Research'n Practical Medicine Journal最新文献

{"title":"ПРОГНОСТИЧЕСКИЕ ФАКТОРЫ РЕЦИДИВОВ ПРИ ХИРУРГИЧЕСКОМ ЛЕЧЕНИИ ДЕСМОИДНЫХ ФИБРОМ ТУЛОВИЩА И КОНЕЧНОСТЕЙ","authors":"А. В. Ядрина, В. Ю. Карпенко, Ольга Вячеславовна Новикова, Н. М. Бычкова, В. А. Державин, А. В. Бухаров","doi":"10.17709/2409-2231-2019-6-1-2","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-2","url":null,"abstract":"Purpose of the study . Evaluation of the results of surgical treatment of desmoid fibroids (DF) using reconstructive plastic surgery and determination of possible prognostic factors of relapses. Patients and methods . The results of surgical treatment of 40 patients with desmoid fibroids of extra abdominal local­ization were analyzed. In 45% of patients, the tumor was located in soft tissues of the shoulder girdle and upper limb, in 35% — on the trunk, in 20% — in soft tissues of the lower limb and in 7% of patients on the neck. The tumor size varied from 2 to 20 cm, the median was 8 ± 4.38 cm. Surgical treatment for newly diagnosed DF was performed in 22 (55%) patients, and for recurrent tumors — in 18 (45%) patients. Results . According to the planned histological study, negative resection boundaries were established in 24/40 patients (63%). In the remaining 16 cases (37%) positive resection margins were obtained: R1 in 14 patients and R2 in 2 patients. Adjuvant treatment is recommended for 14 patients with resection R1/R2. The duration of follow — up after treatment ranged from 6 to 107 months, median‑16.5 months. During follow-up, relapses were diagnosed in 14 patients (35%). No deaths have been reported. Conclusion . Surgical treatment of DF of extraabdominal localization is accompanied by a sufficiently high frequency of relapses. According to the results of the study, an unfavorable factor in the development of relapses is the location of the tumor in soft tissues of the shoulder girdle and upper limb.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129870884","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}

{"title":"COMPARATIVE ANALYSIS OF CONVENTIONAL AND LIQUID-BASED CYTOLOGICAL METHODS FOR CERVICAL SMEARS","authors":"N. Volchenko, T. V. Sushinskaya, O. Borisova, V. Meļņikova, A. Petrov","doi":"10.17709/2409-2231-2019-6-1-8","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-8","url":null,"abstract":"Purpose. Comparative analysis of the diagnostic value of traditional cytology (TC) and liquid cytology (LC) in the identi­fication of cervical intraepithelial neoplasia (CIN) and cervical cancer (CC).Patients and methots. The study included 87 women aged 18 to 80 years. All women were referred with suspicion of CIN, or underwent a control cytological examination after treatment for CIN and cervical cancer. Smears were taken sep­arately from ecto-, endocervix and mixed. Various tools were used (trowel, brushes type D, F and Cervex-Brush Combi). Each patient was sampled at the same time by different types of instruments. All surveyed women were performed at the same time traditional and fluid cytology. Liquid preparations were prepared using SurePath™ technology (BD and Company, Netherlands, USA) and E‑Prep (Biodyne, South Korea). Traditional cytological preparations were stained ac­cording to the Pappenheim method, liquid preparations — by Papanicolaou. A comparative analysis of cytological and histological findings was carried out.Results. According to our data, the number of non-informative material practically coincides in the shopping center and in the LC, from the instruments used the best results were obtained when using a cytobrush of type D and a wood­en spatula. The frequency of detection of CIN squamous epithelium in the LC is somewhat less than in the shopping center (60% vs. 62%). This is due to the lack of experience in evaluating the life cycle drugs. Despite the fact that the overall frequency of CIN detection is somewhat lower in the LC than in the TC, the frequency of detection of high grade squamous intraepithelial lesion (HSIL) is higher in the LC (51% versus 46%). This is due to the fact that cellular elements are concentrated in a limited area and single small HSIL complexes that are missed in the shopping center are better detected in the LC. The sensitivity of the TC smear from the cervix was 96.2%, life cycle — 92.4%. The accuracy of the shopping center is 92%, the life cycle is 89.6%.Conclusion. LC is an alternative to traditional cytological examination in order to detect pretumor diseases and cervical cancer. For an objective assessment of liquid preparations, additional training of cytologists is necessary.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134146948","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}

{"title":"Организация программ реабилитации онкологических пациентов на основе междисциплинарного подхода","authors":"Марина Баллюзек, А. К. Ионова, Мария Машкова, Борис Павлович Степанов, О Л Чагунава","doi":"10.17709/2409-2231-2018-5-4-9","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-9","url":null,"abstract":"Purpose. To improve the technology of cancer patients' rehabilitation in the multidisciplinary hospital using an interdisciplinary approach at the stages of combined treatment of malignant tumors. Patients and methods . The analysis of 845 cases of admission of cancer patients in a multidisciplinary clinic for oncological rehabilitation, including treatment of complications and co morbid diseases, diagnosis and palliative care, on the specialized treatment stages was made. Based on the diagnosis, clinical status, determination of the clinical potential of these patients the need in medical rehabilitation of cancer patients based on the principles of an interdisciplinary approach was established. Results. A low commitment of oncologists to refer patients to multidisciplinary hospitals for supporting general medical treatment programs, which involve the work of multidisciplinary rehabilitation teams, especially at the initial stages of cancer, was revealed. In 94.1% of cases, based on oncologists' recommendation patients were presented to the multidisciplinary hospital only in the advanced stage of malignant disease. However, 64.8% of patients who came only for the purpose of \"hospice\" or palliative care treatment were able to continue their anticancer treatment. In 4.9% of cases among patients, who were referred for palliative care, the severity of their condition was mistakenly regarded as a relapse of cancer, whereas it was caused by comorbid pathology. The low interest of cancer patients in rehabilitation programs in the absence of recommendations from oncologists was revealed. It was shown that supportive therapy based on the principles of interdisciplinary approach is not only needed for patients with far-ongoing manifestations of cancer process, but also for patients with stage I-II of cancer, since even at this stage various complications of cancer disease, the consequences of its treatment and also manifestations of a combined pathology are often encountered. Conclusion . A classification of medical problems of cancer patients was proposed. Based on the newly developed methodology, the algorithm of personified rehabilitation support programs of oncological patients' and guidelines for managing patients at the stages of specialized and rehabilitative treatment using principles of an interdisciplinary approach, were created.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115381745","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}

{"title":"Анализ доступности и направления совершенствования медицинской помощи пациентам при злокачественных новообразованиях в Московской области","authors":"Е. Ю. Огнева, А. Н. Гуров, М. В. Пирогов, Е. В. Гамеева, О. Ю. Александрова","doi":"10.17709/2409-2231-2018-5-4-11","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-11","url":null,"abstract":"Purpose. Carrying out medical and statistical analysis of morbidity and mortality of the population with malignant neoplasms, development of proposals for greater accessibility and areas of improvement of specialized including high-tech medical care (HTMC) for patients with cancer in the Moscow region. Materials and methods . The analysis of morbidity and mortality of the population of the Moscow region from malignant neoplasms and the organization of specialized, including high-tech, medical care to cancer patients on the basis of forms of Federal state statistical observations in relation to the three-level system of the organization of medical care to the population of the region with identification of organizational and financial problems. Results . The incidence of malignant neoplasms in the Moscow region in 2017 amounted to 364.9 per 100 thousand population, which is 1.0% below the level of 2016-365.9 per 100 thousand population and below the average for the Central Federal district and the Russian Federation. The mortality rate from neoplasms in the Moscow region decreased in 2017 to 174.7 cases per 100 thousand population, which is less than the average for the Central Federal district — 207.1 and the Russian Federation — 196.9 per 100 thousand population. At the same time, the volume of specialized medical care (including high — tech medical care) for malignant tumors, in a 24-hour hospital is more than twice the average Russian standard — 13% for SMC and 50% for HTMC. Exceeding the standard of medical care is mainly due to the HTMC 2, which is not planned in the subject of the Russian Federation and is usually in Federal clinics. The share of oncological medical care received outside the medical organizations of the MR is 16%, which exceeds the share of medical care in all other profiles received outside the Moscow region (12%). This situation contributes to the availability of cancer care to the population of the Moscow region. Conclusion. The performed work allowed to draw conclusions that in normative legal acts of Federal level it is necessary to define separately the standard of volumes of specialized, including hi-tech medical care, on the profile of Oncology. Large volumes of HTMC cannot be an unambiguous characteristic of the availability of medical care in General, since HTMC is medical care with the use of complex methods of diagnosis and treatment in clinically complex cases. Large volumes of HTMC can be a consequence of the complexity of clinical cases, but also a consequence of neglect of the disease due to the lack of diagnosis and treatment in the provision of primary health care (PHC) at the 1st level. In the Moscow region, there is a need to redistribute the volume of this medical care not only to cancer dispensaries, but also to other medical organizations. After that, there is a need for the distribution of patients, taking into account the morbidity in the territories, the place of residence of citizens, and taking i","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125762241","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}

{"title":"Удовлетворенность пациентов городской многопрофильной больницы медицинским обслуживанием","authors":"С. А. Суслин, А. В. Вавилов, Р. И. Гиннятулина","doi":"10.17709/2409-2231-2018-5-4-12","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-12","url":null,"abstract":"Aim. Medico-sociological study of patients' satisfaction with the activity of a large city multi-profile N. Pirogov Samara hospital. Materials and methods . The results of the study of patients' satisfaction with a large multidisciplinary hospital in the city of Samara on the activities of the hospital in modern conditions are presented. During the medical and sociological survey, 474 patients were medically screened, the median age of which was 40 years. The sample size of the respondents was 50% of the patients in the hospital. The sample was randomly generated. Results. In the age structure of the respondents (hospitalized patients), persons aged 30-45 and 18-29, who account for 30.4% and 29.5%, respectively, are predominant. Patients of the age category 46-59 years are slightly less — 21.5%, at the age of 60 and older — even less (18.6%). Two-thirds of the respondents (66.7%) indicate a satisfactory assessment of their financial situation, 43.9% of respondents indicate a satisfactory level of health status. Most patients (63.1%) are generally satisfied with the provision of medical care. A fairly low proportion of patients (less than 10%) who spent personal funds during inpatient treatment was noted. Against the background of a relatively high degree (more than 70%) of patients' satisfaction with the processes of diagnosis and treatment, there is a low satisfaction with the sanitary and hygienic conditions of inpatient stay (46.4%). Patients are more satisfied with the relationship with the average medical personnel (75.9%) than with the doctors (63.5%). The average assessment of the quality of the organization of medical care in the hospital was 3.88 on a five-point scale. Conclusion. The main shortcomings in the quality of the organization of medical care were the low material and technical base of the hospital (according to 14.1% of patients), sanitary and hygienic problems (9.7%), claims to food quality (6.8%), shortages of medicines and consumables materials (5.7%). The results of the study of patients' satisfaction with the quality of the services provided reveal the factors that reduce patient satisfaction with medical care and highlight the main directions for its optimization.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115896055","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}

{"title":"Современные методы абляции злокачественных новообразований печени","authors":"Л. И. Москвичева, Д. В. Сидоров, М. В. Ложкин, Л. О. Петров, М. В. Забелин","doi":"10.17709/2409-2231-2018-5-4-6","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-6","url":null,"abstract":"The purpose of this review is to demonstrate the possibility of performing various methods of thermal and non-thermal ablation in patients with primary and metastatic liver tumors on the basis of data available in the world medical literature. As conservative variants of local action in patients with non-resectable primary and secondary liver tumors and inoperable patients, various ablative techniques have been developed and used to achieve local control over the disease and increase the life expectancy of this group of patients. These include: radiofrequency ablation, microwave ablation, HIFU therapy, laser ablation, cryotherapy, chemical destruction of the tumor, irreversible electroporation, stereotactic radiation therapy. The effectiveness of these ablation methods depends on the size and localization of the tumor focus, and for thermal techniques — also on its location relative to large vessels. Ablative techniques have the maximum efficiency (in some cases, similar to surgical intervention) when exposed to early forms of primary cancer or secondary tumor formation of the liver in the presence of a solitary node with a maximum size up to 5 cm or 3 and less foci size up to 3 cm. The effectiveness of local destruction of tumor formations of the liver of larger diameter is increased by carrying out ablation by the second stage after performing chemoembolization of the hepatic artery or by combining various techniques of local action. The use of various modern methods of ablation of solid primary and secondary liver tumors in medical practice can expand the possibilities of antitumor treatment of this category of patients.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117257088","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}

{"title":"The influence of metabolic syndrome on the development and clinical manifestations of benign prostatic hyperplasia","authors":"В. Б. Филимонов, Р. В. Васин, А. А. Костин, В Н Панченко","doi":"10.17709/2409-2231-2018-5-4-5","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-5","url":null,"abstract":"Benign prostatic hyperplasia (BPH) — one of the most common urological diseases that lead to the development of symptoms of the lower urinary tract (SLUT). BPH-multifactorial disease, in which a significant role is given to increase the activity of the enzyme 5a-reductase and hormonal imbalance associated with the exchange of testosterone and dihydrotestosterone. However, to date, not all aspects of the etiology and pathogenesis of this condition have been studied. The results of numerous studies indicate a significant role of complex metabolic disorders included in the modern concept of \"metabolic syndrome\" (MS), the development and progression of BPH/SLUT. The main pathogenetic factors leading to the formation of BPH and concomitant urination disorders are considered to be a violation of the balance of sex hormones, the development of chronic ischemia of the pelvic organs, a violation of carbohydrate and lipid metabolism. The relationship between BPH and MS is one of the most urgent problems of modern medicine. Different components of MS independently from each other can influence more pronounced progression of BPH/SLUT in comparison with development of this disease in men without metabolic disorders that is the reason of lower efficiency of surgical and medical treatment of this group of patients.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117242669","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}

{"title":"Оценка результатов использования сетчатых имплантатов при аллопластике грыж пищеводного отверстия диафрагмы","authors":"Игорь Игоревич Розенфельд, Д. Л. Чиликина","doi":"10.17709/2409-2231-2018-5-4-8","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-8","url":null,"abstract":"The review of the literature examines the results of modern randomized cohort studies on the efficacy of alloplas-ty in hernia of the esophageal aperture of the diaphragm. The complications and relapses after plastic are analyzed by various types of reticular implants: polypropylene, polytetrafluoroethylene, lightweight, resorbable and biological cell — free dermal implants. As a result of the analysis, the presence of serious complications and relapses after the use of certain techniques for alloplasty of the hernia of the esophageal aperture of the diaphragm has been proved, and also identified the problematic issues of the evolutionary development of these techniques in the conduct of operative surgical interventions.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121408028","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}

{"title":"Роль воспаления в течении и лечении колоректального рака","authors":"Т. Н. Гарманова, М. И. Бредихин, И. А. Тулина, П. В. Царьков","doi":"10.17709/2409-2231-2018-5-4-4","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-4","url":null,"abstract":"One of the factors affecting the effectiveness of treatment and determining the prognosis of a patient with colorectal cancer may be inflammatory status both before and after surgical treatment. The review is devoted to the description of possible mechanisms of relationa between patient's inflammatory status and oncogenesis. Particular attention is paid to the ability of tumor cells to modify the immune cells from the antioncogenic to prooncogenic status. The paper makes an attempt to present a unified concept of the impact of postoperative complications on tumor recurrence in the light of the inflammatory response to surgical intervention.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132221344","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}

{"title":"Prediction of success in assisted reproductive technology with the help of morphology of the testis","authors":"N. Kulchenko","doi":"10.17709/2409-2231-2018-5-4-2","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-2","url":null,"abstract":"In the structure of infertile marriage male factor of infertility occurs in about 40-50%. About 30% of infertile men who have sought medical care have oligozoospermia or azoospermia of unknown etiology. The question of the chances of spermatogenesis recovery and increased probability of sperm extraction in repeated assisted reproductive technology (ART) programs is important for both the doctor and the patient.Purpose. To evaluate the morphological changes of spermatogenic epithelium in patients with male infertility in terms of prognosis of ART success.Patients and methods. 264 men with infertility were examined. The scope of clinical study of all patients included: history, examination, determination of blood hormones, study of ejaculate, karyotype, ultrasound. We performed a biopsy of the testis according to the patient's symptoms. Testicular tissue was subjected to morphological examination.Results. Primary infertility was observed in 172 men (65.2%), secondary — 92 (34.8%). 112 (42.4%) patients had severe infertility. The results of morphological studies in these men showed a different degree of violation of spermatogenesis. Based on the study, a diagnostic algorithm of patients with male infertility is proposed, which allows to predict the success of ART taking into account morphological changes in the testicle.Conclusion. On the basis of clinical and morphological study of the features of spermatogenesis of a particular patient a plan can be made for further personal diagnostic and therapeutic measures.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115875048","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}