Pub Date : 2018-12-21DOI: 10.17709/2409-2231-2018-5-4-1
С. А. Бехтерева, А. С. Доможирова, Андрей Владимирович Важенин, И. А. Аксенова
The purpose of the study was to analyze the incidence of primary-multiple cancer (PMC) of the female reproductive system according to the population cancer register of the Chelyabinsk region for 15 years (1999-2013) using the example of PMC of the cervix. Carry out an analysis of the adjusted cumulative survival in the group of patients with PMC of the cervix as compared with solitary cervical cancer. Material and methods. The material was processed using the classification of Zisman I. F. and Kirichenko G. D. (1978) on the sequence of tumors: metachronous, synchronous, mechatronic-synchronous and synchronous-metachronous. The interval of metachronousness is 6 months. The survival rates of cancer patients in the Chelyabinsk region were calculated automatically with the use of the computer program "Calculation of survival rates" — an application to the population-based cancer registry of OOO Novell-SPb. Using the method of continuous sampling, we carried out a retrospective analysis of the case histories of patients with PMC of the female reproductive system treated in the SBEO CRCOD for 15 years (1999-2013). Results. During the period under review, 82 patients with PMC of the cervix uteri were examined, metachronous tumors prevailed in 55 (67.1%), synchronous tumors developed in 27 (33.75%). In the group of metachronous tumors in 12 (21.8%) patients had a combination of three tumors. Three (5.45%) patients had a combination of four tumors. Analysis of combinations of cervical cancer showed that more often, the cervical cancer metachronically met with breast cancer 35% (14 patients), endometrial cancer 17.5% (7 patients), ovarian cancer 7.5% (3 patients). Synchronously cervical cancer was more often combined with breast cancer 42.8% (9 patients), endometrium 28.6% (6 patients), ovaries 23.8% (5 patients) and rectal cancer 4.8% (1 patient). The results of calculation of the index of the adjusted cumulative survival of the study group of the PMC of the cervix showed that in the group of metachronous tumors, survival rates were significantly higher than in the group of synchronous tumors: single-year survival was 84.8 ± 6.3% against 82.4 ± 9.2, three-year survival — 66.8 ± 7.8% against 47, 1 ± 12.1, and five years after the diagnosis, 53.8 ± 8.6% of patients survived. Conclusion. Thus, patients with cervical cancer are at risk of developing cancer of other localizations that share common etiopathogenetic factors, such as HPV infection in women, hormonal disorders.
{"title":"Полинеоплазии у больных раком шейки матки в Челябинской области России","authors":"С. А. Бехтерева, А. С. Доможирова, Андрей Владимирович Важенин, И. А. Аксенова","doi":"10.17709/2409-2231-2018-5-4-1","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-1","url":null,"abstract":"The purpose of the study was to analyze the incidence of primary-multiple cancer (PMC) of the female reproductive system according to the population cancer register of the Chelyabinsk region for 15 years (1999-2013) using the example of PMC of the cervix. Carry out an analysis of the adjusted cumulative survival in the group of patients with PMC of the cervix as compared with solitary cervical cancer. Material and methods. The material was processed using the classification of Zisman I. F. and Kirichenko G. D. (1978) on the sequence of tumors: metachronous, synchronous, mechatronic-synchronous and synchronous-metachronous. The interval of metachronousness is 6 months. The survival rates of cancer patients in the Chelyabinsk region were calculated automatically with the use of the computer program \"Calculation of survival rates\" — an application to the population-based cancer registry of OOO Novell-SPb. Using the method of continuous sampling, we carried out a retrospective analysis of the case histories of patients with PMC of the female reproductive system treated in the SBEO CRCOD for 15 years (1999-2013). Results. During the period under review, 82 patients with PMC of the cervix uteri were examined, metachronous tumors prevailed in 55 (67.1%), synchronous tumors developed in 27 (33.75%). In the group of metachronous tumors in 12 (21.8%) patients had a combination of three tumors. Three (5.45%) patients had a combination of four tumors. Analysis of combinations of cervical cancer showed that more often, the cervical cancer metachronically met with breast cancer 35% (14 patients), endometrial cancer 17.5% (7 patients), ovarian cancer 7.5% (3 patients). Synchronously cervical cancer was more often combined with breast cancer 42.8% (9 patients), endometrium 28.6% (6 patients), ovaries 23.8% (5 patients) and rectal cancer 4.8% (1 patient). The results of calculation of the index of the adjusted cumulative survival of the study group of the PMC of the cervix showed that in the group of metachronous tumors, survival rates were significantly higher than in the group of synchronous tumors: single-year survival was 84.8 ± 6.3% against 82.4 ± 9.2, three-year survival — 66.8 ± 7.8% against 47, 1 ± 12.1, and five years after the diagnosis, 53.8 ± 8.6% of patients survived. Conclusion. Thus, patients with cervical cancer are at risk of developing cancer of other localizations that share common etiopathogenetic factors, such as HPV infection in women, hormonal disorders.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"517 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":"123097684","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}
Pub Date : 2018-12-21DOI: 10.17709/2409-2231-2018-5-4-3
Сергей Константинович Яровой, Р. А. Хромов
Purpose of the study. The aim of this study is to improve the quality of emergency urological care for patients with scrotal and testicular trauma. Patients and methods . The study is a comparison of the results of prospective (according to the algorithm) and retrospective fragments, including a total of 459 patients (414 retrospectively, 45 prospectively). Patients received inpatient urological care for traumatic damage to the scrotum and testicle in D. Pletnyov City Clinical Hospital Department of Health of Moscow, N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology — Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation for the period 2008-2018. Results. The article analyzes the clinical effectiveness of the developed algorithm for the choice of therapeutic tactics in different variants of scrotal and testicular injuries. The key differences between the proposed algorithm and the generally accepted tactics are the extension of indications for emergency testicular revision (to operate with hematocele of any volume) and the same type of antibacterial prevention/therapy of infectious posttraumatic orchitis, regardless of the nature of the injury. Conclusion. When using the algorithm, the following clinical advantages were noted: reducing the likelihood of acute post-traumatic orchitis 2.4 times (p = 0,0271); reduced likelihood of postoperative infectious-inflammatory complications is reduced 2.0 times; reducing the likelihood of orchiectomy or hardening of the testicle 1.4 times.
{"title":"Тупая травма мошонки и яичка: алгоритм выбора лечебной тактики","authors":"Сергей Константинович Яровой, Р. А. Хромов","doi":"10.17709/2409-2231-2018-5-4-3","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-3","url":null,"abstract":"Purpose of the study. The aim of this study is to improve the quality of emergency urological care for patients with scrotal and testicular trauma. Patients and methods . The study is a comparison of the results of prospective (according to the algorithm) and retrospective fragments, including a total of 459 patients (414 retrospectively, 45 prospectively). Patients received inpatient urological care for traumatic damage to the scrotum and testicle in D. Pletnyov City Clinical Hospital Department of Health of Moscow, N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology — Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation for the period 2008-2018. Results. The article analyzes the clinical effectiveness of the developed algorithm for the choice of therapeutic tactics in different variants of scrotal and testicular injuries. The key differences between the proposed algorithm and the generally accepted tactics are the extension of indications for emergency testicular revision (to operate with hematocele of any volume) and the same type of antibacterial prevention/therapy of infectious posttraumatic orchitis, regardless of the nature of the injury. Conclusion. When using the algorithm, the following clinical advantages were noted: reducing the likelihood of acute post-traumatic orchitis 2.4 times (p = 0,0271); reduced likelihood of postoperative infectious-inflammatory complications is reduced 2.0 times; reducing the likelihood of orchiectomy or hardening of the testicle 1.4 times.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"56 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":"129096752","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}
Pub Date : 2018-12-21DOI: 10.17709/2409-2231-2018-5-4-7
И. А. Каприн, З. Э. Эльдарова, В. П. Глабай
In this reviewing article there are discussed such topics as modern classification of acute pancreatitis, indications for surgical treatment of severe and, first of all, infected pancreatic necrosis, modern tendencies in this problem and controversial issues of it. The analysis of two different methods of surgeries («closed» and «open») for drainage of retroperitoneal space depending on the scale of necrotic lesion has been carried out. The perspective use of the natural transluminal endoscopic surgery (ENOTES) in the treatment of acute pancreatitis, complicated by abdominal compartment syndrome, is shown. The frequency of intraoperative and early complications after «closed» and «open» surgical interventions for severe acute pancreatitis has been reviewed; also recognition of the complications, the prevention of their occurrence and the choice of surgical or conservative methods of treating the complications.
{"title":"Хирургическое лечение и осложнения операций при остром панкреатите тяжелого течения","authors":"И. А. Каприн, З. Э. Эльдарова, В. П. Глабай","doi":"10.17709/2409-2231-2018-5-4-7","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-4-7","url":null,"abstract":"In this reviewing article there are discussed such topics as modern classification of acute pancreatitis, indications for surgical treatment of severe and, first of all, infected pancreatic necrosis, modern tendencies in this problem and controversial issues of it. The analysis of two different methods of surgeries («closed» and «open») for drainage of retroperitoneal space depending on the scale of necrotic lesion has been carried out. The perspective use of the natural transluminal endoscopic surgery (ENOTES) in the treatment of acute pancreatitis, complicated by abdominal compartment syndrome, is shown. The frequency of intraoperative and early complications after «closed» and «open» surgical interventions for severe acute pancreatitis has been reviewed; also recognition of the complications, the prevention of their occurrence and the choice of surgical or conservative methods of treating the complications.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"25 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":"124706058","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}
Pub Date : 2018-09-11DOI: 10.17709/2409-2231-2018-5-3-11
Дмитрий Александрович Гаврилов, Э. И. Закиров, Е. В. Гамеева, В. Ю. Семенов, О. Ю. Александрова
In the last 10 years there has been a revolu on in the fi eld of computer image analysis and pa ern recogni on. Modern algorithms of computer vision equaled and even in some problems surpassed human capabili es. This jerk is largely due to the emergence and development of the technology of deep convolu onal neural networks. Recent developments in the fi eld of image processing and machine learning open up the prospect of crea ng systems based on ar fi cial neural convolu onal networks, superior to humans in problems of image classifi ca on, in par cular, in solving problems of analysis of various medical images. Among the most promising applica ons: automated recogni on and classifi ca on of skin diseases, detec on of pathologies on X-ray, CT, MRI, ultrasound imaging. In the proposed project, we will focusour a en on on the diagnosis of human skin diseases. At the moment, melanoma is one of the most dangerous types of malignant tumors of the skin with a lot of deaths due to rapid metastasis, which is difficult to treat. The development of computer vision technology has allowed the development of technical vision systems that allow detec on and classifi ca on of skin diseases with a quality that is comparable and in some cases exceeds the values a ained by man. In this paper, the authors propose an algorithm for the primary diagnosis of skin melanoma based on deep neural networks, achieving an accuracy of 91% for melanoma in dermatoscopic images. At the moment, the algorithm is implemented programma cally and is used in the test version of the online system for detec ng and classifying skin diseases, available at skincheckup.online. Thanks to this development, the prospect of a signifi cantincrease in the propor on of people subjected to preven ve examina on for the presence of skin diseases opens up. Along with this, an addi onal source of informa on for specialized professionals can also play a role in seng the right diagnosis.
{"title":"Автоматизированная диагностика меланомы кожи на основе математической модели искусственной сверточной нейронной сети","authors":"Дмитрий Александрович Гаврилов, Э. И. Закиров, Е. В. Гамеева, В. Ю. Семенов, О. Ю. Александрова","doi":"10.17709/2409-2231-2018-5-3-11","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-3-11","url":null,"abstract":"In the last 10 years there has been a revolu on in the fi eld of computer image analysis and pa ern recogni on. Modern algorithms of computer vision equaled and even in some problems surpassed human capabili es. This jerk is largely due to the emergence and development of the technology of deep convolu onal neural networks. Recent developments in the fi eld of image processing and machine learning open up the prospect of crea ng systems based on ar fi cial neural convolu onal networks, superior to humans in problems of image classifi ca on, in par cular, in solving problems of analysis of various medical images. Among the most promising applica ons: automated recogni on and classifi ca on of skin diseases, detec on of pathologies on X-ray, CT, MRI, ultrasound imaging. In the proposed project, we will focusour a en on on the diagnosis of human skin diseases. At the moment, melanoma is one of the most dangerous types of malignant tumors of the skin with a lot of deaths due to rapid metastasis, which is difficult to treat. The development of computer vision technology has allowed the development of technical vision systems that allow detec on and classifi ca on of skin diseases with a quality that is comparable and in some cases exceeds the values a ained by man. In this paper, the authors propose an algorithm for the primary diagnosis of skin melanoma based on deep neural networks, achieving an accuracy of 91% for melanoma in dermatoscopic images. At the moment, the algorithm is implemented programma cally and is used in the test version of the online system for detec ng and classifying skin diseases, available at skincheckup.online. Thanks to this development, the prospect of a signifi cantincrease in the propor on of people subjected to preven ve examina on for the presence of skin diseases opens up. Along with this, an addi onal source of informa on for specialized professionals can also play a role in seng the right diagnosis.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129427214","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}
Pub Date : 2018-09-09DOI: 10.17709/2409-2231-2018-5-3-12
Y. Udalov, A. Gordienko, A. Samoilov, M. Zabelin, S. A. Bakharev
Planned surgical interven ons account for more than half of all opera ons in the Russian Federa on, of which more than 20–30% are performed for oncological diseases. Characteris c is an increase in the number of operated pa ents in older age groups with severe concomitant pathology and a high percentage of postopera ve complica ons, including due to psychoemo onal pathology, which can be excluded or adjusted at the preopera ve stage.Purpose.Evalua on of the infl uence of the psychoemo onal state of the oncochirical soma cally burdened patient on the lethality and revealing the possibility of correc on of the psychoemo onal state at the preopera ve stage.Paents and methods. In the period from 2006 to 2016 in the departments of therapy and oncology of the Regional Clinical Hospital of the City Clinical Hospital No. 40 of the Moscow City Health Department, AI.Burnazyan The FMBA of Russia analyzed the treatment of 958 soma cally burdened pa ents with various oncopathology who underwent opera ve interven on in a planned manner. An analysis of the psychoemo onal state of pa ents before and aft er surgery was performed using Hamilton diagnos c scales.Results.After a retrospec ve evalua on, it was determined that prac cally all patients of the oncosurgical profi le undergo various psychoemo onal strains of varying strength and dura on, both before and after surgery. This can disrupt the blood fl ow in the organs andssues, and lead to various complica ons, which manifests itself in the form of hypoxia and ischemia, which, in turn, jus fy the development of postopera ve delirium and myocardial infarc on.Conclusions.Clear distinctions between the anxiety severity in groups on outcomes of hospitaliza on of the oncosurgical patient were determined, and the tendency of the rela onship between the level of the anxiety state and the postopera ve complica ons that had been ridden in the early postopera ve period in soma cally burdened pa ents was determined. Patients of the oncosurgical profi le without fail are shown psychopharmacotherapy in the pre- and postopera ve periods, depending on the revealed pathology.
计划手术干预占俄罗斯联邦所有手术的一半以上，其中超过20-30%是针对肿瘤疾病进行的。特点c是增加数量的操作pa树人在老年群体中有严重的病理和高百分比的postopera ve complica ons,包括由于传统病理学psychoemo,可以排除或调整在preopera ve stage.Purpose.Evalua影响力点的传统的psychoemo oncochirical soma卡莉负担病人杀伤力和揭示correc的可能性的传统国家psychoemo preopera阶段。父母和方法。2006年至2016年期间，在莫斯科市卫生局第40市临床医院区域临床医院治疗科和肿瘤科工作。俄罗斯FMBA分析了958例患有各种肿瘤病理的躯体负担父母的治疗情况，他们接受了有计划的手术干预。结果:经过回顾性评估，几乎所有的肿瘤外科患者在手术前和手术后都经历了不同强度和硬脑膜的各种心理情绪压力。这可能会破坏器官和器官的血液流动，并导致各种并发症，表现为缺氧和缺血，从而导致术后谵妄和心肌梗死的发生。结论:确定了各组肿瘤手术患者住院结果的焦虑严重程度之间的明显差异。并测定了父母焦虑状态水平与歌剧后早期曾经历过的歌剧后并发症的关系趋势。肿瘤外科患者无一例外地在术前和术后接受精神药物治疗，这取决于所显示的病理。
{"title":"Psychoemotional stress in somatically burdened oncological surgery patients as one of the factors of postoperative complications","authors":"Y. Udalov, A. Gordienko, A. Samoilov, M. Zabelin, S. A. Bakharev","doi":"10.17709/2409-2231-2018-5-3-12","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-3-12","url":null,"abstract":"Planned surgical interven ons account for more than half of all opera ons in the Russian Federa on, of which more than 20–30% are performed for oncological diseases. Characteris c is an increase in the number of operated pa ents in older age groups with severe concomitant pathology and a high percentage of postopera ve complica ons, including due to psychoemo onal pathology, which can be excluded or adjusted at the preopera ve stage.Purpose.Evalua on of the infl uence of the psychoemo onal state of the oncochirical soma cally burdened patient on the lethality and revealing the possibility of correc on of the psychoemo onal state at the preopera ve stage.Paents and methods. In the period from 2006 to 2016 in the departments of therapy and oncology of the Regional Clinical Hospital of the City Clinical Hospital No. 40 of the Moscow City Health Department, AI.Burnazyan The FMBA of Russia analyzed the treatment of 958 soma cally burdened pa ents with various oncopathology who underwent opera ve interven on in a planned manner. An analysis of the psychoemo onal state of pa ents before and aft er surgery was performed using Hamilton diagnos c scales.Results.After a retrospec ve evalua on, it was determined that prac cally all patients of the oncosurgical profi le undergo various psychoemo onal strains of varying strength and dura on, both before and after surgery. This can disrupt the blood fl ow in the organs andssues, and lead to various complica ons, which manifests itself in the form of hypoxia and ischemia, which, in turn, jus fy the development of postopera ve delirium and myocardial infarc on.Conclusions.Clear distinctions between the anxiety severity in groups on outcomes of hospitaliza on of the oncosurgical patient were determined, and the tendency of the rela onship between the level of the anxiety state and the postopera ve complica ons that had been ridden in the early postopera ve period in soma cally burdened pa ents was determined. Patients of the oncosurgical profi le without fail are shown psychopharmacotherapy in the pre- and postopera ve periods, depending on the revealed pathology.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"311 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122702471","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}
Pub Date : 2018-09-09DOI: 10.17709/2409-2231-2018-5-3-4
S. P. Sviridova, O. Somonova, S. Kashiya, O. Obukhova, A. Sotnikov
In recent decades, significant progress has been made in understanding the mechanisms of platelet function and platelet hemostasis correction. Platelets are considered as the most important participants of both normal, and pathological thrombotic process characteristic of the most different diseases and states. In the present review pathophysiological mechanisms of platelet synthesis of various mediators with paracrine effects, which can influence the function of other cells, are consecrated. The physiology of platelets was considered in detail. The leading role of platelets in pathogenesis of the majority of diseases of cardiovascular system as modulators of inflammatory reactions of the immune response which are considered as the leading mechanism of development of atherosclerosis was shown. The ability of platelets to encode inflammatory proteins allowing them to influence adaptive immunity functions was discussed. The role of platelets as a key component of the innate immune system was presented, which is confirmed by the presence of Tolllike receptors (TLR) and glycoproteins, such as integrin αIIbβ3, glycoprotein Ib-IX and FcγRIIa, involved in interaction with bacterial cells. The pathogenesis of the formation of platelet-leukocyte aggregates due to the rapid reversible interaction of P-selectin (CD62P) on the platelet surface with ligand-1 glycoprotein P-selectin (PSGL-1) on the plasma of leukocytes and the mechanism of extracellular neutrophil traps (NETs), as well as the influence of platelets on the function of lymphocytes was presented. The role of platelets in cancer progression, metastasis and thrombosis is considered, and the interrelation of thrombosis and metastasis in malignant diseases was analyzed. The efficiency of the use of antithrombotic drugs in the prevention of thrombosis and, as a consequence, in the prevention of cardiovascular diseases and cancer was discussed.
{"title":"The role of platelets in inflammation and immunity","authors":"S. P. Sviridova, O. Somonova, S. Kashiya, O. Obukhova, A. Sotnikov","doi":"10.17709/2409-2231-2018-5-3-4","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-3-4","url":null,"abstract":"In recent decades, significant progress has been made in understanding the mechanisms of platelet function and platelet hemostasis correction. Platelets are considered as the most important participants of both normal, and pathological thrombotic process characteristic of the most different diseases and states. In the present review pathophysiological mechanisms of platelet synthesis of various mediators with paracrine effects, which can influence the function of other cells, are consecrated. The physiology of platelets was considered in detail. The leading role of platelets in pathogenesis of the majority of diseases of cardiovascular system as modulators of inflammatory reactions of the immune response which are considered as the leading mechanism of development of atherosclerosis was shown. The ability of platelets to encode inflammatory proteins allowing them to influence adaptive immunity functions was discussed. The role of platelets as a key component of the innate immune system was presented, which is confirmed by the presence of Tolllike receptors (TLR) and glycoproteins, such as integrin αIIbβ3, glycoprotein Ib-IX and FcγRIIa, involved in interaction with bacterial cells. The pathogenesis of the formation of platelet-leukocyte aggregates due to the rapid reversible interaction of P-selectin (CD62P) on the platelet surface with ligand-1 glycoprotein P-selectin (PSGL-1) on the plasma of leukocytes and the mechanism of extracellular neutrophil traps (NETs), as well as the influence of platelets on the function of lymphocytes was presented. The role of platelets in cancer progression, metastasis and thrombosis is considered, and the interrelation of thrombosis and metastasis in malignant diseases was analyzed. The efficiency of the use of antithrombotic drugs in the prevention of thrombosis and, as a consequence, in the prevention of cardiovascular diseases and cancer was discussed.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"18 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120876707","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}
Pub Date : 2018-09-09DOI: 10.17709/2409-2231-2018-5-3-10
A. Zikiryakhodzhayev, A. Kalinina-Masri, L. E. Rotobelskaya, A. Sukhotko, F. Usov, V. V. Ratushnaya, N. V. Evtyagina
Purpose.Determine the survival of the auto-fat gra a er lipofi lling in the process of reconstruc on in pa ents with breast cancer.Paents and methods. The study included 60 pa ents who underwent lipofi lling both at the fi rst stage of recons tu on and at its fi nal stages. The ar cle describes the procedure for performing the lipofi lling procedure, monitoring and evalua on of the degree of survival of the autologous transplant.Results.As a result of the study, we determined the average survival rate of adiposessue in the recipient zone, which was 76.50% (p <0.00001), which further posi vely aff ects the subsequent stages of reconstruc on and the fi nal result as a whole.Conclusion.Given the good survival of the auto-gra , lipofi lling is part of the surgical rehabilita on of pa ents a er combined / complex / surgical treatment. The procedure is applicable in the fi rst stage of delayed reconstruc on, with the replacement of the ssue expander with a silicone endoprosthesis and as a correc ve method at the fi nal stage of reconstruc on.
{"title":"A method for assessing the results of survival of an auto-fat graft after lipofilling in patients with breast cancer during surgical rehabilitation","authors":"A. Zikiryakhodzhayev, A. Kalinina-Masri, L. E. Rotobelskaya, A. Sukhotko, F. Usov, V. V. Ratushnaya, N. V. Evtyagina","doi":"10.17709/2409-2231-2018-5-3-10","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-3-10","url":null,"abstract":"Purpose.Determine the survival of the auto-fat gra a er lipofi lling in the process of reconstruc on in pa ents with breast cancer.Paents and methods. The study included 60 pa ents who underwent lipofi lling both at the fi rst stage of recons tu on and at its fi nal stages. The ar cle describes the procedure for performing the lipofi lling procedure, monitoring and evalua on of the degree of survival of the autologous transplant.Results.As a result of the study, we determined the average survival rate of adiposessue in the recipient zone, which was 76.50% (p <0.00001), which further posi vely aff ects the subsequent stages of reconstruc on and the fi nal result as a whole.Conclusion.Given the good survival of the auto-gra , lipofi lling is part of the surgical rehabilita on of pa ents a er combined / complex / surgical treatment. The procedure is applicable in the fi rst stage of delayed reconstruc on, with the replacement of the ssue expander with a silicone endoprosthesis and as a correc ve method at the fi nal stage of reconstruc on.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"44 37","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120887914","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}
Pub Date : 2018-09-09DOI: 10.17709/2409-2231-2018-5-3-2
М. V. Маkаrоvа, M. Y. Vаlkov, D. Y. Tretjakov
Osteoarthritis (OA) is the most frequent rheumatological pathology of the joints. Standard medical treatment does not always allow to stop the pain syndrome. The alternative method of pain treatment causes by OA is orthovoltage X-ray therapy (OVRT). It was used from 1970. The maximum dose by OVRT lies on the skin surface. Based on the modern methods of diagnosis, choosing the appropriate radiation energy, it is possible to reduce the amount of irradiation of the knee joint.The purpose. Is to present the technique of radiation planning in patients with gonarthritis and compare it with OVRT by dosimetry criteria.Materials and methods. Comparison of dose distribution plans of the orthovoltage beam was carried out according to the two-dimensional axial plan in the area of the isocenter for the energy of 200 kV from two tangential fields and a megavoltage energy beam of 6 MeV for a three-dimensional conformal radiation therapy using 3-and 6-fields isocentric irradiation techniques. To describe amounts of radiation were applied to the CTV (clinical target volume) and PTV (planning target volume). To estimate the volume distribution of the dose, bones forming the knee joint were contoured separately. The indent on the PTV was 3 mm.Results. The application of the 6-fields technique allows achieving 95% dose distribution at 93% of the volume, and 90% of the planned dose of 45 SGR covers 97% of the PTV. The average dose on the skin and the neurovascular bundle are of 150 and 240 cGy, respectively. The average radiation dose per course in critical anatomical areas is 280 cGy and 150 cGy. It can be considered that the target coverage for the compared methods is similar as for OVRT, and for 3D conformal radiation therapy plans for dose distribution of the orthogonal beam in the axial plane in comparison with dose distributions for conformal radiation techniques.Conclusion. The technique of three-dimensional conformal radiation therapy of the knee joint in OA with progressive pain syndrome can potentially lead to an increase in the analgesic effect due to greater coverage with a dose of bone elements of the joint, which are a potential source of pain. Three-dimensional conformal radiotherapy megavoltage beam allows reducing the radiation load on the skin in 2.5 times, which can reduce the frequency of delayed adverse effects.
{"title":"Three-dimensional conformal radiation therapy for the osteoarthritis of knee joint: the radiobiological background, dose distribution analysis","authors":"М. V. Маkаrоvа, M. Y. Vаlkov, D. Y. Tretjakov","doi":"10.17709/2409-2231-2018-5-3-2","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-3-2","url":null,"abstract":"Osteoarthritis (OA) is the most frequent rheumatological pathology of the joints. Standard medical treatment does not always allow to stop the pain syndrome. The alternative method of pain treatment causes by OA is orthovoltage X-ray therapy (OVRT). It was used from 1970. The maximum dose by OVRT lies on the skin surface. Based on the modern methods of diagnosis, choosing the appropriate radiation energy, it is possible to reduce the amount of irradiation of the knee joint.The purpose. Is to present the technique of radiation planning in patients with gonarthritis and compare it with OVRT by dosimetry criteria.Materials and methods. Comparison of dose distribution plans of the orthovoltage beam was carried out according to the two-dimensional axial plan in the area of the isocenter for the energy of 200 kV from two tangential fields and a megavoltage energy beam of 6 MeV for a three-dimensional conformal radiation therapy using 3-and 6-fields isocentric irradiation techniques. To describe amounts of radiation were applied to the CTV (clinical target volume) and PTV (planning target volume). To estimate the volume distribution of the dose, bones forming the knee joint were contoured separately. The indent on the PTV was 3 mm.Results. The application of the 6-fields technique allows achieving 95% dose distribution at 93% of the volume, and 90% of the planned dose of 45 SGR covers 97% of the PTV. The average dose on the skin and the neurovascular bundle are of 150 and 240 cGy, respectively. The average radiation dose per course in critical anatomical areas is 280 cGy and 150 cGy. It can be considered that the target coverage for the compared methods is similar as for OVRT, and for 3D conformal radiation therapy plans for dose distribution of the orthogonal beam in the axial plane in comparison with dose distributions for conformal radiation techniques.Conclusion. The technique of three-dimensional conformal radiation therapy of the knee joint in OA with progressive pain syndrome can potentially lead to an increase in the analgesic effect due to greater coverage with a dose of bone elements of the joint, which are a potential source of pain. Three-dimensional conformal radiotherapy megavoltage beam allows reducing the radiation load on the skin in 2.5 times, which can reduce the frequency of delayed adverse effects.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122995820","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}
Pub Date : 2018-09-09DOI: 10.17709/2409-2231-2018-5-3-15
Z. Agamov
Purpose. The defi ni on of structure of visits to doctors in the city policlinic. Materials and methods. According to the results of doctors interviewing, a form for registra on of pa ents visits was designed. 2531 visits to the therapists, urologists and surgeons were registered. Results. The propor on of visits not related to the medical care was: therapists – 46%, surgeons – 23,4%, urologists – 26,9%. The reasons for visits not related to the medical care were: for preferen al prescrip ons; the doctors opinion for medical and social examina on, for health resort card, for providing to other ins tu ons, cer fi cates; for referral to take tests, research and obtaining their results, for consulta on, hospitaliza on in other ins tu ons. Conclusion. In the structure of visits to doctors of the city polyclinic, a high propor on of visits are not related to the medical care.
{"title":"Analysis of the structure of patients visits to the city polyclinic","authors":"Z. Agamov","doi":"10.17709/2409-2231-2018-5-3-15","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-3-15","url":null,"abstract":"Purpose. The defi ni on of structure of visits to doctors in the city policlinic. Materials and methods. According to the results of doctors interviewing, a form for registra on of pa ents visits was designed. 2531 visits to the therapists, urologists and surgeons were registered. Results. The propor on of visits not related to the medical care was: therapists – 46%, surgeons – 23,4%, urologists – 26,9%. The reasons for visits not related to the medical care were: for preferen al prescrip ons; the doctors opinion for medical and social examina on, for health resort card, for providing to other ins tu ons, cer fi cates; for referral to take tests, research and obtaining their results, for consulta on, hospitaliza on in other ins tu ons. Conclusion. In the structure of visits to doctors of the city polyclinic, a high propor on of visits are not related to the medical care.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"2016 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114693608","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}
Pub Date : 2018-09-09DOI: 10.17709/2409-2231-2018-5-3-8
S. Yarovoy, R. Khromov, Sh. L. Voskanyan
The article analyzes the data of 414 patients with scrotal and testicular injuries treated in 2008–2017 by the forces of urgent andrologic service in Moscow.More than 90% of patients who applied for injury to the scrotum and testicle were under the age of 60 years. In peacetime, in the conditions of the metropolis (Moscow) in the vast majority of cases there is a blunt (without breaking the integrity of the skin) injury of the scrotum and testicle (a total of 89.4%). Of these, 77.3% are blunt sports and domestic injury of the testicle of varying severity with a pronounced predominance of relatively light injuries, in particular, the bruise of the testicle. Open injuries are relatively rare-a total of 10.6%. Among open injuries, ruptures of the scrotum without damage to its organs are predominate (63.6% of the total number of patients who applied for open wounds of the scrotum and its organs).The need for emergency surgical interventions in scrotal injury was unexpectedly low-53.1%, which is due to the predominance of mild trauma options – scrotal injury and testicular injury (a total of 61.4% in the frequency of urological care), in certain situations allowing the possibility of conservative treatment or even dynamic observation.
{"title":"Epidemiological aspects of scrotal and testicle trauma in modern metropolis","authors":"S. Yarovoy, R. Khromov, Sh. L. Voskanyan","doi":"10.17709/2409-2231-2018-5-3-8","DOIUrl":"https://doi.org/10.17709/2409-2231-2018-5-3-8","url":null,"abstract":"The article analyzes the data of 414 patients with scrotal and testicular injuries treated in 2008–2017 by the forces of urgent andrologic service in Moscow.More than 90% of patients who applied for injury to the scrotum and testicle were under the age of 60 years. In peacetime, in the conditions of the metropolis (Moscow) in the vast majority of cases there is a blunt (without breaking the integrity of the skin) injury of the scrotum and testicle (a total of 89.4%). Of these, 77.3% are blunt sports and domestic injury of the testicle of varying severity with a pronounced predominance of relatively light injuries, in particular, the bruise of the testicle. Open injuries are relatively rare-a total of 10.6%. Among open injuries, ruptures of the scrotum without damage to its organs are predominate (63.6% of the total number of patients who applied for open wounds of the scrotum and its organs).The need for emergency surgical interventions in scrotal injury was unexpectedly low-53.1%, which is due to the predominance of mild trauma options – scrotal injury and testicular injury (a total of 61.4% in the frequency of urological care), in certain situations allowing the possibility of conservative treatment or even dynamic observation.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129902220","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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