INTRODUCTION: There is no study in literature for analyzing acanthosis nigricans (AN) in psychotropic induced obesity or hypercholesterolemia. AIM: To assess the prevalence and explore the predictors and morphological patterns in AN in patients on antipsychotics induced hypercholesterolemia versus those with diabetes mellitus. MATERIALS AND METHODS: 491 schizophrenia patients on second generation antipsychotics were screened. 26 out of 491 patients have AN and cholesterol 200 mg/dl but non-diabetic. We used MannWhitney U-test, Pearsons 2 test, Fischer Exact and Spearmans correlation coefficient. RESULTS: In the group of antipsychotics induced hypercholesterolemia having developed AN in 5.29% (26 out of 491) of individuals, we observed significance of Burkes knuckle (p 0.001), knee (p = 0.002), elbow (p = 0.042) compared to patients without hypercholesterolemia. Interestingly Burkes neck severity (p 0.001), neck texture (p = 0.001) and axilla (p = 0.007) index also showed marked differences on MannWhitney U-test and Wilcoxson W-test. On Spearmans correlation coefficient antipsychotics induced hypercholesterolemia was found to affect most positively and significantly as the emergence of AN specifically for neck texture ( = 0.413, p = 0.003) compared to other bodily regions. CONCLUSION: About 5.29% prevalence of AN in the group having obesity secondary to psychotropic drugs which was significantly less than what even non-obese, insulin dependent diabetic patients who almost had 13.55% prevalence, close to three times. This suggests that diabetes is strongly linked with occurrence of AN lesions and might reflect the continuity in the paradigm of metabolic syndrome as its definitive predictor of severity while obesity is the initiation of phase shift in the process.
{"title":"Prevalence, Predictors and Morphological Patterns of Acanthosis Nigricans Between Obese Non-diabetic Patients on Second Generation Antipsychotics Versus Non-obese Insulin Dependent Diabetes mellitus: A Nested Case-Control Study","authors":"","doi":"10.17816/pavlovj95519","DOIUrl":"https://doi.org/10.17816/pavlovj95519","url":null,"abstract":"INTRODUCTION: There is no study in literature for analyzing acanthosis nigricans (AN) in psychotropic induced obesity or hypercholesterolemia. \u0000AIM: To assess the prevalence and explore the predictors and morphological patterns in AN in patients on antipsychotics induced hypercholesterolemia versus those with diabetes mellitus. \u0000MATERIALS AND METHODS: 491 schizophrenia patients on second generation antipsychotics were screened. 26 out of 491 patients have AN and cholesterol 200 mg/dl but non-diabetic. We used MannWhitney U-test, Pearsons 2 test, Fischer Exact and Spearmans correlation coefficient. \u0000RESULTS: In the group of antipsychotics induced hypercholesterolemia having developed AN in 5.29% (26 out of 491) of individuals, we observed significance of Burkes knuckle (p 0.001), knee (p = 0.002), elbow (p = 0.042) compared to patients without hypercholesterolemia. Interestingly Burkes neck severity (p 0.001), neck texture (p = 0.001) and axilla (p = 0.007) index also showed marked differences on MannWhitney U-test and Wilcoxson W-test. On Spearmans correlation coefficient antipsychotics induced hypercholesterolemia was found to affect most positively and significantly as the emergence of AN specifically for neck texture ( = 0.413, p = 0.003) compared to other bodily regions. \u0000CONCLUSION: About 5.29% prevalence of AN in the group having obesity secondary to psychotropic drugs which was significantly less than what even non-obese, insulin dependent diabetic patients who almost had 13.55% prevalence, close to three times. This suggests that diabetes is strongly linked with occurrence of AN lesions and might reflect the continuity in the paradigm of metabolic syndrome as its definitive predictor of severity while obesity is the initiation of phase shift in the process.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131236307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Kalinin, I. Suchkov, E. A. Klimentova, I. N. Shanayev, R. M. Khashumov, V. S. Korbut
INTRODUCTION: The upper third of thigh the area of the femoral triangle, or Scarpas triangle, is of great importance both in anatomy and vascular surgery. It is the place of passage of the main vessels of the lower extremities: the femoral artery, femoral vein and their largest tributaries which are easily accessible in this region due to their superficial location. To note, in the vascular surgery, the femoral vessels are divided to common and superficial ones depending on the level of their location relative to deep femoral vessels. This division is extremely important in the functional aspect, since deep femoral vessels may significantly compensate for the blood flow in case of impaired patency of the superficial femoral vessels. Besides, an important tributary of the common femoral vein is the great saphenous vein forming saphenofemoral junction. Classic anatomy describes vessels of the upper third of thigh as single trunks with permanent topography. At the same time, in the literature there are commonly encountered reports of duplication of the superficial femoral vein, two trunks of the deep femoral artery, and relatively rare reports of atypical saphenofemoral junctions (about 0.02%). The work describes anatomical variants of the FT vessels in one patient: atypical saphenofemoral junction on the right and duplication of the common femoral vein on the left, two trunks of the deep femoral artery on both sides. CONCLUSION: The anatomical variants of FT vessels described in the article, are rare. It is important that clinicians know about them to avoid errors in diagnosis or surgical treatment.
{"title":"Two Rare Anatomical Variants of Femoral Triangle Vessels in One Patient: Case Report","authors":"R. Kalinin, I. Suchkov, E. A. Klimentova, I. N. Shanayev, R. M. Khashumov, V. S. Korbut","doi":"10.17816/pavlovj109525","DOIUrl":"https://doi.org/10.17816/pavlovj109525","url":null,"abstract":"INTRODUCTION: The upper third of thigh the area of the femoral triangle, or Scarpas triangle, is of great importance both in anatomy and vascular surgery. It is the place of passage of the main vessels of the lower extremities: the femoral artery, femoral vein and their largest tributaries which are easily accessible in this region due to their superficial location. To note, in the vascular surgery, the femoral vessels are divided to common and superficial ones depending on the level of their location relative to deep femoral vessels. This division is extremely important in the functional aspect, since deep femoral vessels may significantly compensate for the blood flow in case of impaired patency of the superficial femoral vessels. Besides, an important tributary of the common femoral vein is the great saphenous vein forming saphenofemoral junction. Classic anatomy describes vessels of the upper third of thigh as single trunks with permanent topography. At the same time, in the literature there are commonly encountered reports of duplication of the superficial femoral vein, two trunks of the deep femoral artery, and relatively rare reports of atypical saphenofemoral junctions (about 0.02%). The work describes anatomical variants of the FT vessels in one patient: atypical saphenofemoral junction on the right and duplication of the common femoral vein on the left, two trunks of the deep femoral artery on both sides. \u0000CONCLUSION: The anatomical variants of FT vessels described in the article, are rare. It is important that clinicians know about them to avoid errors in diagnosis or surgical treatment.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123111959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nikolay P. Shiryayev, S. Cheporov, Viktor N. Malashenkо, Yuliya A. Kesel'man, Anastasiya E. Akimova, Valeriya V. Milafetnova
INTRODUCTION: Morbidity with colorectal cancer (CRC) in the Yaroslavl region (YR) accounts for 13.4% of all cases identified in 2021, and ranks third after skin cancer and lung cancer. In the mortality structure, CRC makes 14.2% and is the second leading cause of death. Locally advanced and metastatic forms of the tumor process are identified in more than half the patients. AIM: To evaluate the overall survival rate of patients with metastatic CRC (mCRC) in the territory of the YR depending on the volume of surgical treatment, chemo- and targeted treatment regimens and the presence of RAS genes mutations. MATERIALS AND METHODS: On the base of the Yaroslavl Regional Clinical Oncology Hospital, the data of 291 patients with mCRC who underwent treatment in the period from 2015 to 2022, were analyzed. The mean age of patients was 63.0 8.6 years. There were 52% of men (n = 151), and 48% of women (n = 140). The patients were divided to two groups depending on the status of RAS genes mutations: group I (n = 145) patients with the identified mutation; group II (n = 146) patients with wild-type mutation. The patients were additionally divided to three subgroups depending on the type of treatment: subgroup A (58.1%; n = 169) removal of the primary focus (PF) in combination with antitumor chemotherapy (CT); subgroup B (31.6%; n = 92) CT without surgical treatment; subgroup C (10.3%; n = 30) removal of the PF and resection of liver metastases in combination with CT. RESULTS: The overall survival rate (OSR) depending on the type of treatment was in subgroup A 21.0 (95% confidence interval (CI) 18.6-23.3) months; in subgroup B 11.2 (95% CI 9.912.5) months; in subgroup C 21.0 (95% confidence interval (CI) 18.623.3) months. OSR with RAS mutation: in subgroup 1A 17.7 (95% CI 13.821.7) months; in subgroup IB 11.1 (95% CI 8.313.2) months; in subgroup IC 13.2 (95% CI 4.0722.7) months. OSR with wild-type mutation: subgroup IIA: Cetuximab 33.6 (95% CI 26.740.4) months, Panitumumab 23.8 (95% CI 19.727.9) months (p = 0.01); subgroup IIB: Cetuximab 22.3 (95% CI 17.027.5) months, Panitumumab 15.2 (95% CI 10.719.6) months (p = 0.012); subgroup IIC: Cetuximab 27.5 (95% CI 17.837.1) months, Panitumumab 38.8 (95% CI 13.963.6) months (p = 0.013). CONCLUSIONS: In patients with mutation in RAS genes, the best OSR values were noted in case of surgical removal of the PF in combination with palliative drug therapy. In patients with wild-type mutation of RAS genes the best OSR parameters were recorded in surgical removal of the PF and of metastases in the liver in combination with palliative polyCT and Panitumumab. The lowest OSR was found in the subgroup of patients with use of CT without surgical treatment in the presence of RAS mutation. High OSR parameters were found with mutation in G13codon, and with use of surgical treatment with mutation in A146 codon.
雅罗斯拉夫尔地区(YR)结直肠癌(CRC)的发病率占2021年发现的所有病例的13.4%，仅次于皮肤癌和肺癌，排名第三。在死亡结构中，结直肠癌占14.2%，是第二大死亡原因。在超过一半的患者中发现了局部晚期和转移形式的肿瘤过程。目的:评估YR范围内转移性CRC (mCRC)患者的总生存率，这取决于手术治疗、化疗和靶向治疗方案的数量以及RAS基因突变的存在。材料与方法:以雅罗斯拉夫尔地区临床肿瘤医院为基础，对2015 - 2022年291例接受治疗的mCRC患者资料进行分析。患者平均年龄63.0 ~ 8.6岁。52%的男性(n = 151)， 48%的女性(n = 140)。根据RAS基因突变的状态将患者分为两组:I组(n = 145)已确定突变的患者;II组(n = 146)患者为野生型突变。根据治疗类型将患者进一步分为三个亚组:A亚组(58.1%);n = 169)原发病灶切除(PF)联合抗肿瘤化疗(CT);B亚组占31.6%;n = 92) CT未手术治疗;C亚组(10.3%);n = 30) PF切除及肝转移灶切除联合CT。结果:A亚组总生存率(OSR)取决于治疗类型为21.0个月(95%置信区间(CI) 18.6-23.3);B亚组11.2个月(95% CI 9.912.5);C亚组为21.0个月(95%可信区间(CI) 18.623.3)。伴有RAS突变的OSR: 1A亚组17.7个月(95% CI 13.821.7);IB亚组11.1个月(95% CI 8.313.2);IC亚组为13.2个月(95% CI 4.0722.7)。伴有野生型突变的OSR: IIA亚组:西妥昔单抗33.6 (95% CI 26.740.4)个月，帕尼单抗23.8 (95% CI 19.727.9)个月(p = 0.01);IIB亚组:西妥昔单抗22.3个月(95% CI 17.027.5)，帕尼单抗15.2个月(95% CI 10.719.6) (p = 0.012);IIC亚组:西妥昔单抗27.5个月(95% CI 17.837.1)，帕尼单抗38.8个月(95% CI 13.963.6) (p = 0.013)。结论:在RAS基因突变的患者中，手术切除PF联合姑息性药物治疗的OSR值最好。在RAS基因野生型突变的患者中，手术切除PF和肝脏转移瘤联合姑息性polyCT和Panitumumab记录了最佳的OSR参数。在存在RAS突变的患者中，使用CT而不进行手术治疗的患者的OSR最低。g13密码子突变和A146密码子突变的手术治疗均发现OSR参数较高。
{"title":"Evaluation of Overall Survival Rate of Patients with Metastatic Colorectal Cancer Depending on Choice of Treatment, Location of Primary Focus and RAS Genes Mutation Status","authors":"Nikolay P. Shiryayev, S. Cheporov, Viktor N. Malashenkо, Yuliya A. Kesel'man, Anastasiya E. Akimova, Valeriya V. Milafetnova","doi":"10.17816/pavlovj108986","DOIUrl":"https://doi.org/10.17816/pavlovj108986","url":null,"abstract":"INTRODUCTION: Morbidity with colorectal cancer (CRC) in the Yaroslavl region (YR) accounts for 13.4% of all cases identified in 2021, and ranks third after skin cancer and lung cancer. In the mortality structure, CRC makes 14.2% and is the second leading cause of death. Locally advanced and metastatic forms of the tumor process are identified in more than half the patients. \u0000AIM: To evaluate the overall survival rate of patients with metastatic CRC (mCRC) in the territory of the YR depending on the volume of surgical treatment, chemo- and targeted treatment regimens and the presence of RAS genes mutations. \u0000MATERIALS AND METHODS: On the base of the Yaroslavl Regional Clinical Oncology Hospital, the data of 291 patients with mCRC who underwent treatment in the period from 2015 to 2022, were analyzed. The mean age of patients was 63.0 8.6 years. There were 52% of men (n = 151), and 48% of women (n = 140). The patients were divided to two groups depending on the status of RAS genes mutations: group I (n = 145) patients with the identified mutation; group II (n = 146) patients with wild-type mutation. The patients were additionally divided to three subgroups depending on the type of treatment: subgroup A (58.1%; n = 169) removal of the primary focus (PF) in combination with antitumor chemotherapy (CT); subgroup B (31.6%; n = 92) CT without surgical treatment; subgroup C (10.3%; n = 30) removal of the PF and resection of liver metastases in combination with CT. \u0000RESULTS: The overall survival rate (OSR) depending on the type of treatment was in subgroup A 21.0 (95% confidence interval (CI) 18.6-23.3) months; in subgroup B 11.2 (95% CI 9.912.5) months; in subgroup C 21.0 (95% confidence interval (CI) 18.623.3) months. OSR with RAS mutation: in subgroup 1A 17.7 (95% CI 13.821.7) months; in subgroup IB 11.1 (95% CI 8.313.2) months; in subgroup IC 13.2 (95% CI 4.0722.7) months. OSR with wild-type mutation: subgroup IIA: Cetuximab 33.6 (95% CI 26.740.4) months, Panitumumab 23.8 (95% CI 19.727.9) months (p = 0.01); subgroup IIB: Cetuximab 22.3 (95% CI 17.027.5) months, Panitumumab 15.2 (95% CI 10.719.6) months (p = 0.012); subgroup IIC: Cetuximab 27.5 (95% CI 17.837.1) months, Panitumumab 38.8 (95% CI 13.963.6) months (p = 0.013). \u0000CONCLUSIONS: In patients with mutation in RAS genes, the best OSR values were noted in case of surgical removal of the PF in combination with palliative drug therapy. In patients with wild-type mutation of RAS genes the best OSR parameters were recorded in surgical removal of the PF and of metastases in the liver in combination with palliative polyCT and Panitumumab. The lowest OSR was found in the subgroup of patients with use of CT without surgical treatment in the presence of RAS mutation. High OSR parameters were found with mutation in G13codon, and with use of surgical treatment with mutation in A146 codon.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122529091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuliya V. Terekhovskaya, N. E. K. Akhmedova, D. I. Leonenko, N. N. Nikulina
INTRODUCTION: Pulmonary embolism (PE) is a cardiovascular disease with high mortality: according to autopsy data, PE is the cause of death in every tenth deceased person. Despite a relatively long history of studying PE, the literature data on this problem are scattered, incomplete and often do not represent the Russian population. AIM: To evaluate 12-month survival rate of patients after a past episode of PE and to establish predictors of fatal outcome. MATERIALS AND METHODS: The work was carried out within the Russian SIRENA register. The study included 107 patients (age median and interquartile range 63 (5274) years), who underwent inpatient treatment in Regional Clinical Cardiologic Dispensary of Ryazan (hospitalization from 01.05.2018 to 31.05.2019; inclusion period 13 months). In the period of hospitalization, the information was taken from the data of medical records and objective examinations, and after the discharge through telephone control. Follow-up period from the moment of hospitalization was 12 months; response 84.5%. RESULTS: The 12-month survival rate of patients with PE was 77.1%; recurrence of venous thromboembolism developed in 6.5% of patients, bleeding in 22.4% of patients. The only statistically significant predictor of the development of a fatal outcome after discharge from hospital was the presence of cancer, including that in history (relative risk (RR) 4.4; 95% confidence interval (CI) 1.414.5; p = 0.014). The leading predictors of death from the moment of hospitalization within 12 months were high risk based on the integral assessment of severity and of early death risk (RR 9.9; 95% CI 1.279.5; p = 0.031), age 65 years (RR 5.1; 95% CI 1.715.2; p = 0.003), hospitalization with other than PE primary diagnosis (RR 4.5; 95% CI 1.910.8; p = 0.001), impaired filtration function of kidneys (RR 4.3; 95% CI 1.711.1; p = 0.003). Besides, a statistically significant increase in the risk of death during this period was associated with history of atherosclerotic diseases, stroke, heart failure, oncology, hemodynamic instability in the acute period, the need for loop diuretics during hospitalization and the presence of S1Q3 syndrome. CONCLUSION: The mortality rate of patients with PE in one of the regional vascular centers of Ryazan in 20182019 generally agrees with the data of the previous international studies. The leading predictors of fatal outcome within 12 months from the moment of hospitalization include a severe condition of a patient at the time of hospitalization, age 65 years, untimely diagnosis of PE and reduction of filtration function of kidneys.
肺栓塞(PE)是一种高死亡率的心血管疾病:根据尸检数据，PE是每10个死者中死亡的原因。尽管研究体育的历史相对较长，但关于这一问题的文献数据是分散的，不完整的，而且往往不能代表俄罗斯人口。目的:评估过去PE发作后患者的12个月生存率，并建立致命结局的预测因素。材料和方法:本研究在俄罗斯SIRENA注册系统中进行。该研究纳入107例患者(年龄中位数和四分位数间距为63(5274)岁)，于梁赞地区临床心脏病诊所住院治疗(住院时间为2018年5月1日至2019年5月31日;纳入期13个月)。住院期间通过病历数据和客观检查获取信息，出院后通过电话控制获取信息。自入院之日起随访12个月;84.5%的回应。结果:PE患者12个月生存率为77.1%;6.5%的患者发生静脉血栓栓塞复发，22.4%的患者出血。出院后发生致命结局的唯一有统计学意义的预测因子是癌症的存在，包括病史(相对危险度(RR) 4.4;95%置信区间(CI) 1.414.5;P = 0.014)。基于严重程度和早期死亡风险的综合评估，住院12个月内死亡的主要预测因子为高风险(RR 9.9;95% ci 1.279.5;p = 0.031)， 65岁(RR 5.1;95% ci 1.715.2;p = 0.003)，非原发性PE患者住院(RR 4.5;95% ci 1.910.8;p = 0.001)，肾脏滤过功能受损(RR 4.3;95% ci 1.711.1;P = 0.003)。此外，在此期间死亡风险的统计学显著增加与动脉粥样硬化性疾病、中风、心力衰竭、肿瘤病史、急性期血流动力学不稳定、住院期间需要循环利尿剂和存在S1Q3综合征有关。结论:梁赞某区域血管中心2018 - 2019年PE患者死亡率与国际前期研究数据基本一致。入院后12个月内死亡的主要预测因素包括患者入院时病情严重、年龄65岁、未及时诊断PE和肾脏滤过功能下降。
{"title":"Prognosis for Patients after Pulmonary Embolism and its Determining Factors (Results of 12-Month Follow-Up)","authors":"Yuliya V. Terekhovskaya, N. E. K. Akhmedova, D. I. Leonenko, N. N. Nikulina","doi":"10.17816/pavlovj165196","DOIUrl":"https://doi.org/10.17816/pavlovj165196","url":null,"abstract":"INTRODUCTION: Pulmonary embolism (PE) is a cardiovascular disease with high mortality: according to autopsy data, PE is the cause of death in every tenth deceased person. Despite a relatively long history of studying PE, the literature data on this problem are scattered, incomplete and often do not represent the Russian population. \u0000AIM: To evaluate 12-month survival rate of patients after a past episode of PE and to establish predictors of fatal outcome. \u0000MATERIALS AND METHODS: The work was carried out within the Russian SIRENA register. The study included 107 patients (age median and interquartile range 63 (5274) years), who underwent inpatient treatment in Regional Clinical Cardiologic Dispensary of Ryazan (hospitalization from 01.05.2018 to 31.05.2019; inclusion period 13 months). In the period of hospitalization, the information was taken from the data of medical records and objective examinations, and after the discharge through telephone control. Follow-up period from the moment of hospitalization was 12 months; response 84.5%. \u0000RESULTS: The 12-month survival rate of patients with PE was 77.1%; recurrence of venous thromboembolism developed in 6.5% of patients, bleeding in 22.4% of patients. The only statistically significant predictor of the development of a fatal outcome after discharge from hospital was the presence of cancer, including that in history (relative risk (RR) 4.4; 95% confidence interval (CI) 1.414.5; p = 0.014). The leading predictors of death from the moment of hospitalization within 12 months were high risk based on the integral assessment of severity and of early death risk (RR 9.9; 95% CI 1.279.5; p = 0.031), age 65 years (RR 5.1; 95% CI 1.715.2; p = 0.003), hospitalization with other than PE primary diagnosis (RR 4.5; 95% CI 1.910.8; p = 0.001), impaired filtration function of kidneys (RR 4.3; 95% CI 1.711.1; p = 0.003). Besides, a statistically significant increase in the risk of death during this period was associated with history of atherosclerotic diseases, stroke, heart failure, oncology, hemodynamic instability in the acute period, the need for loop diuretics during hospitalization and the presence of S1Q3 syndrome. \u0000CONCLUSION: The mortality rate of patients with PE in one of the regional vascular centers of Ryazan in 20182019 generally agrees with the data of the previous international studies. The leading predictors of fatal outcome within 12 months from the moment of hospitalization include a severe condition of a patient at the time of hospitalization, age 65 years, untimely diagnosis of PE and reduction of filtration function of kidneys.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126053449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. M. Vdovin, I. Shakhmatov, I. Bobrov, D. Orekhov, Vyacheslav V. Teryayev, V. E. Chernus', A. Momot
INTRODUCTION: Earlier, an ability of exogenous fibrin monomer (FM) introduced at low doses to considerably limit posttraumatic blood loss was established by us on an experimental model of warfarin coagulopathy in vivo. However, the morphologic peculiarities of fibrin formation in the wound area were not considered. AIM: To compare morphologic, hemostasiologic and hemostatic data based on the results of systemic application of exogenous FM to interpret their effects in the model of posttraumatic bleeding with the underlying intake of warfarin. MATERIALS AND METHODS: In the work, Chinchilla male rabbits were used. A comparative analysis of hemostasiologic effects and of morphologic picture of the surface of the liver in the wound area was conducted after a dosed trauma, with a preliminary systemic introduction of FM (0.25 mg/kg intravenously) or a concentrate of prothrombin complex factors (40 IU/kg intravenously) with the underlying intake of warfarin by animals (0.40.5 mg/kg/day per os for 2 weeks). RESULTS: Introduction of FM in warfarinised animals in the conditions of a dosed experimental liver injury promoted a hemostatic effect comparable with that of a concentrate of prothrombin complex factors. Both hemostatic drugs led to intense fibrin formation that reduced posttraumatic blood loss. The use of FM was associated with increase in the thickness of thrombotic deposits and fibrin fibers in the wound surface in comparison with placebo by 4.0 and 1.6 times, respectively (р 0.000001). This process actively involved platelets, which led to 1.7 times reduction of their quantity in the lumen of the blood vessels in the wound vicinity (р 0.0002). No effect of FM on systemic hemostatic reactions in venous blood was found, in contrast to concentrate of prothrombin complex factors. CONCLUSION: Exogenous FM can produce a local hemostatic effect in the conditions of dosed experimental trauma and coagulopathy induced by warfarin intake. The hemostatic effect was mediated by intense thrombosis on the wound surface with the active recruitment of platelets in the process. The peculiarities of the demonstrated effects of FM may be mediated though the mechanisms of its action that have not yet been identified, which necessitates continuation of the research in this direction.
{"title":"Morphologic, Hemostasiologic and Hemostatic Aspects of Systemic Application of Exogenous Fibrin Monomer in Model of Posttraumatic Bleeding with Underlying Intake of Warfarin","authors":"V. M. Vdovin, I. Shakhmatov, I. Bobrov, D. Orekhov, Vyacheslav V. Teryayev, V. E. Chernus', A. Momot","doi":"10.17816/pavlovj108736","DOIUrl":"https://doi.org/10.17816/pavlovj108736","url":null,"abstract":"INTRODUCTION: Earlier, an ability of exogenous fibrin monomer (FM) introduced at low doses to considerably limit posttraumatic blood loss was established by us on an experimental model of warfarin coagulopathy in vivo. However, the morphologic peculiarities of fibrin formation in the wound area were not considered. \u0000AIM: To compare morphologic, hemostasiologic and hemostatic data based on the results of systemic application of exogenous FM to interpret their effects in the model of posttraumatic bleeding with the underlying intake of warfarin. \u0000MATERIALS AND METHODS: In the work, Chinchilla male rabbits were used. A comparative analysis of hemostasiologic effects and of morphologic picture of the surface of the liver in the wound area was conducted after a dosed trauma, with a preliminary systemic introduction of FM (0.25 mg/kg intravenously) or a concentrate of prothrombin complex factors (40 IU/kg intravenously) with the underlying intake of warfarin by animals (0.40.5 mg/kg/day per os for 2 weeks). \u0000RESULTS: Introduction of FM in warfarinised animals in the conditions of a dosed experimental liver injury promoted a hemostatic effect comparable with that of a concentrate of prothrombin complex factors. Both hemostatic drugs led to intense fibrin formation that reduced posttraumatic blood loss. The use of FM was associated with increase in the thickness of thrombotic deposits and fibrin fibers in the wound surface in comparison with placebo by 4.0 and 1.6 times, respectively (р 0.000001). This process actively involved platelets, which led to 1.7 times reduction of their quantity in the lumen of the blood vessels in the wound vicinity (р 0.0002). No effect of FM on systemic hemostatic reactions in venous blood was found, in contrast to concentrate of prothrombin complex factors. \u0000CONCLUSION: Exogenous FM can produce a local hemostatic effect in the conditions of dosed experimental trauma and coagulopathy induced by warfarin intake. The hemostatic effect was mediated by intense thrombosis on the wound surface with the active recruitment of platelets in the process. The peculiarities of the demonstrated effects of FM may be mediated though the mechanisms of its action that have not yet been identified, which necessitates continuation of the research in this direction.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126380385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. P. Pashkin, Aleksandr A. Natal’skiy, E. V. Motyrova, I. A. Lun’kov, V. I. Matrosov, D. V. Mishin, O. D. Peskov
INTRODUCTION: The incidence of failure of intestinal sutures in the early postoperative period reaches 26%. The failure of the duodenal sutures leads to formation of high duodenal fistulas, the treatment of which is one of the most complicated surgical tasks. The article describes a clinical case of failure of duodenal suture after surgery for a duodenal ulcer complicated with bleeding. The failure of the duodenal suture could be provoked by hypoproteinemia and anemia, despite the attempts of their compensation. The presented case demonstrates complexity of the clinical course of this pathology and the possibility of successful application of draining surgery with creation of a controllable duodenal fistula, the subsequent healing of which led to recovery of the patient. To create the controllable duodenal fistula, we used a method of external-internal triple drainage of the duodenal zone (retrograde duodenostomy, gastroenteroanastomosis with a short loop, nasogastral probe). At the initial stage, after surgery, the patient received full parenteral feeding, after restoration of the intestinal peristalsis, feeding was continued through a nasointestinal probe. Infusion therapy, transfusion of blood components were conducted, drugs suppressing gastric and pancreatic secretion, were used. On the 35th postoperative day, the discharge through the duodenal fistula and the nasogastral probe significantly decreased, and completely stopped on the 54th day (immediately after X-ray of stomach with barium sulfate as contrast substance). The patient was discharged with improvement for outpatient follow-up at the place of residence on the 60th day after surgery. In the follow-up period no complaints, good appetite, rapid gaining of weight, complete rehabilitation. In one-year follow-up, no long-term complications and consequences for health were observed. CONCLUSION: A choice of the surgical treatment method of duodenal suture failure remains a subject of discussion. In the presented clinical case, draining surgery with creation of a controllable duodenal fistula proved to be effective. The complete closure of the residual fistula of the duodenum was facilitated by stomach X-ray with use of barium sulfate.
{"title":"Suture Failure of Duodenum after Surgery for Complications of Duodenal Ulcer","authors":"K. P. Pashkin, Aleksandr A. Natal’skiy, E. V. Motyrova, I. A. Lun’kov, V. I. Matrosov, D. V. Mishin, O. D. Peskov","doi":"10.17816/pavlovj110861","DOIUrl":"https://doi.org/10.17816/pavlovj110861","url":null,"abstract":"INTRODUCTION: The incidence of failure of intestinal sutures in the early postoperative period reaches 26%. The failure of the duodenal sutures leads to formation of high duodenal fistulas, the treatment of which is one of the most complicated surgical tasks. The article describes a clinical case of failure of duodenal suture after surgery for a duodenal ulcer complicated with bleeding. The failure of the duodenal suture could be provoked by hypoproteinemia and anemia, despite the attempts of their compensation. The presented case demonstrates complexity of the clinical course of this pathology and the possibility of successful application of draining surgery with creation of a controllable duodenal fistula, the subsequent healing of which led to recovery of the patient. To create the controllable duodenal fistula, we used a method of external-internal triple drainage of the duodenal zone (retrograde duodenostomy, gastroenteroanastomosis with a short loop, nasogastral probe). At the initial stage, after surgery, the patient received full parenteral feeding, after restoration of the intestinal peristalsis, feeding was continued through a nasointestinal probe. Infusion therapy, transfusion of blood components were conducted, drugs suppressing gastric and pancreatic secretion, were used. On the 35th postoperative day, the discharge through the duodenal fistula and the nasogastral probe significantly decreased, and completely stopped on the 54th day (immediately after X-ray of stomach with barium sulfate as contrast substance). The patient was discharged with improvement for outpatient follow-up at the place of residence on the 60th day after surgery. In the follow-up period no complaints, good appetite, rapid gaining of weight, complete rehabilitation. In one-year follow-up, no long-term complications and consequences for health were observed. \u0000CONCLUSION: A choice of the surgical treatment method of duodenal suture failure remains a subject of discussion. In the presented clinical case, draining surgery with creation of a controllable duodenal fistula proved to be effective. The complete closure of the residual fistula of the duodenum was facilitated by stomach X-ray with use of barium sulfate.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129555373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTION: Purposeful cognitive brain activity of an individual depends on blood supply to the cells of the cerebral cortex (CC), and on their autonomic innervation. AIM: To identify peculiarities of the brain hemodynamics and heart rhythm variability (HRV) in young men performing cognitive tasks with unequal effectiveness. MATERIALS AND METHODS: The study involved 42 practically healthy young men (mean age 19.40 1.20 years). The brain hemodynamics was studied using Reo-Spektr-2 rheograph (Neurosoft, Russia) in the initial condition of relative rest and in modeled purposeful cognitive activity. Synchronously with record of rheoencephalogram, rhythmocardiogram was recorded using Varicard 2.51 hardware-software complex (Ramena, Russia). Purposeful cognitive activity was modeled in Physiotest program for psychophysiological studies with use of behavioral model: Schulte Table Test in a two-color SchulteGorbov modification. In statistical data processing, cluster and correlation analyses were used. RESULTS: Based on the effectiveness of SchulteGorbov Table Test, the sample of subjects was divided to two clusters (n = 28 and n = 14). Comparison of clusters in the initial condition of relative physiological rest and during cognitive activity revealed differences in rheoencephalographic parameters, which reflects unequal hemodynamic supply of the brain in representatives of the given clusters. Differences in HRV parameter were found reflecting the different levels of tension of adaptation mechanisms in the initial condition and in cognitive activity. The results of the correlation analysis demonstrated different dependence between the parameters of rheoencephalogram, HRV and parameters of the effectiveness of Schulte-Gorbov Test in representatives of different clusters. CONCLUSIONS: (1) High-effective subjects are characterized by shorter time of propagation of the rheographic wave and longer time of slow blood filling of the right vertebral artery basin, and by higher rheographic index asymmetry coefficient in the basin of the left internal carotid artery and of vertebral arteries of both hemispheres during cognitive activity compared to low-effective subjects. (2) Physiological support of purposeful activity of an individual with unequal effectiveness of salvation of cognitive tasks is characterized not only by different levels of brain hemodynamics and activity of autonomic regulatory mechanisms, but also by certain type of correlation relationships of these parameters with parameters of purposeful behavior, in particular, with the total time of fulfilment of the task and efficiency coefficient.
{"title":"Peculiarities of Brain Hemodynamics and Heart Rhythm Variability in Young Men in Performing Modeled Cognitive Activity with Unequal Effectiveness","authors":"P. A. Kulagin, M. Lapkin, E. Trutneva","doi":"10.17816/pavlovj109281","DOIUrl":"https://doi.org/10.17816/pavlovj109281","url":null,"abstract":"INTRODUCTION: Purposeful cognitive brain activity of an individual depends on blood supply to the cells of the cerebral cortex (CC), and on their autonomic innervation. \u0000AIM: To identify peculiarities of the brain hemodynamics and heart rhythm variability (HRV) in young men performing cognitive tasks with unequal effectiveness. \u0000MATERIALS AND METHODS: The study involved 42 practically healthy young men (mean age 19.40 1.20 years). The brain hemodynamics was studied using Reo-Spektr-2 rheograph (Neurosoft, Russia) in the initial condition of relative rest and in modeled purposeful cognitive activity. Synchronously with record of rheoencephalogram, rhythmocardiogram was recorded using Varicard 2.51 hardware-software complex (Ramena, Russia). Purposeful cognitive activity was modeled in Physiotest program for psychophysiological studies with use of behavioral model: Schulte Table Test in a two-color SchulteGorbov modification. In statistical data processing, cluster and correlation analyses were used. \u0000RESULTS: Based on the effectiveness of SchulteGorbov Table Test, the sample of subjects was divided to two clusters (n = 28 and n = 14). Comparison of clusters in the initial condition of relative physiological rest and during cognitive activity revealed differences in rheoencephalographic parameters, which reflects unequal hemodynamic supply of the brain in representatives of the given clusters. Differences in HRV parameter were found reflecting the different levels of tension of adaptation mechanisms in the initial condition and in cognitive activity. The results of the correlation analysis demonstrated different dependence between the parameters of rheoencephalogram, HRV and parameters of the effectiveness of Schulte-Gorbov Test in representatives of different clusters. \u0000CONCLUSIONS: (1) High-effective subjects are characterized by shorter time of propagation of the rheographic wave and longer time of slow blood filling of the right vertebral artery basin, and by higher rheographic index asymmetry coefficient in the basin of the left internal carotid artery and of vertebral arteries of both hemispheres during cognitive activity compared to low-effective subjects. (2) Physiological support of purposeful activity of an individual with unequal effectiveness of salvation of cognitive tasks is characterized not only by different levels of brain hemodynamics and activity of autonomic regulatory mechanisms, but also by certain type of correlation relationships of these parameters with parameters of purposeful behavior, in particular, with the total time of fulfilment of the task and efficiency coefficient.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116035617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kepiya T. Temirkhanova, L. Deryagina, E. D. Pyatibrat, A. O. Pyatibrat
INTRODUCTION: The importance of the study is determined by increasing instability of the society and involvement of civilian population in military conflicts. AIM: To determine peculiarities of sexual development of adolescents whose mothers experienced life-threatening stress in the period preceding pregnancy. MATERIALS AND METHODS: To evaluate the evidence of the secondary sexual signs, hormonal status, anthropometric data and immunity parameters, 2,980 medical records and data of preventive examinations of schoolchildren of the Republic of Dagestan were analyzed. The observation group included 1,416 schoolchildren whose mothers experienced a life-threatening mental trauma, and the control group included 1,564 adolescents whose mothers did not face life-threatening situations. RESULTS: The data of a comparative analysis of the regulation of physiological development of sons of women who suffered a life-threatening mental trauma, show multidirectional changes in the concentration of gonadotropic hormones with higher concentrations of estrogens, low levels of androgens, manifested by retardation of the formation of secondary sexual signs, reduced physical strength and endurance in puberty in comparison with boys of the control group. Daughters of mothers who experienced a life-threatening stress, in contrast to girls of the control group, were characterized in puberty by higher levels of luteinizing, follicle-stimulating hormones, earlier development of mammary glands and growth of pubic hair. At the same time, in transition from the prepubertal to pubertal period, these girls were characterized by earlier reduction of the activity of adrenal cortex in these girls, early menarche in the pubertal period and retardation of stabilization of the menstrual cycle rhythm. CONCLUSION: The adolescents being the offspring of women, who experienced a psychogenic life-threatening trauma, are characterized by disorders in physiologic maturation: boys by retardation, girls by acceleration and disharmony of the pubertal development.
{"title":"Physiological Peculiarities of Puberty Period of Adolescents Whose Mothers Were Under High Risk of Terroristic Attack","authors":"Kepiya T. Temirkhanova, L. Deryagina, E. D. Pyatibrat, A. O. Pyatibrat","doi":"10.17816/pavlovj106328","DOIUrl":"https://doi.org/10.17816/pavlovj106328","url":null,"abstract":"INTRODUCTION: The importance of the study is determined by increasing instability of the society and involvement of civilian population in military conflicts. \u0000AIM: To determine peculiarities of sexual development of adolescents whose mothers experienced life-threatening stress in the period preceding pregnancy. \u0000MATERIALS AND METHODS: To evaluate the evidence of the secondary sexual signs, hormonal status, anthropometric data and immunity parameters, 2,980 medical records and data of preventive examinations of schoolchildren of the Republic of Dagestan were analyzed. The observation group included 1,416 schoolchildren whose mothers experienced a life-threatening mental trauma, and the control group included 1,564 adolescents whose mothers did not face life-threatening situations. \u0000RESULTS: The data of a comparative analysis of the regulation of physiological development of sons of women who suffered a life-threatening mental trauma, show multidirectional changes in the concentration of gonadotropic hormones with higher concentrations of estrogens, low levels of androgens, manifested by retardation of the formation of secondary sexual signs, reduced physical strength and endurance in puberty in comparison with boys of the control group. Daughters of mothers who experienced a life-threatening stress, in contrast to girls of the control group, were characterized in puberty by higher levels of luteinizing, follicle-stimulating hormones, earlier development of mammary glands and growth of pubic hair. At the same time, in transition from the prepubertal to pubertal period, these girls were characterized by earlier reduction of the activity of adrenal cortex in these girls, early menarche in the pubertal period and retardation of stabilization of the menstrual cycle rhythm. \u0000CONCLUSION: The adolescents being the offspring of women, who experienced a psychogenic life-threatening trauma, are characterized by disorders in physiologic maturation: boys by retardation, girls by acceleration and disharmony of the pubertal development.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126401406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Lipatov, Eduard V. Fronchek, A. Y. Grigor'yan, D. A. Severinov, M. D. Naimzada, L. Y. Zakutayeva
INTRODUCTION: Chitosan-based local hemostatic agents are most promising in terms of effective stoppage of bleeding, additional properties (for example, antibacterial effect) and stimulation of regeneration. New forms of them are being developed for different types of organ damage. AIM: To evaluate the hemostatic effect of samples of new chitosan-based local hemostatic agents on a liver resection model. MATERIALS AND METHODS: An in vivo experiment was performed on 60 white male rats of Wistar line of 200 g250 g mass. The animals were divided to 4 study groups of 15 animals, respectively, depending on the kind of hemostatic agent and additional introduction of an anticoagulant that enhanced bleeding. As study materials, hemostatic collagen sponge (control groups No. 1.1 and 1.2) and also samples of new chitosan-based hemostatic agents Сhitocol-Hemo (Evers, Russia) were used. The rats under general anesthesia underwent midline laparotomy followed by laparopexy by dissecting the falciform ligament of the liver and placement of a gauze turunda between the diaphragm and the left liver lobule with displacement of the latter into the wound. After this, a sterile gauze turunda of the known mass was placed under the left lateral lobe of the liver, and resection of this lobe was performed at 10 mm distance from the edge. The bleeding was stopped by application of the tested materials. The mass of blood loss (gravimetric parameters) and the time of bleeding were evaluated. The reliability of the differences was determined using nonparametric Mann-Whitney test. RESULTS: In animals that were not administered the anticoagulant before modeling of the liver trauma, statistically significant differences were found only in such parameters as increase in the sample mass after impregnation with blood, in percent. Here, the value of this parameter in the group with use of hemostatic collagen sponge (2262.9) was three times that in the group using hemostatic Сhitocol-Hemo (722.7) p = 0.000003. The differences between the groups with heparin therapy were of similar character (p = 000003). CONCLUSION: The hemostatic effect of the sample of Сhitocol-Hemo hemostatic agent was confirmed in an acute experiment on a model of liver injury in rats on the basis of measurement of the mass of blood lost, of blood absorbed by the sample, and also of bleeding time. This hemostatic effect is probably provided due to positive physicochemical characteristics (porous structure, stroma/pores ratio and composition of the agent.
{"title":"Evaluation of Effectiveness of New Samples of Chitosan-Based Local Hemostatic Agents After Liver Resection in Experiment","authors":"V. Lipatov, Eduard V. Fronchek, A. Y. Grigor'yan, D. A. Severinov, M. D. Naimzada, L. Y. Zakutayeva","doi":"10.17816/pavlovj108094","DOIUrl":"https://doi.org/10.17816/pavlovj108094","url":null,"abstract":"INTRODUCTION: Chitosan-based local hemostatic agents are most promising in terms of effective stoppage of bleeding, additional properties (for example, antibacterial effect) and stimulation of regeneration. New forms of them are being developed for different types of organ damage. \u0000AIM: To evaluate the hemostatic effect of samples of new chitosan-based local hemostatic agents on a liver resection model. \u0000MATERIALS AND METHODS: An in vivo experiment was performed on 60 white male rats of Wistar line of 200 g250 g mass. The animals were divided to 4 study groups of 15 animals, respectively, depending on the kind of hemostatic agent and additional introduction of an anticoagulant that enhanced bleeding. As study materials, hemostatic collagen sponge (control groups No. 1.1 and 1.2) and also samples of new chitosan-based hemostatic agents Сhitocol-Hemo (Evers, Russia) were used. The rats under general anesthesia underwent midline laparotomy followed by laparopexy by dissecting the falciform ligament of the liver and placement of a gauze turunda between the diaphragm and the left liver lobule with displacement of the latter into the wound. After this, a sterile gauze turunda of the known mass was placed under the left lateral lobe of the liver, and resection of this lobe was performed at 10 mm distance from the edge. The bleeding was stopped by application of the tested materials. The mass of blood loss (gravimetric parameters) and the time of bleeding were evaluated. The reliability of the differences was determined using nonparametric Mann-Whitney test. \u0000RESULTS: In animals that were not administered the anticoagulant before modeling of the liver trauma, statistically significant differences were found only in such parameters as increase in the sample mass after impregnation with blood, in percent. Here, the value of this parameter in the group with use of hemostatic collagen sponge (2262.9) was three times that in the group using hemostatic Сhitocol-Hemo (722.7) p = 0.000003. The differences between the groups with heparin therapy were of similar character (p = 000003). \u0000CONCLUSION: The hemostatic effect of the sample of Сhitocol-Hemo hemostatic agent was confirmed in an acute experiment on a model of liver injury in rats on the basis of measurement of the mass of blood lost, of blood absorbed by the sample, and also of bleeding time. This hemostatic effect is probably provided due to positive physicochemical characteristics (porous structure, stroma/pores ratio and composition of the agent.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"159 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124716231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. V. Solov’yeva, A. Gurbanova, Ivan A. Maksimtsev, O. Lazareva, E. A. Maksimtseva
INTRODUCTION: Myocardial bridging (MB) is considered a benign pathology, however, its existence is often associated with angina pectoris, myocardial infarction, ventricular tachycardia and sudden cardiac death. The clinical significance of MB is determined by the dynamic stenosis of the coronary artery, which depends on the rate and strength of heart contractions and is poorly visualized by instrumental methods, which impairs timely diagnosis and early administration of the adequate treatment. A clinical case of a combined damage to the coronary bed in a 58-year-old patient is presented: MB of the anterior interventricular artery (AIVA) causing dynamically significant narrowing of the tunnel artery and hemodynamically insignificant atherosclerotic lesion of the coronary arteries. MB was typically located in the mid-segment of the AIVA. The diagnosis of the anomaly of the coronary bed was established after coronary angiography: MB of AIVA led to stenosis of the tunnel segment to 80% and was the cause of angina attacks. Stenting of the AIVA with a drug-coated stent was performed. The effectiveness of the stenting can be referred to a peculiar feature of this case, since in the treatment of this pathology the preference is given to myotomy and coronary artery bypass grafting as more effective methods. The follow-up period was 7.5 years; after stenting of the tunnel segment of the AIVA the anginal attacks did not recur. CONCLUSION: The described clinical case demonstrates the role of MB in the development of myocardial ischemia. With timely diagnosis of the coronary blood flow disorders, successful revascularization and adequate pharmacotherapy in accordance with the current clinical recommendations, the prognosis is good.
{"title":"Role of Myocardial Bridging in Myocardial Ischemia: Case Report","authors":"A. V. Solov’yeva, A. Gurbanova, Ivan A. Maksimtsev, O. Lazareva, E. A. Maksimtseva","doi":"10.17816/pavlovj109080","DOIUrl":"https://doi.org/10.17816/pavlovj109080","url":null,"abstract":"INTRODUCTION: Myocardial bridging (MB) is considered a benign pathology, however, its existence is often associated with angina pectoris, myocardial infarction, ventricular tachycardia and sudden cardiac death. The clinical significance of MB is determined by the dynamic stenosis of the coronary artery, which depends on the rate and strength of heart contractions and is poorly visualized by instrumental methods, which impairs timely diagnosis and early administration of the adequate treatment. A clinical case of a combined damage to the coronary bed in a 58-year-old patient is presented: MB of the anterior interventricular artery (AIVA) causing dynamically significant narrowing of the tunnel artery and hemodynamically insignificant atherosclerotic lesion of the coronary arteries. MB was typically located in the mid-segment of the AIVA. The diagnosis of the anomaly of the coronary bed was established after coronary angiography: MB of AIVA led to stenosis of the tunnel segment to 80% and was the cause of angina attacks. Stenting of the AIVA with a drug-coated stent was performed. The effectiveness of the stenting can be referred to a peculiar feature of this case, since in the treatment of this pathology the preference is given to myotomy and coronary artery bypass grafting as more effective methods. The follow-up period was 7.5 years; after stenting of the tunnel segment of the AIVA the anginal attacks did not recur. \u0000CONCLUSION: The described clinical case demonstrates the role of MB in the development of myocardial ischemia. With timely diagnosis of the coronary blood flow disorders, successful revascularization and adequate pharmacotherapy in accordance with the current clinical recommendations, the prognosis is good.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127239173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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