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On the history of management of the third stage of labor in Kazan (to the 155th anniversary of the birth of Professor V.S. Gruzdev) 喀山第三阶段劳动管理史(致格鲁兹杰夫教授诞辰155周年)
Pub Date : 2021-04-06 DOI: 10.17816/KMJ2021-249
L. A. Kozlov
The article aims to show the experience of the Kazan Obstetrics and Gynaecology Clinic named after V.S. Gruzdev for replacing the obstetric operation manual removal of the placenta with other techniques to prevent serious postpartum complications. Research methods the historical study of primary literature sources. Manual removal of the placenta always associated with the risk of infection and developing puerperal sepsis. That is why obstetricians are constantly looking for a replacement for this operation. In 1895, even in the pre-Kazan period of work, professor Gruzdev successfully performed a method of inserting saline into the umbilical vessels to speed-up placental separation in the third stage of labor. While working in Kazan, on his proposal, doctor L.S. Sidorova (1936), and then Professor P.V. Manenkov (1942, 1948, 1955) and doctor M.V. Korotkova (1958) thoroughly studied and implemented the method of Budimilich in the work of the maternity ward of the clinic. This method involves replacing the saline solution with the crude alum solution. The second measure, preventing hemorrhage in the third stage of labor and avoiding manual removal of the placenta, was the successfully testing intravenous pituitrin (oxytocin) injection by Z.N. Yakubova, completed with the defense of her doctoral dissertation (1962). The high efficiency of these methods allowed us to recommend to them for widespread obstetric practice.
本文旨在展示喀山以V.S. Gruzdev命名的喀山妇产科诊所用其他技术代替产科手术人工胎盘摘除术的经验,以防止严重的产后并发症。研究方法:主要文献史料的历史研究。人工移除胎盘总是与感染和发生产褥期败血症的风险相关。这就是为什么产科医生一直在寻找替代这种手术的方法。1895年,甚至在喀山工作之前,格鲁兹德夫教授就成功地在分娩第三阶段将生理盐水注入脐带血管,以加速胎盘分离。在喀山工作期间,根据他的建议,L.S. Sidorova医生(1936年)、P.V. Manenkov教授(1942年、1948年、1955年)和M.V. Korotkova医生(1958年)在诊所产科病房的工作中深入研究并实施了Budimilich的方法。这种方法包括用粗明矾溶液代替生理盐水。第二项措施是防止分娩第三阶段出血和避免人工移除胎盘,这是Z.N.雅库博娃(Z.N. Yakubova)成功地测试了静脉注射垂体后叶素(催产素),并完成了她的博士论文答辩(1962)。这些方法的高效率使我们能够向他们推荐广泛的产科实践。
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引用次数: 0
Distension methods of surgical correction of hypospadias in boys 男孩尿道下裂手术矫治的扩张方法
Pub Date : 2021-04-06 DOI: 10.17816/KMJ2021-216
N. R. Akramov, I. Kagantsov, E. I. Khaertdinov
Difficulties in the treatment of hypospadias in boys persist to this day. After surgical correction of hypospadias, fistulas, strictures, urethral diverticula, retraction of the meatus, glans dehiscence and other complications occur. At the same time, it is quite difficult to understand the whole variety of proposed methods for correcting hypospadias, which creates confusion for specialists and negatively affects the results of treatment. The literature describes more than 300 different methods of correcting hypospadias, but none of the methods is perfect, and there are no generally accepted treatment standards. Despite this, it is an established fact that the choice of the surgery procedure depends on the type of hypospadias. A successful technique of hypospadias repair should be completed with a good cosmetic and functional result. The article presents an overview of the distension techniques of urethroplasty. For the first time, the experience of urethral advancement was presented at the end of the XIX century, but the technique was unpopular and did not have significant success. However, by the end of the XX century, more effective distension techniques of urethroplasty began to be developed, which were widely used around the world (Koff S.A., Ti-Seng Chang, Belman A.B., MAGPI, LUM, etc.). According to scientific literature, urethral advancement is a safe and reliable way to correct distal hypospadias, and it is considered as an alternative to creating a neourethra. This technique has many competitive advantages, such as the short operation time, the absence of urethral tubularization, excellent functional and cosmetic results, and a small number of complications. It, therefore, follows that distension techniques of urethroplasty are considered a good option for correcting distal hypospadias, which should be in the arsenal of every pediatric surgeon and urologist.
治疗男孩尿道下裂的困难一直持续到今天。手术矫正后尿道下裂、瘘管、狭窄、尿道憩室、尿道道缩回、龟头开裂等并发症发生。同时,很难理解各种各样的矫正尿道下裂的方法,这给专家带来了困惑,并对治疗结果产生了负面影响。文献描述了300多种不同的矫正尿道下裂的方法,但没有一种方法是完美的,也没有普遍接受的治疗标准。尽管如此,手术方式的选择取决于尿道下裂的类型,这是一个既定的事实。一个成功的尿道下裂修复技术应该完成良好的外观和功能的结果。本文综述了尿道成形术中的扩张技术。19世纪末首次出现了尿道前移术的经验,但该技术并不受欢迎,并没有取得显著的成功。然而,到20世纪末,更有效的尿道成形术扩张技术开始发展,在世界范围内得到广泛应用(Koff S.A, Ti-Seng Chang, Belman A.B, MAGPI, LUM等)。据科学文献报道,尿道前移是一种安全可靠的矫正尿道下裂的方法,被认为是一种替代神经尿道的方法。该技术具有手术时间短、无需尿道管化、功能美观效果好、并发症少等竞争优势。因此,尿道成形术的扩张技术被认为是矫正远端尿道下裂的一个很好的选择,这应该是每个儿科外科医生和泌尿科医生的军械库。
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引用次数: 0
A case report of psoriasis exacerbation following COVID-19 COVID-19后银屑病加重1例报告
Pub Date : 2021-04-06 DOI: 10.17816/KMJ2021-238
D. R. Khaliullina, R. Abdrakhmanov
The article presents a clinical case of severe exacerbation of psoriasis after a novel coronavirus infection A 60 years old patient who has recovered from Corona Virus Disease 2019 (COVID-19) was admitted to the Republican Skin and Venereal Disease Dispensary of the Republic of Tatarstan for inpatient treatment with a diagnosis “Large plaque psoriasis involving palms and soles Progressive stage Scalp psoriasis Nail psoriasis” This was the first time the patient had experienced psoriasis exacerbation of this severity in his medical history Presumably, exacerbation of psoriasis was due to the use of hydroxychloroquine The exacerbation of psoriasis during the pandemic outbreak of Coronavirus disease can be explained by the following reasons: use of hydroxychloroquine, excessive inflammatory response to COVID-19, psychological stress, anxiety, depression, the decline in household income, limited outdoor activities It is necessary to focus attention of physicians to the fact that patients who have suffered from COVID-19 may develop exacerbation of psoriasis © 2021 Kazan Medical Journal All rights reserved
本文报道1例新型冠状病毒感染后银屑病严重加重的临床病例,患者60岁,2019冠状病毒病(COVID-19)康复后,入住鞑靼斯坦共和国皮肤病和性病药房住院治疗,诊断为“大斑块银屑病累及手掌和脚底,进展期头皮银屑病指甲银屑病”,这是患者第一次经历银屑病推测银屑病的加重与使用羟氯喹有关。冠状病毒大流行期间银屑病的加重可解释为以下原因:使用羟氯喹、对COVID-19的过度炎症反应、心理压力、焦虑、抑郁、家庭收入下降、户外活动受限。医生有必要注意到,患有COVID-19的患者可能会发展为银屑病恶化©2021喀山医学杂志版权所有
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引用次数: 0
Impact of gender and age on long-term outcomes of isolated coronary bypass surgery 性别和年龄对孤立性冠状动脉搭桥手术远期疗效的影响
Pub Date : 2021-04-06 DOI: 10.17816/KMJ2021-167
M. Poteev, R. Yakubov, A. G. Khaisanov
Aim. Search for predictors of death and analysis of long-term survival after coronary bypass surgery. Methods. The study included 1742 patients who underwent isolated coronary bypass surgery in Emergency Hospital (Naberezhnye Chelny) between 2011 and 2019, of whom 345 (19.8%) women and 1397 (80.2%) men. The women were older: their average age was 65.896.98 years versus 61.297.71 years for men (p 0.001). The primary end point was death from any cause in the long-term postoperative period. Results. The primary end point occurred in 170 patients (9.8% of the total sample), including 19 women and 151 men (11.2 vs. 88.8%). The average follow-up period was 43.6527.55 months, the median follow-up period 41 months. Both the 5-year survival rate (89% for women against 76% for men; p=0.042) and overall survival rate for the entire observation period were higher in women (86% versus 74%; p=0.042). Multivariate Cox regression analysis revealed that the long-term survival statistically significantly associated with age: up to 59 years [hazard ratio (HR) 0,43; confidence interval (CI) 0,280,65; р 0,001] and aged between 60 and 69 years (HR 0,62; CI 0,410,9; р 0,018), with gender: for female (HR 0,46; CI 0,290,77; р 0,002) and with factor of aortic occlusion during extracorporeal circulation (HR 2,42; CI 1,13-5,17; р 0,022) as well as the number of used internal thoracic arteries: one (HR 0,12; CI 0,020,65; р 0,015) or two (HR 0,08; CI 0,010,95; р 0,045). Conclusion. Both 5-year and overall survival in women was higher; factors such as female gender and young age significantly influence survival in the long-term follow-up period after coronary bypass surgery, increasing it.
的目标。冠状动脉搭桥手术后死亡预测因素的研究和长期生存分析。方法。该研究包括2011年至2019年期间在急诊医院(Naberezhnye Chelny)接受孤立冠状动脉搭桥手术的1742名患者,其中345名(19.8%)女性和1397名(80.2%)男性。女性年龄较大:她们的平均年龄为65.896.98岁,而男性为61.297.71岁(p 0.001)。主要终点是术后长期内任何原因导致的死亡。结果。主要终点发生在170例患者中(占总样本的9.8%),包括19例女性和151例男性(11.2比88.8%)。平均随访时间43.6527.55个月,中位随访时间41个月。5年生存率(女性89%,男性76%;P =0.042),女性在整个观察期的总生存率更高(86%对74%;p = 0.042)。多因素Cox回归分析显示,长期生存率与年龄有统计学显著相关:≥59岁[危险比(HR) 0.43;置信区间(CI) 0,280,65;[0,001],年龄在60 - 69岁之间(HR 0,62;CI 0410年,9;* 0,018),性别:女性(HR 0,46;CI 0290, 77;在体外循环期间伴有主动脉阻塞因素(HR 2,42;CI 1之比是13比5 17;使用的胸内动脉数量:1 (HR 0,12;CI 0020, 65;* 0,015)或两个(HR 0,08;CI 0010, 95;р0045)。结论。女性患者的5年生存率和总生存率均较高;女性、年轻等因素显著影响冠状动脉搭桥术后长期随访期的生存率,使其增加。
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引用次数: 0
Epidemiological aspects of central serous chorioretinopathy 中枢性浆液性脉络膜视网膜病变的流行病学方面
Pub Date : 2021-04-06 DOI: 10.17816/KMJ2021-228
D. R. Agliullin, G. Khasanova, E. Abdulaeva, S. Agliullina, A. Amirov, A. Kuskov, A. Kim, A. Rascheskov, D. Lipinskiy
Aim. To analyze the incidence of central serous chorioretinopathy among the Kazans population between 2009 and 2018. Methods. A descriptive epidemiological study of the incidence of Central serous chorioretinopathy of the population of Kazan between 2009 and 2018 was conducted. It included an analysis of long-term changes in the incidence of male and female population and an assessment of the structure of morbidity by sex for the entire period and in dynamics. Testing for differences was performed using the nonparametric MannWhitney U test and Chi-square test with Yates correction. Results. 831 new cases of central serous chorioretinopathy were registered in Kazan during 20092018, the ratio of men and women was approximately 1:1. In the dynamics of morbidity, the proportion of men increased from 24.2% in 2009 to 60.7% in 2018 (р=0.000002), while the proportion of women decreased from 75.8% in 2009 to 39.3% in 2018 (р=0.000002). The long-term dynamics for 20092018 is characterized by a statistically significant increase in the incidence rate of central serous chorioretinopathy in men (p=0.004) from 3.2 per 100 000 in 2009 to 14.8 per 100 000 in 2018. During the study period, the incidence rate in women remains at the same level, varying from 5.4 per 100 000 to 8 per 100 000 (p=0.663). Men are more likely to have central serous chorioretinopathy at a younger age (р=0.0001). The median age at the time of diagnosis in women was 55 years (Q25Q75 4565 years), in men 45 years (Q25Q75 3756 years). Conclusion. From 2009 to 2018, the incidence rate of central serous chorioretinopathy among men in Kazan significantly increased in both intensive (p=0.004) and extensive indicators (p=0.000002); сentral serous chorioretinopathy in men develops at an earlier age compared with women (median age of women at the time of diagnosis was 55 years, median age of men 45 years, p=0.0001).
的目标。分析喀山人群2009 - 2018年中枢性浆液性脉络膜视网膜病变的发病率。方法。对喀山地区2009 - 2018年人群中枢性浆液性脉络膜视网膜病变发病率进行了描述性流行病学研究。它包括对男性和女性人口发病率的长期变化的分析,以及对整个时期按性别划分的发病率结构和动态的评估。差异检验采用非参数MannWhitney U检验和卡方检验,并进行耶茨校正。结果:喀山2009 - 2018年共新登记中枢性浆液性脉络膜视网膜病变831例,男女比例约为1:1。在发病率动态方面,男性比例从2009年的24.2%上升到2018年的60.7% (r =0.000002),而女性比例从2009年的75.8%下降到2018年的39.3% (r =0.000002)。2009 - 2018年的长期动态特征是,男性中枢性浆液性脉络膜视网膜病变的发病率(p=0.004)从2009年的每10万人3.2例增加到2018年的每10万人14.8例。在研究期间,妇女的发病率保持在同一水平,从每10万人5.4到每10万人8不等(p=0.663)。男性在年轻时更容易发生中枢性浆液性脉络膜视网膜病变(r =0.0001)。女性诊断时的中位年龄为55岁(Q25Q75 - 4565岁),男性为45岁(Q25Q75 - 3756岁)。结论。从2009年到2018年,喀山地区男性中心性浆液性脉络膜视网膜病变的发病率在密集指标(p=0.004)和广泛指标(p=0.000002)上均显著增加;与女性相比,男性中心性浆液性脉络膜视网膜病变的发病年龄更早(女性诊断时的中位年龄为55岁,男性中位年龄为45岁,p=0.0001)。
{"title":"Epidemiological aspects of central serous chorioretinopathy","authors":"D. R. Agliullin, G. Khasanova, E. Abdulaeva, S. Agliullina, A. Amirov, A. Kuskov, A. Kim, A. Rascheskov, D. Lipinskiy","doi":"10.17816/KMJ2021-228","DOIUrl":"https://doi.org/10.17816/KMJ2021-228","url":null,"abstract":"Aim. To analyze the incidence of central serous chorioretinopathy among the Kazans population between 2009 and 2018. \u0000Methods. A descriptive epidemiological study of the incidence of Central serous chorioretinopathy of the population of Kazan between 2009 and 2018 was conducted. It included an analysis of long-term changes in the incidence of male and female population and an assessment of the structure of morbidity by sex for the entire period and in dynamics. Testing for differences was performed using the nonparametric MannWhitney U test and Chi-square test with Yates correction. \u0000Results. 831 new cases of central serous chorioretinopathy were registered in Kazan during 20092018, the ratio of men and women was approximately 1:1. In the dynamics of morbidity, the proportion of men increased from 24.2% in 2009 to 60.7% in 2018 (р=0.000002), while the proportion of women decreased from 75.8% in 2009 to 39.3% in 2018 (р=0.000002). The long-term dynamics for 20092018 is characterized by a statistically significant increase in the incidence rate of central serous chorioretinopathy in men (p=0.004) from 3.2 per 100 000 in 2009 to 14.8 per 100 000 in 2018. During the study period, the incidence rate in women remains at the same level, varying from 5.4 per 100 000 to 8 per 100 000 (p=0.663). Men are more likely to have central serous chorioretinopathy at a younger age (р=0.0001). The median age at the time of diagnosis in women was 55 years (Q25Q75 4565 years), in men 45 years (Q25Q75 3756 years). \u0000Conclusion. From 2009 to 2018, the incidence rate of central serous chorioretinopathy among men in Kazan significantly increased in both intensive (p=0.004) and extensive indicators (p=0.000002); сentral serous chorioretinopathy in men develops at an earlier age compared with women (median age of women at the time of diagnosis was 55 years, median age of men 45 years, p=0.0001).","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79081807","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
The effectiveness of kinesio taping in edema-reducing treatment for fractures of the lower jaw 运动贴在下颌骨折减水肿治疗中的效果
Pub Date : 2021-04-06 DOI: 10.17816/KMJ2021-243
D. Gasimzade, F. Takhavieva, S. Ksembaev, O. Ivanov
Aim. To assess the effect of Kinesio taping on edema reduction among the patients with fractures of the mandible (lower jaw) in the early postsurgical period of osteosynthesis. Methods. Patients with unilateral mandibular angle fractures with displacement of fragments (49 men at the age of 1850 years), divided into 2 groups: the main group 26 patients (with the inclusion of Kinesio taping in the complex of treatment) and the control group 23 patients (the traditional complex of treatment). All patients underwent splinting of the jaw and miniplate osteosynthesis. Kinesio tapes were applied the next day after surgery to the skin above and below the surgical wound. Three out of five standard landmarks were used to measure edema on the 1st and 5th days after osteosynthesis. Data were analyzed by using descriptive statistics and Student's test. In all cases, the level of statistical significance was 5% (p 0.05). Results. On the day after osteosynthesis, the patients of the main group showed a statistically significant (р 0.003) increase in the measured length for all three landmarks compared with the intact side due to pronounced postoperative edema. On the 5th day after the inclusion of Kinesio taping in the complex of treatment, there was a reduction in edema the indicators of the fractured and intact sides did not differ significantly from each other (р 0.05). In patients of the comparison group, the decrease in the parameters of postoperative edema on the 5th day of observation was negligible and insignificant in all measurements (р 0.05). Conclusion. The results indicate the effectiveness of using Kinesio taping for mandibular fractures in the early postoperative period of osteosynthesis, which makes it possible to achieve a significant reduction in postoperative edema; Kinesio taping is a promising, easy-to-perform method that can be used to reduce inflammatory edema in fractures of the mandible.
的目标。目的探讨肌内效贴贴对骨融合术后早期下颌骨骨折患者水肿的影响。方法。选取单侧下颌角骨折伴碎片移位患者49例,年龄1850岁,男性49例,分为2组:主组26例(采用肌内效贴膜复合治疗),对照组23例(采用传统复合治疗)。所有患者均接受了下颌夹板和微型钢板接骨术。术后第二天将肌内效贴贴在手术创面上下的皮肤上。在植骨后第1天和第5天,用5个标准地标中的3个来测量水肿。数据分析采用描述性统计和学生检验。所有病例的差异均为5% (p < 0.05)。结果。在接骨后的第一天,由于术后明显的水肿,主组患者的三个地标的测量长度与完整侧相比有统计学意义(0.003)的增加。肌内效贴敷复合治疗后第5天,水肿明显减少,骨折侧和完整侧各项指标差异无统计学意义(0.05)。对照组患者术后第5天水肿各项指标的下降可忽略不计,各项指标均不显著(0.05)。结论。结果表明,在术后早期使用肌内效贴带治疗下颌骨骨折是有效的,可以显著减少术后水肿;肌内效贴布是一种很有前途的,易于操作的方法,可用于减少下颌骨骨折的炎症性水肿。
{"title":"The effectiveness of kinesio taping in edema-reducing treatment for fractures of the lower jaw","authors":"D. Gasimzade, F. Takhavieva, S. Ksembaev, O. Ivanov","doi":"10.17816/KMJ2021-243","DOIUrl":"https://doi.org/10.17816/KMJ2021-243","url":null,"abstract":"Aim. To assess the effect of Kinesio taping on edema reduction among the patients with fractures of the mandible (lower jaw) in the early postsurgical period of osteosynthesis. \u0000Methods. Patients with unilateral mandibular angle fractures with displacement of fragments (49 men at the age of 1850 years), divided into 2 groups: the main group 26 patients (with the inclusion of Kinesio taping in the complex of treatment) and the control group 23 patients (the traditional complex of treatment). All patients underwent splinting of the jaw and miniplate osteosynthesis. Kinesio tapes were applied the next day after surgery to the skin above and below the surgical wound. Three out of five standard landmarks were used to measure edema on the 1st and 5th days after osteosynthesis. Data were analyzed by using descriptive statistics and Student's test. In all cases, the level of statistical significance was 5% (p 0.05). \u0000Results. On the day after osteosynthesis, the patients of the main group showed a statistically significant (р 0.003) increase in the measured length for all three landmarks compared with the intact side due to pronounced postoperative edema. On the 5th day after the inclusion of Kinesio taping in the complex of treatment, there was a reduction in edema the indicators of the fractured and intact sides did not differ significantly from each other (р 0.05). In patients of the comparison group, the decrease in the parameters of postoperative edema on the 5th day of observation was negligible and insignificant in all measurements (р 0.05). \u0000Conclusion. The results indicate the effectiveness of using Kinesio taping for mandibular fractures in the early postoperative period of osteosynthesis, which makes it possible to achieve a significant reduction in postoperative edema; Kinesio taping is a promising, easy-to-perform method that can be used to reduce inflammatory edema in fractures of the mandible.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80029198","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
Psychosocial adaptation to chronic heart failure in patients with coronary heart disease 冠心病患者慢性心力衰竭的社会心理适应
Pub Date : 2021-04-06 DOI: 10.17816/KMJ2021-156
A. G. Zhidyaevskij, G. Galyautdinov, V. Mendelevich, A. G. Gataullina, A. Kuzmenko
Aim. To assess the effects of acquired social status, neurotic conditions, type D personality, cognitive functions, quality of life and adherence to treatment on psychosocial adaptation of patients with coronary heart disease (IHD) to chronic heart failure (CHF), depending on the severity of decompensation. Methods. 87 patients with coronary artery disease and chronic heart failure aged between 55 and 72 years were examined. All patients were divided into two groups depending on the functional class of chronic heart failure [New York Heart Association (NYHA) class IIV]. The first group included 41 patients with NYHA functional class III, the second group 46 patients with NYHA functional class IIIIV. For a comprehensive study of the psychosocial adaptation of patients, a set of standardized questionnaires was used: the abridged variant of the Minnesota Multiphasic Personality Inventory (SMOL), a clinical questionnaire for identifying and assessing neurotic condition, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 36-Item Short Form Health Survey Questionnaire (SF-36), the Mini Mental State Examination (MMSE), 14-question test Type D Scale-14 (DS14), MoriskyGreen test, the short version of the AUDIT questionnaire (AUDIT-C). We collected data on the patient's social status: gender, education, income level. The results obtained were analyzed. Results. Based on the SMOL personality profiles, patients of the second group were classified as neurotic an increase was noted in three neurotic scales: hypochondria (U=541; p=0.030), hysteria (U=579; p=0.048), and autism/schizoid (U=577.5; p=0.047) compared with patients of the first group. According to the results of the clinical questionnaire for the identification and assessment of neurotic condition, the greatest differences were found between patients of first and second groups on the scale of autonomic disorders (U=571; p=0.039) and neurotic depression (U=576; p=0.046). Comparing the groups according to the MLHFQ score, quality of life in patients of the second group was markedly reduced (U=447.5; p 0.001). According to the SF-36 questionnaire, a decrease in the quality of life was also found in patients of the second group on the scale Physical functioning (U=554; p=0.032) and Physical component of health (U=573.5; p=0.044). The cognitive status in patients of the second group was significantly decreased compared with the first group (U=427; p 0.001). No significant differences were found in adherence to treatment between the two groups (U=757; p=0.666). Also, there were no patients with type D personality on both subscales (U=717.5; p=0.483, U=784; p=0.933) and according to the AUDIT-C scores, there are no significant differences between men (U=681.5; p=0.257) and women (U=728.5; p=0.425) in both groups of patients. Conclusion. Signs of social maladjustment in patients with more severe NYHA functional class of the disease are expressed by significantly more pronounced social isol
的目标。评估获得性社会地位、神经症、D型人格、认知功能、生活质量和坚持治疗对冠心病(IHD)患者对慢性心力衰竭(CHF)的心理社会适应的影响,这取决于失代偿的严重程度。方法:对55 ~ 72岁冠心病合并慢性心力衰竭患者87例进行回顾性分析。所有患者根据慢性心力衰竭的功能等级分为两组[纽约心脏协会(NYHA) IIV级]。第一组41例NYHA功能III级,第二组46例NYHA功能III、iv级。为了全面研究患者的社会心理适应情况,我们使用了一套标准化的问卷:明尼苏达州多相人格量表(SMOL)、诊断和评估神经症的临床问卷、明尼苏达州心力衰竭患者生活问卷(MLHFQ)、36题简短健康调查问卷(SF-36)、迷你精神状态检查问卷(MMSE)、14题D型量表-14 (DS14)、MoriskyGreen测验、审计问卷(AUDIT- c)。我们收集了病人的社会地位数据:性别、教育程度、收入水平。对所得结果进行了分析。结果。根据SMOL人格特征,第二组患者被归类为神经症,并在三个神经症量表上有所增加:疑病症(U=541;p=0.030),癔症(U=579;p=0.048),自闭症/精神分裂(U=577.5;P =0.047)。根据神经状态识别与评估临床问卷结果,第一组与第二组患者在自主神经障碍量表上差异最大(U=571;p=0.039)和神经症抑郁症(U=576;p = 0.046)。根据MLHFQ评分比较,第二组患者的生活质量明显降低(U=447.5;p 0.001)。根据SF-36问卷,第二组患者在身体功能量表上的生活质量也有所下降(U=554;p=0.032)和健康的身体成分(U=573.5;p = 0.044)。第二组患者的认知状态较第一组显著降低(U=427;p 0.001)。两组患者的治疗依从性无显著差异(U=757;p = 0.666)。两份量表均无D型人格患者(U=717.5;p = 0.483 U = 784;p=0.933),根据AUDIT-C评分,男性间差异无统计学意义(U=681.5;p=0.257)和女性(U=728.5;P =0.425)。结论。更严重的NYHA功能级别患者的社会适应不良迹象表现为更明显的社会孤立(自闭症),倾向于避免与他人交流,对自己的问题孤立,以及对慢性心力衰竭的躯体表现的疑病症关注;社会适应水平降低的主要原因可能是神经质得分高,从而导致认知能力的功能性下降和生活质量的显著下降。
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引用次数: 0
Clinical case of intussusception of the jejunum into gastroenteroanastomosis after gastric ­resection 胃切除术后空肠肠套叠进入胃肠吻合术1例
Pub Date : 2021-04-06 DOI: 10.17816/KMJ2021-234
F. Akhmetzyanov, V. Egorov, A. Daminov, N. D. Sirazitdinov
Intussusception is one of the varieties of mixed (strangulation and obturation) mechanical intestinal obstruction. It arises as a result of the introduction of the adducting segment of the intestine into the abducting one. Gastroduodenal intussusception is an extremely rare type of high intestinal obstruction. It most often occurs after surgery on the stomach and much less often in non-operated patients. Intussusception of the jejunum into the stomach can occur soon after surgery, but most often, this complication occurs 515 years after the intervention. This paper describes a case of retrograde intussusception that arose 9 years after the Billroth II gastric resection with Braun anastomosis. This clinical case acquaints specialists with the possibility to encounter this pathology in clinical practice and demonstrates the appropriateness of differential diagnostics in cases with similar clinical symptoms.
肠套叠是混合型(绞窄型和闭合型)机械性肠梗阻的一种。它是由于肠内收段进入外展段而产生的。胃十二指肠肠套叠是一种极为罕见的高度肠梗阻。它最常发生在胃手术后,在未手术的患者中很少发生。手术后不久可发生空肠肠套叠,但最常见的是,这种并发症发生在干预后515年。本文报告1例逆行性肠套叠发生于Billroth II型胃切除术合并Braun吻合术后9年。该临床病例使专家认识到在临床实践中可能遇到这种病理,并证明了在具有类似临床症状的病例中进行鉴别诊断的适当性。
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引用次数: 0
Assessing the effectiveness of prevention of mother-to-child HIV transmission 评估预防艾滋病毒母婴传播的有效性
Pub Date : 2021-04-06 DOI: 10.17816/KMJ2021-176
R. M. Khamidulina, M. G. Katyagina, I. S. Zolotova, L. E. Ziganshina
Aim. To analyze the outcomes of a set of interventions to prevent vertical transmission of the human immunodeficiency virus (HIV) in the Republic of Mari El. Methods. A retrospective analysis of temporary registration forms Notifications of the termination of pregnancy in an HIV-infected woman and Notifications of a newborn born by an HIV-infected mother, case histories and outpatient medical records of HIV-infected women who gave birth in 20002018 was carried out. The study included all children born in the Republic of Mari El to HIV-positive women registered with the Republican Center for the Prevention and Control of AIDS and Infectious Diseases, as well as children whose HIV status is detected after birth as a result of epidemiological investigations. The assessment of the risks of transmission as an outcome of the three-step preventive interventions has been carried out. A comparative analysis of the results of perinatal prevention of HIV transmission in the Republic of Mari El and other regions of the Russian Federation was performed. Results. A total of 299 HIV-infected pregnant women and 368 children born to these women during the study period were registered in the region; 63 (21.7%) of these women had more than one child. Over the entire study period, 18 (4.8%) children with confirmed HIV infection were registered. The most common factor associated with infant HIV infection is late maternal HIV diagnosis: (1) several years after childbirth in the absence of antiretroviral (ARV) prophylaxis and the infants were breastfeeding (11 cases, 64.7%); (2) during or shortly after childbirth, when the patient did not receive entire three-step antiretroviral prophylaxis during pregnancy and childbirth (6 cases, 29.4%); (3) in the third trimester of pregnancy (1 case, 5.5%). An important limitation for the successful prevention of vertical transmission of HIV was the lack of routine HIV testing, which is required by women and their partners before and at various stages during pregnancy. A single case of self-infection indicates the need to introduce preventive measures from early adolescence among children. Conclusion. Due to the late maternal HIV diagnosis, during or after delivery, HIV transmission events occurred either with limited or no limited antiretroviral prophylaxis.
的目标。分析马里埃尔共和国预防人类免疫缺陷病毒(艾滋病毒)垂直传播的一套干预措施的结果。方法。回顾性分析2000 - 2018年艾滋病毒感染妇女的临时登记表《艾滋病毒感染妇女终止妊娠通知单》和《艾滋病毒感染母亲分娩新生儿通知单》、病例史和门诊病历。这项研究包括在马里埃尔共和国艾滋病和传染病预防和控制中心登记的艾滋病毒阳性妇女所生的所有儿童,以及通过流行病学调查在出生后检测出艾滋病毒状况的儿童。已经对作为三步预防干预措施结果的传播风险进行了评估。对马里埃尔共和国和俄罗斯联邦其他地区围产期预防艾滋病毒传播的结果进行了比较分析。结果。在研究期间,该地区共登记了299名感染艾滋病毒的孕妇和这些妇女所生的368名儿童;这些妇女中有63人(21.7%)有一个以上的孩子。在整个研究期间,登记了18名(4.8%)确认感染艾滋病毒的儿童。与婴儿HIV感染相关的最常见因素是母亲HIV诊断较晚:(1)分娩后若干年没有抗逆转录病毒(ARV)预防,婴儿母乳喂养(11例,64.7%);(2)在分娩期间或分娩后不久,患者在怀孕和分娩期间未接受完整的三步抗逆转录病毒预防治疗(6例,29.4%);(3)妊娠晚期(1例,5.5%)。成功预防艾滋病毒垂直传播的一个重要限制是缺乏妇女及其伴侣在怀孕前和怀孕期间各个阶段所要求的常规艾滋病毒检测。一例自我感染表明需要在儿童中从青春期早期就采取预防措施。结论。由于产妇艾滋病毒诊断较晚,在分娩期间或分娩后,艾滋病毒传播事件发生在有限或没有有限的抗逆转录病毒预防措施的情况下。
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引用次数: 2
The glutathione system in bone tissue under the action of copper-zinc ore components and antioxidants administration 骨组织中谷胱甘肽系统在铜锌矿成分和抗氧化剂作用下的作用
Pub Date : 2021-04-06 DOI: 10.17816/KMJ2021-199
G. R. Kuramshina, Курамшина Гульназ Ришатовна, F. Kamilov, Камилов Феликс Хусаинович
Aim. To study changes in the glutathione system in bone tissue during chronic intoxication with elements contained in copper-zinc pyrite ore and antioxidant vitamin administration. Methods. 36 mature male white rats were divided into three groups (control, comparison, experimental). The rats of the experimental and comparison groups received intragastrically copper-zinc pyrite ore powder in a 2% starch solution as a suspension at a dosage of 60 mg/100 g bodyweight daily for three months. During the last month, the experimental group received an antioxidant vitamin preparation (the complex of vitamins with a trace element) containing α-tocopherol, β-carotene, ascorbic acid and selenium. The content of reduced glutathione, free thiol groups in proteins, the activity of glutathione peroxidase, glutathione transferase, glutathione reductase, gamma-glutamyl transferase, and glucose-6-phosphate dehydrogenase were determined in homogenates derived from femoral epiphysis. The statistical analysis of the results was performed using Statistica 6.0 software. The median (Me) and percentiles (Q1 and Q2) were calculated, a non-parametric Mann–Whitney U test was carried out to compare study groups. Results. Chronic intoxication with elements contained in copper-zinc pyrite ore causes impairment of the glutathione system in bone tissue. Intoxicated rats showed a decrease in the reduced glutathione content to 71.9% (р=0.014) and free sulfhydryl groups of proteins to 77.8% (р=0.0143), inhibition of glutathione-dependent antioxidant enzymes activities, and disruption of the glutathione reduction system in tissues, compared to the control group. Antioxidant vitamin administration increased the levels of reduced glutathione and free thiol groups of proteins, activated the enzymes involved in the glutathione system: the reduced glutathione content increased to 94.8% (p=0.2132), glutathione peroxidase activity to 85.7% (p=0.0432), glutathione transferase — up to 94.3% (p=0.5251), glutathione reductase — up to 86.1% (p=0.0442) compared to the control group. Conclusion. Chronic intoxication with metals contained in copper-zinc pyrite ore leads to decreasing the content of reduced glutathione and free thiol groups of proteins in bones along with reducing glutathione reductase and glucose-6-phosphate dehydrogenase activities, inhibition of glutathione peroxidase and glutathione transferase; an antioxidant vitamin administration increases the activity of glutathione reduction enzymes in bone tissue, the content of reduced glutathione and free sulfhydryl groups of proteins, the activities of glutathione peroxidase and glutathione transferase.
的目标。研究黄铁矿铜锌元素和抗氧化维生素慢性中毒时骨组织谷胱甘肽系统的变化。方法:将36只成年雄性大鼠分为对照组、对照组、实验组。实验组和对照组大鼠ig含2%淀粉溶液的铜锌黄铁矿粉作为混悬液,剂量为60 mg/100 g体重,每日3个月。在最后一个月里,实验组接受了一种抗氧化维生素制剂(维生素与微量元素的复合物),其中含有α-生育酚、β-胡萝卜素、抗坏血酸和硒。测定股骨骨骺匀浆中还原性谷胱甘肽、蛋白质中游离巯基的含量、谷胱甘肽过氧化物酶、谷胱甘肽转移酶、谷胱甘肽还原酶、γ -谷氨酰基转移酶和葡萄糖-6-磷酸脱氢酶的活性。采用Statistica 6.0软件对结果进行统计分析。计算中位数(Me)和百分位数(Q1和Q2),采用非参数Mann-Whitney U检验比较各研究组。结果。铜锌黄铁矿中含有的元素慢性中毒会导致骨组织中谷胱甘肽系统的损伤。与对照组相比,中毒大鼠的还原性谷胱甘肽含量下降至71.9% (r =0.014),蛋白质的游离巯基含量下降至77.8% (r =0.0143),依赖谷胱甘肽的抗氧化酶活性受到抑制,组织中谷胱甘肽还原系统受到破坏。抗氧化维生素增加了还原性谷胱甘肽和游离巯基蛋白的水平,激活了参与谷胱甘肽系统的酶:与对照组相比,还原性谷胱甘肽含量增加到94.8% (p=0.2132),谷胱甘肽过氧化物酶活性增加到85.7% (p=0.0432),谷胱甘肽转移酶增加到94.3% (p=0.5251),谷胱甘肽还原酶增加到86.1% (p=0.0442)。结论。慢性铜锌黄铁矿金属中毒导致骨中还原性谷胱甘肽和游离巯基含量降低,谷胱甘肽还原酶和葡萄糖-6-磷酸脱氢酶活性降低,谷胱甘肽过氧化物酶和谷胱甘肽转移酶活性受到抑制;抗氧化维生素可以增加骨组织中谷胱甘肽还原酶的活性,蛋白质中还原性谷胱甘肽和游离巯基的含量,谷胱甘肽过氧化物酶和谷胱甘肽转移酶的活性。
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引用次数: 0
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