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Clinical case of multivisceral en bloc resection for locally advanced cancer of the colon hepatic flexure 结肠肝曲局部晚期癌症多脏器全切除术的临床病例
Pub Date : 2024-07-25 DOI: 10.17816/kmj628774
V. I. Egorov, F. Akhmetzyanov, Harshal A. Kaulgud, D. M. Ruvinskiy
BACKGROUND: Currently, 15–20% of colorectal cancer cases are diagnosed at the locally advanced T4b stage. Treatment of this category of patients causes significant difficulties due to the degree of prevalence and the presence of a complicated course of the disease itself. AIM: Demonstration of a clinical case with an operation — multivisceral resection with pancreatoduodenal resection — for locally advanced cancer of the right half of the colon, as well as the oncological rationale for this operation. MATERIAL AND METHODS: This paper describes a case of treatment of a female patient with locally advanced adenocarcinoma of the colon hepatic angle, complicated by toxic-anemic syndrome and symptoms of partial intestinal obstruction. She underwent en bloc multivisceral resection with pancreatoduodenal resection. RESULTS: The patient was discharged on the 10th day after surgery in satisfactory condition, no complications were registered. Subsequently, adjuvant treatment was carried out: 5 courses of therapeutic polychemotherapy according to the XELOX regimen (capecitabine was received on an outpatient basis at a dose of 1500 mg 2 times a day, course 2 weeks). 12 months after surgery, progression of the disease in the form of metastases to the lungs was established, and 6 courses of bevacizumab therapy were administered. Currently the process has stabilized. CONCLUSION: A clinical case demonstrates the possibility of R0 resection for locally advanced cancer of the colon hepatic flexure with ingrowth into the liver, pancreas, duodenum and achieving good long-term results.
背景:目前,15%-20% 的结直肠癌病例被诊断为局部晚期 T4b 阶段。由于发病率高且病程复杂,这类患者的治疗非常困难。目的:展示一个针对右半结肠局部晚期癌症的手术--多脏器切除加胰十二指肠切除--的临床病例,以及该手术的肿瘤学原理。材料与方法:本文描述了一例女性结肠肝角局部晚期腺癌患者的治疗情况,该患者并发中毒性贫血综合征和部分肠梗阻症状。她接受了胰十二指肠切除术和多脏器全切除术。结果:患者术后第10天出院,情况良好,未出现并发症。随后进行了辅助治疗:按照XELOX方案进行了5个疗程的多化疗(卡培他滨在门诊接受,剂量为1500毫克,每天2次,疗程2周)。手术 12 个月后,肺部转移导致病情恶化,患者接受了 6 个疗程的贝伐单抗治疗。目前,病情已趋于稳定。结论:一例临床病例表明,对于向肝、胰腺、十二指肠生长的结肠肝曲局部晚期癌症,可以进行 R0 切除术,并取得良好的长期效果。
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引用次数: 0
Treatment of arterial hypertension in patients with chronic kidney disease from the perspective of the 2023 European recommendations 从 2023 年欧洲建议的角度看慢性肾病患者动脉高血压的治疗
Pub Date : 2024-07-25 DOI: 10.17816/kmj626252
O. Sigitova
Hypertension is a common disease in the adult population with an increasing tendency, it leads to damage to target organs, including the kidneys, with the development of chronic kidney disease, and increases the risk of cardiovascular complications and mortality. The paper provides an overview of the European guidelines for the treatment of arterial hypertension, updated in 2023, approved by the European Kidney Association and the International Society of Hypertension, in the context of chronic kidney disease — in comparison with the previous European guidelines (2018) and the current National clinical guidelines (2021). The updated recommendations retain the main provisions of the strategy for the treatment of arterial hypertension with chronic kidney disease of the 2018 European recommendations. Updates have been made to the classification of the main and additional groups of drugs for the treatment of arterial hypertension. For the first time, a new group of “special drugs for the treatment of concomitant pathology” has been added, including three classes of drugs: (1) neprilysin receptor antagonists, (2) sodium-glucose transporter-2 inhibitors, (3) non-steroidal mineralocorticoid receptor antagonists. A step-by-step algorithm for choosing antihypertensive drugs for arterial hypertension depending on the stage of chronic kidney disease has been updated. Recommendations for the treatment of resistant arterial hypertension were covered in detail. Some new recommendations were included for blood pressure targets based on albuminuria levels and other factors. A slightly modified scale for assessing cardiovascular risk in patients with arterial hypertension was presented and the role of chronic kidney disease stages III–V as an independent factor of high or very high cardiovascular risk was confirmed.
高血压是成年人群中的一种常见疾病,且有不断上升的趋势,它会导致包括肾脏在内的靶器官受损,发展成慢性肾脏病,并增加心血管并发症和死亡的风险。本文概述了欧洲肾脏协会和国际高血压学会批准的欧洲动脉高血压治疗指南(2023 年更新)在慢性肾脏病方面的内容--与之前的欧洲指南(2018 年)和当前的国家临床指南(2021 年)进行了比较。更新后的建议保留了 2018 年欧洲建议中关于慢性肾脏病动脉高血压治疗策略的主要规定。对治疗动脉高血压的主要药物组和附加药物组的分类进行了更新。首次新增了一组 "治疗并发病症的特殊药物",包括三类药物:(1)肾利蛋白受体拮抗剂;(2)钠-葡萄糖转运体-2抑制剂;(3)非类固醇矿皮质激素受体拮抗剂。更新了根据慢性肾脏病阶段选择动脉高血压降压药物的逐步算法。详细介绍了治疗抵抗性动脉高血压的建议。根据白蛋白尿水平和其他因素对血压目标值提出了一些新的建议。对评估动脉性高血压患者心血管风险的量表进行了小幅修改,并确认了慢性肾脏病 III-V 期作为高或极高心血管风险独立因素的作用。
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引用次数: 0
The role of the placenta in the formation of gestational complications in women with metabolic syndrome 胎盘在代谢综合征妇女妊娠并发症形成过程中的作用
Pub Date : 2024-07-25 DOI: 10.17816/kmj626829
A. Orazmuradov, E. Mukovnikova, I.V. Bekbaeva, A.A. Orazmuradova, Zh. Suleymanova
Over the past decade, the prevalence of metabolic syndrome has increased significantly worldwide, and in most countries around the world this non-communicable disease has become a major health threat. Today, the mechanisms of metabolic syndrome influence on the development of various pregnancy complications are actively discussed. Studies of the pathophysiological mechanisms of the relationship between metabolic disorders and placental-associated pregnancy complications deserve special attention. The placenta performs essential functions throughout pregnancy and serves as a site for nutrient exchange and gas exchange between the pregnant woman and the fetus. Metabolic changes in women are closely associated with a number of placentally mediated obstetric complications, including preeclampsia, placental insufficiency, macrosomia, fetal growth restriction and antenatal fetal death. It is believed that it is in the first trimester of pregnancy that trophoblast cells are most sensitive to metabolic changes in homeostasis, which leads to their ischemia, impaired proliferation, invasion and angiogenesis. In pregnancies complicated by metabolic syndrome, the placenta is exposed to inflammation, oxidative stress, dyslipidemia, hyperglycemia, and altered hormone levels. Such metabolic changes can affect the development and function of the placenta, leading to abnormal fetal growth, as well as metabolic and cardiovascular disorders in children in the long term. Despite the wide range of pregnancy complications with metabolic syndrome, the mechanisms of their development have not been sufficiently studied. The purpose of this review was to summarize current knowledge about the pathophysiological mechanisms of the influence of metabolic syndrome on the development and function of the placenta.
近十年来,代谢综合征的发病率在全球范围内大幅上升,在世界大多数国家,这种非传染性疾病已成为一种主要的健康威胁。如今,人们正在积极讨论代谢综合征对各种妊娠并发症发生的影响机制。代谢紊乱与胎盘相关妊娠并发症之间的病理生理机制研究值得特别关注。胎盘在整个妊娠过程中发挥着重要的功能,是孕妇和胎儿进行营养交换和气体交换的场所。妇女体内的代谢变化与许多由胎盘介导的产科并发症密切相关,包括子痫前期、胎盘功能不全、巨大儿、胎儿生长受限和产前胎儿死亡。一般认为,在妊娠头三个月,滋养层细胞对代谢平衡的变化最为敏感,从而导致其缺血、增殖受损、侵袭和血管生成。在患有代谢综合征的妊娠中,胎盘会受到炎症、氧化应激、血脂异常、高血糖和激素水平变化的影响。这些代谢变化会影响胎盘的发育和功能,导致胎儿发育异常,长期还会引起儿童代谢和心血管疾病。尽管代谢综合征的妊娠并发症种类繁多,但对其发生机制的研究却并不充分。本综述旨在总结目前有关代谢综合征影响胎盘发育和功能的病理生理机制的知识。
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引用次数: 0
Results of surgical treatment of adrenocortical cancer 肾上腺皮质癌手术治疗的结果
Pub Date : 2024-07-25 DOI: 10.17816/kmj630263
L. P. Kotelnikova, A. Fedachuk
BACKGROUND: Adrenalectomy is the only possible method of radical treatment of adrenocortical cancer, and surgical approach (laparotomy or laparoscopy) remains a subject of debate. AIM: To evaluate one-year mortality in patients with adrenocortical cancer and determine its relationship with age, stage of the disease, tumor characteristics according to computed tomography results, and surgical approach. MATERIAL AND METHODS: In the Perm Regional Clinical Hospital, over the past 7 years, 107 patients have been operated on for adrenal tumors, of which 15 (14.01%) people were diagnosed with adrenocortical cancer. Adrenalectomy was performed by open (11) and laparoscopic (4) approaches. The results were assessed by the number of local relapses of the disease and life expectancy. Statistical analysis was carried out using standard application programs Statistica for Windows 10.0. Nonparametric methods of descriptive statistics were used. To determine the relationship between individual pairs of characteristics and the degree of its severity, the Spearman correlation coefficient (r) was calculated. RESULTS: Stage I of the disease according to the ENSAT classification was found in 1 case, II — in 7, III — in 5, IV — in 2 cases. The size of tumors removed laparoscopically was significantly smaller (p=0.042) compared to those operated on with an open approach. One-year survival rate was 80%. Surgical approach and combined operations did not affect one-year mortality (r=0.277; p=0.298 and r=–0.462; p=0.071). A relationship was found between lethal outcomes and age (r=–0.539; p=0.030), and the rate of washout of the contrast agent from the tumor in the delayed phase when performing computed tomography (r=–0.845; p=0.034). In case of lethal outcomes, the rate of washout of the contrast agent was the lowest. The life expectancy of patients depended on the stage of the disease (r=–0.590; p=0.016). CONCLUSION: One-year mortality in patients with adrenocortical cancer was 20% and had a moderate positive correlation with age, stage of the disease and a strong correlation with tumor characteristics based on bolus-enhanced computed tomography, but had no relationship with the chosen surgical approach.
背景:肾上腺切除术是根治肾上腺皮质癌的唯一可行方法,而手术方法(开腹手术或腹腔镜手术)仍是一个争论的话题。目的:评估肾上腺皮质癌患者的一年死亡率,并确定其与年龄、疾病分期、计算机断层扫描结果显示的肿瘤特征以及手术方法之间的关系。材料与方法:过去 7 年中,彼尔姆地区临床医院为 107 名肾上腺肿瘤患者实施了手术,其中 15 人(14.01%)被确诊为肾上腺皮质癌。肾上腺切除术通过开腹(11 例)和腹腔镜(4 例)方式进行。手术结果根据局部复发次数和预期寿命进行评估。统计分析使用标准应用程序 Statistica for Windows 10.0 进行。使用的是描述性统计的非参数方法。为了确定各对特征与疾病严重程度之间的关系,计算了斯皮尔曼相关系数(r)。结果:根据 ENSAT 分类,1 例患者为 I 期,7 例为 II 期,5 例为 III 期,2 例为 IV 期。与开腹手术相比,腹腔镜下切除的肿瘤体积明显较小(P=0.042)。一年生存率为80%。手术方式和联合手术对一年死亡率没有影响(r=0.277;p=0.298 和 r=-0.462;p=0.071)。死亡结果与年龄(r=-0.539;p=0.030)和进行计算机断层扫描时造影剂在延迟期冲出肿瘤的比率(r=-0.845;p=0.034)之间存在关系。在致命结果中,造影剂的冲出率最低。患者的预期寿命取决于疾病的分期(r=-0.590;p=0.016)。结论:肾上腺皮质癌患者的一年死亡率为20%,与年龄和疾病分期呈中度正相关,与基于栓剂增强计算机断层扫描的肿瘤特征呈强相关,但与选择的手术方法无关。
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引用次数: 0
Personal development and professional path of the outstanding domestic odontologist, Professor G.I. Vilga 国内杰出的牙科专家 G.I. Vilga 教授的个人发展和职业道路
Pub Date : 2024-07-25 DOI: 10.17816/kmj501776
K. A. Pashkov, V. A. Bondar'
The article presents for the first time a complete scientific biography of Gilarii-Zdislav Ivanovich Vilga, created on the basis of archival and literary sources of the early twentieth century. G.I. Vilga was a recognized founder of Russian forensic dentistry and one of the founders of Russian maxillofacial surgery. However, his services to domestic dentistry were not limited to this. Signs of the institutionalization of dentistry in Russia at the end of the 19th and beginning of the 20th centuries were the reform of education (private dental schools, the first departments of odontology at universities), the emergence of specialized societies, congresses and the press. Professor G.I. Vilga was one of the first private assistant professors of odontology at Moscow University, the founder of the Moscow dental school and its head, chairman of the Moscow Odontological Society and editor of its printed organ, board chairman of the Russian Dental Union and two All-Russian Dental Congresses. All this gives us the right to consider him one of the founders of domestic dentistry.
文章根据二十世纪初的档案和文学资料,首次完整地介绍了吉拉里-兹德斯拉夫-伊万诺维奇-维尔加的科学传记。G.I. Vilga 是公认的俄罗斯法医牙科创始人和俄罗斯颌面外科创始人之一。然而,他对国内牙科的贡献并不仅限于此。19 世纪末 20 世纪初,俄罗斯牙科制度化的标志是教育改革(私立牙科学校、大学的首批牙科系)、专业协会、大会和新闻媒体的出现。G.I. Vilga 教授是莫斯科大学首批私立牙科助理教授之一,莫斯科牙科学校的创始人和校长,莫斯科牙科协会主席及其印刷机关报的编辑,俄罗斯牙科联盟理事会主席,以及两次全俄牙科大会的主席。所有这些都使我们有权将他视为国内牙科奠基人之一。
{"title":"Personal development and professional path of the outstanding domestic odontologist, Professor G.I. Vilga","authors":"K. A. Pashkov, V. A. Bondar'","doi":"10.17816/kmj501776","DOIUrl":"https://doi.org/10.17816/kmj501776","url":null,"abstract":"The article presents for the first time a complete scientific biography of Gilarii-Zdislav Ivanovich Vilga, created on the basis of archival and literary sources of the early twentieth century. G.I. Vilga was a recognized founder of Russian forensic dentistry and one of the founders of Russian maxillofacial surgery. However, his services to domestic dentistry were not limited to this. Signs of the institutionalization of dentistry in Russia at the end of the 19th and beginning of the 20th centuries were the reform of education (private dental schools, the first departments of odontology at universities), the emergence of specialized societies, congresses and the press. Professor G.I. Vilga was one of the first private assistant professors of odontology at Moscow University, the founder of the Moscow dental school and its head, chairman of the Moscow Odontological Society and editor of its printed organ, board chairman of the Russian Dental Union and two All-Russian Dental Congresses. All this gives us the right to consider him one of the founders of domestic dentistry.","PeriodicalId":17750,"journal":{"name":"Kazan medical journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141804559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative assessment of the osmotic and anti-inflammatory activity of soft dosage forms of pyrimidine drugs on hydrophilic bases in an experiment 在实验中对亲水性基质上的嘧啶类药物软制剂的渗透和抗炎活性进行比较评估
Pub Date : 2024-07-25 DOI: 10.17816/kmj606656
A. G. Izmailov, S. V. Dobrokvashin, S. G. Izmailov, E. Lukoyanychev, Andrey Yu. Zharinov
BACKGROUND: Despite the constant search for new medications for local prevention of surgical infection, the problem of purulent-inflammatory complications from postoperative soft tissue wounds remains relevant to this day. AIM: To experimentally study the osmotic activity and anti-inflammatory properties of the developed xymedone-containing ointment composition levoxycol in comparison with the well-known ointment dioxomethyltetrahydropyrimidine + chloramphenicol (levomekol). MATERIAL AND METHODS: The anti-inflammatory properties of the ointments were studied in vivo on 60 outbred male Wistar rats, which were divided into three groups, 20 animals each. The first group served as control. In the second group of animals, levomekol ointment was used, in the third group — levoxycol. An assessment of the osmotic activity of the experimental ointment composition levoxycol in comparison with a known drug was carried out in an in vitro experiment. To evaluate the anti-inflammatory activity of ointments, a model of carrageenan-induced edema of rat paws was used. To analyze differences in the frequency of the studied outcomes in groups of animals, the Mann–Whitney U test was used. RESULTS: Osmotic activity showed that wipes soaked in ointment forms absorbed the following amount of contrast (Me [Q1; Q3]): levomekol — 28.2 (26.4; 31.3) ml; levoxycol — 41.8 (39.5; 43.4) ml (p=0.001). The anti-inflammatory activity of the ointment forms manifested itself in the form of suppression of swelling of the rats' paws at 3 and 5 hours after the injection of carrageenan. When using the ointment form of levomekol, the volume of displaced liquid with the introduction of carrageenan, starting from 3 hours, was 1.8±0.19 ml. When using the ointment form of levoxicol, the amount of displaced liquid when carrageenan was administered, starting from 3 hours, was 1.57±0.16 ml (p=0.013). CONCLUSION: In vitro experiments have shown that the ointment form of levoxicol has a longer osmotic activity; experimental data in vivo indicated that the use of the developed ointment form of levoxicol, in contrast to the ointment form of levomekol, has a positive effect on the course of inflammatory processes in soft tissues in the first 2–3 hours by reducing the volume of displaced fluid.
背景:尽管人们一直在寻找用于局部预防手术感染的新药物,但术后软组织伤口的化脓性炎症并发症问题至今仍然存在。目的:通过实验研究所开发的含喜树碱软膏成分左旋氧氟沙星与知名软膏二氧甲基四氢嘧啶+氯霉素(左旋美可)的渗透活性和抗炎特性。材料与方法:在 60 只近亲繁殖的雄性 Wistar 大鼠身上对药膏的抗炎特性进行了活体研究,这些大鼠分为三组,每组 20 只。第一组为对照组。第二组使用左旋美可软膏,第三组使用左旋氧可软膏。在体外实验中,与已知药物相比,对实验性软膏成分左旋氧氟沙星的渗透活性进行了评估。为了评估软膏的抗炎活性,使用了角叉菜胶诱导的大鼠爪水肿模型。采用 Mann-Whitney U 检验来分析各组动物出现研究结果频率的差异。结果:渗透活性显示,浸泡在药膏中的湿巾吸收了以下数量的对比剂(Me [Q1; Q3]):左旋美可 - 28.2 (26.4; 31.3) ml;左旋氧可 - 41.8 (39.5; 43.4) ml (p=0.001)。在注射角叉菜胶 3 小时和 5 小时后,软膏形式的抗炎活性表现为抑制大鼠爪子的肿胀。在使用左旋咪唑软膏时,从 3 小时开始,随着角叉菜胶的引入,液体流出量为 1.8±0.19 毫升。在使用左旋咪唑软膏的情况下,从 3 个小时开始使用卡拉胶时,流出的液体量为 1.57±0.16 毫升(p=0.013)。结论:体外实验表明,左旋西可软膏具有更长的渗透活性;体内实验数据表明,与左旋美可软膏相比,使用开发的左旋西可软膏在最初的 2-3 小时内通过减少移位液体量对软组织炎症过程有积极影响。
{"title":"Comparative assessment of the osmotic and anti-inflammatory activity of soft dosage forms of pyrimidine drugs on hydrophilic bases in an experiment","authors":"A. G. Izmailov, S. V. Dobrokvashin, S. G. Izmailov, E. Lukoyanychev, Andrey Yu. Zharinov","doi":"10.17816/kmj606656","DOIUrl":"https://doi.org/10.17816/kmj606656","url":null,"abstract":"BACKGROUND: Despite the constant search for new medications for local prevention of surgical infection, the problem of purulent-inflammatory complications from postoperative soft tissue wounds remains relevant to this day. \u0000AIM: To experimentally study the osmotic activity and anti-inflammatory properties of the developed xymedone-containing ointment composition levoxycol in comparison with the well-known ointment dioxomethyltetrahydropyrimidine + chloramphenicol (levomekol). \u0000MATERIAL AND METHODS: The anti-inflammatory properties of the ointments were studied in vivo on 60 outbred male Wistar rats, which were divided into three groups, 20 animals each. The first group served as control. In the second group of animals, levomekol ointment was used, in the third group — levoxycol. An assessment of the osmotic activity of the experimental ointment composition levoxycol in comparison with a known drug was carried out in an in vitro experiment. To evaluate the anti-inflammatory activity of ointments, a model of carrageenan-induced edema of rat paws was used. To analyze differences in the frequency of the studied outcomes in groups of animals, the Mann–Whitney U test was used. \u0000RESULTS: Osmotic activity showed that wipes soaked in ointment forms absorbed the following amount of contrast (Me [Q1; Q3]): levomekol — 28.2 (26.4; 31.3) ml; levoxycol — 41.8 (39.5; 43.4) ml (p=0.001). The anti-inflammatory activity of the ointment forms manifested itself in the form of suppression of swelling of the rats' paws at 3 and 5 hours after the injection of carrageenan. When using the ointment form of levomekol, the volume of displaced liquid with the introduction of carrageenan, starting from 3 hours, was 1.8±0.19 ml. When using the ointment form of levoxicol, the amount of displaced liquid when carrageenan was administered, starting from 3 hours, was 1.57±0.16 ml (p=0.013). \u0000CONCLUSION: In vitro experiments have shown that the ointment form of levoxicol has a longer osmotic activity; experimental data in vivo indicated that the use of the developed ointment form of levoxicol, in contrast to the ointment form of levomekol, has a positive effect on the course of inflammatory processes in soft tissues in the first 2–3 hours by reducing the volume of displaced fluid.","PeriodicalId":17750,"journal":{"name":"Kazan medical journal","volume":"106 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of the treatment effectiveness in patients with stage IIB–IIIB ovarian cancer 评估 IIB-IIIB 期卵巢癌患者的治疗效果
Pub Date : 2024-07-25 DOI: 10.17816/kmj624991
V. N. Zhurman
BACKGROUND: The relevance of the study is due to the urgent problem of assessing therapy effectiveness for stage IIB–IIIB ovarian cancer. AIM: Study of patients' survival rates after surgical treatment of various forms of stages IIB–IIIB of ovarian cancer depending on a number of clinical and morphological factors. MATERIAL AND METHODS: The material for the study was long-term observations of patients who received treatment from 2004 to 2021 at the Primorsky Regional Oncology Dispensary, the source was the medical record of an inpatient (form 003/u). The group of patients with stage IIB–IIIB ovarian cancer consisted of 107 patients, average age 50.7±11.5 years. Of these, 43 (40.2%) were women with stage IIB, 46 (43.0%) patients with stage IIIA, 3 (2.8%) patients with stage IIIA2, 15 (14.0%) patients with stage IIIB. Overall survival and progression-free survival were assessed. Statistical methods included survival analysis using the Kaplan–Meier method with the construction of survival curves, medians and standard errors of survival time, and comparison of survival between groups of patients using the log-rank test. RESULTS: In patients with low-grade serous carcinoma, the five-year progression-free survival rate was higher than in patients with high-grade serous carcinoma (71.1±13.5 and 39.5±7.7%, respectively; p 0.01). Primary surgical treatment performed in gynecological hospitals reduced the median life expectancy and five-year survival rate by 150.0 months and 25.9% (p 0.01; RR=3.4; 95% CI=1.2–9.4). Interval cytoreduction reduced the median time to progression and five-year progression-free survival in patients with stage IIB–IIIB ovarian cancer (53.0±35.2 months and 43.7±16.5%) compared with patients underwent primary surgery (70.0±37.5 months and 57.3±6.0%). The five-year survival rate was higher in patients receiving a combination of platinum and taxanes — 94.7±5.1% (p 0.01; HR=0.2; 95% CI=0.05–0.5). CONCLUSION: In patients with stage IIB–IIIB ovarian cancer, factors such as primary surgical treatment performed in specialized gynecological oncology hospitals and adjuvant chemotherapy with platinum drugs in combination with taxane agents statistically significantly increase survival.
背景:这项研究的意义在于评估 IIB-IIIB 期卵巢癌的治疗效果这一紧迫问题。目的:研究各种形式的 IIB-IIIB 期卵巢癌患者手术治疗后的生存率,这取决于一些临床和形态学因素。材料与方法:研究材料是对 2004 年至 2021 年在滨海边疆区肿瘤医院接受治疗的患者进行的长期观察,来源是住院病人的病历(003/u 表)。IIB-IIIB 期卵巢癌患者共 107 人,平均年龄(50.7±11.5)岁。其中,女性 IIB 期患者 43 人(40.2%),IIIA 期患者 46 人(43.0%),IIIA2 期患者 3 人(2.8%),IIIB 期患者 15 人(14.0%)。对总生存期和无进展生存期进行了评估。统计方法包括使用 Kaplan-Meier 法进行生存分析,构建生存曲线、生存时间的中位数和标准误差,以及使用对数秩检验比较患者组间的生存率。结果:低级别浆液性癌患者的五年无进展生存率高于高级别浆液性癌患者(分别为 71.1±13.5% 和 39.5±7.7%; P 0.01)。在妇科医院进行的初级手术治疗使患者的中位预期寿命和五年生存率分别缩短了150.0个月和25.9%(P 0.01;RR=3.4;95% CI=1.2-9.4)。与接受初级手术的患者(70.0±37.5个月和57.3±6.0%)相比,间期细胞减灭术缩短了IIB-IIIB期卵巢癌患者的中位进展时间和五年无进展生存期(53.0±35.2个月和43.7±16.5%)。接受铂类和紫杉类药物联合治疗的患者五年生存率更高(94.7±5.1%)(P 0.01;HR=0.2;95% CI=0.05-0.5)。结论:对于 IIB-IIIB 期卵巢癌患者,在妇科肿瘤专科医院进行初次手术治疗以及铂类药物联合紫杉类药物进行辅助化疗等因素可显著提高患者的生存率。
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引用次数: 0
Comorbidity of chronic heart failure of ischemic etiology and chronic obstructive pulmonary disease: 5-year follow-up 缺血性慢性心力衰竭与慢性阻塞性肺病的合并症:5 年随访
Pub Date : 2024-07-25 DOI: 10.17816/kmj625374
Elena V. Khazova, Olga V. Boulashova, Violetta M. Iakubova, M. I. Malkova
BACKGROUND: The combination of chronic heart failure and chronic obstructive pulmonary disease contributes to the formation of the phenotype and survival of patients. AIM: To study the 5-year prognosis and develop a prognostic model of adverse events in patients with chronic heart failure of ischemic origin in comorbidity with chronic obstructive pulmonary disease. MATERIAL AND METHODS: Clinical signs of patients with chronic heart failure of ischemic origin (n=517), including those in combination with chronic obstructive pulmonary disease (n=118), and outcomes over 5 years according to end points: death from all causes, cardiovascular death, composite endpoint — all fatal and non-fatal cardiovascular events, were studied. Quantitative variables were presented as mean and standard deviation or median and interquartile range; categorical — in the form of absolute value and percentage. Quantitative intergroup differences were assessed using the Mann–Whitney test, and categorical differences were assessed using the Pearson χ2 test. Time to event was analyzed using the Kaplan–Meier method; hazard ratio — by Cox regression. Models were developed using binary logistic regression. Statistical processing was carried out in the Jamovi, R 4.3.1 programs. RESULTS: The clinical portrait of a patient with chronic heart failure of ischemic origin in the presence of chronic obstructive pulmonary disease was characterized by a predominance of men in older age groups, a high frequency of smoking, a worse quality of life, determined by the Minnesota Questionnaire, and a high level of high-sensitivity C-reactive protein, α1- and α2-globulins. Patients with heart failure in the presence of chronic obstructive pulmonary disease had higher overall and cardiovascular mortality (p=0.029 and p=0.02), the frequency of hospitalizations not related to cardiovascular disease (p=0.02), less non-fatal cardiovascular events (p=0.04). CONCLUSION: In patients with heart failure, the presence of chronic obstructive pulmonary disease increased the risk of death from all causes by 2.07 times, cardiovascular mortality by 2.24 times, and achieving the combined endpoint by 1.68 times. Regression models were developed to determine the probability of risk of death from all causes and cardiovascular death.
背景:慢性心力衰竭和慢性阻塞性肺病的合并症有助于患者表型的形成和生存。目的:研究慢性缺血性心力衰竭合并慢性阻塞性肺疾病患者的 5 年预后,并建立不良事件预后模型。材料与方法:研究缺血性慢性心力衰竭患者(517 人)的临床症状,包括合并慢性阻塞性肺病的患者(118 人),以及根据终点(所有原因导致的死亡、心血管死亡、复合终点--所有致命和非致命心血管事件)得出的 5 年预后结果。定量变量以平均值和标准差或中位数和四分位数间距表示;分类变量以绝对值和百分比表示。组间定量差异采用 Mann-Whitney 检验,分类差异采用 Pearson χ2 检验。事件发生时间采用 Kaplan-Meier 法分析;危险比采用 Cox 回归法分析。使用二元逻辑回归建立模型。统计处理在 Jamovi 和 R 4.3.1 程序中进行。结果:伴有慢性阻塞性肺病的缺血性慢性心力衰竭患者的临床特征是:老年男性居多、吸烟率高、明尼苏达问卷调查显示生活质量较差、高敏感 C 反应蛋白、α1 和 α2-球蛋白水平较高。伴有慢性阻塞性肺疾病的心力衰竭患者的总死亡率和心血管死亡率较高(P=0.029 和 P=0.02),住院次数与心血管疾病无关(P=0.02),非致命性心血管事件较少(P=0.04)。结论:在心力衰竭患者中,存在慢性阻塞性肺病会使各种原因导致的死亡风险增加 2.07 倍,心血管死亡风险增加 2.24 倍,达到综合终点的风险增加 1.68 倍。我们建立了回归模型来确定因各种原因死亡和心血管疾病死亡的风险概率。
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引用次数: 0
Undernutrition as a risk factor for tuberculosis disease 营养不良是结核病的一个风险因素
Pub Date : 2024-07-25 DOI: 10.17816/kmj634433
This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Franco JVA, Bongaerts B, Metzendorf MI, Risso A, Guo Y, Peña Silva L, Boeckmann M, Schlesinger S, Damen JAAG, Richter B, Baddeley A, Bastard M, Carlqvist A, Garcia-Casal MN, Hemmingsen B, Mavhunga F, Manne-Goehler J, Viney K, Bellorini J. Undernutrition as a risk factor for tuberculosis disease. Cochrane Database of Systematic Reviews. 2024. Issue 6. Art. No. CD015890. doi: 10.1002/14651858.CD015890.pub2
本出版物是 Cochrane 系统综述通俗语言摘要 (PLS) 的俄文译本:Franco JVA、Bongaerts B、Metzendorf MI、Risso A、Guo Y、Pena Silva L、Boeckmann M、Schlesinger S、Damen JAAG、Richter B、Baddeley A、Bastard M、Carlqvist A、Garcia-Casal MN、Hemmingsen B、Mavhunga F、Manne-Goehler J、Viney K、Bellorini J.营养不良是结核病的危险因素。Cochrane 系统综述数据库。2024.第 6 期。Art.DOI: 10.1002/14651858.CD015890.pub2
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引用次数: 0
100 years of Infectious Diseases Department of Kazan State Medical University 喀山国立医科大学传染病系成立 100 周年
Pub Date : 2024-07-25 DOI: 10.17816/kmj633599
Irina V. Nikolaeva, G. Murtazina
In June 2024, the Department of Infectious Diseases of Kazan State Medical University celebrated its 100th anniversary. The department was organized during a tense epidemic situation on infectious diseases in Russia due to the need for specialized training of medical personnel, as well as conducting active scientific research on infectious pathology. Throughout the history of the department, its staff included outstanding scientists and talented teachers who were not only engaged in scientific research and the educational process, but also actively participated in the fight against infectious diseases in practical healthcare. Currently, the staff of the department is actively introducing advanced teaching methods, conducting scientific research, developing protocols and clinical recommendations. Numerous graduates of the department, who have received the specialty of infectious disease doctor, work effectively in all corners of our country.
2024 年 6 月,喀山国立医科大学传染病系迎来了建系 100 周年。该系是在俄罗斯传染病疫情紧张的情况下组建的,当时需要对医务人员进行专业培训,并积极开展传染病学的科学研究。在该系的历史上,其工作人员包括杰出的科学家和优秀教师,他们不仅从事科学研究和教育工作,还积极参与实际医疗中的传染病防治工作。目前,科室工作人员正在积极引进先进的教学方法,开展科学研究,制定方案和临床建议。该科室众多获得传染病医生专业的毕业生在祖国的各个角落卓有成效地工作着。
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Kazan medical journal
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