F. Akhmetzyanov, Ахметзянов Фоат Шайхутдинович, N. A. Valiev, Валиев Наиль Абулкарямович, V. Egorov, Егоров Василий Иванович, M. I. Shaymardanov, Шаймарданов Марат Ильсурович
Gastric stump cancer is a carcinoma which forms no earlier than 5 years after surgery for benign disease. The incidence ranges from 2.4 to 5% among patients with stomach cancer. Previous operations lead to the emergence of an adhesive process in the abdominal cavity, changes in the anatomy and topography of the abdominal organs, as well as the development of new ways of lymph outflow. These factors lead to the re-surgery becomes technically more complicated and requires high professional training from the surgeon. Of particular surgical interest is the issue of restoration of the digestive tract, which directly depends on the nature and volume of the previous surgery. In this paper, the authors describe cases of surgical treatment of gastric stump cancer in two patients, who had previously undergone pancreaticoduodenectomy.
{"title":"The option of surgery for gastric stump cancer in patients who have previously undergone pancreaticoduodenectomy","authors":"F. Akhmetzyanov, Ахметзянов Фоат Шайхутдинович, N. A. Valiev, Валиев Наиль Абулкарямович, V. Egorov, Егоров Василий Иванович, M. I. Shaymardanov, Шаймарданов Марат Ильсурович","doi":"10.17816/KMJ2021-100","DOIUrl":"https://doi.org/10.17816/KMJ2021-100","url":null,"abstract":"Gastric stump cancer is a carcinoma which forms no earlier than 5 years after surgery for benign disease. The incidence ranges from 2.4 to 5% among patients with stomach cancer. Previous operations lead to the emergence of an adhesive process in the abdominal cavity, changes in the anatomy and topography of the abdominal organs, as well as the development of new ways of lymph outflow. These factors lead to the re-surgery becomes technically more complicated and requires high professional training from the surgeon. Of particular surgical interest is the issue of restoration of the digestive tract, which directly depends on the nature and volume of the previous surgery. In this paper, the authors describe cases of surgical treatment of gastric stump cancer in two patients, who had previously undergone pancreaticoduodenectomy.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83506891","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}
Endoscopic esophageal stent implantation is an effective method for dysphagia management in malignant esophageal stricture. However, this technology is associated with the risk of many complications, including those fatal to life. These include bleeding, restenosis, stent fragmentation and destruction, stent migration, pneumomediastinum, the formation of esophageal fistulas, perforations, clogging of the stent with food, retrosternal pain, gastroesophageal reflux changes, airway compression, aspiration pneumonia, and fever. The overall complication rate is 3640%. Mortality rates associated with stenting is between 3.9 and 27.2%. Nevertheless, today there are ways to minimize the incidence of complications due to the constant progress of endoscopic technologies and improvements in the design of modern stents. In addition, most endoscopic interventions can manage the vast majority of complications effectively after stent implantation subject to their early detection. Optimal selection of an esophageal stent and careful selection of patients with a low risk of complications associated with stent implantation are important problems in the prevention of complications to achieve high efficiency of stenting. Evaluation of risk factors for possible complications, the design of stents and their characteristics, as well as using modern methods of effective management of possible complications improves the quality and duration of life in incurable patients with esophageal cancer. The review reflects all possible complications of stenting in esophageal and gastroesophageal junction, factors affecting the occurrence of complications, as well as modern and effective methods of their correction and prevention.
{"title":"Complications of endoscopic esophageal stent implantation","authors":"A. I. Ivanov, V. Popov, M. V. Burmistrov","doi":"10.17816/KMJ2021-74","DOIUrl":"https://doi.org/10.17816/KMJ2021-74","url":null,"abstract":"Endoscopic esophageal stent implantation is an effective method for dysphagia management in malignant esophageal stricture. However, this technology is associated with the risk of many complications, including those fatal to life. These include bleeding, restenosis, stent fragmentation and destruction, stent migration, pneumomediastinum, the formation of esophageal fistulas, perforations, clogging of the stent with food, retrosternal pain, gastroesophageal reflux changes, airway compression, aspiration pneumonia, and fever. The overall complication rate is 3640%. Mortality rates associated with stenting is between 3.9 and 27.2%. Nevertheless, today there are ways to minimize the incidence of complications due to the constant progress of endoscopic technologies and improvements in the design of modern stents. In addition, most endoscopic interventions can manage the vast majority of complications effectively after stent implantation subject to their early detection. Optimal selection of an esophageal stent and careful selection of patients with a low risk of complications associated with stent implantation are important problems in the prevention of complications to achieve high efficiency of stenting. Evaluation of risk factors for possible complications, the design of stents and their characteristics, as well as using modern methods of effective management of possible complications improves the quality and duration of life in incurable patients with esophageal cancer. The review reflects all possible complications of stenting in esophageal and gastroesophageal junction, factors affecting the occurrence of complications, as well as modern and effective methods of their correction and prevention.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86283017","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}
A. G. Naumov, Наумов Алексей Георгиевич, A. S. Shprykov, Шпрыков Александр Сергеевич, D. Sutyagina, Сутягина Дина Андреевна, E. R. Kryukov, Крюков Эмиль Ришатович, P. A. Bochkarev, Бочкарёв Павел Алексеевич, M. Spiridonov, Спиридонов Михаил Александрович
The article provides information about a prominent Nizhny Novgorod surgeon, the first head of the tuberculosis ¬department of the Gorky Medical Institute named after S.M. Kirov (now Privolzhsky Research Medical University) Ivan Semenovich Nikolaev. Ivan Semyonovich Nikolaev went through the horrors of the Great Patriotic War, worked with prominent doctors of his time (L.V. Bogush, B.A. Korolev, S.S. Yudin), achieved unprecedented success in the surgical treatment of pulmonary and extrapulmonary tuberculosis, received the degree of Doctor of Medical Sciences after defending the candidate's thesis (for the first time in the history of the Gorky Medical Institute named after S.M. Kirov) due to the uniqueness and fundamental nature of the scientific materials presented. Professor Ivan Semyonovich Nikolaev successfully combined pedagogical, scientific and medical work with great organizational and social work. For many years, I.S. Nikolaev was a member of the board of the All-Union and All-Russian ¬Society of Phthisiologists, for more than 20 years he was the Chairman of the Board of the Gorky Scientific Medical Society of Phthisiologists, a member of the editorial board of the journal “Problems of Tuberculosis”. Many times Ivan Semyonovich Nikolaev represented the Nizhny Novgorod phthisiology and medical institute at the All-Union and All-Russian congresses and conferences of phthisiologists was a member of their presidiums. In 1988, Ivan Semyonovich Nikolaev, due to his age, left the position of head of the tuberculosis department and worked as a consultant professor for several years, and then retired. In recent years, he lived in his native village Paustovo (Vyaznikovsky district, Vladimir region). In 1999, Ivan Semyonovich died.
{"title":"Surgeon, citizen, teacher (to the 100th anniversary of the birth of Professor I.S. Nikolaev)","authors":"A. G. Naumov, Наумов Алексей Георгиевич, A. S. Shprykov, Шпрыков Александр Сергеевич, D. Sutyagina, Сутягина Дина Андреевна, E. R. Kryukov, Крюков Эмиль Ришатович, P. A. Bochkarev, Бочкарёв Павел Алексеевич, M. Spiridonov, Спиридонов Михаил Александрович","doi":"10.17816/KMJ2021-110","DOIUrl":"https://doi.org/10.17816/KMJ2021-110","url":null,"abstract":"The article provides information about a prominent Nizhny Novgorod surgeon, the first head of the tuberculosis ¬department of the Gorky Medical Institute named after S.M. Kirov (now Privolzhsky Research Medical University) Ivan Semenovich Nikolaev. Ivan Semyonovich Nikolaev went through the horrors of the Great Patriotic War, worked with prominent doctors of his time (L.V. Bogush, B.A. Korolev, S.S. Yudin), achieved unprecedented success in the surgical treatment of pulmonary and extrapulmonary tuberculosis, received the degree of Doctor of Medical Sciences after defending the candidate's thesis (for the first time in the history of the Gorky Medical Institute named after S.M. Kirov) due to the uniqueness and fundamental nature of the scientific materials presented. Professor Ivan Semyonovich Nikolaev successfully combined pedagogical, scientific and medical work with great organizational and social work. For many years, I.S. Nikolaev was a member of the board of the All-Union and All-Russian ¬Society of Phthisiologists, for more than 20 years he was the Chairman of the Board of the Gorky Scientific Medical Society of Phthisiologists, a member of the editorial board of the journal “Problems of Tuberculosis”. Many times Ivan Semyonovich Nikolaev represented the Nizhny Novgorod phthisiology and medical institute at the All-Union and All-Russian congresses and conferences of phthisiologists was a member of their presidiums. In 1988, Ivan Semyonovich Nikolaev, due to his age, left the position of head of the tuberculosis department and worked as a consultant professor for several years, and then retired. In recent years, he lived in his native village Paustovo (Vyaznikovsky district, Vladimir region). In 1999, Ivan Semyonovich died.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78203266","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}
E. Lukoyanychev, Лукоянычев Егор Евгеньевич, S. G. Izmaylov, Измайлов Сергей Геннадьевич, A. Mironov, Миронов Андрей Александрович, A. Izmaylov, Измайлов Александр Геннадьевич, A. Bodrov, Бодров Алексей Анатольевич, S. N. Bogdanov, Богданов Сергей Николаевич, O. S. Kolchina, Колчина Оксана Степановна, S. A. Melnik, Мельник Светлана Анатольевна, D. Evsyukov, Евсюков Дмитрий Алексеевич, T. V. Vadyaeva, Вадяева Татьяна Викторовна
Aim. To study the effect of pyrimidine medication hydroxyethyldimethyldihydropyrimidine on the systemic inflammation after prosthetic repair of the anterior abdominal wall hernia. Methods. We prospectively analyzed two groups of patients aged between 18 and 80 years, who underwent prosthetic repair of the aponeurosis defect in the anterior abdominal wall hernia with a standard polypropylene mesh implant. The main group (n=16) was given 0.5 g hydroxyethyldimethyldihydropyrimidine per os 3 times a day ¬before meals for 5–7 days from the first day after the operation. In the control group (n=16), patients received basic therapy without hydroxyethyldimethyldihydropyrimidine. Results. The postoperative period in patients after elective prosthetic hernioplasty of anterior abdominal wall was associated with an imbalance of the immune system with a tendency to lymphocytopenia (count in blood changed by –27.0%; p=0.20, Wilcoxon criterion) without significant leukocytopenia (count in blood changed by –4.9%; p=1.00, Wilcoxon criterion) and an 82.8% increase in C-reactive protein content (p=0.2, Wilcoxon criterion) compared to baseline values before the surgery. The proposed pharmacological support of prosthetic hernioplasty of the anterior abdominal wall with hydroxyethyldimethyldihydropyrimidine allowed to correct the postoperative lymphocytopenia (p=0.04, U-criterion) and reduce the concentration of C-reactive protein by 223.6% (p=0.03, U-criterion) compared with the control, which was also associated with a decrease in the number of local complications of prosthetic hernioplasty. Conclusion. The use of hydroxyethyldimethyldihydropyrimidine in patients after prosthetic hernioplasty is associated with a significant decrease in the C-reactive protein level, prevention of postoperative lymphocytopenia and a decrease in the number of local wound complications; C-reactive protein level can serve as one of the early and significant indicators of postoperative complications in this category of patients.
的目标。目的探讨嘧啶类药物羟乙基二甲基二氢嘧啶对腹前壁疝修复术后全身性炎症的影响。方法。我们前瞻性地分析了两组年龄在18岁至80岁之间的患者，他们采用标准聚丙烯网状物假体修复前腹壁疝的腱膜缺损。主组16例患者术后第1天起，每日3次，餐前给予羟乙基二甲基二氢嘧啶0.5 g / s，连续5 ~ 7 d。对照组(n=16)患者接受基础治疗，不使用羟乙基二甲基二氢嘧啶。结果。选择性前腹壁人工疝成形术患者术后出现免疫系统失衡，淋巴细胞减少倾向(血中计数改变-27.0%;p=0.20, Wilcoxon标准)，无明显的白细胞减少(血液中白细胞计数变化-4.9%;p=1.00, Wilcoxon标准)，c反应蛋白含量较术前基线值增加82.8% (p=0.2, Wilcoxon标准)。应用羟基乙基二甲基二氢嘧啶对前腹壁人工疝成形术进行药理学支持，可纠正术后淋巴细胞减少症(p=0.04, u -标准)，与对照组相比，可使c反应蛋白浓度降低223.6% (p=0.03, u -标准)，并可减少人工疝成形术局部并发症的发生。结论。在人工疝成形术后患者中使用羟乙基二甲基二氢嘧啶可显著降低c反应蛋白水平，预防术后淋巴细胞减少症和减少局部伤口并发症;c反应蛋白水平可作为这类患者术后并发症的早期、重要指标之一。
{"title":"Pharmacological stimulation of mesh implant engraftment after ventral hernia repair","authors":"E. Lukoyanychev, Лукоянычев Егор Евгеньевич, S. G. Izmaylov, Измайлов Сергей Геннадьевич, A. Mironov, Миронов Андрей Александрович, A. Izmaylov, Измайлов Александр Геннадьевич, A. Bodrov, Бодров Алексей Анатольевич, S. N. Bogdanov, Богданов Сергей Николаевич, O. S. Kolchina, Колчина Оксана Степановна, S. A. Melnik, Мельник Светлана Анатольевна, D. Evsyukov, Евсюков Дмитрий Алексеевич, T. V. Vadyaeva, Вадяева Татьяна Викторовна","doi":"10.17816/KMJ2021-6","DOIUrl":"https://doi.org/10.17816/KMJ2021-6","url":null,"abstract":"Aim. To study the effect of pyrimidine medication hydroxyethyldimethyldihydropyrimidine on the systemic inflammation after prosthetic repair of the anterior abdominal wall hernia. Methods. We prospectively analyzed two groups of patients aged between 18 and 80 years, who underwent prosthetic repair of the aponeurosis defect in the anterior abdominal wall hernia with a standard polypropylene mesh implant. The main group (n=16) was given 0.5 g hydroxyethyldimethyldihydropyrimidine per os 3 times a day ¬before meals for 5–7 days from the first day after the operation. In the control group (n=16), patients received basic therapy without hydroxyethyldimethyldihydropyrimidine. Results. The postoperative period in patients after elective prosthetic hernioplasty of anterior abdominal wall was associated with an imbalance of the immune system with a tendency to lymphocytopenia (count in blood changed by –27.0%; p=0.20, Wilcoxon criterion) without significant leukocytopenia (count in blood changed by –4.9%; p=1.00, Wilcoxon criterion) and an 82.8% increase in C-reactive protein content (p=0.2, Wilcoxon criterion) compared to baseline values before the surgery. The proposed pharmacological support of prosthetic hernioplasty of the anterior abdominal wall with hydroxyethyldimethyldihydropyrimidine allowed to correct the postoperative lymphocytopenia (p=0.04, U-criterion) and reduce the concentration of C-reactive protein by 223.6% (p=0.03, U-criterion) compared with the control, which was also associated with a decrease in the number of local complications of prosthetic hernioplasty. Conclusion. The use of hydroxyethyldimethyldihydropyrimidine in patients after prosthetic hernioplasty is associated with a significant decrease in the C-reactive protein level, prevention of postoperative lymphocytopenia and a decrease in the number of local wound complications; C-reactive protein level can serve as one of the early and significant indicators of postoperative complications in this category of patients.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79224541","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}
A. M. Ziganshin, V. Mudrov, S. F. Nasyrova, V. Z. Galimzyanov, D. Salimonenko, A. Alekseeva, I. M. Nasibulin, A. Yaschuk
Aim. To compare the results of using traditional and distance education technologies in the training of obstetricians and gynecologists in the continuing medical education cycles. Methods. The effectiveness of the use of traditional and distance learning technologies in the training of obstetrician-gynecologists on the continuing medical education cycles was assessed based on Bashkir State Medical University. The study included an assessment of the knowledge of obstetricians and gynaecologists trained in the 36-hour program. Two study groups were selected. The group I included 28 doctors, whose training and knowledge assessment was carried out mainly using traditional education technologies. The group II consisted of 30 doctors, whose training and knowledge assessment was carried out using distance education technologies. The final effectiveness of the use of the studied technologies was evaluated based on the analysis of the final test results and the solution of situational clinical tasks as a General interview. The research results processing was performed by IBM SPSS Statistics Version 25.0. Results. The study revealed that the use of distance learning technologies does not lead to a decrease in the physician's level of training: 70.0% in group I, 60.7% in group II (χ2=0.11, df=1, p=0.74). Meanwhile, the distance learning format causes difficulties for doctors of the older age group: in group I, there is a direct moderate correlation between age and performance (r=0.497, p=0.007), in group II — a noticeable inverse correlation (r=–0.689, p <0.001). Conclusion. Based on the results of the study, it is necessary to take a differentiated approach to the formation of groups for distance learning in the future.
的目标。比较在继续医学教育周期中使用传统和远程教育技术培训妇产科医生的效果。方法。在巴什基尔国立医科大学的基础上，评估了在妇产科医生继续医学教育周期培训中使用传统和远程学习技术的有效性。这项研究包括对接受过36小时培训的妇产科医生的知识进行评估。选择了两个研究组。第一组28名医生，主要采用传统教育技术进行培训和知识评估。第二组为30名医生，采用远程教育技术对其进行培训和知识评估。基于对最终测试结果的分析和作为一般访谈的情境临床任务的解决方案，评估了所研究技术使用的最终有效性。采用IBM SPSS Statistics Version 25.0对研究结果进行处理。结果。研究显示，使用远程学习技术并不会导致医生的培训水平下降:第一组为70.0%，第二组为60.7% (χ2=0.11, df=1, p=0.74)。同时，远程学习的形式给年龄较大的医生带来了困难:在第一组中，年龄与绩效呈正相关(r=0.497, p=0.007)，在第二组中，年龄与绩效呈显著的负相关(r= - 0.689, p <0.001)。结论。基于研究结果，未来有必要对远程学习群体的形成采取差异化的方法。
{"title":"Distance learning opportunities during the COVID-19 epidemic","authors":"A. M. Ziganshin, V. Mudrov, S. F. Nasyrova, V. Z. Galimzyanov, D. Salimonenko, A. Alekseeva, I. M. Nasibulin, A. Yaschuk","doi":"10.17816/kmj2020-876","DOIUrl":"https://doi.org/10.17816/kmj2020-876","url":null,"abstract":"Aim. To compare the results of using traditional and distance education technologies in the training of obstetricians and gynecologists in the continuing medical education cycles. Methods. The effectiveness of the use of traditional and distance learning technologies in the training of obstetrician-gynecologists on the continuing medical education cycles was assessed based on Bashkir State Medical University. The study included an assessment of the knowledge of obstetricians and gynaecologists trained in the 36-hour program. Two study groups were selected. The group I included 28 doctors, whose training and knowledge assessment was carried out mainly using traditional education technologies. The group II consisted of 30 doctors, whose training and knowledge assessment was carried out using distance education technologies. The final effectiveness of the use of the studied technologies was evaluated based on the analysis of the final test results and the solution of situational clinical tasks as a General interview. The research results processing was performed by IBM SPSS Statistics Version 25.0. Results. The study revealed that the use of distance learning technologies does not lead to a decrease in the physician's level of training: 70.0% in group I, 60.7% in group II (χ2=0.11, df=1, p=0.74). Meanwhile, the distance learning format causes difficulties for doctors of the older age group: in group I, there is a direct moderate correlation between age and performance (r=0.497, p=0.007), in group II — a noticeable inverse correlation (r=–0.689, p <0.001). Conclusion. Based on the results of the study, it is necessary to take a differentiated approach to the formation of groups for distance learning in the future.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83299599","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}
Aim. To conduct a comparative analysis of the effectiveness of X-ray diagnostics and computed tomography in detecting injuries in patients with blunt chest trauma. Methods. We examined 68 patients with chest injuries (men and women) and an average age of 34.6±7 years (between 18 and 65 years). The causes of injury were: road accidents — 37 (54.4%), falls from a height — 21 (30.8%), blunt blow to the chest — 10 (14.8%). The results of X-ray and computed tomography examination of patients were compared. Results. X-ray examination revealed a chest bone fracture in 24 (35.3%) patients, while computed tomography revealed a bone fracture in 32 (47.1%) cases (χ2=1.943; p=0.163). This allows us to state that the results of compu¬ted tomography scans are more accurate in the diagnosis of chest fractures. computed tomography scan revealed chest injuries — pneumothorax and hemothorax, in 56 (82.4%) cases, while X-ray examination in 37 (54.4%) ¬cases (χ2=12.277; p <0.001). Thus, the results of the study showed that computed tomography is a more informative ¬method of diagnosis compared to radiography, since computed tomography revealed 11.8% more cases of chest bones fractures, and 28.0% more cases of chest cavity damage with blunt trauma. Conclusion. Our study allows us to recommend computed tomography of the chest in blunt trauma as the initial preferred diagnostic radiology.
{"title":"Comparative characteristics of computed tomography and radiography in the diagnosis of blunt chest trauma","authors":"G. Gasimzade, Гасымзаде Говхар Шаин гызы","doi":"10.17816/kmj2020-926","DOIUrl":"https://doi.org/10.17816/kmj2020-926","url":null,"abstract":"Aim. To conduct a comparative analysis of the effectiveness of X-ray diagnostics and computed tomography in detecting injuries in patients with blunt chest trauma. Methods. We examined 68 patients with chest injuries (men and women) and an average age of 34.6±7 years (between 18 and 65 years). The causes of injury were: road accidents — 37 (54.4%), falls from a height — 21 (30.8%), blunt blow to the chest — 10 (14.8%). The results of X-ray and computed tomography examination of patients were compared. Results. X-ray examination revealed a chest bone fracture in 24 (35.3%) patients, while computed tomography revealed a bone fracture in 32 (47.1%) cases (χ2=1.943; p=0.163). This allows us to state that the results of compu¬ted tomography scans are more accurate in the diagnosis of chest fractures. computed tomography scan revealed chest injuries — pneumothorax and hemothorax, in 56 (82.4%) cases, while X-ray examination in 37 (54.4%) ¬cases (χ2=12.277; p <0.001). Thus, the results of the study showed that computed tomography is a more informative ¬method of diagnosis compared to radiography, since computed tomography revealed 11.8% more cases of chest bones fractures, and 28.0% more cases of chest cavity damage with blunt trauma. Conclusion. Our study allows us to recommend computed tomography of the chest in blunt trauma as the initial preferred diagnostic radiology.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84620785","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}
F. Nezhmetdinova, Нежметдинова Фарида Тансыковна, M. E. Guryleva, Гурылёва Марина Элисовна
The recent pandemic caused by the novel coronavirus strain (COVID-19) has suddenly and radically shattered all ideas about the norm, not only in medical practice but also in society. This has particularly affected the healthcare system, physicians, and the distribution of life-sustaining therapy in the context of limited resources and the absence of a known treatment protocol. One of the main ethical dilemmas of the coronavirus epidemic has been the confrontation between public health ethics, reflected in the fair distribution of limited resources and a focus on public safety, and patient-centred clinical ethics. Ultimately, the COVID-19 pandemic is putting medical staff in tragic situations that they have never faced. And in the case of a shortage of medical staff — doctors and nurses, ventilators and other life-supporting devices for patients or even just beds in hospitals, it frequently becomes necessary to classify patients and decide an order to determine who, where and what kind of help will receive (or not receive) and in what queue to provide it. Another important problem was the problem of digital control of citizens, who must limit their freedoms for preserving the health of other citizens. The fear is widely shared that the situation will allow manipulation citizens in the future when there is no epidemiological need. Also, the problem of the responsibi-lity of politicians and authorized organizations for the health not only its people but all over the world arises. These and other questions today require bioethical expertise.
{"title":"Medical, social and ethical issues related to COVID-19","authors":"F. Nezhmetdinova, Нежметдинова Фарида Тансыковна, M. E. Guryleva, Гурылёва Марина Элисовна","doi":"10.17816/kmj2020-841","DOIUrl":"https://doi.org/10.17816/kmj2020-841","url":null,"abstract":"The recent pandemic caused by the novel coronavirus strain (COVID-19) has suddenly and radically shattered all ideas about the norm, not only in medical practice but also in society. This has particularly affected the healthcare system, physicians, and the distribution of life-sustaining therapy in the context of limited resources and the absence of a known treatment protocol. One of the main ethical dilemmas of the coronavirus epidemic has been the confrontation between public health ethics, reflected in the fair distribution of limited resources and a focus on public safety, and patient-centred clinical ethics. Ultimately, the COVID-19 pandemic is putting medical staff in tragic situations that they have never faced. And in the case of a shortage of medical staff — doctors and nurses, ventilators and other life-supporting devices for patients or even just beds in hospitals, it frequently becomes necessary to classify patients and decide an order to determine who, where and what kind of help will receive (or not receive) and in what queue to provide it. Another important problem was the problem of digital control of citizens, who must limit their freedoms for preserving the health of other citizens. The fear is widely shared that the situation will allow manipulation citizens in the future when there is no epidemiological need. Also, the problem of the responsibi-lity of politicians and authorized organizations for the health not only its people but all over the world arises. These and other questions today require bioethical expertise.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88297840","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}
V. Borodulin, Бородулин Владимир Иосифович, M. Podolskaya, Подольская Марина Алексеевна, V. J. Al'bickiy, Альбицкий Валерий Юрьевич, A. V. Topolyanskiy, Тополянский Алексей Викторович
The work aimed to introduce new scientific data and use well-known data about the professor, doctor of medicine, a well-known therapist, director of the Kazan Clinical Institute (Kazan Institute for Advanced Medical Studies) in 1920–1930 Roman Albertovich Luria. The multifaceted activity of R.A. Luria as a health care organizer, teacher, scientist, practitioner, author of unique monographs on internal medicine is shown. In 1920–1941, R.A. Luria was a member of the Soviet scientific and medical elite of healthcare organizers and therapists. In the history of domestic medicine R.A. Luria is the organizer of the Soviet system of postgraduate education of doctors, a prominent scientist who made a significant contribution to the development of the national clinic of internal diseases in the first half of the twentieth century, and the pride of Kazan medicine, who remained in the memory of Kazan citizens as a doctor “capable of creating a miracle”.
{"title":"Outstanding organizer of post-graduate education of physicians, the representative of the Soviet therapeutic elite Roman Albertovich Luria","authors":"V. Borodulin, Бородулин Владимир Иосифович, M. Podolskaya, Подольская Марина Алексеевна, V. J. Al'bickiy, Альбицкий Валерий Юрьевич, A. V. Topolyanskiy, Тополянский Алексей Викторович","doi":"10.17816/kmj2020-937","DOIUrl":"https://doi.org/10.17816/kmj2020-937","url":null,"abstract":"The work aimed to introduce new scientific data and use well-known data about the professor, doctor of medicine, a well-known therapist, director of the Kazan Clinical Institute (Kazan Institute for Advanced Medical Studies) in 1920–1930 Roman Albertovich Luria. The multifaceted activity of R.A. Luria as a health care organizer, teacher, scientist, practitioner, author of unique monographs on internal medicine is shown. In 1920–1941, R.A. Luria was a member of the Soviet scientific and medical elite of healthcare organizers and therapists. In the history of domestic medicine R.A. Luria is the organizer of the Soviet system of postgraduate education of doctors, a prominent scientist who made a significant contribution to the development of the national clinic of internal diseases in the first half of the twentieth century, and the pride of Kazan medicine, who remained in the memory of Kazan citizens as a doctor “capable of creating a miracle”.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88710594","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}
A. Kalininskaya, Калининская Алефтина Александровна, N. A. Bayanovа, Баянова Наталья Александровна
Aim. To assess the territorial accessibility of primary health care (PHC) to the rural population in the Orenburg ¬region. Methods. Statistical, monographic, organizational experiment research methods were applied. Statistical proces¬sing was carried out by using the Statistica 10.0 software. Basic statistics were calculated (arithmetic mean, weighted arithmetic mean). All parameters were checked by using Shapiro–Wilk, Kolmogorov–Smirnov and Lilliefors tests for normal distribution. The parametric method of statistics (Student's t-test) was used. Results. The assessment of the territorial accessibility of primary medical health care to the population of the Orenburg region was carried out using the methodology developed by us for calculating the criteria for the accessibility of primary medical health care to the rural population “Rating of medical organizations according to the criterion of territorial accessibility of primary medical care to the rural population”. The use the methodology allows ¬making management decisions regarding the territorial planning of primary health care for the rural population in the selection of problem areas with low accessibility of primary medical care. In the Orenburg region, there are the following problems: different levels of accessibility of primary health care with a variety of distance up to 30 km and different population sizes in settlements create difficulties in organizing the provision of primary health care; remoteness from the regional center up to 300 km forms a personnel deficit. Conclusion. Application of the methodology “Rating of medical organizations according to the criterion of territorial accessibility of primary medical care to the rural population” in the Orenburg region has allowed the development of the following recommendations for making management decisions at the regional level: (1) prioritization of territories for priority measures to ensure the availability help; (2) selection of the form of primary health care organization for the timely medical care provision to the population; (3) the formation of competition among medical organizations in the ranking of the availability of primary health care.
{"title":"Scientific substantiation of the assessment of the territorial availability of primary medical health care to the rural population","authors":"A. Kalininskaya, Калининская Алефтина Александровна, N. A. Bayanovа, Баянова Наталья Александровна","doi":"10.17816/kmj2020-890","DOIUrl":"https://doi.org/10.17816/kmj2020-890","url":null,"abstract":"Aim. To assess the territorial accessibility of primary health care (PHC) to the rural population in the Orenburg ¬region. Methods. Statistical, monographic, organizational experiment research methods were applied. Statistical proces¬sing was carried out by using the Statistica 10.0 software. Basic statistics were calculated (arithmetic mean, weighted arithmetic mean). All parameters were checked by using Shapiro–Wilk, Kolmogorov–Smirnov and Lilliefors tests for normal distribution. The parametric method of statistics (Student's t-test) was used. Results. The assessment of the territorial accessibility of primary medical health care to the population of the Orenburg region was carried out using the methodology developed by us for calculating the criteria for the accessibility of primary medical health care to the rural population “Rating of medical organizations according to the criterion of territorial accessibility of primary medical care to the rural population”. The use the methodology allows ¬making management decisions regarding the territorial planning of primary health care for the rural population in the selection of problem areas with low accessibility of primary medical care. In the Orenburg region, there are the following problems: different levels of accessibility of primary health care with a variety of distance up to 30 km and different population sizes in settlements create difficulties in organizing the provision of primary health care; remoteness from the regional center up to 300 km forms a personnel deficit. Conclusion. Application of the methodology “Rating of medical organizations according to the criterion of territorial accessibility of primary medical care to the rural population” in the Orenburg region has allowed the development of the following recommendations for making management decisions at the regional level: (1) prioritization of territories for priority measures to ensure the availability help; (2) selection of the form of primary health care organization for the timely medical care provision to the population; (3) the formation of competition among medical organizations in the ranking of the availability of primary health care.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79261075","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}
Aim. To assess the anatomical possibility of the use of the thoracodorsal nerve as a donor for nerve transfer to the musculocutaneous nerve. Methods. Anatomical dissection of the brachial plexus with layer-by-layer dissection of secondary bundles, short and long branches was performed in 121 male and female corpses. The localization of the origin of thoracodorsal and musculocutaneous nerves relative to the clavicle, the takeoff angle (degrees) from the secondary bundle, the length (in centimeters) of the nerves from the site of origin to the latissimus dorsi muscle entry point and the perforation of the coracobrachialis muscle, respectively, were investigated. The length of the thoracodorsal nerve with and without extramuscular branches was studied separately. Results. It was revealed that, in 58.7% of cases, the thoracodorsal nerve has the optimal length required for transposition to the musculocutaneous nerve. The excess length of the thoracodorsal nerve was between 0.1 and 9.1 cm. In 41.3% of cases, the length of the thoracodorsal nerve is not enough for transposition. Of these, in 17.4% of cases, the shortage of the length of the thoracodorsal nerve was –2 cm or less, which categorically does not allow its transfer to the musculocutaneous nerve. Only in 5% of cases, the length of the nerve was not enough for transposition in the use of the thoracodorsal nerve with extramuscular branches. Conclusion. Due to tension in many cases, the thoracodorsal nerve transfer to the musculocutaneous nerve can be performed with difficulty, and in some cases it is impossible, solving the problem in this category of people dictates the development of new surgical techniques with the thoracodorsal nerve or the use of another nerve as a donor.
{"title":"Anatomical aspects of the use of the thoracodorsal nerve as a donor in musculocutaneous nerve injury","authors":"N. S. Gorbunov, K. Kober, E. V. Kasparov","doi":"10.17816/kmj2020-820","DOIUrl":"https://doi.org/10.17816/kmj2020-820","url":null,"abstract":"Aim. To assess the anatomical possibility of the use of the thoracodorsal nerve as a donor for nerve transfer to the musculocutaneous nerve. Methods. Anatomical dissection of the brachial plexus with layer-by-layer dissection of secondary bundles, short and long branches was performed in 121 male and female corpses. The localization of the origin of thoracodorsal and musculocutaneous nerves relative to the clavicle, the takeoff angle (degrees) from the secondary bundle, the length (in centimeters) of the nerves from the site of origin to the latissimus dorsi muscle entry point and the perforation of the coracobrachialis muscle, respectively, were investigated. The length of the thoracodorsal nerve with and without extramuscular branches was studied separately. Results. It was revealed that, in 58.7% of cases, the thoracodorsal nerve has the optimal length required for transposition to the musculocutaneous nerve. The excess length of the thoracodorsal nerve was between 0.1 and 9.1 cm. In 41.3% of cases, the length of the thoracodorsal nerve is not enough for transposition. Of these, in 17.4% of cases, the shortage of the length of the thoracodorsal nerve was –2 cm or less, which categorically does not allow its transfer to the musculocutaneous nerve. Only in 5% of cases, the length of the nerve was not enough for transposition in the use of the thoracodorsal nerve with extramuscular branches. Conclusion. Due to tension in many cases, the thoracodorsal nerve transfer to the musculocutaneous nerve can be performed with difficulty, and in some cases it is impossible, solving the problem in this category of people dictates the development of new surgical techniques with the thoracodorsal nerve or the use of another nerve as a donor.","PeriodicalId":17798,"journal":{"name":"Kazanskiy meditsinskiy zhurnal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73051656","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：