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Comparative Analysis of Personality-Related and Value-and-Meaning-Related Characteristics of Narcological Patients and Healthy Individuals (Abstainers) in Terms of Tertiary Prevention 在三级预防方面,精神病患者与健康个体(戒酒者)的人格相关特征和价值意义相关特征的比较分析
Pub Date : 2022-12-28 DOI: 10.17816/pavlovj109308
V. V. Korduban, O. Buzik, T. Agibalova
INTRODUCTION: Achievement of absolute sobriety, its maintenance and preservation are the main tasks of the stage of tertiary prophylaxis of narcological patients. AIM: To perform a comparative analysis of personality- and value-and-meaning-related characteristics of narcological patients with syndrome of addiction to psychoactive substances, with similar characteristics of healthy individuals without significant experience in use of alcohol and other psychoactive substances (absolute and relative abstainers). MATERIALS AND METHODS: The age, gender, level of education, experience in use of nicotine in the past and present, leading coping strategies, levels of religiosity and magic thinking have been studied. RESULTS: Two diametrically opposite images of abstainers were identified: on the one end individuals with higher level of education and lower levels of religiosity and magic thinking, and on the other individuals with lower level of education, but higher levels of religiosity and magic thinking. The group of abstainers is in general characterized by absence of the experience in nicotine use. CONCLUSION: Taking into account personality- and value-and-meaning-related characteristics helps more accurately determine the goals and directions of psychotherapeutic and rehabilitation measures, to differentiate patients according to rehabilitation programs, increases the level of motivation and adherence to treatment, which in turn leads to a longer and stable remission.
实现绝对清醒,它的维护和保存是初级预防阶段的主要任务麻醉患者。目的:比较分析具有精神活性物质成瘾综合征的神经科患者的人格和价值与意义相关特征,与没有使用酒精和其他精神活性物质的显著经验的健康个体(绝对和相对戒毒者)的相似特征。材料与方法:对年龄、性别、受教育程度、过去和现在使用尼古丁的经历、主要应对策略、宗教信仰水平和神奇思维进行了研究。结果:发现了两种截然相反的戒酒者形象:一端是受教育程度较高,但宗教信仰和魔法思维水平较低的人;另一端是受教育程度较低,但宗教信仰和魔法思维水平较高的人。戒烟者的一般特点是没有使用尼古丁的经验。结论:考虑人格和价值与意义相关的特征有助于更准确地确定心理治疗和康复措施的目标和方向,根据康复方案区分患者,提高治疗的动机和依从性,从而导致更长期和稳定的缓解。
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引用次数: 0
Intra-shift and Inter-shift Dynamics of Stress Index of Regulatory Systems in Medical Personnel of Mobile Emergency Medical Teams in Modern Conditions 现代条件下流动急救医疗队医务人员调节系统压力指数的班内、班间动态
Pub Date : 2022-12-28 DOI: 10.17816/pavlovj106170
T. Bolobonkina, Aleksey A. Dement’yev, N. Minaeva, Mihail M. Lapkin, P. A. Kulagin
INTRODUCTION: In conditions of spread of the new coronavirus infection SARS-CoV-2 (COVID-19), the work regimen and working conditions of the mobile emergency medical teams have changed, the range of occupational hazards has expanded, which led to unfavorable alterations in the functional state of the nervous system of workers. AIM: To study the influence of the professional activity on the functional state of an organism of medical workers of mobile emergency medical teams in conditions of COVID-19 pandemic. MATERIALS AND METHODS: Parameters of the functional state of an organism of medical workers of mobile emergency medical teams were studied before, after the work and between shifts in the period from May to October 2021. The extent of centralization of the heart rhythm control was evaluated by use of strain index (SI) of regulatory systems. The sample included 67 workers of mobile teams (21 men and 46 women), 16 doctors and 51 paramedics. The average age of workers participating in the study was 36.28 2.82 years. RESULTS: By the end of shift, in more than half the medical workers of mobile EMT, SI grew by 74.75 units (p = 0,021). The age (2 = 6.467; р = 0.040) and length of service (2 = 6.069; р = 0.049) influenced the distribution of workers with different SI dynamics on the basis of the results of the work shift. By the beginning of the next shift, in 60.71% of workers included into the study, a significant increase in SI was recorded on average by 74.02 (р = 0.001) compared to the beginning of the previous shift. The influence of length of service on the distribution of workers with different dynamics of SI in the successive shifts into groups was recorded (2 = 7.313; р = 0.026). CONCLUSIONS: The dynamics of the growth of the strain index of regulatory systems indicates low effectiveness of recovery of the functional state of an organism of workers in the period of scheduled rest. The greatest influence on the growth of parameters was exerted by length of service, which indicates the negative impact of working conditions on the functional state of an organism of workers.
在新型冠状病毒感染新冠肺炎(COVID-19)传播条件下,流动应急医疗队的工作制度和工作条件发生了变化,职业危害范围扩大,导致工作人员神经系统功能状态发生了不利的变化。目的:研究新型冠状病毒病疫情下流动应急医疗队医务人员职业活动对机体功能状态的影响。材料与方法:研究2021年5月至10月流动应急医疗队医务人员工作前、工作后和轮班间的一种生物体功能状态参数。采用调节系统应变指数(应变指数)评价心律控制的集中化程度。样本包括67名流动小组的工作人员(21名男性,46名女性),16名医生和51名护理人员。参与研究的工人的平均年龄为36.28 - 2.82岁。结果:当班结束时,半数以上流动EMT医务人员的SI增加了74.75单位(p = 0.021)。年龄(2 = 6.467;r = 0.040)和服务年限(2 = 6.069;(r = 0.049)根据工作班次的结果影响了不同SI动态的工人分布。在下一个班次开始时,60.71%的工人被纳入研究,与上一个班次开始时相比,SI平均显著增加了74.02 (χ = 0.001)。记录工龄对连续换班不同SI动态工人分布的影响(2 = 7.313;= 0.026)。结论:调节系统应变指数的动态增长表明,工人机体在计划休息期间恢复功能状态的有效性较低。对参数增长影响最大的是工龄,这表明工作条件对工人有机体的功能状态有负面影响。
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引用次数: 0
Protective Effects of L-Arginine on Mitochondria of Rat Epididymis in Hyperhomocysteinemia Induced by Prolonged Methionine Load l -精氨酸对蛋氨酸长期负荷所致高同型半胱氨酸血症大鼠附睾线粒体的保护作用
Pub Date : 2022-12-28 DOI: 10.17816/pavlovj109410
V. Zvyagina, K. Shumaev, E. Belskikh, O. M. Uryasyev, Sabina R. Akhmedova, Y. Marsyanova, A. Shitikova, Ol’ga N. Suchkova
INTRODUCTION: The study of markers of oxidative stress, metabolites of nitric oxide (II) (NOx) and the balance of carnitine fractions in mitochondria of rat epididymis, permits to evaluate the protective role of L-arginine in experimental hyperhomocysteinemia. AIM: To study the influence of L-arginine on the parameters of energy metabolism, level of NO metabolites, oxidative modification of proteins and balance of carnitine fractions in mitochondria of the head and tail of rat epididymis in hyperhomocysteinemia. MATERIALS AND METHODS: In animals of group 1 (n = 8), severe hyperhomocysteinemia (HHcy) was modeled by administration of methionine suspension at a dose of 1.5 g/kg twice daily for 21 days with addition of 1% methionine in drinking water; group 2 rats (n = 8) received suspension base without methionine; animals of group 3 (n = 8) were daily administered L-arginine solution at a dose of 500 mg/kg intragastrically against the background methionine load from day 11 to day 21; group 4 animals (n = 8) were administered L-arginine solution of at a dose of 500 mg/kg for 10 days; group 5 (n = 8) served as a control for group 4 and received drinking water intragastrically. Concentrations of total homocysteine and NOx were determined in serum. In the mitochondrial fraction of the homogenate of epididymis tissues, the level of oxidatively modified proteins (OMP), the concentration of NOx, lactate and carnitine fractions, the activity of lactate dehydrogenase (LDH), superoxide dismutase (SOD), H+-ATPase, succinate dehydrogenase (SDH) were evaluated. RESULTS: HHcy was accompanied by reduction of the level of NOx in blood serum and mitochondria of epididymis head tissues. In mitochondria of tissues of head and tail of epididymis, a marked reduction of all fractions of carnitine, activity of LDH, H+-ATPase, SDH, increase in the activity of SOD and in the level of OMP were observed. With modeled HHcy, L-arginine reduced the extent of hyperhomocysteinemia, prevented reduction of NOx level in the blood serum and epididymis head and reduced the content of OMP of the epididymis mitochondria. CONCLUSION: L-arginine introduced in combination with methionine, reduces the extent of severity of hyperhomocysteinemia. The positive effect of L-arginine on increase in the concentration of NOx metabolites in blood serum and mitochondria of epididymis in conditions of methionine load was also confirmed. L-arginine exhibits antioxidant properties, reducing the severity of oxidative stress induced by hyperhomocysteinemia. Differences in the adaptive response to oxidative stress of the mitochondria of the head and tail of epididymis were demonstrated.
通过对氧化应激标志物、一氧化氮(NOx)代谢物和大鼠附睾线粒体中肉碱组分平衡的研究,可以评估l -精氨酸在实验性高同型半胱氨酸血症中的保护作用。目的:研究l -精氨酸对高同型半胱氨酸血症大鼠附睾头尾线粒体能量代谢参数、NO代谢产物水平、蛋白质氧化修饰及肉碱组分平衡的影响。材料与方法:第1组(n = 8),采用蛋氨酸混悬液(1.5 g/kg,每日2次,连续21 d),并在饮水中添加1%蛋氨酸的方法,建立严重高同型半胱氨酸血症(HHcy)模型;2组大鼠(n = 8)给予不含蛋氨酸的悬液碱;第3组(n = 8)从第11天至第21天,在背景蛋氨酸负荷的基础上,每天灌胃500 mg/kg的l -精氨酸溶液;4组动物(n = 8)给予l -精氨酸溶液,剂量为500 mg/kg,连续10 d;第5组(n = 8)作为第4组的对照,给予灌胃饮水。测定血清中总同型半胱氨酸和氮氧化物浓度。测定附睾组织匀浆线粒体组分氧化修饰蛋白(OMP)水平、NOx、乳酸和肉碱组分浓度、乳酸脱氢酶(LDH)、超氧化物歧化酶(SOD)、H+- atp酶、琥珀酸脱氢酶(SDH)活性。结果:HHcy可降低附睾头部组织血清及线粒体NOx水平。在附睾头尾组织线粒体中,肉毒碱各组分明显降低,LDH、H+- atp酶、SDH活性明显升高,SOD活性和OMP水平明显升高。在模型HHcy中,l -精氨酸降低了高同型半胱氨酸血症的程度,阻止了血清和附睾头部NOx水平的降低,降低了附睾线粒体OMP含量。结论:l -精氨酸联合蛋氨酸可降低高同型半胱氨酸血症的严重程度。在蛋氨酸负荷条件下,l -精氨酸对血清和附睾线粒体NOx代谢物浓度的升高也有积极作用。l -精氨酸具有抗氧化特性,可降低高同型半胱氨酸血症引起的氧化应激的严重程度。附睾头部和尾部线粒体对氧化应激的适应性反应存在差异。
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引用次数: 0
Case Report of Development of Atypical Hemolytic-Uremic Syndrome in Pregnancy 妊娠期发生不典型溶血性尿毒症综合征1例报告
Pub Date : 2022-12-28 DOI: 10.17816/pavlovj106407
E. Smirnova, Ol'ga V. Kurtikova
Atypical hemolytic-uremic syndrome (aHUS) is an ultra-rare (orphan) disease with a progressive course, which is a systemic thrombotic microangiopathy resulting from uncontrolled activation of the alternative complement pathway. There exist the so called obstetric thombotic microangiopathies (pre-eclampsia, HELLP syndrome) which are considered as triggers causing development of aHUS in pregnancy in genetically predisposed female patients. Here, the main peculiarity of these pathologies is the improvement of the condition of the puerpera after delivery. In case of non-obstetric thombotic microangiopathies, delivery does not lead to regress of symptoms, on the contrary, microangiopathic process progresses with rapid development of multiorgan failure. The development of thrombotic thrombocytopenic purpura and aHUS in pregnancy may induce physiological changes in the organism of a pregnant woman. There occurs a build-up of the activity of von Willebrand factor with a parallel reduction of the activity of ADAMTS 13 enzyme (metalloprotease that cleaves its super-large multimers). This is probably a physiological adaptation of the body to minimize blood loss during childbirth. As a result of the imbalance, the risk of developing thrombotic microangiopathy increases by the end of II beginning of III trimester. The concept of chronic uncontrolled activation of the alternative complement pathway implies a genetic defect of regulatory proteins with increased formation of C5 convertase, increased release of C5a a strong chemoattractant, and of membraneattacking complex C5bC9, which leads to damage to endothelial cells, exposure of the subendothelial layer and thrombosis. The currently used drug eculizumab is a recombinant humanized monoclonal antibody that binds to the complement C5 protein and suppresses the activation of complement-mediated cell lysis. The article presents a clinical case of the development of aHUS in a patient during pregnancy, the main stages of diagnostic search are considered, routing is determined and the therapy used is justified.
非典型溶血性尿毒症综合征(aHUS)是一种具有进行性病程的超罕见(孤儿)疾病,是一种由替代补体途径不受控制的激活引起的系统性血栓性微血管病变。存在所谓的产科血栓性微血管病变(先兆子痫,HELLP综合征),这被认为是在遗传易感的女性患者怀孕期间导致aHUS发展的触发因素。在这里,这些病理的主要特点是分娩后产妇状况的改善。对于非产科血栓性微血管病变,分娩并不会导致症状的消退,相反,微血管病变过程会随着多器官功能衰竭的快速发展而进展。血栓性血小板减少性紫癜和妊娠期aHUS的发展可能会引起孕妇机体的生理变化。血管性血友病因子的活性随着ADAMTS - 13酶(切割其超大多聚体的金属蛋白酶)活性的平行降低而增加。这可能是身体的一种生理适应,以尽量减少分娩时的失血。由于这种不平衡,发展成血栓性微血管病的风险在妊娠末期和妊娠初期增加。替代补体途径的慢性不受控制激活的概念意味着调节蛋白的遗传缺陷,C5转化酶的形成增加,C5a(强化学引诱剂)的释放增加,以及膜攻击复合物C5bC9的释放增加,导致内皮细胞损伤,内皮下层暴露和血栓形成。目前使用的药物eculizumab是一种重组人源化单克隆抗体,与补体C5蛋白结合,抑制补体介导的细胞裂解的激活。本文介绍了一个临床病例的发展aHUS患者在怀孕期间,诊断搜索的主要阶段是考虑,路线确定和使用的治疗是合理的。
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引用次数: 0
Variant Anatomy of the Right Ventricular Moderator Band in Human Heart in Early Antenatal Period of Development 胎儿发育早期人类心脏右心室调节带的变异解剖
Pub Date : 2022-12-28 DOI: 10.17816/pavlovj106689
A. Yakimov
INTRODUCTION: The information about the variants of the structure and topography of the moderator band (MB) that connects the interventricular septum with the anterior papillary muscle and the anterior wall of the right ventricle in the heart of a fetus and a newborn, is of great importance for cardiac surgery. AIM: To establish the prevalence of the MB and describe the variants of its shape, structure and position in the right ventricle of the normal human heart in the early antenatal period of development. MATERIALS AND METHODS: Using Olympus SZX2-ZB10 stereomicroscope with 4.725X to 15X magnification, formalin-fixed hearts of fetuses and stillborns of 1728 weeks were studied. The results are presented in the form of median, 25th and 75th percentiles, extreme values. Correlation analysis was performed. Significance of the difference of proportions was evaluated by one-sided t-test. The results are presented in the form of median (Me), 25th and 75th percentiles (Q25%Q75%). RESULTS: MB was found in 73 of 90 preparations (81.1%), in 48 cases (66%) it was bridge-like, and in 24 of 72 (33.3%) ― parietal. MB had flattened (crest-like) or cylindrical shape (62.5% vs 33%; p = 0.0002). The most common was flattened bridge-like variant. The length of MB was 2.2 (1.753.0) mm, width 1.35 (0.91.75) mm, thickness 1.0 (0.651.5) mm. The band mainly originated from the interventricular septum between the middle and apical thirds of the longitudinal axis, and the anterior and middle thirds of the transverse axis of the interventricular septum. It typically terminated with the attachment to the anterior papillary muscle (47.7%), or to the anterior wall of the right ventricle immediately in front of this muscle (38.5%). In 22.2% of cases, the MB had papillary muscles on it, and in 37.5%, the secondary trabeculae extended from it to the apex of the ventricle. CONCLUSION: MB is a normal, but not obligatory structure of the heart in the antenatal period, its normal anatomy is variable and is manifested by typical and rare variants of the form, position, beginning and end, which in many cases can impede diagnostics and treatment of the pathology of the right ventricle.
胎儿和新生儿心脏中连接室间隔、前乳头肌和右心室前壁的调节带(MB)的结构和地形的变化对心脏外科手术具有重要意义。目的:了解胎儿早期正常心脏右心室MB的发病情况,描述其形态、结构和位置的变异。材料与方法:采用4.725 ~ 15倍倍率的Olympus SZX2-ZB10立体显微镜,对1728周的胎儿和死胎进行福尔马林固定心脏的研究。结果以中位数、第25百分位和第75百分位、极值的形式呈现。进行相关分析。比例差异的显著性采用单侧t检验。结果以中位数(Me)、第25百分位和第75百分位(Q25%Q75%)的形式呈现。结果:90例制剂中73例(81.1%)检出MB, 48例(66%)呈桥状,72例中24例(33.3%)呈壁状。MB呈扁平状(冠状)或圆柱形(62.5% vs 33%;P = 0.0002)。最常见的是扁平的桥状变种。MB的长度为2.2 (1.753.0)mm,宽度为1.35 (0.91.75)mm,厚度为1.0 (0.651.5)mm,主要发源于室间隔纵轴的中三分之一和顶三分之一之间以及室间隔横轴的前三分之一和中三分之一之间。它通常以附着于前乳头肌(47.7%)或紧靠于该肌肉前方的右心室前壁(38.5%)而终止。在22.2%的病例中,MB上有乳头状肌,37.5%的病例中,继发性小梁从它延伸到脑室顶端。结论:MB是胎儿期心脏的一种正常但非必需的结构,其正常解剖结构多变,表现为典型而罕见的形式、位置、起止变异,在许多情况下妨碍了右心室病理的诊断和治疗。
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引用次数: 0
Peculiarities of Temperament and Character of Patients with Comorbid Psychiatric Pathology and Combined Dependence on Psychostimulants and Other Psychoactive Substances 精神病理共病及精神兴奋剂及其他精神活性物质联合依赖患者的气质特征
Pub Date : 2022-12-28 DOI: 10.17816/pavlovj105870
K. N. Poplevchenkov, T. Agibalova, O. Buzik, Denis A. Mischenko
INTRODUCTION: According to official statistics, there is an annual increase in the production and consumption of various psychostimulants, and as a result, an increase in the number of patients with addiction of psychostimulants. At the same time, there are no effective methods of treating such disorders within the framework of a modern personalized approach to therapy. AIM: To study peculiarities of the temperament and character of patients with combined dependence on psychostimulants and other psychoactive substances (PASs) and with comorbid psychiatric pathology to increase the effectiveness of psychotherapeutic methods in personalized therapeutic approach. MATERIALS AND METHODS: The study included 325 patients (ethnic Russian men and women aged from 18 to 50 years) with the diagnosis: dependence on psychostimulants and dependence on psychostimulants in combination with comorbid psychiatric pathology, who signed the informed consent. R. Cloninger method of assessment of the temperament and character (Temperament and Character Inventory, TCI-125) was used. RESULTS: Patients were divided to groups depending on PASs used by them and the existence of comorbid psychiatric pathology. Of temperament dimensions, the novelty seeking predominated in all the groups (up to 15 points; р 0.002) in comparison with harm avoidance (up to 10 points; р 0.112), reward dependence (up to 9 points; р 0.442) and persistence (up to 3 points; р 0.226). This combination of temperament dimensions corresponds to antisocial personality disorder. High cooperativeness (17 points; p 0.005) was observed in patients with a full course of rehabilitation and remissions up to 12 months. The maximal self-transcendence (10 points; p 0.02) corresponded to psychiatric pathology. CONCLUSION: On the basis of the results obtained, personality profiles of patients were determined. Patients of the first profile with dependence only on psychostimulants with minimal novelty seeking dimension of the temperament along with high cooperativeness character trait were more communicative, adapted to the treatment and rehabilitation program, and had longer remission periods. Patients of the second profile with a combined dependence on psychostimulants and other PASs with maximal novelty seeking dimension in the temperament along with minimal values on the character scales required the maximal effort of the specialists to keep them in the treatment and rehabilitation program. Patients of the third profile with dependence on psychostimulants and comorbid psychiatric pathology with maximal novelty seeking dimension in the temperament together with maximal self-transcendence were characterized by suspiciousness and required a special gradual establishment of psychotherapeutic contact to involve them in the treatment and rehabilitation process.
导言:根据官方统计,各种精神兴奋剂的生产和消费每年都在增加,因此,精神兴奋剂成瘾的患者人数也在增加。与此同时,在现代个性化治疗方法的框架内,没有有效的方法来治疗这些疾病。目的:研究精神兴奋剂及其他精神活性物质联合依赖(PASs)患者的气质及性格特点,以提高心理治疗方法在个性化治疗中的有效性。材料和方法:研究纳入325例诊断为精神兴奋剂依赖和精神兴奋剂依赖合并共病精神病理的患者(俄罗斯族,男女,年龄18 - 50岁),并签署知情同意书。采用R. Cloninger气质与性格评定法(temperament and character Inventory, TCI-125)。结果:根据患者使用的PASs及是否存在精神病理合并症将患者分组。气质维度上,追求新奇在所有组中占主导地位(高达15分;与避免伤害相比(高达10分;0.112),奖励依赖性(最高9分;0.442)和持久性(高达3分;р0.226)。这种气质维度的组合对应于反社会人格障碍。合作度高(17分;P 0.005),在整个康复过程和缓解达12个月的患者中观察到。最大自我超越(10分;P < 0.02)符合精神病理。结论:在所得结果的基础上,确定了患者的性格特征。第一种类型的患者仅对精神兴奋剂依赖,且气质中寻求新奇的维度最小,同时具有较高的合作性性格特征,其沟通能力更强,适应治疗和康复计划,缓解期更长。第二种类型的患者同时依赖精神兴奋剂和其他PASs在气质上具有最大的新奇追求维度以及在性格量表上的最小值需要专家付出最大的努力来保持他们在治疗和康复计划中。第三种类型的患者具有精神兴奋剂依赖和精神病理共病,在气质上具有最大的新奇追求维度和最大的自我超越,以怀疑为特征,需要特殊的逐步建立心理治疗接触,使其参与治疗和康复过程。
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引用次数: 0
Analysis of Recorded Morbidity, Prevalence and Hospital Mortality of Patients with Symptomatic Multiple Myeloma in the Ryazan Region for 10 Years 梁赞地区10年症状性多发性骨髓瘤发病率、患病率及住院死亡率分析
Pub Date : 2022-12-28 DOI: 10.17816/pavlovj108985
Sergey G. Bolotin, Mariya S. Zenina, A. V. Solov’yeva, A. Pristupa
INTRODUCTION: Multiple myeloma (MM) is a disease whose substrate is plasma cells; it is characterized by the production of monoclonal immunoglobulin. Epidemiology of MM in Russia is insufficiently studied. Of interest is a study of dynamics of the main epidemiological parameters of multiple myeloma in the context of a poor epidemiological prognosis for oncological diseases in the Russian Federation and in the world in general. AIM: To analyze the main epidemiological parameters of symptomatic MM in the Ryazan region for 10 years (20102019). MATERIALS AND METHODS: A total of 343 medical records of patients with symptomatic MM were analyzed, of them 146 men (age median 65 years), 197 women (age median 64 years). The patients underwent inpatient treatment in the hematology and chemotherapy department of Ryazan Regional Clinical Hospital from 2010 to 2019. The epidemiological analysis consisted in evaluation of the parameters of the registered morbidity, prevalence and hospital mortality. The criterion for inclusion in the study was the existence of symptomatic MM in the patient. For statistical processing, Microsoft information and analytical system, Office package was used. RESULTS: The highest amount of new cases of MM were identified in 2018 (4.19 per 100,000 population), the lowest in 2012 (1.83 per 100,000 population). In the analyzed period, the number of cases of newly diagnosed MM per year increased by 30.3%. Most patients at the time of diagnosis were in the age group of 6069 years. Morbidity with MM in the age group of 3049 years was comparable in men and women, however, among the patients 50 years women predominated. Over 10 years, the index of MM prevalence in the Ryazan region increased 1.43 times: from 6.71 to 9.6 per 100,000 population, index of hospital mortality from 1.4% to 3.3%. CONCLUSION: The growth of the registered mortality and prevalence of MM in the Ryazan region in 20102019 was identified, which corresponds to the dynamics in other regions of the Russian Federation. Also, during the analyzed period, an increase in hospital mortality of patients with MM was observed in the region.
简介:多发性骨髓瘤(MM)是一种基底为浆细胞的疾病;它的特点是产生单克隆免疫球蛋白。俄罗斯MM的流行病学研究不足。有趣的是,在俄罗斯联邦和全世界肿瘤疾病流行病学预后不佳的背景下,对多发性骨髓瘤主要流行病学参数的动态进行研究。目的:分析梁赞地区10年(2010 - 2019)症状性MM的主要流行病学参数。材料与方法:对343例有症状性MM患者的病历进行分析,其中男性146例(中位年龄65岁),女性197例(中位年龄64岁)。患者于2010 - 2019年在梁赞地区临床医院血液科和化疗科住院治疗。流行病学分析包括评估登记发病率、患病率和住院死亡率等参数。纳入研究的标准是患者是否存在症状性MM。统计处理采用Microsoft信息分析系统,Office软件包。结果:2018年MM新发病例数最高(4.19 / 10万人),2012年最低(1.83 / 10万人)。在分析期间,每年新诊断的MM病例数增加了30.3%。诊断时大多数患者年龄在6069岁。3049岁年龄组MM的发病率在男性和女性中是相当的,然而,在50岁的患者中,女性占主导地位。10年来,梁赞地区MM患病率指数增加了1.43倍:从每10万人6.71人增加到9.6人,医院死亡率指数从1.4%增加到3.3%。结论:2010 - 2019年梁赞地区MM登记死亡率和患病率的增长趋势与俄罗斯联邦其他地区的动态一致。此外,在分析期间,观察到该地区MM患者的住院死亡率增加。
{"title":"Analysis of Recorded Morbidity, Prevalence and Hospital Mortality of Patients with Symptomatic Multiple Myeloma in the Ryazan Region for 10 Years","authors":"Sergey G. Bolotin, Mariya S. Zenina, A. V. Solov’yeva, A. Pristupa","doi":"10.17816/pavlovj108985","DOIUrl":"https://doi.org/10.17816/pavlovj108985","url":null,"abstract":"INTRODUCTION: Multiple myeloma (MM) is a disease whose substrate is plasma cells; it is characterized by the production of monoclonal immunoglobulin. Epidemiology of MM in Russia is insufficiently studied. Of interest is a study of dynamics of the main epidemiological parameters of multiple myeloma in the context of a poor epidemiological prognosis for oncological diseases in the Russian Federation and in the world in general. \u0000AIM: To analyze the main epidemiological parameters of symptomatic MM in the Ryazan region for 10 years (20102019). \u0000MATERIALS AND METHODS: A total of 343 medical records of patients with symptomatic MM were analyzed, of them 146 men (age median 65 years), 197 women (age median 64 years). The patients underwent inpatient treatment in the hematology and chemotherapy department of Ryazan Regional Clinical Hospital from 2010 to 2019. The epidemiological analysis consisted in evaluation of the parameters of the registered morbidity, prevalence and hospital mortality. The criterion for inclusion in the study was the existence of symptomatic MM in the patient. For statistical processing, Microsoft information and analytical system, Office package was used. \u0000RESULTS: The highest amount of new cases of MM were identified in 2018 (4.19 per 100,000 population), the lowest in 2012 (1.83 per 100,000 population). In the analyzed period, the number of cases of newly diagnosed MM per year increased by 30.3%. Most patients at the time of diagnosis were in the age group of 6069 years. Morbidity with MM in the age group of 3049 years was comparable in men and women, however, among the patients 50 years women predominated. Over 10 years, the index of MM prevalence in the Ryazan region increased 1.43 times: from 6.71 to 9.6 per 100,000 population, index of hospital mortality from 1.4% to 3.3%. \u0000CONCLUSION: The growth of the registered mortality and prevalence of MM in the Ryazan region in 20102019 was identified, which corresponds to the dynamics in other regions of the Russian Federation. Also, during the analyzed period, an increase in hospital mortality of patients with MM was observed in the region.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124212949","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}
引用次数: 0
Achievements and Prospects for Vascular Surgery in Treatment of Vertebrobasilar Insufficiency 血管外科治疗椎基底动脉功能不全的成就与展望
Pub Date : 2022-12-28 DOI: 10.17816/pavlovj109601
Artur V. Kondaraki, A. V. Chupin, B. Alekyan, V. A. Kul’bak
Vertebrobasilar insufficiency (VBI) remains an important problem in the modern medicine since approximately every fourth cerebral infarction occurs in the posterior circulation of the brain. These strokes are accompanied by severe consequences and a high risk of repeated events. The article presents the current concepts for surgical treatment of lesions of the subclavian (ScA) and vertebral (VA) arteries responsible for the development of VBI. In the open surgical treatment of symptomatic lesion of the ScA, primarily of occlusion one, extrathoracic interventions prevail in the form of carotid-subclavian bypass and carotid-subclavian transposition. According to our analysis, the results of carotid-subclavian transposition prove to be more preferable. In the endovascular intervention on the ScA, balloon angioplasty is used with possible stenting. In the analysis, we found no differences in the long-term patency between angioplasty and stenting, although the extent of technical success was higher in the group of stenting. In case of stenosis of the ScA, the world medicine gives priority to endovascular methods. To date, there are no sharply defined criteria permitting to choose between the open and endovascular interventions for treatment of the ScA occlusion, although a probable technical failure of endovascular revascularization and higher long-term patency give priority to open surgery. As for symptomatic stenosis of VA, to date there is no evidence of the advantage of stenting over conservative therapy. Thus, surgical intervention should rather be used in case the drug treatment is ineffective. The same can be said about the open reconstruction of the VA, except for the cases of contraindications for stenting of the VA, for example, its tortuosity.
椎基底动脉功能不全(VBI)仍然是现代医学中的一个重要问题,因为大约四分之一的脑梗死发生在脑后循环。这些中风伴随着严重的后果和重复事件的高风险。本文介绍了目前的概念,手术治疗病变的锁骨下(ScA)和椎动脉(VA)负责VBI的发展。在对症性ScA病变的开放手术治疗中,主要是闭塞性ScA,胸外干预以颈动脉-锁骨下搭桥和颈动脉-锁骨下转位的形式为主。根据我们的分析,颈动脉-锁骨下转位的效果更佳。在ScA的血管内介入治疗中,球囊血管成形术与可能的支架植入一起使用。在分析中,我们发现血管成形术和支架置入术在长期通畅方面没有差异,尽管支架置入术组的技术成功程度更高。对于冠脉狭窄的情况,国际医学以血管内治疗为主。迄今为止,没有明确的标准允许在开放和血管内介入治疗ScA闭塞之间进行选择,尽管血管内血运重建可能的技术失败和更高的长期通畅优先考虑开放手术。对于有症状的室间隔狭窄,迄今为止没有证据表明支架置入优于保守治疗。因此,在药物治疗无效的情况下,应采用手术干预。对于静脉曲张的开放性重建也是如此,除了静脉曲张支架的禁忌症,比如它的扭曲。
{"title":"Achievements and Prospects for Vascular Surgery in Treatment of Vertebrobasilar Insufficiency","authors":"Artur V. Kondaraki, A. V. Chupin, B. Alekyan, V. A. Kul’bak","doi":"10.17816/pavlovj109601","DOIUrl":"https://doi.org/10.17816/pavlovj109601","url":null,"abstract":"Vertebrobasilar insufficiency (VBI) remains an important problem in the modern medicine since approximately every fourth cerebral infarction occurs in the posterior circulation of the brain. These strokes are accompanied by severe consequences and a high risk of repeated events. The article presents the current concepts for surgical treatment of lesions of the subclavian (ScA) and vertebral (VA) arteries responsible for the development of VBI. In the open surgical treatment of symptomatic lesion of the ScA, primarily of occlusion one, extrathoracic interventions prevail in the form of carotid-subclavian bypass and carotid-subclavian transposition. According to our analysis, the results of carotid-subclavian transposition prove to be more preferable. In the endovascular intervention on the ScA, balloon angioplasty is used with possible stenting. In the analysis, we found no differences in the long-term patency between angioplasty and stenting, although the extent of technical success was higher in the group of stenting. In case of stenosis of the ScA, the world medicine gives priority to endovascular methods. To date, there are no sharply defined criteria permitting to choose between the open and endovascular interventions for treatment of the ScA occlusion, although a probable technical failure of endovascular revascularization and higher long-term patency give priority to open surgery. As for symptomatic stenosis of VA, to date there is no evidence of the advantage of stenting over conservative therapy. Thus, surgical intervention should rather be used in case the drug treatment is ineffective. The same can be said about the open reconstruction of the VA, except for the cases of contraindications for stenting of the VA, for example, its tortuosity.","PeriodicalId":113364,"journal":{"name":"I.P. Pavlov Russian Medical Biological Herald","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123580222","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}
引用次数: 0
Experimentally Justified Choice of Optimal Antiseptic Solution for Hygienic Care of Oral Cavity and Dentures 口腔及义齿卫生护理最佳灭菌液的实验研究
Pub Date : 2022-12-28 DOI: 10.17816/pavlovj108653
R. Rozov, V. Trezubov, V. D. Vagner, A. Urakov, Aleksey P. Reshetnikov
INTRODUCTION: The range of antiseptic agents used in clinical practice, is rather wide. However, only single studies are devoted to comparative characteristics of their effectiveness in the conditions of the oral cavity. AIM: To choose the optimal antiseptic dental cleaner by experimental study. MATERIALS AND METHODS: An aqueous solution of Furacilin (0.02%), chlorhexidine bigluconate (0.05%), Miramistin (0.01%), cetylpyridinium chloride (0.05%), hydrogen peroxide (3%), Iodinol, Rotokan, distilled water were used as washing liquids for elimination of dental plaque. The model of the dentition was created from quartz plates with an imitation of fresh plaque. Biomaterial imitating dental plaque included two solutions: 1) a strong fresh infusion of black tea leaves, cooled to +25C; 2) oatmeal jelly with temperature from +60C to +65C. The authors method of screening dental cleaners was used, based on comparing the transparency of the laboratory model of the dentition before and after exposure to the test solution by determination with an amperemeter of strength of the electric current in the photosensor device from the oxyhemograph sensor after white light emitted by a mini-emitter passed through biological material and plates and fell on it. RESULTS: The cleaning capacity of distilled water is the lowest (p 0.050.001). Rotokan, Furacilin and Iodinol have a low cleaning capacity, and Iodinol can cause a burn of the gingival cuff in case of high reaction to it, and allergic reactions. Hydrogen peroxide has an average degree of efficiency, but it dries the oral mucosa. Chlorhexidine bigluconate has the highest cleaning effect, Miramistin and cetylpyridinium chloride are slightly inferior to it (p 0.05). By the cleaning capacity, chlorhexidine bigluconate solution is significantly superior to hydrogen peroxide (p 0.05), Iodinol (p 0.02), Furacilin (p 0.02), Rotokan (p 0.01). CONCLUSION: The described method received the patent for invention of the Russian Federation No. 2019121293. Experimental studies have shown the best cleaning effect of 0.05% solution of chlorhexidine bigluconate.
简介:在临床实践中使用的防腐剂的范围是相当广泛的。然而,只有单一的研究致力于比较它们在口腔条件下的有效性。目的:通过实验研究选择最佳的抗菌洁牙剂。材料与方法:以呋喃西林(0.02%)、双光酸氯己定(0.05%)、米拉米司汀(0.01%)、氯化十六烷基吡啶(0.05%)、过氧化氢(3%)、碘、罗托康、蒸馏水为清除牙菌斑的洗涤液。牙列的模型是用石英板模仿新鲜牙菌斑制成的。仿造牙菌斑的生物材料包括两种解决方案:1)将新鲜红茶冲泡,冷却至+25℃;2)燕麦果冻,温度从+60℃到+65℃。利用微型发射器发出的白光穿过生物材料和生物板照射到牙列上后,用安培计测量血氧仪传感器在光敏装置中的电流强度,比较实验模型暴露于测试溶液前后的透明度,采用作者的方法筛选洁牙剂。结果:蒸馏水的清洁能力最低(p 0.050.001)。罗托坎、呋喃西林和碘的清洁能力较低,碘如果对其反应高,会引起牙龈袖口烧伤和过敏反应。过氧化氢的效率一般,但它会使口腔黏膜干燥。双糖酸氯己定的清洁效果最高,米拉米司汀和氯化十六烷基吡啶稍劣(p < 0.05)。从清洗能力上看,双光酸氯己定溶液明显优于双氧水(p 0.05)、碘(p 0.02)、呋喃西林(p 0.02)、罗托康(p 0.01)。结论:所述方法已获得俄罗斯联邦发明专利No. 2019121293。实验研究表明,以0.05%的双糖酸氯己定溶液清洗效果最佳。
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引用次数: 0
Changes in Metabolic Parameters of Rats in Different Age Periods After Prenatal Stress 产前应激后不同年龄阶段大鼠代谢参数的变化
Pub Date : 2022-12-28 DOI: 10.17816/pavlovj106532
A. S. Martyusheva, A. Subbotina, A. Abramova, Irina V. Alekseeva, S. Pertsov
INTRODUCTION: Currently, biomedical specialists give special attention to studying the influence of stressogenic factors on an organism of a pregnant woman, the embryonic development of the fetus and the subsequent development of offspring in the early and late ontogenesis. It has been found in a number of studies that prenatal stress can lead to reduction of physical activity and hormonal disorders. The factors leading to disorders in regulation of immune and metabolic homeostasis have been identified. Despite considerable interest in the study of the consequences of prenatal stress, its impact on changes in metabolic intensity in different periods of postnatal ontogenesis in animals of different genders has not been sufficiently studied. AIM: To study parameters of metabolism intensity in different age periods of postnatal ontogenesis in rats offspring of both genders after intrauterine stress load. MATERIALS AND METHODS: Stress load was modeled in daily forced swimming of pregnant rats at 1012C for 5 min. Oxygen consumption, carbon dioxide excretion (ml/h/kg), and heat exchange (kcal/h/kg) in male and female rats were determined using a Phenomaster automated modular unit (TSE Systems GmbH, Germany) on the 21st, 30th and 60th day of the ontogenesis. Statistical significance of differences between the studied parameters was assessed using Mann-Whitney U-test for independent groups. RESULTS: The study parameters of intact animals practically did not differ in the suckling (the 21st day) and infantile period (the 30th day), but significantly decreased in the juvenile period of development (the 60th day). It was found that the intrauterine stress did not lead to statistically significant changes in the absolute values of metabolic parameters as compared to the control, but affected the period of appearance of age-related variations of these parameters in male rats. In these animals, the volumes of oxygen consumption, carbon dioxide excretion, and the level of heat radiation reduced as early as in the infantile period (as compared to 21-day-old rats) and reached the minimum level by the 60th day of the postnatal ontogenesis. In female rats subjected to intrauterine stress, changes in the study parameters in different periods of life were similar to those of intact animals. CONCLUSION: Therefore, prenatal stress modeled by swimming of female parents in cold water, has a modulating effect on age-related dynamics of metabolic parameters of male rats, which was manifested by the decrease in these parameters in the earlier period of development.
导读:目前,生物医学专家特别关注研究应激因素对孕妇机体、胎儿胚胎发育和后代在个体发生早期和晚期的后续发育的影响。许多研究发现,产前压力会导致身体活动减少和荷尔蒙紊乱。导致免疫和代谢稳态调节失调的因素已经确定。尽管对产前应激后果的研究有相当大的兴趣,但其对不同性别动物出生后个体发生不同时期代谢强度变化的影响尚未得到充分研究。目的:研究子宫内应激负荷对雌雄大鼠子代出生后不同年龄阶段机体代谢强度的影响。材料与方法:模拟妊娠大鼠在1012C下每天强迫游泳5分钟的应激负荷。在个体发生的第21、30和60天,使用Phenomaster自动化模块化装置(TSE Systems GmbH, Germany)测定雄性和雌性大鼠的耗氧量、二氧化碳排泄量(ml/h/kg)和热交换量(kcal/h/kg)。采用Mann-Whitney u检验对独立组进行研究参数间差异的统计学显著性评估。结果:完整动物的研究参数在哺乳期(第21天)和婴儿期(第30天)几乎没有差异,但在幼年发育期(第60天)显著降低。研究发现,与对照组相比,宫内应激没有导致代谢参数绝对值发生统计学意义上的显著变化,但影响了雄性大鼠这些参数出现年龄相关变化的时间。在这些动物中,氧气消耗量、二氧化碳排泄量和热辐射水平早在婴儿期就减少了(与21日龄大鼠相比),并在出生后第60天达到最低水平。在宫内应激的雌性大鼠中,不同生命时期的研究参数变化与完整动物相似。结论:由此可见,雌性亲本在冷水中游泳模拟的产前应激对雄性大鼠代谢参数的年龄相关动态具有调节作用,表现为发育早期代谢参数的降低。
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引用次数: 0
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I.P. Pavlov Russian Medical Biological Herald
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