Pub Date : 2023-05-05DOI: 10.17816/mechnikov112622
N. Amirov, P. Krivorotko, V. Mortada, R. V. Donskikh, R. Pesotskiy, A. Emelyanov, T. Tabagua, L. Gigolaeva, S. Yerechshenko, A. Komyakhov, K. Nikolaev, K. Zernov, E. Zhiltsova, Yana I. Bondarchuk, D. Enaldieva, A. Bessonov, A. Artemyeva, S. Novikov, E. Busko, T. Semiglazova, V. Semiglazov, A. Belyaev
BACKGROUND: Neoadjuvant systemic therapy for triple-negative and HER2-positive breast cancer can achieve a complete pathologic response in approximately 60% of patients. Pathological complete response to neoadjuvant systemic therapy is a predictive factor consistent with a positive prognosis which can be accurately determined by percutaneous vacuum aspiration biopsy. AIM: To evaluate the amount of surgery in the group of patients with triple-negative and HER2-positive early breast cancer whose complete pathologic response was confirmed by vacuum aspiration biopsy and who did not undergo standard surgery. MATERIALS AND METHODS: The following single-centre study has been conducted in the Russian Federation. Women aged 18 years old and older with unicentric (cT1-2N0-1M0 by classification TNM) triple-negative or HER2-positive breast cancer with complete clinical response after neoadjuvant systemic therapy according to imaging diagnostic methods. The patients underwent vacuum aspiration biopsy on the mammary gland under ultrusound control with standard amount of surgical intervention on the axillary region. In case when no invasive or in situ disease was detected, no further breast surgery was performed and the patients underwent standard radiation therapy. The survival with no tumor relapse in the ipsilateral mammary gland was assessed as the primary endpoint. The study is registered on сlinicaltrials.gov, NCT04293796. RESULTS: Between June 2020 and May 2022, twenty-seven (84.4%) patients (all women; mean age 47.5 (3268) years) were enrolled in the study and underwent visually controlled vacuum aspiration biopsy. The average initial tumor size was 20.5 (735) mm. 7 (25.9%) patients initially had metastases in the axillary lymph nodes confirmed by puncture biopsy; 15 (55.6%) patients had HER2-positive breast cancer, and 12 (44.4%) had triple-negative breast cancer. A study of vacuum aspiration biopsy samples showed that 6 (22.2%) patients had a residual tumor, and 21 (77.8%) patients achieved complete pathologic response (95% confidence interval 53.2 to 81.4). At a median follow-up of 12.4 months, there were no tumor relapses in the ipsilateral mammary gland in 21 patients with complete pathologic response confirmed by vacuum aspiration biopsy after neoadjuvant systemic therapy, as well as other relapses or progression of the disease. CONCLUSIONS: The patients with a complete pathologic response, which is confirmed by the vacuum aspiration biopsy method, who refused to perform surgery on the mammary gland do not demonstrate worse results with a short period of observation. However, additional prospective clinical studies are needed.
{"title":"The amount of surgery in patients with early breast cancer and complete clinical response to neoadjuvant systemic therapy","authors":"N. Amirov, P. Krivorotko, V. Mortada, R. V. Donskikh, R. Pesotskiy, A. Emelyanov, T. Tabagua, L. Gigolaeva, S. Yerechshenko, A. Komyakhov, K. Nikolaev, K. Zernov, E. Zhiltsova, Yana I. Bondarchuk, D. Enaldieva, A. Bessonov, A. Artemyeva, S. Novikov, E. Busko, T. Semiglazova, V. Semiglazov, A. Belyaev","doi":"10.17816/mechnikov112622","DOIUrl":"https://doi.org/10.17816/mechnikov112622","url":null,"abstract":"BACKGROUND: Neoadjuvant systemic therapy for triple-negative and HER2-positive breast cancer can achieve a complete pathologic response in approximately 60% of patients. Pathological complete response to neoadjuvant systemic therapy is a predictive factor consistent with a positive prognosis which can be accurately determined by percutaneous vacuum aspiration biopsy. \u0000AIM: To evaluate the amount of surgery in the group of patients with triple-negative and HER2-positive early breast cancer whose complete pathologic response was confirmed by vacuum aspiration biopsy and who did not undergo standard surgery. \u0000MATERIALS AND METHODS: The following single-centre study has been conducted in the Russian Federation. Women aged 18 years old and older with unicentric (cT1-2N0-1M0 by classification TNM) triple-negative or HER2-positive breast cancer with complete clinical response after neoadjuvant systemic therapy according to imaging diagnostic methods. The patients underwent vacuum aspiration biopsy on the mammary gland under ultrusound control with standard amount of surgical intervention on the axillary region. In case when no invasive or in situ disease was detected, no further breast surgery was performed and the patients underwent standard radiation therapy. The survival with no tumor relapse in the ipsilateral mammary gland was assessed as the primary endpoint. The study is registered on сlinicaltrials.gov, NCT04293796. \u0000RESULTS: Between June 2020 and May 2022, twenty-seven (84.4%) patients (all women; mean age 47.5 (3268) years) were enrolled in the study and underwent visually controlled vacuum aspiration biopsy. The average initial tumor size was 20.5 (735) mm. 7 (25.9%) patients initially had metastases in the axillary lymph nodes confirmed by puncture biopsy; 15 (55.6%) patients had HER2-positive breast cancer, and 12 (44.4%) had triple-negative breast cancer. A study of vacuum aspiration biopsy samples showed that 6 (22.2%) patients had a residual tumor, and 21 (77.8%) patients achieved complete pathologic response (95% confidence interval 53.2 to 81.4). At a median follow-up of 12.4 months, there were no tumor relapses in the ipsilateral mammary gland in 21 patients with complete pathologic response confirmed by vacuum aspiration biopsy after neoadjuvant systemic therapy, as well as other relapses or progression of the disease. \u0000CONCLUSIONS: The patients with a complete pathologic response, which is confirmed by the vacuum aspiration biopsy method, who refused to perform surgery on the mammary gland do not demonstrate worse results with a short period of observation. However, additional prospective clinical studies are needed.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85686004","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 : 2023-05-05DOI: 10.17816/mechnikov112617
U. Mukhametov, S. Lyulin, D. Borzunov, I. Gareev
Bone morphogenetic proteins have been used in clinical practice in orthopedics, spine surgery, and maxillofacial surgery for nearly a decade. According to research findings, in most cases the frequency of coalescence when using bone morphogenetic proteins is comparable to or higer that the corresponding indicator when using an autograft. To date, BMP-2 and BMP-7 are commercially available for clinical use and have shown efficacy equal to that of autograft in bone defect replacement. This study analyzes existing clinical trials registered on the clinicaltirals.gov website for the therapeutic use of BMP-2 and BMP-7 in pathologies of the musculoskeletal system. The search strategy was to use the material from the clinicaltrials.gov website, which focuses on key terms such as bonemorphogenetic protein 2 or BMP-2, bone morphogenetic protein 7 or BMP-7, recombinant bone morphogenetic protein 2 or rhBMP-2, recombinant bone morphogenetic protein 7 or rhBMP-7, InductOs, Op1, bone and diseases of the musculoskeletal system. The inclusion and exclusion criteria were divided into two stages. By October 2022, about 85 clinical trials had been registered using BMP-2 and about 12 using BMP-7. Most of the studies are in Phase 2, Phase 23, or Phase 4. Most of them focus on areas such as tibial trauma therapy and spinal surgery. However, only 12 clinical trials using BMP-2 provide meaningful results. All the clinical trials have similar preparation methods, and 12 clinical trials have provided positive results without serious side effects. There is a wide potential for clinical use of BMP-2. Many preclinical and clinical studies on the use of BMP-2 and BMP-7 are currently underway; their future results will further explore their therapeutic potential in treating musculoskeletal diseases.
{"title":"Clinical use of bone morphogenetic proteins BMP-2 and BMP-7: analysis of current clinical trials","authors":"U. Mukhametov, S. Lyulin, D. Borzunov, I. Gareev","doi":"10.17816/mechnikov112617","DOIUrl":"https://doi.org/10.17816/mechnikov112617","url":null,"abstract":"Bone morphogenetic proteins have been used in clinical practice in orthopedics, spine surgery, and maxillofacial surgery for nearly a decade. According to research findings, in most cases the frequency of coalescence when using bone morphogenetic proteins is comparable to or higer that the corresponding indicator when using an autograft. To date, BMP-2 and BMP-7 are commercially available for clinical use and have shown efficacy equal to that of autograft in bone defect replacement. \u0000This study analyzes existing clinical trials registered on the clinicaltirals.gov website for the therapeutic use of BMP-2 and BMP-7 in pathologies of the musculoskeletal system. \u0000The search strategy was to use the material from the clinicaltrials.gov website, which focuses on key terms such as bonemorphogenetic protein 2 or BMP-2, bone morphogenetic protein 7 or BMP-7, recombinant bone morphogenetic protein 2 or rhBMP-2, recombinant bone morphogenetic protein 7 or rhBMP-7, InductOs, Op1, bone and diseases of the musculoskeletal system. The inclusion and exclusion criteria were divided into two stages. \u0000By October 2022, about 85 clinical trials had been registered using BMP-2 and about 12 using BMP-7. Most of the studies are in Phase 2, Phase 23, or Phase 4. Most of them focus on areas such as tibial trauma therapy and spinal surgery. However, only 12 clinical trials using BMP-2 provide meaningful results. All the clinical trials have similar preparation methods, and 12 clinical trials have provided positive results without serious side effects. \u0000There is a wide potential for clinical use of BMP-2. Many preclinical and clinical studies on the use of BMP-2 and BMP-7 are currently underway; their future results will further explore their therapeutic potential in treating musculoskeletal diseases.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86642117","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 : 2023-05-05DOI: 10.17816/mechnikov112531
D. S. Evdokimov, S. Boldueva, Valeria S. Feoktistova, S. Ermolov
BACKGROUND: The pathophysiological mechanisms underlying takotsubo syndrome are still being actively investigated, but it is generally accepted that sympathetic nervous system hyperactivity is of key importance. The method for assessing heart rate variability allows to study the vegetative status of a patient, however, there are few scientific works on this topic at present, and the results obtained are ambiguous. AIM: To study heart rate variability in patients with takotsubo syndrome in acute and late periods of the disease at rest, when performing vegetative tests (the deep-breath test, active orthostatic test), as well as before and after mental stress tests and to compare the data obtained with the results of the examination of the control group. MATERIALS AND METHODS: The study included patients with takotsubo syndrome (n = 48), including 43 (89.6%) women; the average age of the patients was 63.3 13.5 years, and healthy volunteers of the same sex and age (control group, n = 40). All the subjects with takotsubo syndrome in the acute (first 714 days from the onset of the disease) and in the long-term periods of the disease (after 1 year and 2 years) and the ones in the control group underwent cardiorhythmography at rest to assess the heart rate variability after mental stress tests and against the background of vegetative tests. RESULTS: According to the cardiorhythmography at rest, in 47 (97.9%) patients with takotsubo syndrome, the influence of sympathetic nervous system on the heart rate prevailed, which persisted in the long-term period of the disease. The vegetative tests revealed a paradoxical reaction of the sympathetic nervous system and reduced activity of the parasympathetic nervous system in the acute and late periods of takotsubo syndrome, compared with the control group. In the acute and long-term periods in the patients with takotsubo syndrome after mental stress tests, in comparison with control group, there was no increase in parasympathetic nervous system activity. CONCLUSIONS: According to the study findings, the patients with takotsubo syndrome revealed autonomic dysfunction in the form of an excessive increase in the activity of the sympathetic nervous system both before the onset of the disease, and in the acute and long-term periods as well as a decrease in vagal tone, which was reflected in the suppressed response of the parasympathetic nervous system to the deep-breath test and mental stress tests.
{"title":"Features of autonomic regulation of heart rate in patients with takotsubo syndrome","authors":"D. S. Evdokimov, S. Boldueva, Valeria S. Feoktistova, S. Ermolov","doi":"10.17816/mechnikov112531","DOIUrl":"https://doi.org/10.17816/mechnikov112531","url":null,"abstract":"BACKGROUND: The pathophysiological mechanisms underlying takotsubo syndrome are still being actively investigated, but it is generally accepted that sympathetic nervous system hyperactivity is of key importance. The method for assessing heart rate variability allows to study the vegetative status of a patient, however, there are few scientific works on this topic at present, and the results obtained are ambiguous. \u0000AIM: To study heart rate variability in patients with takotsubo syndrome in acute and late periods of the disease at rest, when performing vegetative tests (the deep-breath test, active orthostatic test), as well as before and after mental stress tests and to compare the data obtained with the results of the examination of the control group. \u0000MATERIALS AND METHODS: The study included patients with takotsubo syndrome (n = 48), including 43 (89.6%) women; the average age of the patients was 63.3 13.5 years, and healthy volunteers of the same sex and age (control group, n = 40). All the subjects with takotsubo syndrome in the acute (first 714 days from the onset of the disease) and in the long-term periods of the disease (after 1 year and 2 years) and the ones in the control group underwent cardiorhythmography at rest to assess the heart rate variability after mental stress tests and against the background of vegetative tests. \u0000RESULTS: According to the cardiorhythmography at rest, in 47 (97.9%) patients with takotsubo syndrome, the influence of sympathetic nervous system on the heart rate prevailed, which persisted in the long-term period of the disease. The vegetative tests revealed a paradoxical reaction of the sympathetic nervous system and reduced activity of the parasympathetic nervous system in the acute and late periods of takotsubo syndrome, compared with the control group. In the acute and long-term periods in the patients with takotsubo syndrome after mental stress tests, in comparison with control group, there was no increase in parasympathetic nervous system activity. \u0000CONCLUSIONS: According to the study findings, the patients with takotsubo syndrome revealed autonomic dysfunction in the form of an excessive increase in the activity of the sympathetic nervous system both before the onset of the disease, and in the acute and long-term periods as well as a decrease in vagal tone, which was reflected in the suppressed response of the parasympathetic nervous system to the deep-breath test and mental stress tests.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83672517","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 : 2023-05-05DOI: 10.17816/mechnikov112609
P. Krivorotko, Yana I. Bondarchuk, R. Donskih, E. Zhiltsova, N. Amirov, S. Bagnenko, A. Chernaya, R. Pesotskiy, A. Emelyanov, V. Mortada, T. Tabagua, L. Gigolaeva, S. Yerechshenko, A. Komyakhov, K. Nikolaev, K. Zernov, D. Enaldieva, Alexsander A. Bessonov, A. Artemyeva, E. Busko, V. Semiglazov, T. Semiglazova, V. Semiglazov, A. Belyaev
BACKGROUND: Surgical treatment of breast cancer plays a major role in the combined and complex treatment of patients. The purity of the examined edges of the resected breast tissue is the main indicator of the reliability of the breast-conserving surgery and one of the main factors in the development of local recurrence. Neoadjuvant (preoperative) systemic therapy allows evaluating the effectiveness of therapy in vivo and reducing the size of the initial formation, both in locally advanced and resectable forms of breast cancer. The main advantage of this treatment is the ability for surgeons to perform breast-conserving surgery to improve patients quality of life and aesthetic outcomes without compromising disease-free and overall survival. AIM: To study the clinical and pathological characteristics and analyze of the breast-conserving surgery in patients with breast cancer after neoadjuvant chemotherapy. MATERIALS AND METHODS: 156 performed breast-conserving surgery after neoadjuvant chemotherapy were analyzed. Breast-conserving resection implied radical removal of the residual tumor node within healthy breast tissues with the achievement of negative resection margins. If pathologists detected stained invasive cells/cancer in situ in a formalin-fixed preparation, a second surgical intervention was performed. RESULTS: Of the 156 studied anatomical preparations after breast-conserving surgery, a positive margin was found in 4 (2.56%) cases. In 4 patients, positive margin was represented by ductal carcinoma in situ. According to the results of trephine biopsy, no intraductal component was found before neoadjuvant chemotherapy. The greatest length of the ductal carcinoma in situ section is 2.2 mm. In 3 cases, the distance to the stained resection margin of the micropreparation was 1 mm. As a result of repeated pathomorphological examination of pre-cut margins after surgical intervention, cancer in situ was not found. CONCLUSIONS: The ongoing neoadjuvant systemic therapy for breast cancer with a partial or complete response of the tumor increases the percentage of breast-conserving surgery performed in patients who initially belong to the group of radical mastectomy, but who want to save breast tissue.
{"title":"Control of resection margins after neoadjuvant systemic therapy in breast-conserving surgery in breast cancer patients","authors":"P. Krivorotko, Yana I. Bondarchuk, R. Donskih, E. Zhiltsova, N. Amirov, S. Bagnenko, A. Chernaya, R. Pesotskiy, A. Emelyanov, V. Mortada, T. Tabagua, L. Gigolaeva, S. Yerechshenko, A. Komyakhov, K. Nikolaev, K. Zernov, D. Enaldieva, Alexsander A. Bessonov, A. Artemyeva, E. Busko, V. Semiglazov, T. Semiglazova, V. Semiglazov, A. Belyaev","doi":"10.17816/mechnikov112609","DOIUrl":"https://doi.org/10.17816/mechnikov112609","url":null,"abstract":"BACKGROUND: Surgical treatment of breast cancer plays a major role in the combined and complex treatment of patients. The purity of the examined edges of the resected breast tissue is the main indicator of the reliability of the breast-conserving surgery and one of the main factors in the development of local recurrence. Neoadjuvant (preoperative) systemic therapy allows evaluating the effectiveness of therapy in vivo and reducing the size of the initial formation, both in locally advanced and resectable forms of breast cancer. The main advantage of this treatment is the ability for surgeons to perform breast-conserving surgery to improve patients quality of life and aesthetic outcomes without compromising disease-free and overall survival. \u0000AIM: To study the clinical and pathological characteristics and analyze of the breast-conserving surgery in patients with breast cancer after neoadjuvant chemotherapy. \u0000MATERIALS AND METHODS: 156 performed breast-conserving surgery after neoadjuvant chemotherapy were analyzed. Breast-conserving resection implied radical removal of the residual tumor node within healthy breast tissues with the achievement of negative resection margins. If pathologists detected stained invasive cells/cancer in situ in a formalin-fixed preparation, a second surgical intervention was performed. \u0000RESULTS: Of the 156 studied anatomical preparations after breast-conserving surgery, a positive margin was found in 4 (2.56%) cases. In 4 patients, positive margin was represented by ductal carcinoma in situ. According to the results of trephine biopsy, no intraductal component was found before neoadjuvant chemotherapy. The greatest length of the ductal carcinoma in situ section is 2.2 mm. In 3 cases, the distance to the stained resection margin of the micropreparation was 1 mm. As a result of repeated pathomorphological examination of pre-cut margins after surgical intervention, cancer in situ was not found. \u0000CONCLUSIONS: The ongoing neoadjuvant systemic therapy for breast cancer with a partial or complete response of the tumor increases the percentage of breast-conserving surgery performed in patients who initially belong to the group of radical mastectomy, but who want to save breast tissue.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"278 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82813324","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 : 2023-01-20DOI: 10.17816/mechnikov108505
A. Timofeeva, V. Minina, Evgeniya A. Astafeva
Breast cancer is a widespread oncological disorder, which is considered one of the leading causes of mortality among women. DNA repair processes a well as its methylation involving genes of folate cycle play a crucial role in cancerogenesis. The aim of the study is to generalize the current data about association between polymorphic variants of folate cycle genes MTHFR С677Т (rs1801133), MTR A2756G (rs1805087), MTRR А66G (rs1801394) with risk of breast cancer development. The search of scientific papers has been conducted using PubMed and elibrary.ru sources. Original and randomized surveys published from 2008 till 2022 have been included in this review. The study has accumulated sufficient data on MTHFR С677Т polymorphic variant in breast cancer patients, having significant influence on disease development. However, the data about MTR A2756G and MTRR A66G variants is quite limited. According to the findigs of many scientific papers, there is no link between polymorphic variants of these genes and breast cancerogenesis manifestation. Such factors like ethniсity and sufficient consumption of folates with nutrition can have significant impact on results and conclusions of studies about role of folate cycle genes in breast cancer patients. Further investigation of MTHFR С677Т (rs1801133), MTR A2756G (rs1805087) and MTRR А66G (rs1801394) genetic polymorphic variants with consideration of gene-environment and gene-gene interactions could explain the presence of individual differences of breast cancer risk.
{"title":"Polymorphism of folate metabolism genes in breast cancer patients","authors":"A. Timofeeva, V. Minina, Evgeniya A. Astafeva","doi":"10.17816/mechnikov108505","DOIUrl":"https://doi.org/10.17816/mechnikov108505","url":null,"abstract":"Breast cancer is a widespread oncological disorder, which is considered one of the leading causes of mortality among women. DNA repair processes a well as its methylation involving genes of folate cycle play a crucial role in cancerogenesis. The aim of the study is to generalize the current data about association between polymorphic variants of folate cycle genes MTHFR С677Т (rs1801133), MTR A2756G (rs1805087), MTRR А66G (rs1801394) with risk of breast cancer development. The search of scientific papers has been conducted using PubMed and elibrary.ru sources. Original and randomized surveys published from 2008 till 2022 have been included in this review. \u0000The study has accumulated sufficient data on MTHFR С677Т polymorphic variant in breast cancer patients, having significant influence on disease development. However, the data about MTR A2756G and MTRR A66G variants is quite limited. According to the findigs of many scientific papers, there is no link between polymorphic variants of these genes and breast cancerogenesis manifestation. Such factors like ethniсity and sufficient consumption of folates with nutrition can have significant impact on results and conclusions of studies about role of folate cycle genes in breast cancer patients. \u0000Further investigation of MTHFR С677Т (rs1801133), MTR A2756G (rs1805087) and MTRR А66G (rs1801394) genetic polymorphic variants with consideration of gene-environment and gene-gene interactions could explain the presence of individual differences of breast cancer risk.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79313850","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 : 2023-01-20DOI: 10.17816/mechnikov112095
V. Mazurov, Inna Z. Gaidukova, Elena E. Nochvay, M. Petrova, O. Inamova, S. Mazurenko, Y. A. Petrova, A. S. Bychkova, S. Vorobyev
Disseminated seronegative echinococcosis, occurring with damage to soft tissues, bones and joints, is a rare variant of the course of helminthiasis, often associated with diagnostic difficulties, a high probability of complications and difficult treatment. This article presents a case of disseminated seronegative echinococcosis, clinically and laboratory simulating a severe form of WeberChristian panniculitis complicated by sepsis. The advantages and disadvantages of serological and morphological studies in the verification of disseminated echinococcosis are discussed, as well as the feasibility of using repeated histological studies in cases of echinococcosis under the masks of rheumatic diseases.
{"title":"Disseminated seronegative echinococcosis: difficulties of diagnosis and treatment","authors":"V. Mazurov, Inna Z. Gaidukova, Elena E. Nochvay, M. Petrova, O. Inamova, S. Mazurenko, Y. A. Petrova, A. S. Bychkova, S. Vorobyev","doi":"10.17816/mechnikov112095","DOIUrl":"https://doi.org/10.17816/mechnikov112095","url":null,"abstract":"Disseminated seronegative echinococcosis, occurring with damage to soft tissues, bones and joints, is a rare variant of the course of helminthiasis, often associated with diagnostic difficulties, a high probability of complications and difficult treatment. \u0000This article presents a case of disseminated seronegative echinococcosis, clinically and laboratory simulating a severe form of WeberChristian panniculitis complicated by sepsis. The advantages and disadvantages of serological and morphological studies in the verification of disseminated echinococcosis are discussed, as well as the feasibility of using repeated histological studies in cases of echinococcosis under the masks of rheumatic diseases.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87900545","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 : 2023-01-20DOI: 10.17816/mechnikov112258
O.V. Shalak, E. Satygo, R. Deev, E. V. Presnyakov
BACKGROUND: According to clinical and statistical observations, there is the high prevalence of gingival recession in children and adults. Currently, the methods of treating gingival recession are considered as corrective surgical measures. However, all modern corrective techniques are traumatic and force the patient to refuse surgical treatment in the presence of a shallow recession with a depth of no more than 2 mm. The depth of gingival recession in the absence of treatment progresses, which causes clinicians to search for alternative minimally invasive therapy for such patients. AIM: The aim of our study is to determine the effectiveness of prevention and non-surgical treatment of gum recession using a Radiesse filler (Merz North America, USА). MATERIAL AND METHODS: 36 patients (men and women) of the young age between 1844 with thin and intermediate biotype of gums and bones and patients with initial signs of gum recession (not more than 2 mm) have been examined. The state of periodontal tissues and changes in them have been assessed by clinical examination methods; laser Doppler flowmetry and a morphological analysis of tissues have been performed. RESULTS: Two injections of a Radiess filler have been found to improve the condition of the patients with gum recession compared with the initial values. CONCLUSIONS: Gingival recession after two injections of a Radiesse filler steadily decreases compared to its initial values. In the absence of treatment, a statistically significant (p 0.05) increase in the depth of gingival recession has been noted after 12 months from the start of observation. When using a Radiesse dermal filler to support the keratinized zone of the gums, a decrease in microcirculation in the injection zone is observed in the first month, however, after 6 and 12 months, its value significantly increases compared to the initial value and the data of the control group.
背景:根据临床和统计观察，儿童和成人牙龈萎缩的患病率很高。目前，治疗牙龈萎缩的方法被认为是一种矫正手术措施。然而，所有现代矫正技术都是创伤性的，并且在深度不超过2mm的浅衰退存在时迫使患者拒绝手术治疗。在治疗进展缓慢的情况下，牙龈深度衰退，这使得临床医生寻找替代的微创治疗方法。目的:我们研究的目的是确定使用Radiesse填充剂预防和非手术治疗牙龈萎缩的有效性(Merz North America, USА)。材料和方法:36例(男性和女性)年龄在1844年之间，牙龈和骨骼的薄和中等生物型和牙龈退缩的初始迹象(不超过2mm)的患者进行了检查。通过临床检查方法评估牙周组织的状态和变化;激光多普勒血流仪和形态学分析的组织进行了。结果:与初始值相比，两次注射Radiess填充剂可改善牙龈退缩患者的状况。结论:与初始值相比，两次注射Radiesse填充剂后牙龈退缩稳步减少。在没有治疗的情况下，观察开始12个月后，牙龈萎缩深度有统计学意义(p 0.05)增加。当使用Radiesse真皮填充物支持牙龈角化区时，在第一个月观察到注射区微循环减少，但在6个月和12个月后，其数值与初始值和对照组的数据相比显着增加。
{"title":"The effectivnes of Radiesse in dental practice for prevention and non-surgical treatment of gum recession","authors":"O.V. Shalak, E. Satygo, R. Deev, E. V. Presnyakov","doi":"10.17816/mechnikov112258","DOIUrl":"https://doi.org/10.17816/mechnikov112258","url":null,"abstract":"BACKGROUND: According to clinical and statistical observations, there is the high prevalence of gingival recession in children and adults. Currently, the methods of treating gingival recession are considered as corrective surgical measures. However, all modern corrective techniques are traumatic and force the patient to refuse surgical treatment in the presence of a shallow recession with a depth of no more than 2 mm. The depth of gingival recession in the absence of treatment progresses, which causes clinicians to search for alternative minimally invasive therapy for such patients. \u0000AIM: The aim of our study is to determine the effectiveness of prevention and non-surgical treatment of gum recession using a Radiesse filler (Merz North America, USА). \u0000MATERIAL AND METHODS: 36 patients (men and women) of the young age between 1844 with thin and intermediate biotype of gums and bones and patients with initial signs of gum recession (not more than 2 mm) have been examined. The state of periodontal tissues and changes in them have been assessed by clinical examination methods; laser Doppler flowmetry and a morphological analysis of tissues have been performed. \u0000RESULTS: Two injections of a Radiess filler have been found to improve the condition of the patients with gum recession compared with the initial values. \u0000CONCLUSIONS: Gingival recession after two injections of a Radiesse filler steadily decreases compared to its initial values. In the absence of treatment, a statistically significant (p 0.05) increase in the depth of gingival recession has been noted after 12 months from the start of observation. When using a Radiesse dermal filler to support the keratinized zone of the gums, a decrease in microcirculation in the injection zone is observed in the first month, however, after 6 and 12 months, its value significantly increases compared to the initial value and the data of the control group.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86076074","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 : 2023-01-20DOI: 10.17816/mechnikov112556
N. Zarkua, A. P. Krivov, V. Akimov, S. Lysenkov
BACKGROUND: In recent years, there has been a significant increase in the number of patients of older age groups with cholelithiasis and its complications. Trans-light endoscopic and hybrid technologies for the treatment of cholelithiasis complicated by mechanical jaundice in such patients can reduce the proportion of traditional operations, the frequency of complications and mortality. AIM: To develop an algorithm for the treatment of cholelithiasis complicated by mechanical jaundice in elderly and senile patients based on the use of modern minimally invasive and hybrid technologies. MATERIALS AND METHODS: The analysis of the treatment of 116 elderly and senile patients with cholelithiasis complicated by mechanical jaundice from 2016 to 2021 has been carried out. RESULTS: After a comprehensive examination of patients, the following pathology has been diagnosed: choledocholithiasis (cholecystectomy in the anamnesis) in 7.8%; сholedocholithiasis (cholecystectomy in the anamnesis) + stricture of the distal choledochus in 9.5%; сholecystocholedocholithiasis in 82.7%, including choledocholithiasis without major duodenal papilla stricture in 7.3%, Mirizzi syndrome (including major duodenal papilla stenosis in 3.1%) in 5.2%, choledocholithiasis + stricture of the distal choledochus in 79.2% and choledocholithiasis + stricture of the distal choledochus + parafaterial diverticulum in 8.3% of the patients. The severity of the comorbidity index according to the Kaplan Feinstein scale in 2.6% of patients corresponded to a mild degree, in 70.7% to a moderate degree, in 26.7% to a severe degree. Trans-luminous endoscopic and hybrid technologies have been used to eliminate the stricture of the distal part of the bile duct and sanitation of the bile ducts. Traditional operations by endovideosurgical and mini-access as well as laparotomy have been performed in 5.2%, 13.8% and 2.6% of the patients, respectively. The mortality rate was 3.5%. Complications associated with endoscopic interventions have developed in 5 (4.3%) patients, including retrograde cholangiopancreatography-induced pancreatitis in 2, bleeding from the incision of the duodenal papilla in 3 patients. CONCLUSIONS: Trans-light endoscopic and hybrid technologies for the treatment of cholelithiasis complicated by mechanical jaundice in patients with severe comorbidity index can reduce the proportion of traditional operations, the frequency of complications and mortality.
{"title":"Minimally invasive technologies for treatment of gallstone disease complicated by mechanical jaundice in patients of elderly and senior age","authors":"N. Zarkua, A. P. Krivov, V. Akimov, S. Lysenkov","doi":"10.17816/mechnikov112556","DOIUrl":"https://doi.org/10.17816/mechnikov112556","url":null,"abstract":"BACKGROUND: In recent years, there has been a significant increase in the number of patients of older age groups with cholelithiasis and its complications. Trans-light endoscopic and hybrid technologies for the treatment of cholelithiasis complicated by mechanical jaundice in such patients can reduce the proportion of traditional operations, the frequency of complications and mortality. \u0000AIM: To develop an algorithm for the treatment of cholelithiasis complicated by mechanical jaundice in elderly and senile patients based on the use of modern minimally invasive and hybrid technologies. \u0000MATERIALS AND METHODS: The analysis of the treatment of 116 elderly and senile patients with cholelithiasis complicated by mechanical jaundice from 2016 to 2021 has been carried out. \u0000RESULTS: After a comprehensive examination of patients, the following pathology has been diagnosed: choledocholithiasis (cholecystectomy in the anamnesis) in 7.8%; сholedocholithiasis (cholecystectomy in the anamnesis) + stricture of the distal choledochus in 9.5%; сholecystocholedocholithiasis in 82.7%, including choledocholithiasis without major duodenal papilla stricture in 7.3%, Mirizzi syndrome (including major duodenal papilla stenosis in 3.1%) in 5.2%, choledocholithiasis + stricture of the distal choledochus in 79.2% and choledocholithiasis + stricture of the distal choledochus + parafaterial diverticulum in 8.3% of the patients. The severity of the comorbidity index according to the Kaplan Feinstein scale in 2.6% of patients corresponded to a mild degree, in 70.7% to a moderate degree, in 26.7% to a severe degree. Trans-luminous endoscopic and hybrid technologies have been used to eliminate the stricture of the distal part of the bile duct and sanitation of the bile ducts. Traditional operations by endovideosurgical and mini-access as well as laparotomy have been performed in 5.2%, 13.8% and 2.6% of the patients, respectively. The mortality rate was 3.5%. Complications associated with endoscopic interventions have developed in 5 (4.3%) patients, including retrograde cholangiopancreatography-induced pancreatitis in 2, bleeding from the incision of the duodenal papilla in 3 patients. \u0000CONCLUSIONS: Trans-light endoscopic and hybrid technologies for the treatment of cholelithiasis complicated by mechanical jaundice in patients with severe comorbidity index can reduce the proportion of traditional operations, the frequency of complications and mortality.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74491279","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 : 2023-01-20DOI: 10.17816/mechnikov108408
V. N. Marchenko, O. Shchukina, D. Davydov, A. I. Bogacheva, V. Banko, A. Makarenko
Spondyloarthritis is a group of musculoskeletal inflammatory diseases, including axial and peripheral forms. The current classification of these diseases emphasizes the diagnostic importance of the well-known association between spondyloarthritis and inflammatory bowel diseases (Crohns disease and ulcerative colitis). According to many large clinical studies, both spondyloarthritis and inflammatory bowel diseases demonstrate increased cardiovascular risk, but the underlying mechanisms are not entirely clear. One of the possible ways to involve the cardiovascular system in these diseases is supposed to be the formation of endothelial vascular dysfunction developing in many inflammatory and non-inflammatory conditions. At the same time, endothelial dysfunction needs to be analyzed multidimensionally due to its participation in regulation of many processes, such as the providing of vascular tone, cell migration, angiogenesis, and hemostasis. This review examines the latest data on endothelial dysfunction in axial spondyloarthritis and inflammatory bowel diseases, and separately analyzes the studies of this phenomenon in patients with inflammatory bowel diseases-associated axial spondyloarthritis. Special attention is paid to modern laboratory and instrumental methods for assessing endothelial function and their potential diagnostic significance in clinical practice.
{"title":"Endothelial dysfunction in axial spondyloarthritis associated with inflammatory bowel disease","authors":"V. N. Marchenko, O. Shchukina, D. Davydov, A. I. Bogacheva, V. Banko, A. Makarenko","doi":"10.17816/mechnikov108408","DOIUrl":"https://doi.org/10.17816/mechnikov108408","url":null,"abstract":"Spondyloarthritis is a group of musculoskeletal inflammatory diseases, including axial and peripheral forms. The current classification of these diseases emphasizes the diagnostic importance of the well-known association between spondyloarthritis and inflammatory bowel diseases (Crohns disease and ulcerative colitis). According to many large clinical studies, both spondyloarthritis and inflammatory bowel diseases demonstrate increased cardiovascular risk, but the underlying mechanisms are not entirely clear. One of the possible ways to involve the cardiovascular system in these diseases is supposed to be the formation of endothelial vascular dysfunction developing in many inflammatory and non-inflammatory conditions. At the same time, endothelial dysfunction needs to be analyzed multidimensionally due to its participation in regulation of many processes, such as the providing of vascular tone, cell migration, angiogenesis, and hemostasis. \u0000This review examines the latest data on endothelial dysfunction in axial spondyloarthritis and inflammatory bowel diseases, and separately analyzes the studies of this phenomenon in patients with inflammatory bowel diseases-associated axial spondyloarthritis. Special attention is paid to modern laboratory and instrumental methods for assessing endothelial function and their potential diagnostic significance in clinical practice.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81202927","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 : 2023-01-20DOI: 10.17816/mechnikov114844
N. A. Korobkov, N. Bakulina, Natalia S. Lodyagina
BACKGROUND: There is an insufficient number of studies studying the association of postpartum infectious and inflammatory complications with anemia of inflammation, which undoubtedly contributes to the risk of postpartum infection and the severity of its course. AIM: To assess the prevalence of anemia of inflammation in pregnant women, to determine its prognostic value as an independent predictor of the progression of endometritis after caesarean section. MATERIALS AND METHODS: A retrospective study of case histories and data from primary medical records of 648 puerperas delivered by caesarean section has been carried out. 406 of the patients have been diagnosed with endometritis after caesarean section and 242 with a physiological course of the postoperative period. Anemia during pregnancy has been diagnosed with a decrease in hemoglobin 110 g/l (in the first trimester) and 105 g/l (in the second and third trimesters). Primary iron deficiency was determined by the level of serum ferritin. Anemia of inflammation has been diagnosed after exclusion of iron deficiency in the presence of documented signs of an inflammatory process (chronic diseases) and in accordance with the international hematological criteria: normochromic normocytic anemia, normo-/hyperferritinemia (serum ferritin 30 g/l), hypotransferrinemia (transferrin 2 g/l) and the level of C-reactive protein in the blood ( 6 mg/l). RESULTS: Anemia of inflammation can be attributed to the most significant predictors of the development of endometritis. The odds ratio for this factor was 4.12 (95% confidence interval 1.286.19; p 0.001). The study has also shown that significant factors in the development of endometritis after caesarean section are obesity (odds ratio 3.45; 95% confidence interval 1.145.11; p = 0.005), asymptomatic bacteriuria (odds ratio 3.68; 95% confidence interval 1.314.94; p 0.001), carbohydrate metabolism disorders (odds ratio 2.84; 95% confidence interval 1.543.52; p = 0.012) and arterial hypertension (odds ratio 2.14; 95% confidence interval 1.124.04; p = 0.032). CONCLUSIONS: The prevalence of anemia of inflammation in pregnancy is 2.1%. Anemia of inflammation complicates the course of pregnancy 5.5 times more often in puerperas with endometritis after caesarean section (27.4 vs. 4.9%; 2 = 52.1; p 0.001), which makes it possible to classify it as a significant predictor of the development of postoperative infectious and inflammatory complications.
{"title":"Anemia of inflammation is a predictor of the progression of postoperative infection in obstetrics","authors":"N. A. Korobkov, N. Bakulina, Natalia S. Lodyagina","doi":"10.17816/mechnikov114844","DOIUrl":"https://doi.org/10.17816/mechnikov114844","url":null,"abstract":"BACKGROUND: There is an insufficient number of studies studying the association of postpartum infectious and inflammatory complications with anemia of inflammation, which undoubtedly contributes to the risk of postpartum infection and the severity of its course. \u0000AIM: To assess the prevalence of anemia of inflammation in pregnant women, to determine its prognostic value as an independent predictor of the progression of endometritis after caesarean section. \u0000MATERIALS AND METHODS: A retrospective study of case histories and data from primary medical records of 648 puerperas delivered by caesarean section has been carried out. 406 of the patients have been diagnosed with endometritis after caesarean section and 242 with a physiological course of the postoperative period. Anemia during pregnancy has been diagnosed with a decrease in hemoglobin 110 g/l (in the first trimester) and 105 g/l (in the second and third trimesters). Primary iron deficiency was determined by the level of serum ferritin. Anemia of inflammation has been diagnosed after exclusion of iron deficiency in the presence of documented signs of an inflammatory process (chronic diseases) and in accordance with the international hematological criteria: normochromic normocytic anemia, normo-/hyperferritinemia (serum ferritin 30 g/l), hypotransferrinemia (transferrin 2 g/l) and the level of C-reactive protein in the blood ( 6 mg/l). \u0000RESULTS: Anemia of inflammation can be attributed to the most significant predictors of the development of endometritis. The odds ratio for this factor was 4.12 (95% confidence interval 1.286.19; p 0.001). The study has also shown that significant factors in the development of endometritis after caesarean section are obesity (odds ratio 3.45; 95% confidence interval 1.145.11; p = 0.005), asymptomatic bacteriuria (odds ratio 3.68; 95% confidence interval 1.314.94; p 0.001), carbohydrate metabolism disorders (odds ratio 2.84; 95% confidence interval 1.543.52; p = 0.012) and arterial hypertension (odds ratio 2.14; 95% confidence interval 1.124.04; p = 0.032). \u0000CONCLUSIONS: The prevalence of anemia of inflammation in pregnancy is 2.1%. Anemia of inflammation complicates the course of pregnancy 5.5 times more often in puerperas with endometritis after caesarean section (27.4 vs. 4.9%; 2 = 52.1; p 0.001), which makes it possible to classify it as a significant predictor of the development of postoperative infectious and inflammatory complications.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81613300","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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