Pub Date : 2020-10-19DOI: 10.23888/pavlovj2020283377-390
Gennadii E. Sheiko, A. Belova, M. N. Kudykin
Multiple sclerosis (MS) is a widespread dysimmune-neurodegenerative disease of the central nervous system of unclear etiology. Despite significant achievements in the therapy of MS, the level of progressing disability and early mortality remains alarmingly high. The main aim of the given review is to give a detailed description of new promising medical drugs for treatment of MS. In the article the data of preclinical and clinical trials are given, presumptive mechanisms of the medical drugs under development are described. Development of new therapeutic approaches in treatment of MS is of great interest in modern science. The given review highlights new methods of treatment that are now undergoing clinical trialы and will probably come to the clinical practice in the near future.
{"title":"Prospects in treatment of multiple sclerosis: near future","authors":"Gennadii E. Sheiko, A. Belova, M. N. Kudykin","doi":"10.23888/pavlovj2020283377-390","DOIUrl":"https://doi.org/10.23888/pavlovj2020283377-390","url":null,"abstract":"Multiple sclerosis (MS) is a widespread dysimmune-neurodegenerative disease of the central nervous system of unclear etiology. Despite significant achievements in the therapy of MS, the level of progressing disability and early mortality remains alarmingly high. The main aim of the given review is to give a detailed description of new promising medical drugs for treatment of MS. In the article the data of preclinical and clinical trials are given, presumptive mechanisms of the medical drugs under development are described. Development of new therapeutic approaches in treatment of MS is of great interest in modern science. The given review highlights new methods of treatment that are now undergoing clinical trialы and will probably come to the clinical practice in the near future.","PeriodicalId":13184,"journal":{"name":"I.P.Pavlov Russian Medical Biological Herald","volume":"15 1","pages":"377-390"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78818650","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 : 2020-10-19DOI: 10.23888/pavlovj2020283300-311
E. Konovalova, A. E. Lavrova, M. Presnyakova
Aim . To perform a comparative analysis of clinical and anamnestic data and of the condition of primary hemostasis in chronic liver diseases in children and to identify additional informative diagnostic criteria that reflect severity of the course of autoimmune hepatitis (AIH) and chronic viral hepatitis C (CVHC) in children. Materials and Methods. 91 Patients from 3 to 7 years old were examined, of them: 60 children with AIH and 31 children with CVHC. The control group included 15 children of I and II health groups. In all the patients the clinic-anamnestic data and the condition of the primary hemostasis were evaluated. Concentrations of endothelin-1 and homocysteine, activity of Willebrand factor, amount of platelets and their aggregation activity were determined. Results. AIH is characterized by a more aggressive course as compared to CVHC manifested by clinical signs of a severe liver damage, significant biochemical changes and a high rate of fibrosis within the first two years. In all the children there were found disorders in the primary hemostasis interrelated with the main clinical and laboratory syndromes reflecting the severity of the liver damage. AIH is characterized by a higher concentration of homocysteine (р=0.007) and of the activity of Willebrand factor (р=0.037) in comparison with CVHC. Conclusions. Signs of a severe liver damage are not characteristic of children with CVHC in the first 10 years of the disease, however, disorders of the primary hemostasis are present characterized by hyperaggregation of platelets and by endothelial dysfunction. AIH in children is characterized by aggressive course and more pronounced deviations of the primary hemostasis in comparison with CVHC. In AIH and CVHC, the pathology of the primary hemostasis is closely related to some clinical-laboratory symptoms that reflect severity of the disease.
{"title":"Characteristics of clinical and anamnestic data and of condition of primary hemostasis in chronic diseases of liver in children","authors":"E. Konovalova, A. E. Lavrova, M. Presnyakova","doi":"10.23888/pavlovj2020283300-311","DOIUrl":"https://doi.org/10.23888/pavlovj2020283300-311","url":null,"abstract":"Aim . To perform a comparative analysis of clinical and anamnestic data and of the condition of primary hemostasis in chronic liver diseases in children and to identify additional informative diagnostic criteria that reflect severity of the course of autoimmune hepatitis (AIH) and chronic viral hepatitis C (CVHC) in children. Materials and Methods. 91 Patients from 3 to 7 years old were examined, of them: 60 children with AIH and 31 children with CVHC. The control group included 15 children of I and II health groups. In all the patients the clinic-anamnestic data and the condition of the primary hemostasis were evaluated. Concentrations of endothelin-1 and homocysteine, activity of Willebrand factor, amount of platelets and their aggregation activity were determined. Results. AIH is characterized by a more aggressive course as compared to CVHC manifested by clinical signs of a severe liver damage, significant biochemical changes and a high rate of fibrosis within the first two years. In all the children there were found disorders in the primary hemostasis interrelated with the main clinical and laboratory syndromes reflecting the severity of the liver damage. AIH is characterized by a higher concentration of homocysteine (р=0.007) and of the activity of Willebrand factor (р=0.037) in comparison with CVHC. Conclusions. Signs of a severe liver damage are not characteristic of children with CVHC in the first 10 years of the disease, however, disorders of the primary hemostasis are present characterized by hyperaggregation of platelets and by endothelial dysfunction. AIH in children is characterized by aggressive course and more pronounced deviations of the primary hemostasis in comparison with CVHC. In AIH and CVHC, the pathology of the primary hemostasis is closely related to some clinical-laboratory symptoms that reflect severity of the disease.","PeriodicalId":13184,"journal":{"name":"I.P.Pavlov Russian Medical Biological Herald","volume":"35 1","pages":"300-311"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86977347","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 : 2020-10-19DOI: 10.23888/pavlovj2020283391-398
I. B. Boyko
Aim . Analysis of some controversial provisions of Article (Art.) 66 «Determination of the Moment of Death of a Person and of Termination of Resuscitation Activities» of Federal law «On Fundamental Healthcare Principles in the Russian Federation» of November 21, 2011 №323-FL (FL 323) directly concerning the issue of death of a person, and justification of making amendments to the title and text of the above mentioned norm. Due to the absence of definition of the concept of «death» in FL 323, the author presents his own definition of death of a person. The used term «the moment of death of a person» as a determinant/indicator of the occurrence of death seems to be erroneous. This term cannot be extended to the fact of biological death. Under FL 323, death of the brain is considered to be equivalent to death of a person and today is inextricably linked with organ transplantation. However, in reality it is not so, and in this sense it is a typical juridical fiction that justifies legal removal of organs from living patients. Amendments to the title and wording of Article 66 FL 323 are proposed.
{"title":"Statement of death in Russian legislation (critical analysis of article 66 of federal law «On fundamental healthcare principles in the Russian Federation» of 21.11.2011 №323-FL)","authors":"I. B. Boyko","doi":"10.23888/pavlovj2020283391-398","DOIUrl":"https://doi.org/10.23888/pavlovj2020283391-398","url":null,"abstract":"Aim . Analysis of some controversial provisions of Article (Art.) 66 «Determination of the Moment of Death of a Person and of Termination of Resuscitation Activities» of Federal law «On Fundamental Healthcare Principles in the Russian Federation» of November 21, 2011 №323-FL (FL 323) directly concerning the issue of death of a person, and justification of making amendments to the title and text of the above mentioned norm. Due to the absence of definition of the concept of «death» in FL 323, the author presents his own definition of death of a person. The used term «the moment of death of a person» as a determinant/indicator of the occurrence of death seems to be erroneous. This term cannot be extended to the fact of biological death. Under FL 323, death of the brain is considered to be equivalent to death of a person and today is inextricably linked with organ transplantation. However, in reality it is not so, and in this sense it is a typical juridical fiction that justifies legal removal of organs from living patients. Amendments to the title and wording of Article 66 FL 323 are proposed.","PeriodicalId":13184,"journal":{"name":"I.P.Pavlov Russian Medical Biological Herald","volume":"1 1","pages":"391-398"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88702102","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 : 2020-10-19DOI: 10.23888/pavlovj2020283275-282
V. Bashkatova, N. Bogdanova, E. Alexeeva, G. Nazarova, S. Sudakov
Aim. A comparative study of the influence of nitric oxide synthase (NO-synthase) inhibitors on the parameters of anxiety, motor activity and pain sensitivity of rats. Materials and Methods. The work was conducted on male rats of Wistar line. The anxiety level and locomotor activity of rats were studied in the «elevated plus maze» (EPM) test. Pain sensitivity of the animals was tested on the «hotplate» apparatus. In the work, selective inhibitor of inducible isoform of NO-synthase – aminoguanidine – at a dose of 50 mg/kg, and non-selective inhibitor of this enzyme – N-nitro-L-arginine – at a dose of 50 mg/kg, were used. Rats of the control group were introduced the equivalent quantity of normal saline. NO-synthase inducible inhibitor – aminoguadinine did not produce any influence on the anxiety level, but led to reduction of the horizontal motor activity of rats. Introduction of non-selective NO-synthase inhibitor – N-nitro-L-arginine – was accompanied by reduction of the anxiety and of the locomotor activity of animals in the EPM test. Both investigated NO-synthase inhibitors induced alteration of pain sensitivity of rats in the form of hypoalgesia. Here, the most pronounced nociceptive effect was observed with introduction of non-selective NO-synthase inhibitor. Conclusion . In the work the evidence of participation of inducible isoform of NO-synthase in realization of the motor activity and pain sensitivity processes in rats is shown. In result of the conducted experiments it was found that introduction of non-selective NO-synthase inhibitor N-nitro-L-arginine was accompanied by evident alterations of anxious behavior, locomotor activity and nociceptive sensitivity of rats. The results obtained confirm the important role of the system of regulation of nitric oxide synthesis in neurochemical mechanisms of behavioral reactions in rats.
的目标。一氧化氮合酶(NO-synthase, NO-synthase)抑制剂对大鼠焦虑、运动活动及疼痛敏感性影响的比较研究。材料与方法。本研究以Wistar系雄性大鼠为实验对象。采用“升高+迷宫”(EPM)试验研究了大鼠的焦虑水平和运动活动。在“热板”装置上测试动物的疼痛敏感性。本研究采用no -合成酶诱导异构体氨基胍选择性抑制剂50mg /kg, n-硝基- l -精氨酸非选择性抑制剂50mg /kg。对照组大鼠给予等量生理盐水。no合酶诱导抑制剂氨基胍定对大鼠焦虑水平无影响，但导致大鼠水平运动活性降低。在EPM试验中，引入非选择性no合成酶抑制剂n-硝基- l -精氨酸可以减少动物的焦虑和运动活动。两者都研究了no合酶抑制剂以痛觉减退的形式诱导大鼠疼痛敏感性的改变。在这里，引入非选择性no合酶抑制剂观察到最明显的伤害性作用。结论。在这项工作中，no合酶的诱导异构体参与实现大鼠的运动活动和疼痛敏感过程的证据显示。实验结果发现，非选择性no合成酶抑制剂n-硝基- l -精氨酸的引入会显著改变大鼠的焦虑行为、运动活动和伤害敏感性。结果证实了一氧化氮合成调控系统在大鼠行为反应的神经化学机制中的重要作用。
{"title":"Peculiarities of influence of NO-synthase inhibitors on behavioral parameters of rats","authors":"V. Bashkatova, N. Bogdanova, E. Alexeeva, G. Nazarova, S. Sudakov","doi":"10.23888/pavlovj2020283275-282","DOIUrl":"https://doi.org/10.23888/pavlovj2020283275-282","url":null,"abstract":"Aim. A comparative study of the influence of nitric oxide synthase (NO-synthase) inhibitors on the parameters of anxiety, motor activity and pain sensitivity of rats. Materials and Methods. The work was conducted on male rats of Wistar line. The anxiety level and locomotor activity of rats were studied in the «elevated plus maze» (EPM) test. Pain sensitivity of the animals was tested on the «hotplate» apparatus. In the work, selective inhibitor of inducible isoform of NO-synthase – aminoguanidine – at a dose of 50 mg/kg, and non-selective inhibitor of this enzyme – N-nitro-L-arginine – at a dose of 50 mg/kg, were used. Rats of the control group were introduced the equivalent quantity of normal saline. NO-synthase inducible inhibitor – aminoguadinine did not produce any influence on the anxiety level, but led to reduction of the horizontal motor activity of rats. Introduction of non-selective NO-synthase inhibitor – N-nitro-L-arginine – was accompanied by reduction of the anxiety and of the locomotor activity of animals in the EPM test. Both investigated NO-synthase inhibitors induced alteration of pain sensitivity of rats in the form of hypoalgesia. Here, the most pronounced nociceptive effect was observed with introduction of non-selective NO-synthase inhibitor. Conclusion . In the work the evidence of participation of inducible isoform of NO-synthase in realization of the motor activity and pain sensitivity processes in rats is shown. In result of the conducted experiments it was found that introduction of non-selective NO-synthase inhibitor N-nitro-L-arginine was accompanied by evident alterations of anxious behavior, locomotor activity and nociceptive sensitivity of rats. The results obtained confirm the important role of the system of regulation of nitric oxide synthesis in neurochemical mechanisms of behavioral reactions in rats.","PeriodicalId":13184,"journal":{"name":"I.P.Pavlov Russian Medical Biological Herald","volume":"1 1","pages":"275-282"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89948536","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 : 2020-10-19DOI: 10.23888/pavlovj2020283312-322
A. Kazantsev, K. Chernykh, N. Zarkua, R. Lider, E. Burkova, G. Bagdavadze, E. Y. Kalinin, T. E. Zaitseva, A. E. Chikin, Y. Linets, K. Kubachev
Aim. Analysis of hospital and long-term results of carotid endarterectomy (CEA) in different periods of acute cerebrovascular event (ACVE). Materials and Methods . The given study was retrospective and was conducted using the method of patients sampling. In the period from 2010 to 2019, 1113 patients with ACVE in history who were later conducted CEA, were selected. Depending on the time interval between the last ACVE and CAE, all the patients were divided into 4 groups: the 1 st group – in the acutest period of ACVE (1-3 days) (n=24; 2.2%); the 2 nd group – in the acute period of ACVE (up to 28 days) (n=493; 44.3%); the 3 rd group – in the early rehabilitation period of ACVE (up to 6 months) (n=481; 43.2%); the 4 th group – in the late rehabilitation period of ACVE (up to 2 years) (n=115; 10.3%). The long-term period was 34.8±12.5 months. Results . In the hospitalization period of observation the following complications were found: lethal outcome ((group 1 – 0%; group 2 – 0.4% (n=2); group 3 – 0.2% (n=1); group 4 – 0%; р=0.16)); myocardial infarction ((group 1 – 0%; group 2 – 0.4% (n=2); group 3 – 0%; group 4 – 0.9% (n=1); р=0.35)); ACVE/transient ischemic attack (TIA), ((group 1 – 4.2% (n=1); group 2 – 0.4% (n=2); group 3 – 0.2% (n=1); group 4 – 0%; р 1-2 =0.01; р 1-3 =0.009; р 1-4 =0.01)). By the end of hospitalization period the composite endpoint consisting of lethal outcome + myocardial infarction + ACVE/TIA made in group 1 – 4.2% (n=1), in group 2 – 1.2% (n=6), in group 3 – 0.4% (n=2), in group 4 – 2.6% (n=3), р=0.08. Complications of the long-term follow-up period were: lethal outcome from all causes ((group 1 – 25% (n=6); group 2 – 5.5% (n=27); group 3 – 7.3% (n=35); group 4 – 14% (n=16); р 1-2 =0.002; р 1-3 =0.008; р 2-4 =0.012)); lethal outcome from cardiovascular causes ((group 1 – 4.2% (n=1); group 2 – 3.6% (n=18); group 3 – 4.8% (n=23); group 4 – 5.2% (n=6); р=0.79)), myocardial infarction ((group 1 – 12.5% (n=3); group 2 – 3.6% (n=18); group 3 – 5.4% (n=26); group 4 – 6.1% (n=7); р=0.15)), ACVE/TIA ((group 1 – 16.6% (n=4); group 2 – 6.3% (n=31); group 3 – 6% (n=29); group 4 – 11.3% (n=13); р=0.05)); composite endpoint including lethal outcome + myocardial infarction + ACVE/TIA ((group 1 – 54.2% (n=13); group 2 – 15.4% (n=76); group 3 – 18.7% (n=90); group 4 – 31.3% (n=36); р 1-2 =0.0001; р 1-3 =0.0001; р 1-4 =0.005; р 2-4 =0.0006; р 3-4 =0.012)). Conclusion. Application of CEA demonstrated effectiveness and safety in the acute and early rehabilitation period of ACVE.
{"title":"Immediate and long-term results of carotid endarterectomy in different periods of ischemic stroke","authors":"A. Kazantsev, K. Chernykh, N. Zarkua, R. Lider, E. Burkova, G. Bagdavadze, E. Y. Kalinin, T. E. Zaitseva, A. E. Chikin, Y. Linets, K. Kubachev","doi":"10.23888/pavlovj2020283312-322","DOIUrl":"https://doi.org/10.23888/pavlovj2020283312-322","url":null,"abstract":"Aim. Analysis of hospital and long-term results of carotid endarterectomy (CEA) in different periods of acute cerebrovascular event (ACVE). Materials and Methods . The given study was retrospective and was conducted using the method of patients sampling. In the period from 2010 to 2019, 1113 patients with ACVE in history who were later conducted CEA, were selected. Depending on the time interval between the last ACVE and CAE, all the patients were divided into 4 groups: the 1 st group – in the acutest period of ACVE (1-3 days) (n=24; 2.2%); the 2 nd group – in the acute period of ACVE (up to 28 days) (n=493; 44.3%); the 3 rd group – in the early rehabilitation period of ACVE (up to 6 months) (n=481; 43.2%); the 4 th group – in the late rehabilitation period of ACVE (up to 2 years) (n=115; 10.3%). The long-term period was 34.8±12.5 months. Results . In the hospitalization period of observation the following complications were found: lethal outcome ((group 1 – 0%; group 2 – 0.4% (n=2); group 3 – 0.2% (n=1); group 4 – 0%; р=0.16)); myocardial infarction ((group 1 – 0%; group 2 – 0.4% (n=2); group 3 – 0%; group 4 – 0.9% (n=1); р=0.35)); ACVE/transient ischemic attack (TIA), ((group 1 – 4.2% (n=1); group 2 – 0.4% (n=2); group 3 – 0.2% (n=1); group 4 – 0%; р 1-2 =0.01; р 1-3 =0.009; р 1-4 =0.01)). By the end of hospitalization period the composite endpoint consisting of lethal outcome + myocardial infarction + ACVE/TIA made in group 1 – 4.2% (n=1), in group 2 – 1.2% (n=6), in group 3 – 0.4% (n=2), in group 4 – 2.6% (n=3), р=0.08. Complications of the long-term follow-up period were: lethal outcome from all causes ((group 1 – 25% (n=6); group 2 – 5.5% (n=27); group 3 – 7.3% (n=35); group 4 – 14% (n=16); р 1-2 =0.002; р 1-3 =0.008; р 2-4 =0.012)); lethal outcome from cardiovascular causes ((group 1 – 4.2% (n=1); group 2 – 3.6% (n=18); group 3 – 4.8% (n=23); group 4 – 5.2% (n=6); р=0.79)), myocardial infarction ((group 1 – 12.5% (n=3); group 2 – 3.6% (n=18); group 3 – 5.4% (n=26); group 4 – 6.1% (n=7); р=0.15)), ACVE/TIA ((group 1 – 16.6% (n=4); group 2 – 6.3% (n=31); group 3 – 6% (n=29); group 4 – 11.3% (n=13); р=0.05)); composite endpoint including lethal outcome + myocardial infarction + ACVE/TIA ((group 1 – 54.2% (n=13); group 2 – 15.4% (n=76); group 3 – 18.7% (n=90); group 4 – 31.3% (n=36); р 1-2 =0.0001; р 1-3 =0.0001; р 1-4 =0.005; р 2-4 =0.0006; р 3-4 =0.012)). Conclusion. Application of CEA demonstrated effectiveness and safety in the acute and early rehabilitation period of ACVE.","PeriodicalId":13184,"journal":{"name":"I.P.Pavlov Russian Medical Biological Herald","volume":"264 1","pages":"312-322"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86321118","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 : 2020-10-19DOI: 10.23888/pavlovj2020283399-405
F. Fontana, O. Babenko
Aim of this letter is to attract the attention of journal readers to the study of exosomes as an important direction in the development of Oncology, in particular, in the diagnosis and treatment of prostate cancer. Exosomes are produced by tumor cells and regulate proliferation, metastasis, and the development of chemoresistance. Their extraction from biological fluids allows further use of these vesicles as potential biomarkers of prostate cancer. In the future, exosomes can be successfully used in the delivery of drugs and other anti-tumor substances to cancer cells.
{"title":"Role of exosomes in diagnosis and therapy of prostate cancer","authors":"F. Fontana, O. Babenko","doi":"10.23888/pavlovj2020283399-405","DOIUrl":"https://doi.org/10.23888/pavlovj2020283399-405","url":null,"abstract":"Aim of this letter is to attract the attention of journal readers to the study of exosomes as an important direction in the development of Oncology, in particular, in the diagnosis and treatment of prostate cancer. Exosomes are produced by tumor cells and regulate proliferation, metastasis, and the development of chemoresistance. Their extraction from biological fluids allows further use of these vesicles as potential biomarkers of prostate cancer. In the future, exosomes can be successfully used in the delivery of drugs and other anti-tumor substances to cancer cells.","PeriodicalId":13184,"journal":{"name":"I.P.Pavlov Russian Medical Biological Herald","volume":"5 1","pages":"399-405"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75960848","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 : 2020-10-19DOI: 10.23888/pavlovj2020283323-333
S. V. Ivanov, I. Ivanov, E. G. Obyedkov, L. P. Popova
Aim. To study the influence of deproteinized dialysate from blood of milk-fed calves on the type of exudative discharge and dynamics of inflammatory reaction after hernia repair with plastics of the anterior abdominal wall with hernioendoprosthesis of polypropylene. Materials and Methods . The study involved 59 patients being on stationary treatment in the surgical department of Kursk Regional Clinical Hospital. Patients were hospitalized for the herniation of small or medium dimension. The patients were divided to two groups: the main (n=30) and control (n=29) groups. After endoprosthetics, the patients of the control group were given complex conservative treatment. The patients of the main group, besides standard treatment, were administered deproteinized dialysate from blood of milk-fed calves intravenously in drips 10 ml + 200 ml of 0.9% sodium chloride solution within 7 days. For cytological examination and determination of the type of cytograms, the traumatic discharge was collected and analyzed using the method of M.F. Kamaev and M.A. Palthsev. Results . Cytomorphometric examination was conducted on the third, fifth and seventh day after endoprosthetics with the aim of studying dynamic changes. Determination of cell composition and also of its changes characteristic of each studied period, was necessary for obtaining further information characterizing inflammatory process in the region of placement of the endoprosthesis. After endoprosthetics in patients who were administered hemodialysate, the inflammatory reaction was less pronounced than in patients who did not receive the preparation. This was associated with a more dynamic change of stages of the inflammatory process. In patients of the main group who received deproteinized dialysate, regenerative type of inflammation first appeared on the fifth day and made 6.9%; by the seventh day the share of patients with the regenerative type rose to 17.5%, while in the patients of the control group no regeneration stage was observed in both periods. Conclusion . Analysis of the efficiency of influence of hemodialysate on the inflammatory reaction in plastics of the anterior abdominal wall with polypropylene endoprosthesis evidences faster course of all stages of inflammation and reduction of its intensity by 10%.
的目标。目的:研究牛乳犊牛血液去蛋白透析液对前腹壁塑料疝修补术聚丙烯疝修补术后渗出物类型及炎症反应动态的影响。材料与方法。该研究涉及59名在库尔斯克地区临床医院外科接受固定治疗的患者。患者因中、小尺寸疝而住院。将患者分为两组:主治疗组(n=30)和对照组(n=29)。对照组患者在修复后给予复杂的保守治疗。主组患者在标准治疗的基础上，于7 d内静脉滴注乳牛血液去蛋白透析液10 ml + 0.9%氯化钠溶液200 ml。采用M.F. Kamaev和M.A. Palthsev的方法收集创伤出院液，进行细胞学检查和细胞图类型的确定。结果。分别于修复后第3天、第5天和第7天进行细胞形态学检查，观察其动态变化。确定细胞组成及其在每个研究时期的变化特征，对于获得表征假体放置区域炎症过程的进一步信息是必要的。在给予血液透析液的患者进行体内修复术后，炎症反应比没有接受该制剂的患者更不明显。这与炎症过程阶段的动态变化有关。主组接受去蛋白透析液的患者，第5天首次出现再生型炎症，占6.9%;到第7天，再生型患者的比例上升到17.5%，而对照组患者在两个时期均未观察到再生阶段。结论。血液透析液对前腹壁塑料聚丙烯假体炎症反应的影响效果分析表明，各阶段炎症的病程加快，炎症强度降低10%。
{"title":"Determination of clinical efficiency of deproteinized dialysate from blood of milk-fed calves after endoprosthetics in patients with ventral hernias","authors":"S. V. Ivanov, I. Ivanov, E. G. Obyedkov, L. P. Popova","doi":"10.23888/pavlovj2020283323-333","DOIUrl":"https://doi.org/10.23888/pavlovj2020283323-333","url":null,"abstract":"Aim. To study the influence of deproteinized dialysate from blood of milk-fed calves on the type of exudative discharge and dynamics of inflammatory reaction after hernia repair with plastics of the anterior abdominal wall with hernioendoprosthesis of polypropylene. Materials and Methods . The study involved 59 patients being on stationary treatment in the surgical department of Kursk Regional Clinical Hospital. Patients were hospitalized for the herniation of small or medium dimension. The patients were divided to two groups: the main (n=30) and control (n=29) groups. After endoprosthetics, the patients of the control group were given complex conservative treatment. The patients of the main group, besides standard treatment, were administered deproteinized dialysate from blood of milk-fed calves intravenously in drips 10 ml + 200 ml of 0.9% sodium chloride solution within 7 days. For cytological examination and determination of the type of cytograms, the traumatic discharge was collected and analyzed using the method of M.F. Kamaev and M.A. Palthsev. Results . Cytomorphometric examination was conducted on the third, fifth and seventh day after endoprosthetics with the aim of studying dynamic changes. Determination of cell composition and also of its changes characteristic of each studied period, was necessary for obtaining further information characterizing inflammatory process in the region of placement of the endoprosthesis. After endoprosthetics in patients who were administered hemodialysate, the inflammatory reaction was less pronounced than in patients who did not receive the preparation. This was associated with a more dynamic change of stages of the inflammatory process. In patients of the main group who received deproteinized dialysate, regenerative type of inflammation first appeared on the fifth day and made 6.9%; by the seventh day the share of patients with the regenerative type rose to 17.5%, while in the patients of the control group no regeneration stage was observed in both periods. Conclusion . Analysis of the efficiency of influence of hemodialysate on the inflammatory reaction in plastics of the anterior abdominal wall with polypropylene endoprosthesis evidences faster course of all stages of inflammation and reduction of its intensity by 10%.","PeriodicalId":13184,"journal":{"name":"I.P.Pavlov Russian Medical Biological Herald","volume":"225 1","pages":"323-333"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74673812","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 : 2020-10-19DOI: 10.23888/pavlovj2020283290-299
K. Ageeva, E. Filippov
Aim . To study the prognostic value of the results of dynamic capnography in the complex assessment of parameters of the respiratory system in 6-minute walk test in patients with chronic heart failure (CHF). Materials and Methods . 73 Patients were examined: the group of study included 48 patients with IIA or IIB stage CHF (mean age 57.9±4.6 years, 23 men), the control group included 25 practically healthy volunteers (mean age 47.6±3.5 years, 9 men). The patients were conducted complex determination of parameters of the respiratory system: clinical scaling before and after 6-minute walk test (6MWT), instrumental examinations including spirometry, capnography and pulse oximetry before, during and after physical activity. The analysis of survival was conducted on the basis of the dynamic follow-up of patients within 5 years (60 months). Results. In the analysis of parameters of dyspnea at rest, all the parameters were higher in the group of patients with CHF (р<0.05). The distance walked by the patients with CHF in 6 minutes was 488.23±90.84 m, which was significantly less than in the control group (815.60±53.89 m, р=0.009). Dyspnea as the cause of stoppage/slowing down of walking in 6MWT, was also more often recorded in patients with CHF (93.8±3.0% and 48.0±5.1%, р=0.049). Besides, in 6MWT the patients noted: weakness in legs (50.1±5.0% in the group of CHF and 40.0±5.0% in the control group, р=0.014), palpitation (29.0±4.6% and 20.0±4.1%, respectively, р=0.004). Worsening of dyspnea parameters in 6MWT was more evident in patients with CHF than in the control group (р<0.01). In the CHF group, hypocapnic type of ventilation was revealed in 6MWT, analysis of РЕТСО 2 trend graphs revealed a wave-like increase in the parameters, the so called periodic breathing (PB). CO 2 trend was recorded in CHF group in 58.3±1.0% of cases (the difference with the control group with р=0.046), the trend of heart rate – in 18.8±0.3% of cases (р=0.027). Cox proportional hazards regression analysis of mortality in patients with CHF showed a prognostic significance of a complex model comprising the following parameters of a patient: body mass index (р=0.005), left ventricular end-diastolic dimension (р=0.034), left ventricular end-systolic dimension (р=0.002), left ventricular ejection fraction (р=0.041), 6MWT distance (р=0.004), desaturation (р=0.009), and the presence of signs of PB during 6MWT (р=0.005). Model coefficients were statistically significant at р<0.0001. Conclusions. Dynamic capnography and pulse oximetry allow to identify signs of PB in patients with CHF during 6MWT which may deepen a complex assessment of parameters of the cardio-respiratory system in patients with CHF in order to determine tolerance to physical exercise as well as the effectiveness of the conducted treatment. Complex assessment of survival of patients with CHF showed prognostic significance of the following parameters of a patient: body mass index, left ventricular end-diastolic dimensio
{"title":"Prognostic role of results of dynamic capnography in integral assessment of parameters of respiratory system in 6-minute walk test in patients with chronic heart failure","authors":"K. Ageeva, E. Filippov","doi":"10.23888/pavlovj2020283290-299","DOIUrl":"https://doi.org/10.23888/pavlovj2020283290-299","url":null,"abstract":"Aim . To study the prognostic value of the results of dynamic capnography in the complex assessment of parameters of the respiratory system in 6-minute walk test in patients with chronic heart failure (CHF). Materials and Methods . 73 Patients were examined: the group of study included 48 patients with IIA or IIB stage CHF (mean age 57.9±4.6 years, 23 men), the control group included 25 practically healthy volunteers (mean age 47.6±3.5 years, 9 men). The patients were conducted complex determination of parameters of the respiratory system: clinical scaling before and after 6-minute walk test (6MWT), instrumental examinations including spirometry, capnography and pulse oximetry before, during and after physical activity. The analysis of survival was conducted on the basis of the dynamic follow-up of patients within 5 years (60 months). Results. In the analysis of parameters of dyspnea at rest, all the parameters were higher in the group of patients with CHF (р<0.05). The distance walked by the patients with CHF in 6 minutes was 488.23±90.84 m, which was significantly less than in the control group (815.60±53.89 m, р=0.009). Dyspnea as the cause of stoppage/slowing down of walking in 6MWT, was also more often recorded in patients with CHF (93.8±3.0% and 48.0±5.1%, р=0.049). Besides, in 6MWT the patients noted: weakness in legs (50.1±5.0% in the group of CHF and 40.0±5.0% in the control group, р=0.014), palpitation (29.0±4.6% and 20.0±4.1%, respectively, р=0.004). Worsening of dyspnea parameters in 6MWT was more evident in patients with CHF than in the control group (р<0.01). In the CHF group, hypocapnic type of ventilation was revealed in 6MWT, analysis of РЕТСО 2 trend graphs revealed a wave-like increase in the parameters, the so called periodic breathing (PB). CO 2 trend was recorded in CHF group in 58.3±1.0% of cases (the difference with the control group with р=0.046), the trend of heart rate – in 18.8±0.3% of cases (р=0.027). Cox proportional hazards regression analysis of mortality in patients with CHF showed a prognostic significance of a complex model comprising the following parameters of a patient: body mass index (р=0.005), left ventricular end-diastolic dimension (р=0.034), left ventricular end-systolic dimension (р=0.002), left ventricular ejection fraction (р=0.041), 6MWT distance (р=0.004), desaturation (р=0.009), and the presence of signs of PB during 6MWT (р=0.005). Model coefficients were statistically significant at р<0.0001. Conclusions. Dynamic capnography and pulse oximetry allow to identify signs of PB in patients with CHF during 6MWT which may deepen a complex assessment of parameters of the cardio-respiratory system in patients with CHF in order to determine tolerance to physical exercise as well as the effectiveness of the conducted treatment. Complex assessment of survival of patients with CHF showed prognostic significance of the following parameters of a patient: body mass index, left ventricular end-diastolic dimensio","PeriodicalId":13184,"journal":{"name":"I.P.Pavlov Russian Medical Biological Herald","volume":"18 1","pages":"290-299"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76833597","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 : 2020-10-19DOI: 10.23888/pavlovj2020283334-339
O. V. Zaitsev, A. V. Koshkina, D. A. Khubezov, V. Yudin, V. V. Barsukov
Aim. To evaluate diagnostic value of laparoscopic inguinal allohernioplasty in identification of occult forms of hernias of the inguinal region. Materials and Methods. The study was conducted on the basis of the results of surgical treatment of patients with inguinal hernias on the base of the Department of Hospital Surgery of RyazSMU in Ryazan State Emergency Care Hospital and on the base of the Department of Surgery, Obstetrics and Gynecology of Additional Postgraduate Education Faculty in Ryazan Regional Clinical Hospital, from 2015 to 2020 (n=207). Operations were performed with the absence of contraindications to narcosis and carboxyperitoneum, and if patients desired to be operated on by the proposed method. In all the patients included into the study, hernioplasty was performed using laparoscopic approach, with preperitoneal placement of the endoprosthetic mesh. For purity of the experiment, only polypropylene meshes were used. Standard meshes from monofilament polypropylene were used with surface density 65-80 g/m 2 and volumetric porosity 80-85%. Meshes 15x15 cm dimension were used with cut angle with 7.5A cm catheti. Results. Of 207 patients, 28 were operated on for bilateral inguinal hernias. Only in one of them hernia was diagnosed in the preoperative stage. In the rest 27 patients, an occult hernia was found opposite to the previously diagnosed side. In 17 patients, besides hernias diagnosed in the preoperative and intraoperative stages, occult hernias were detected in the process of dissection of the preperitoneal space. Conclusion. Laparoscopic inguinal allohernioplasty permits to diagnose occult hernias that were not detected in the preoperative examination: femoral, obturator, inguinal hernias on the contralateral and/or unilateral side. This permits to perform hernioplasty taking into account the intraoperative finding, in one surgical procedure without subjecting the patient to repeated hospitalization, narcosis and operation.
{"title":"Diagnostic value of laparoscopic inguinal allohernioplasty in detection of occult hernias of inguinal region","authors":"O. V. Zaitsev, A. V. Koshkina, D. A. Khubezov, V. Yudin, V. V. Barsukov","doi":"10.23888/pavlovj2020283334-339","DOIUrl":"https://doi.org/10.23888/pavlovj2020283334-339","url":null,"abstract":"Aim. To evaluate diagnostic value of laparoscopic inguinal allohernioplasty in identification of occult forms of hernias of the inguinal region. Materials and Methods. The study was conducted on the basis of the results of surgical treatment of patients with inguinal hernias on the base of the Department of Hospital Surgery of RyazSMU in Ryazan State Emergency Care Hospital and on the base of the Department of Surgery, Obstetrics and Gynecology of Additional Postgraduate Education Faculty in Ryazan Regional Clinical Hospital, from 2015 to 2020 (n=207). Operations were performed with the absence of contraindications to narcosis and carboxyperitoneum, and if patients desired to be operated on by the proposed method. In all the patients included into the study, hernioplasty was performed using laparoscopic approach, with preperitoneal placement of the endoprosthetic mesh. For purity of the experiment, only polypropylene meshes were used. Standard meshes from monofilament polypropylene were used with surface density 65-80 g/m 2 and volumetric porosity 80-85%. Meshes 15x15 cm dimension were used with cut angle with 7.5A cm catheti. Results. Of 207 patients, 28 were operated on for bilateral inguinal hernias. Only in one of them hernia was diagnosed in the preoperative stage. In the rest 27 patients, an occult hernia was found opposite to the previously diagnosed side. In 17 patients, besides hernias diagnosed in the preoperative and intraoperative stages, occult hernias were detected in the process of dissection of the preperitoneal space. Conclusion. Laparoscopic inguinal allohernioplasty permits to diagnose occult hernias that were not detected in the preoperative examination: femoral, obturator, inguinal hernias on the contralateral and/or unilateral side. This permits to perform hernioplasty taking into account the intraoperative finding, in one surgical procedure without subjecting the patient to repeated hospitalization, narcosis and operation.","PeriodicalId":13184,"journal":{"name":"I.P.Pavlov Russian Medical Biological Herald","volume":"95 1","pages":"334-339"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83957843","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 : 2020-10-19DOI: 10.23888/pavlovj2020283340-349
O. Kit, O. V. Katelnitskaya, A. Maslov, Yuriy A. Gevorkyan, E. Kolesnikov
Aim. To evaluate results of venous resections in tumor infiltration of venous wall in pancreatic cancer (PC). Materials and Methods. The study included 74 patients with PC and tumor invasion of the wall of the mesenteric-portal system (T3 N0-1 M0). The control group included patients (n=53), receiving palliative chemotherapy. The average age of patients in the group of surgical treatment was 61.8±9.8 years, in the control group – 63.2±10.1 years (р>0.05), the average diameter of the tumor was 39 mm and 43 mm, respectively (р>0.05). In 62 cases of the group of surgical treatment the tumor was located in the head of pancreas (P), the patients were conducted pancreaticoduodenal resection with venous resection. In the rest of cases (n=12) the tumor was located in the body of P, corporocaudal resection of P was conducted with venous resection. Results. In the early postoperative period 2.7% of patients developed thrombosis of the reconstruction zone, 1.4% developed bleeding. 30-Day postoperative lethality was 4.1%. Median survival in surgical treatment of PC with venous resection was higher in comparison with palliative chemotherapy: 19 months vs 13 months, р 0.05). Conclusions. Angioplastic interventions permitting to achieve microscopically complete resection of the tumor in PC with tumor infiltration of mesenteric-portal system, permit to improve survival of patients in comparison with palliative chemotherapy.
的目标。目的探讨胰腺癌静脉壁肿瘤浸润静脉切除术的效果。材料与方法。本研究纳入74例PC伴肿瘤侵袭肠系膜-门静脉系统壁(T3 N0-1 M0)的患者。对照组为53例接受姑息性化疗的患者。手术治疗组患者平均年龄为61.8±9.8岁，对照组患者平均年龄为63.2±10.1岁(p >0.05)，肿瘤平均直径分别为39 mm和43 mm (p >0.05)。手术治疗组肿瘤位于胰头(P) 62例，行胰十二指肠联合静脉切除术。其余病例(n=12)肿瘤位于P体，对P行尾尾切除并静脉切除。结果。术后早期2.7%的患者发生重建区血栓形成，1.4%的患者发生出血。术后30天死亡率为4.1%。静脉切除手术治疗PC的中位生存期高于姑息性化疗:19个月vs 13个月，(0.05)。结论。与姑息性化疗相比，血管成形术可以在显微镜下完全切除肠系膜-门静脉系统浸润的PC患者的肿瘤，从而提高患者的生存率。
{"title":"Venous resections and reconstructions in surgery of pancreatic cancer","authors":"O. Kit, O. V. Katelnitskaya, A. Maslov, Yuriy A. Gevorkyan, E. Kolesnikov","doi":"10.23888/pavlovj2020283340-349","DOIUrl":"https://doi.org/10.23888/pavlovj2020283340-349","url":null,"abstract":"Aim. To evaluate results of venous resections in tumor infiltration of venous wall in pancreatic cancer (PC). Materials and Methods. The study included 74 patients with PC and tumor invasion of the wall of the mesenteric-portal system (T3 N0-1 M0). The control group included patients (n=53), receiving palliative chemotherapy. The average age of patients in the group of surgical treatment was 61.8±9.8 years, in the control group – 63.2±10.1 years (р>0.05), the average diameter of the tumor was 39 mm and 43 mm, respectively (р>0.05). In 62 cases of the group of surgical treatment the tumor was located in the head of pancreas (P), the patients were conducted pancreaticoduodenal resection with venous resection. In the rest of cases (n=12) the tumor was located in the body of P, corporocaudal resection of P was conducted with venous resection. Results. In the early postoperative period 2.7% of patients developed thrombosis of the reconstruction zone, 1.4% developed bleeding. 30-Day postoperative lethality was 4.1%. Median survival in surgical treatment of PC with venous resection was higher in comparison with palliative chemotherapy: 19 months vs 13 months, р 0.05). Conclusions. Angioplastic interventions permitting to achieve microscopically complete resection of the tumor in PC with tumor infiltration of mesenteric-portal system, permit to improve survival of patients in comparison with palliative chemotherapy.","PeriodicalId":13184,"journal":{"name":"I.P.Pavlov Russian Medical Biological Herald","volume":"11 1","pages":"340-349"},"PeriodicalIF":0.0,"publicationDate":"2020-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90875557","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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