs for the combined therapy of GBM
Ibba ML, Ciccone G, Condorelli G, de Franciscis V, Catuogno S, Moryachkov RV, Morozov E, Esposito CL. Aptamer-based RNA-bio-drugs for the combined therapy of GBM. Siberian Medical Review. 2022;(5):114.. DOI 10.20333/25000136-2022-5-114
This paper describes a novel combined approach to targeting GBM with multiple RNA-based therapeutics. Overall, the results demonstrate the good potential of a smart safe and clinically applicable combined regimen for the treatment of glioblastoma, opening up a new avenue in the treatment of this aggressive disease.
Keywords: cancer, aptamer, RNA therapeutics, targeted delivery
Zamay G. S., Koshmanova A. A., Khorzhevskii V. A., Lubnin A. M., Babkin V. A., Medvedeva E. N., Zamay T. N.
Magnetomechanical regeneration of bone tissue using of superparamagnetic nanoparticles
Zamay GS,Koshmanova AA, Khorzhevskii VA, Lubnin AM, Babkin VA, Medvedeva EN, Zamay TN. Magnetomechanical regeneration of bone tissue using of superparamagnetic nanoparticles. Siberian Medical Review. 2022;(5):115-116. DOI 10.20333/25000136-2022-5-115-116
Here we evaluated the ability of superparamagnetic ferroarabinogalactan nanoparticles functionalized with RGD peptide (an integrin receptor ligand) to accelerate the repair of a cranial vault defect under the influence of a low-frequency alternating magnetic field. A defect of the cranial vault was used as a model of a bone injury, which is usually used on rodents, since the structure of the cranial vault allows creating a standardized burr hole that can be analyzed using histological and radiographic analysis. Functionalization of ferroarabinogalactans with the RGD peptide was performed by incubation of ferroarabinogalactans with the peptide. The study of the effectiveness of magnetomechanical transduction in vivo was carried out on 8-week-old male ICR mice. Magnetomechanical stimulation of bone tissue caused regeneration in the group of animals treated with FeAG functionalized with the RGD peptide (the cranial defect was practically restored after 7 days). At the same time, in the groups of control animals, the restoration of the bone defect did not occur during this time. After 2 weeks of magnetomechanical therapy, cranial vault defects in the animals of the experimental group were completely restored. Mice in the control groups did not recover. Ferroarabinogalactans effectively restore bone defects in a low-frequency magnetic field.
Keywords: regeneration, bone, ferroarabinogalactan, integrin, mechanotransduction.