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Post-injection necrosis of femoral soft tissues induced by diclofenac, nonsteroidal anti-inflammatory drug (clinical case) 非甾体抗炎药双氯芬酸致股骨软组织注射后坏死(临床一例)
Pub Date : 2023-06-15 DOI: 10.34215/1609-1175-2023-2-86-88
V. A. Atoian, M. F. Fadeev, A. S. Zolotov, E. Zinkova, B. Geltser
Nikolau syndrome is a rare post-injection complication with unclear etiology and pathogenesis, characterized by the development of acute local pain syndrome, localized erythematous rash, livedoid and hemorrhagic skin lesions with foci of ischemic necrosis. The paper presents a clinical case of Nikolau syndrome induced by intramuscular administration of diclofenac solution as an analgesic after hip replacement. The analysis of the causes, clinical picture and stages of treatment of post-injection complication was carried out.
尼古劳综合征是一种罕见的注射后并发症,病因和发病机制尚不清楚,其特点是急性局部疼痛综合征,局限性红斑皮疹,样血和出血性皮肤病变伴缺血性坏死灶。本文报道一例髋关节置换术后肌注双氯芬酸溶液引起的尼古劳综合征。对注射后并发症的原因、临床表现及治疗分期进行分析。
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引用次数: 0
Development of tuberculosis surgical service in Primorsky krai 滨海边疆区肺结核外科服务的发展
Pub Date : 2023-06-15 DOI: 10.34215/1609-1175-2023-2-98-100
S. Belov
To the 65th anniversary of the thoracic department of the Primorsky Regional Tuberculosis DispensaryThe paper reviews the main stages of the sixty-five-year history of the Thoracic Surgical Department of Primorsky Krai TB Dispensary. During this time, the department has handled all the difficulties of establishing the TB service, turning it to a platform for mastering new technologies in close cooperation with leading research institutions of Russia. Due to high professionalism and considerable efforts of managers, doctors and whole staff, the department is rapidly developing in the field of practical medical care and scientific work. All these historical chapters are inextricably interlinked with people whose respectful work and personal talents serve as an example for new generations of specialists.
为了纪念滨海边疆区结核病医院胸外科成立65周年,本文回顾了滨海边疆区结核病医院胸外科65年历史的主要阶段。在此期间,该部处理了建立结核病服务的所有困难,并与俄罗斯主要研究机构密切合作,将其转变为掌握新技术的平台。由于管理人员、医生和全体员工的高度敬业精神和不懈努力,科室在实际医疗和科学工作领域得到了迅速发展。所有这些历史篇章都与人们密不可分,他们令人尊敬的工作和个人才能为新一代专家树立了榜样。
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引用次数: 0
Clinical case of renal manifestations in the onset of diffuse large B-cell lymphoma in a teenager 以肾脏表现起病的弥漫大b细胞淋巴瘤1例临床分析
Pub Date : 2023-06-15 DOI: 10.34215/1609-1175-2023-2-94-97
O. Bykova, A. Nее, T. A. Shumatova, N. G. Prikhodchenko, Е. V. Sergeeva, O. V. Semeshina
This article presents a clinical case of diffuse large B-cell lymphoma in a teenager, who had laboratory and clinical signs of acute kidney injury in the onset of the disease. The presented case is characterized by the late manifestation of the disease in the absence of classical tumor markers. The diagnosis was verified only following a repeat spine MRI. This case may be relevant for pediatricians, pediatric oncologists and hematologists, pediatric nephrologists.
本文报告一个青少年弥漫性大b细胞淋巴瘤的临床病例,他在发病时有急性肾损伤的实验室和临床症状。本病例的特点是在缺乏经典肿瘤标志物的情况下,疾病的晚期表现。诊断仅在重复脊柱MRI检查后得到证实。这个病例可能与儿科医生、儿科肿瘤学家、血液学家、儿科肾病学家有关。
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引用次数: 0
Treatment of patients with major burn injury in the Burn Unit, Far Eastern District Medical Center of Federal Medical Biological Agency, Russia 俄罗斯联邦医学生物机构远东地区医疗中心烧伤科对严重烧伤患者的治疗
Pub Date : 2023-06-15 DOI: 10.34215/1609-1175-2023-2-89-93
P. А. Griban, S. Terehov, K. V. Maystrovskiy, V. Usov, A. Polezhaev, V. V. Protopopov, S. Sotnichenko, V. A. Bogdanov
The present study involves an analysis of treatment results of the severe burn patients of the Burn Unit, Far Eastern District Medical Center in 2020–2022. The paper describes a clinical case of comprehensive intensive treatment of a patient with major burn injury (80% body surface area burned). The study indicates a vital importance of the fastest evacuation of severely burned patients to a special care unit and adequate intensive therapy to be carried out during transportation. This enables an invasive surgical approach to be adopted, including effective early removal of necrotic tissues, leading to a reduction in the number of complications and improvement of treatment outcomes. The recovery of patients with major burn injury highly correlates with total availability of medication and instruments, individual management of patients, and active rehabilitation measures.
本研究对远东区医疗中心烧伤科2020-2022年重症烧伤患者的治疗结果进行了分析。本文报道了一例严重烧伤(体表面积80%烧伤)患者的综合强化治疗的临床病例。该研究表明,将严重烧伤患者迅速转移到特殊护理病房以及在运输过程中进行适当的强化治疗至关重要。这使得可以采用侵入性手术方法,包括有效的早期切除坏死组织,从而减少并发症的数量并改善治疗结果。严重烧伤患者的康复与药物和器械的总体可用性、患者的个体管理和积极的康复措施高度相关。
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引用次数: 0
А clinical case of endovascular treatment for myocardial infarction combined with ischemic stroke А血管内治疗心肌梗死合并缺血性脑卒中临床一例
Pub Date : 2023-06-15 DOI: 10.34215/1609-1175-2023-2-81-85
N. Grachev, V. G. Rapovka
The paper presents a clinical case of endovascular treatment for a patient affected by acute myocardial infarction combined with acute ischemic stroke. The study emphasizes a role of early diagnosis of ischemic stroke in timely detection of cerebral embolism in large vessels during the postoperative period. Treatment strategy is analyzed along with the effectiveness of intravascular thrombectomy that significantly reduces mortality and disability of patients with acute cerebrovascular disease.
本文报道一例急性心肌梗死合并急性缺血性脑卒中的血管内治疗。本研究强调早期诊断缺血性脑卒中在术后及时发现大血管脑栓塞中的作用。分析了急性脑血管病患者的治疗策略,以及血管内取栓术显著降低患者死亡率和致残率的有效性。
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引用次数: 0
Dietary patterns of preschool children with type I diabetes 学龄前1型糖尿病儿童的饮食模式
Pub Date : 2023-06-14 DOI: 10.34215/1609-1175-2023-2-41-47
T. A. Yunatskaya, D. V. Turchaninov, N. Vlasenko, E. Pavlinova, A. V. Brusentsova
Objective. To evaluate the actual diet of children with type I diabetes in order to develop recommendations for nutrition correction.Materials and methods. An observational study of actual diet of the case-control type was conducted in a group of children with type I diabetes mellitus (DM1; n=47) and a comparison group of conditionally healthy children living in Omsk Oblast (n=43). Actual nutrition was studied by analyzing the frequency of food consumption reported by parents in interviews.Results. The level of energy consumed with food in the group of children with DM1 accounted for 1929 kcal. It corresponded to physiological needs and was consistent with the comparison group. However, consumption of fats was higher than recommended, while that of carbohydrates was, on the contrary, lower. Energy from added sugars and saturated fats was at twice the recommended levels. Protein intake was adequate to physiological needs, but the proportion of animal proteins was greater in the group of children with diabetes. The author noted excessive consumption of fats and shortage of omega-3 fatty acids. The amount of carbohydrates in the diet of children with DM1 was lower than the physiological needs, but did not differ from the comparison group, the consumption of simple sugars was greater in children from the comparison group. There were no differences in consumption of minerals and vitamins, with the exception of vitamin A, which was greater in the diet of children with DM1. The amounts of vitamin A, D, beta-carotene, vitamin B9 and iodine were lower than recommended. An excess of sodium and phosphorus in the diet and calcium imbalance were also revealed.Conclusion. Nutrition of children with type I diabetes is considered to be improper. The nutrition imbalances are similar in both groups. When consumption of carbohydrates is insufficient, an excess of simple sugars is noted. Priority micronutrients for correction are vitamins A and D, folates, iodine.
目标。评估1型糖尿病儿童的实际饮食,为营养矫正提供建议。材料和方法。对一组1型糖尿病儿童(DM1;n=47)和生活在鄂木斯克州的条件健康儿童对照组(n=43)。通过分析父母在访谈中报告的食物消费频率,研究实际营养状况。患有DM1的儿童从食物中消耗的能量为1929千卡,与生理需求相符,与对照组一致。然而,脂肪的摄入量高于推荐值,而碳水化合物的摄入量则相反,低于推荐值。来自添加糖和饱和脂肪的能量是推荐水平的两倍。蛋白质摄入量足以满足生理需要,但动物蛋白的比例在糖尿病儿童组中更高。作者注意到过度消耗脂肪和缺乏omega-3脂肪酸。DM1患儿饮食中碳水化合物的含量低于生理需求,但与对照组没有差异,对照组儿童单糖的摄入量更高。在矿物质和维生素的摄入量上没有差异,但维生素A在DM1患儿的饮食中含量更高。维生素A、D、β -胡萝卜素、维生素B9和碘的含量低于推荐值。饮食中钠、磷过量,钙失衡。1型糖尿病儿童的营养被认为是不适当的。两组人的营养失衡情况相似。当碳水化合物摄入不足时,单糖就会过量。需要优先纠正的微量营养素是维生素A和D、叶酸、碘。
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引用次数: 0
Еffectiveness of ct-guided transthoracic biopsy Еffectiveness的ct引导下经胸活检
Pub Date : 2023-06-14 DOI: 10.34215/1609-1175-2023-2-37-40
A. S. Shapovalov, S. Belov, A. Grigoryuk, N. A. Pushkina, N. A. Pimenov
Objective. To evaluate the effectiveness of CT-guided thoracic biopsy in the diagnosis of lung and mediastinal malignancies.Materials and methods. A retrospective analysis of 32 cases of CT-guided transthoracic biopsy was performed. Lung and mediastinal masses suspicious for malignancy with a size of more than 2.0 cm in the area available for manipulation were the indication for Cor-biopsy with additional examination of impression smears. A step-by-step procedure involved CT positioning of the object, marking by the radiation therapy program, and performing the procedure. The cytological and histological materials were evaluated and compared.Results. The analysis of manipulations performed in 32 patients with lung masses (75±7.7%) and mediastinal masses (25±7.7%) proved the technical effectiveness of the procedure, which lasted 37±9 minutes. The diagnosis was confirmed by cytological analysis of impression smears in 81.3±6.9% of cases, and using histological methods – in 71.9±8% (p>0.05). The agreement between the results obtained by both methods was 53.1±8.8%. Immunohistochemical analysis of the material was performed in 69.6±9.6% of patients. Procedural complications (pneumothorax and hemoptysis) were observed in 21.9±7.3% of patients. Cytological examination allowed the results of a planned histological and immunohistochemical analysis to be foreseen with a high degree of probability.Conclusion. CT-guided transthoracic puncture is a highly effective method of diagnosing lung and mediastinal malignancies, which allows their morphological characterization to be done in 81% of cases.
目标。目的:探讨ct引导下胸腔活检对肺部及纵隔恶性肿瘤的诊断价值。材料和方法。回顾性分析32例ct引导下的经胸活检。肺和纵隔肿块疑似恶性肿瘤,在可操作区域大小大于2.0 cm,是ct活检的指征,并进行额外的印象涂片检查。一个循序渐进的过程包括用CT定位目标,通过放射治疗程序进行标记,并执行该程序。细胞学和组织学资料进行评价和比较。通过对32例肺肿块(75±7.7%)和纵隔肿块(25±7.7%)的手法分析,证实了该手术的技术有效性,手术时间为37±9分钟。印迹涂片细胞学检查(81.3±6.9%)和组织学检查(71.9±8%)确诊(p < 0.05)。两种方法测定结果的一致性为53.1±8.8%。69.6±9.6%的患者对材料进行免疫组化分析。21.9±7.3%患者出现手术并发症(气胸、咯血)。细胞学检查使计划的组织学和免疫组织化学分析的结果具有很高的概率预测性。ct引导下的经胸穿刺是诊断肺部和纵隔恶性肿瘤的一种非常有效的方法,它可以在81%的病例中进行形态学表征。
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引用次数: 0
Surgery of presacral cysts: case series analysis and literature review 骶前囊肿的外科治疗:病例系列分析及文献回顾
Pub Date : 2023-06-14 DOI: 10.34215/1609-1175-2023-2-15-19
K. Stegnii, Zh.A. Rakhmonov, R. Goncharuk, M. Krekoten, E. Dvoinikova, E. Morova, M. Dmitriev
The presacral, or pararectal, space is a potential site for the formation of various cysts and tumors, since it contains a variety of embryonic tissues. Magnetic resonance imaging is the principal method for the diagnosis of presacral cysts, and endoscopic ultrasonography is an auxiliary method. These masses are subject to surgical removal, even in cases of asymptomatic course. The paper presents the successful experience of treating 3 patients using various surgical approaches and describes their advantages and disadvantages.
骶前或直肠旁空间是形成各种囊肿和肿瘤的潜在场所,因为它包含各种胚胎组织。骶前囊肿的诊断以磁共振成像为主,超声内镜为辅助。即使在无症状的情况下,这些肿块也需要手术切除。本文介绍了不同手术入路治疗3例患者的成功经验及优缺点。
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引用次数: 0
Сorrelation between somatotypes and body fat changes in patients with liver cirrhosis Сorrelation肝硬化患者体型与体脂变化之间的关系
Pub Date : 2023-06-14 DOI: 10.34215/1609-1175-2023-2-60-64
Y. Zharikov, R. Maslennikov, A. N. Gadzhiakhmedova, A. Aliyeva, V. Nikolenko, V. Ivashkin
Objective. To evaluate the nature of changes in body fat composition in cirrhotic patients of various somatotypes.Materials and methods. The data of 46 cirrhotic patients and 20 volunteers were analyzed. Anthropometric examination was carried out according to methodological requirements with assessing the body composition of patients by means of bioimpedance analysis using ABC-01 Medass system (NTC Medass, Russia). Somatotypes were determined according to the Heath–Carter method. Ranks for the somatotype scale were assigned as endomorphy scores increased. Spearman rank correlation was used to identify the relationships between the variables. Differences between continuous variables were determined using the Mann–Whitney test. Statistical analysis was performed using Statistica 10 (StatSoft Inc., USA).Results. Child–Pugh scores for men and women were 9 (7.3–11.8) and 7 (6–9), respectively. Body fat percentage (BFP) of cirrhotic patients accounted for 27.7% (23.3–33) in men and 41.2% (33.6–46.3) in women. In healthy volunteers, the BFP was 21.9% (13.9–26.3) in men and 32.7% (29.3–41.6) in women. Assessment of the relationships between liver cirrhosis severity and body fat was characterized by a correlation coefficient of r = -0.47528 (p-value < 0.001). A significant negative correlation was determined between the liver cirrhosis severity according to Child–Pugh scores and somatotypes (r = -0.30536, p = 0.03905).Conclusion. The results of this study emphasize the correlation between somatotypes and changes in BFP in patients with liver cirrhosis of various degrees of severity. The sum of Child–Pugh scores and endomorphic indicators demonstrated the inverse relationship, which must be taken into account when developing mathematical models of the personalized prognosis of liver cirrhosis.
目标。目的:评价不同体型肝硬化患者体脂组成变化的性质。材料和方法。分析了46例肝硬化患者和20名志愿者的数据。根据方法学要求进行人体测量,采用ABC-01 Medass系统(NTC Medass,俄罗斯)进行生物阻抗分析,评估患者的身体组成。根据Heath-Carter法测定体型。躯体型量表的等级是根据自同态得分的增加而分配的。Spearman秩相关用于确定变量之间的关系。使用Mann-Whitney检验确定连续变量之间的差异。统计学分析采用Statistica 10 (StatSoft Inc., USA)。男性和女性的Child-Pugh得分分别为9分(7.3-11.8)和7分(6-9)。肝硬化患者体脂率(BFP)男性为27.7%(23.3-33),女性为41.2%(33.6-46.3)。在健康志愿者中,男性BFP为21.9%(13.9-26.3),女性为32.7%(29.3-41.6)。评估肝硬化严重程度与体脂之间的关系时,相关系数r = -0.47528 (p值< 0.001)。Child-Pugh评分肝硬化严重程度与躯体型呈显著负相关(r = -0.30536, p = 0.03905)。本研究结果强调了不同严重程度肝硬化患者的躯体类型与BFP变化之间的相关性。Child-Pugh评分与自同态指标的总和呈反比关系,在建立肝硬化个体化预后的数学模型时必须考虑到这一点。
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引用次数: 0
Prediction of chickenpox in adults 成人水痘的预测
Pub Date : 2023-06-14 DOI: 10.34215/1609-1175-2023-2-48-53
T. A. Krivolutskaya, A. Makarov
Aim. To evaluate the potential for detecting of gene allelic polymorphism for chickenpox in adults.Materials and methods. The examination involved 201 conscripted soldiers of Caucasian race, aged between 18 and 24, who were born in and served in Zabaykalsky Krai. Determination of gene polymorphism was carried out via polymerase chain reaction. Genomic DNA was extracted from whole blood leukocytes using DNA-Express reagent. IBM SPSS Statistics 25.0 (International Business Machines Corporation, License No. Z125-3301-14, USA) was used for statistical processing of the results.Results. IL-10(G1082A) obtains the highest predictive value for chickenpox, while TLR9(T1237C) – the lowest. More commonly, chickenpox affects adults with IL-10(C819T), IL-10(G1082A) and TLR9(A2848G). TLR9(T1237C) is insignificant for chickenpox. TT and TC IL-10(G1082A), GA and AA TLR9(A2848G), AG and GG IL-10(C819T) are activators of chickenpox. AA IL-10(G1082A), CC IL-10(C819T), AA TLR9(A2848G) are chickenpox protectors. Android app was created for prognosis and early diagnosis of chickenpox in adults.Conclusion. Genes GA, AA IL-10(G1082A, and TT, CT IL-10(C819T), as well as AG, GG TLR9(A2848G) predispose to chickenpox, and gene AA TLR9(A2848G) reduces the probability of developing the disease. Considering that, the main prognostic markers for chickenpox in adults are polymorphisms of genes IL-10(G1082A), TLR9(A2848G), IL-10(C819T), the developed diagnostic model allows for the prediction and early diagnosis of the disease.
的目标。目的探讨成人水痘基因等位基因多态性检测的潜力。材料和方法。该调查涉及201名被征召的高加索士兵,年龄在18至24岁之间,他们出生在扎巴卡尔斯基边疆区并在那里服役。采用聚合酶链反应测定基因多态性。用DNA- express试剂从全血白细胞中提取基因组DNA。IBM SPSS Statistics 25.0(国际商业机器公司,许可证号:采用Z125-3301-14,美国)对结果进行统计处理。IL-10(G1082A)对水痘的预测价值最高,而TLR9(T1237C)的预测价值最低。更常见的是,水痘会影响携带IL-10(C819T)、IL-10(G1082A)和TLR9(A2848G)的成年人。TLR9(T1237C)对水痘不显著。TT和TC IL-10(G1082A), GA和AA TLR9(A2848G), AG和GG IL-10(C819T)是水痘的激活剂。AA IL-10(G1082A)、CC IL-10(C819T)、AA TLR9(A2848G)是水痘保护剂。为成人水痘的预后和早期诊断开发了Android应用程序。基因GA、AA IL-10(G1082A)和TT、CT IL-10(C819T)以及AG、GG TLR9(A2848G)易患水痘,而基因AA TLR9(A2848G)可降低患水痘的概率。考虑到成人水痘的主要预后标志物是IL-10(G1082A)、TLR9(A2848G)、IL-10(C819T)基因多态性,建立的诊断模型可以预测和早期诊断水痘。
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引用次数: 0
期刊
Pacific Medical Journal
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