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Urgent total pancreatoduodenectomy for profuse gastro-intestinal bleeding caused by renal cancer metastases to the pancreas 癌症胰腺转移引起大量胃肠出血的紧急全胰十二指肠切除术
Pub Date : 2023-06-29 DOI: 10.22363/2313-0245-2023-27-2-246-253
Andrey G. Mylnikov, Aleksey E. Klimov, Temurbek Sh. Kurbanniyozov, Nina V. Bujmestru, Anna A. Chernjaeva, Tatyana A. Gusarova
Renal cancer (RC) can spread to different organs, metastatic damage of the pancreas is quite rare. But, in contrast of primary and other metastatic malignant tumors, pancreatic RC metastases can be resectable in 80 % of cases with nearly 90 % 5-year survival rate. Pancreatic oncologic surgery includes 3 different types of resection: distal pancreatic resection, pancreatoduodenal resection and total duodenopancreatectomy. The last type is the most extensive procedure, incorporates except of total removal of the pancreatic gland, total excision of duodenum and, in some cases, partial gastrectomy. In surgery of pancreatic tumors using of total duodenopancreatectomy is relatively rare (6,7-12,3 %). And in spite of low mortality (5-6,25 %) in recent years, whole removal of the gland inevitably leads to severe metabolic changes such as complete exocrine insufficiency and unstable insulin-depended diabetes mellitus which need lifetime medical correction. Gastrointestinal bleeding from pancreatic metastases of RC as a disease complication occurs quite rare and appears due to invasion of cancer tissue located in the pancreatic head to duodenal mucosa and then ulcerated. There are few single observations or little series (2-4 cases) described in literature. Pancreatoduodenal resection in such cases is the main type of surgical intervention. Now we present a case of successful urgent total duodenopancreatectomy, performed for recurrent profuse gastrointestinal bleeding from pancreatic head metastasis of RC invaded duodenum after previously radical nephrectomy. During the operation several cancer nodes in the pancreatic body and tail were found that defined the total gland removal. Postoperative period proceeded uneventfully and the patient was discharged on 15th day. Uniqueness of this case is that emergency total duodenopancreatectomy was successfully done for profuse gastrointestinal bleeding as the only possible chance for cure. We have not found similar reports in the available literature.
肾癌(RC)可以扩散到不同的器官,转移损害胰腺是相当罕见的。但是,与原发性和其他转移性恶性肿瘤相比,胰腺RC转移在80%的病例中可以切除,5年生存率接近90%。胰腺肿瘤手术包括三种不同类型的切除术:远端胰腺切除术、胰十二指肠切除术和全十二指肠胰腺切除术。最后一种是范围最广的手术,除全部切除胰腺外,还包括全部切除十二指肠,在某些情况下还包括部分胃切除术。在胰腺肿瘤手术中,采用全十二指肠胰切除术是比较少见的(6,7-12,3 %)。尽管近年来死亡率较低(5-6,25 %),但整个腺体的切除不可避免地导致严重的代谢变化,如完全外分泌功能不全和不稳定的胰岛素依赖型糖尿病,需要终生医疗纠正。胰腺癌转移性胃肠道出血作为一种疾病并发症是相当罕见的,它的出现是由于位于胰腺头部的癌组织浸润到十二指肠粘膜,然后溃烂。文献中很少有单独观察或小系列(2-4例)的描述。胰十二指肠切除术是这类病例的主要手术干预方式。现在我们报告一个成功的紧急全十二指肠胰切除术的病例,在先前的根治性肾切除术后,进行了胰脏头部转移灶侵袭十二指肠的复发性大量胃肠道出血。术中发现胰腺体和尾部的几个癌淋巴结,确定了全腺切除。术后顺利进行,患者于第15天出院。本病例的独特之处在于急诊全十二指肠胰切除术成功地治疗了大量胃肠道出血,这是唯一可能治愈的机会。我们在现有文献中没有发现类似的报道。
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引用次数: 0
Endometrial hyperplasia and progesterone resistance: a complex relationship 子宫内膜增生与黄体酮抵抗:一个复杂的关系
Pub Date : 2023-03-27 DOI: 10.22363/2313-0245-2023-27-1-65-70
M. Orazov, L. Mikhaleva, I. A. Mullina
The endometrium is one of the most dynamic tissues that constantly undergoes changes during the menstrual cycle in women of the reproductive period. All these processes take place mainly under the influence of steroid hormones that are produced in the woman’s body. However, it is important to remember that throughout life the endometrial tissue undergoes changes under the influence of various factors that lead to imbalances in hormonal regulation. All these changes can lead to the development of endometrial hyperplasia, which has a high risk of both recurrence and malignization. Over the past few decades, the incidence of endometrial cancer has increased in many countries. This trend is thought to be related to the increasing prevalence of obesity, as well as to changing female reproductive patterns. Although there are currently no well-established screening programmers for endometrial cancer, endometrial hyperplasia is a recognized precursor, and its detection provides an opportunity for prevention. Studying the pathogenesis and risk factors will give a great advantage in the future to prevent possible complications. At this point, the activity and inhibition of the different hormone isoforms can lead to different hyperplastic processes. The management of patients depends on many factors: age, species, reproductive potential and other factors. Therefore, a comprehensive approach to treatment is always necessary. In recent years, interest in the study of endometrial hyperplasia has increased dramatically due to the increase in endometrial cancer. Therefore, the issue of early diagnosis and prevention is most urgent in modern gynecology and requires further study. This review reflects the current understanding of the disruption of progesterone signaling mechanisms in endometrial hyperplasia according to domestic and foreign literature.
子宫内膜是生殖期女性月经周期中不断发生变化的最具活力的组织之一。所有这些过程主要是在女性体内产生的类固醇激素的影响下发生的。然而,重要的是要记住,在一生中,子宫内膜组织在各种因素的影响下发生变化,这些因素会导致激素调节失衡。所有这些变化都会导致子宫内膜增生的发展,子宫内膜增生具有很高的复发和恶性风险。在过去的几十年里,癌症子宫内膜癌的发病率在许多国家都有所上升。这一趋势被认为与肥胖患病率的增加以及女性生育模式的变化有关。尽管目前没有公认的子宫内膜癌症筛查程序,但子宫内膜增生是公认的前兆,其检测为预防提供了机会。研究其发病机制和危险因素将在未来预防可能的并发症方面具有很大的优势。在这一点上,不同激素亚型的活性和抑制可以导致不同的增生过程。患者的管理取决于许多因素:年龄、物种、生殖潜力和其他因素。因此,全面的治疗方法总是必要的。近年来,由于子宫内膜癌症的增加,人们对子宫内膜增生研究的兴趣急剧增加。因此,早期诊断和预防问题是现代妇科学中最紧迫的问题,需要进一步研究。这篇综述反映了目前国内外文献对子宫内膜增生中孕酮信号机制破坏的理解。
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引用次数: 0
Diagnostic and prognostic role of cardiac pathology multicomplex autoimmune biological markers 心脏病理多复杂自身免疫生物学标志物的诊断和预后作用
Pub Date : 2023-03-27 DOI: 10.22363/2313-0245-2023-27-1-71-82
Elvira D. Lovochkina
Relevance . Despite the large list of biological markers of cardiovascular diseases, not all have evidence-b ased effectiveness and independent prognostic value. Laboratory diagnostics of serum cardiospecific auto-antibodies for the diagnosis of myocyte cell damage has several potential advantages compared to the evaluation of traditional methods. These include the analysis of natural globulins to troponin I (cTnI), to alpha-a ctin 1 (ACTC1), to the heavy chain of beta-myosin 7B (MUN7B), which are based on a self-sustaining immune response to the myocardium’s own auto-antigens, which leads to damage to the cells expressing them. Purpose: To determine the diagnostic and practical value of quantitative indicators for the autoantibody complex to cardiomyocyte proteins to troponin I, to alpha-a ctin 1 and to the heavy chain of beta-myosin 7B in patients with cardiac pathology. Materials and Methods. The study of auto-antibodies to cTnI, ACTC1 and MUN7B in blood serum using laboratory enzyme immunoassay was carried out in patients with cardiac pathology undergoing inpatient treatment at the Regional Clinical Cardiology Dispensary in Stavropol. Additionally, an instrumental and laboratory examination was carried out in accordance with the clinical recommendations developed by the Association of Cardiovascular Surgeons, the Cardiological Society of Russia and approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation. The work was examined and approved by the Ethics Committee of the North Caucasus Federal University. Results and Discussion . Changes in the level of autoantibodies to cTnI, ACTC1 and MUN7B proteins in blood serum were statistically significant (p 0.01 v. s. p 0.01). A persistent increase in the level of auto-antibodies to cTnI by 2.36 ng/ml (694.11 %), to ACTC1 by 3.6 ng/ml (141.73 %) and to MUN7B by 1.74 ng/ml (119.17 %) was found in individuals with confirmed cardiac pathology, when other criteria for laboratory analysis were within acceptable values, which determine their diagnostic and evidentiary effectiveness. Conclusion . The results of the study showed the relationship of changes in the activity of cardiospecific auto-A T to cardiomyocyte proteins (Anti-cTnI, Anti ACTC1, Anti-M YH7B) in patients with cardiac pathologies, indicating not only systemic membrane disorders (membranopathies), but also serve as convincing evidence of direct chemical changes in cardiomyocytes. A correlation has also been established between cardiomarkers of necrosis and ischemia and autoimmune globulins Anti-cTnI, Anti ACTC1, Anti-MYH7B, that confirms diagnostic and practical value of this laboratory analysis.
的相关性。尽管心血管疾病的生物标志物有很多,但并非所有的生物标志物都具有基于证据的有效性和独立的预后价值。与评估传统方法相比,实验室诊断血清心脏特异性自身抗体诊断心肌细胞损伤具有几个潜在的优势。其中包括对天然球蛋白、肌钙蛋白I (cTnI)、α -肌动蛋白1 (ACTC1)、β -肌球蛋白7B重链(MUN7B)的分析,这些球蛋白是基于对心肌自身抗原的自我维持免疫反应,从而导致表达它们的细胞受损。目的:探讨心肌细胞蛋白、肌钙蛋白I、α -a肌动蛋白1和β -肌球蛋白7B重链自身抗体复合物定量指标对心脏病变患者的诊断价值和实用价值。材料与方法。采用实验室酶免疫分析法对斯塔夫罗波尔地区临床心脏病诊所住院治疗的心脏病患者血清中cTnI、ACTC1和MUN7B自身抗体进行了研究。此外,根据俄罗斯心脏病学会心血管外科医生协会制定的临床建议,并经俄罗斯联邦卫生部科学和实践委员会批准,进行了仪器和实验室检查。这项工作得到了北高加索联邦大学伦理委员会的审查和批准。结果和讨论。血清cTnI、ACTC1、MUN7B蛋白自身抗体水平变化均有统计学意义(p < 0.01 vs . p < 0.01)。当实验室分析的其他标准在可接受的范围内,这决定了其诊断和证据有效性时,在确认心脏病理的个体中,发现cTnI抗体水平持续增加2.36 ng/ml (694.11%), ACTC1抗体水平持续增加3.6 ng/ml (141.73%), MUN7B抗体水平持续增加1.74 ng/ml(119.17%)。结论。本研究结果显示心脏病变患者心脏特异性auto-A - T对心肌细胞蛋白(Anti- ctni, Anti- ACTC1, Anti- m - YH7B)活性变化的关系,不仅提示全身性膜疾病(膜病),而且为心肌细胞直接化学变化提供了令人信服的证据。心肌坏死和缺血标志物与自身免疫球蛋白Anti- ctni、Anti- ACTC1、Anti- myh7b之间也存在相关性,证实了本实验室分析的诊断和实用价值。
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引用次数: 0
Group B streptococcus in obstetrics: unsolved problems 产科B群链球菌:尚未解决的问题
Pub Date : 2023-03-27 DOI: 10.22363/2313-0245-2023-27-1-9-16
V. Radzinsky, O. Doronina, A. Olenev, O. V. Stetsyuk
For several decades, among all possible pathogens of neonatal infections, group B streptococcus has been one of the leading positions. Sepsis, meningitis, and pneumonia are among the most common clinical manifestations of neonatal infection associated with group B streptococcus. In this review, our goal was to analyze the literature demonstrating a worldwide approach to the prevention of vertical transmission of group B streptococcus from mother to child. When writing the review, scientific publications of foreign and domestic authors from the PubMed database were studied. The review considers the drugs of choice for intranatal antibiotic prophylaxis, and their pharmacodynamic, and pharmacokinetic features. The analysis details the problem of the growth of resistance of group B streptococcus to antibacterial drugs. The antimicrobial activity of lactoferrin was noted at a minimum inhibitory concentration of 500 μg/ml. The presented review also reflects the protective and therapeutic effects of oral intake of probiotics containing Lactobacillus acidophilus, Lactobacillus salivarius, Lactobacillus rhamnosus GR-1, and Lactobacillus reuteri RC-14 . Based on the analysis, it can be concluded that penicillin G and ampicillin have the most pronounced bactericidal effect against group B streptococcus. At the same time, the most common side effects of β-lactam penicillins include an allergic reaction with the possible development of anaphylactic shock. Given this, the antibiotics of the first-line reserve group include cefazolin, clindamycin, and vancomycin. At the same time, it is important to take into account the decrease in the therapeutic concentration of clindamycin with a change in the alpha-1-acid glycoprotein in the blood of the mother and fetus, the nephrotoxic effect of vancomycin and the cross-a llergic reaction of cefazolin with antibiotics of the penicillin group. A promising direction in solving the problem of group B streptococcus is the development of new strategies for the prevention of perinatal infection of the fetus and newborn based on a more detailed study of the effects of lactoferrin and probiotics.
几十年来,在新生儿感染的所有可能病原体中,B群链球菌一直处于领先地位。败血症、脑膜炎和肺炎是与B组链球菌相关的新生儿感染最常见的临床表现。在这篇综述中,我们的目标是分析文献,这些文献证明了一种在全球范围内预防B组链球菌母婴垂直传播的方法。在撰写这篇综述时,研究了PubMed数据库中外国和国内作者的科学出版物。这篇综述考虑了用于产前抗生素预防的药物选择,以及它们的药效学和药代动力学特征。该分析详细说明了B组链球菌对抗菌药物耐药性增长的问题。乳铁蛋白在最低抑制浓度为500μg/ml时具有抗菌活性。该综述还反映了口服含有嗜酸乳杆菌、唾液乳杆菌、鼠李糖乳杆菌GR-1和罗伊氏乳杆菌RC-14的益生菌的保护和治疗效果。分析表明,青霉素G和氨苄青霉素对B群链球菌的杀菌作用最为明显。同时,β-内酰胺青霉素最常见的副作用包括过敏反应,可能发展为过敏性休克。鉴于此,一线储备组的抗生素包括头孢唑林、克林霉素和万古霉素。同时,重要的是要考虑到克林霉素治疗浓度的降低和母体和胎儿血液中α-1-酸糖蛋白的变化、万古霉素的肾毒性作用以及头孢唑林与青霉素组抗生素的交叉过敏反应。在更详细地研究乳铁蛋白和益生菌的作用的基础上,开发预防胎儿和新生儿围产期感染的新策略是解决B群链球菌问题的一个有希望的方向。
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引用次数: 0
Immunological and immunohistochemical features of endometrial implantation factor in healthy patients of late reproductive age 健康育龄晚期患者子宫内膜植入因子的免疫学和免疫组织化学特征
Pub Date : 2023-03-27 DOI: 10.22363/2313-0245-2023-27-1-46-56
E. I. Kravtsova, N. Kolesnikova, I. N. Lukoshkina, K. V. Uryupina, V. A. Avakimyan
Аbstract. Relevance. The number of women of older reproductive age is steadily increasing, and repeated failures of Assisted Reproductive Technologies programs during the transfer of high-quality embryos indicate the possibility of disruption of embryo implantation processes associated with impaired receptivity and functionality of the endometrium. Morphological, immunological and immunohistochemical changes in the endometrium associated with age factor may be decisive for the formation of the «implantation window» and correction of these changes and may improve the outcomes of Assisted Reproductive Technologies for a cohort of patients of older reproductive age. The aim of the study - to expand the pathogenetic understanding of the violation of the implantation ability of the endometrium in healthy patients of older reproductive age. Materials and Methods. A prospective sample study of 46 patients (group 1), aged 38 to 45 years with an officially registered diagnosis of infertility lasting no more than 4 years, with a successful gynecological and obstetric history, who were about to have their first IVF attempt, was conducted. The patients were examined according to Order № 803n of the Ministry of Health of the Russian Federation. Additionally, the level of peripheral blood melatonin, the determination of progesterone, estrogen, HLA-DR (MHC II), CD56 (NK cells), CD138, leukemia inhibiting factor receptors in the endometrium were studied. Concentrations of IL-6, IL-10, TGFß, and VGEF were determined in the cervical secretion, with the calculation of the pro-inflammatory index, as the ratio of IL-6/IL-10 cu and the ratio of TGFß1/VEGF. Statistical data processing was performed using the Statistica 10.0 application software package (StatSoft, Inc., USA). Results and Discussion. In the group of healthy patients of older reproductive age, there is an imbalance of steroid receptors and secretory transformation of the endometrium against the background of relative hyperestrogenism, with a decrease in the reception of own hormones in the endometrium. A decrease in melatonin signals a disorder of pineal and pituitary control over ovarian cycling. There is a decrease in the expression of leukemia inhibiting factor. Signs of inactive chronic endometritis with an autoimmune component are monitored, confirmed by a pro-inflammatory cytokine balance. The predominance of fibrosis processes over angiogenesis processes is confirmed by an increase in the ratio of TGFß1/VEGF and highly resistant blood flow in the uterine arteries. Conclusion. Standard pre-gravidar preparation cannot compensate for all factors that violate the implantation potential of the endometrium in this cohort of patients and requires the development of new complex techniques that directly affect the diversity of all factors that ensure the natural extinction of reproductive potential in order to increase the effectiveness of Assisted Reproductive Technologies programs.
Аbstract。关联育龄以上妇女的数量正在稳步增加,辅助生殖技术项目在高质量胚胎移植过程中的反复失败表明,胚胎植入过程可能会中断,子宫内膜的接受能力和功能受损。与年龄因素相关的子宫内膜形态学、免疫学和免疫组织化学变化可能对“植入窗口”的形成和这些变化的纠正起决定性作用,并可能改善辅助生殖技术对老年生殖年龄患者的疗效。本研究的目的是扩大对健康育龄患者子宫内膜植入能力受损的病因认识。材料和方法。对46名患者(第1组)进行了前瞻性样本研究,这些患者年龄在38至45岁之间,官方登记的不孕诊断持续时间不超过4年,有成功的妇科和产科病史,即将进行首次试管婴儿尝试。根据医嘱对患者进行检查№ 803n。此外,还研究了外周血褪黑素水平、孕酮、雌激素、HLA-DR(MHC II)、CD56(NK细胞)、CD138、子宫内膜白血病抑制因子受体的测定。通过计算促炎指数,确定宫颈分泌物中IL-6、IL-10、TGFß和VGEF的浓度,即IL-6/IL-10 cu的比率和TGFł1/VEGF的比率。使用Statistica 10.0应用软件包(StatSoft,股份有限公司,USA)进行统计数据处理。结果和讨论。在生殖年龄较大的健康患者组中,在相对充血的背景下,类固醇受体和子宫内膜分泌转化失衡,子宫内膜自身激素的接收减少。褪黑激素的减少标志着松果体和垂体对卵巢循环的控制紊乱。白血病抑制因子的表达减少。监测具有自身免疫成分的非活动性慢性子宫内膜炎的迹象,并通过促炎细胞因子平衡来证实。TGFß1/VEGF比率的增加和子宫动脉中高阻力血流证实了纤维化过程优于血管生成过程。结论标准的孕前准备无法弥补这一患者队列中侵犯子宫内膜植入潜力的所有因素,需要开发新的复杂技术,直接影响所有因素的多样性,以确保生殖潜力的自然消失,从而提高辅助生殖技术的有效性程序。
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引用次数: 1
Clinical features and risk factors of IgE-independent aтopic dermatitis in children 儿童ige非依赖型aтopic皮炎的临床特点及危险因素分析
Pub Date : 2023-03-27 DOI: 10.22363/2313-0245-2023-27-1-90-100
Alaa A.M. Nemer, O. Zhukova, G. Tereshchenko
Relevance. Atopic dermatitis (AD) is an inflammatory disease characterized by a chronic course with periods of remissions and exacerbations. IgE-independent atopic dermatitis is a medical and social problem of our time, since the disease manifests itself most often in childhood and is one of the most frequent forms of dermatoses among the pediatric population. The prevalence of atopic dermatitis among children is up to 20 %, among adults - 2-8 %. Recently, there has been a significant increase in atopic diseases worldwide. The aim: to study specific features of IgE-independent atopic dermatitis in children living in a metropolis. Materials and Methods. A prospective cohort study was conducted, which included 451 children aged 5 to 14 years with a diagnosis of AD who applied for outpatient care at the Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology for the period 2020-2021. All parents (guardians) have given voluntary informed consent to the participation of children in the study and the publication of personal data. Examination of patients included general clinical methods, assessment of the SCORAD index and laboratory allergological examination (total and 73 specific IgE in blood serum with the most common food and aeroallergens). In 103 (22.8 %) children (57 (55.3 %) boys and 46 (44.7 %) girls), the results of the allergological analysis did not confirm concomitant allergic sensitization. Atopic dermatitis in these children was defined as IgE-independent. Results and Discussion. Predictors of the development of IgE-independent AD were hereditary predisposition [odds ratio (OR) 2.42; 95 % confidence interval (CI) 1.12-5.25], artificial feeding [OR 4.04; 95 % CI 1.46-11.20], comorbidities [OR 1.42; 95 % CI 0.57-3.52], late onset [OR 1.67; 95 % CI 0.81-3.41]. According to the SCORAD index, the majority of patients (75.7 %) had a moderate degree of AD and no seasonality. Features of skin rashes corresponded to the age periods of the course of AD: erythematous-squamous forms with lichenification foci prevailed. For the first time, the features of IgE-independent atopic dermatitis in children were shown. The role of risk factors for the development of IgE-independent atopic dermatitis in children has been shown for the first time. Conclusion. IgE-independent type of AD can be diagnosed in every fifth child with AD. The study of risk factors will allow predicting the development of this type of disease.
关联特应性皮炎(AD)是一种炎症性疾病,其特征是慢性病程有缓解和恶化期。IgE非依赖性特应性皮炎是我们这个时代的一个医学和社会问题,因为这种疾病最常见于儿童期,也是儿科人群中最常见的皮肤病之一。儿童特应性皮炎的患病率高达20%,成人为2-8%。最近,世界范围内的特应性疾病显著增加。目的:研究大都市儿童IgE非依赖性特应性皮炎的具体特征。材料和方法。进行了一项前瞻性队列研究,其中包括451名5至14岁的诊断为AD的儿童,他们在2020-2021年期间申请了莫斯科皮肤病学和美容科学与实践中心的门诊护理。所有父母(监护人)都自愿知情同意儿童参与研究和公布个人数据。对患者的检查包括一般临床方法、SCORAD指数评估和实验室过敏性检查(最常见的食物和空气过敏原血清中的总IgE和73特异性IgE)。在103名(22.8%)儿童(57名(55.3%)男孩和46名(44.7%)女孩)中,过敏原分析结果未证实伴随的过敏性致敏。这些儿童的特应性皮炎被定义为IgE非依赖性。结果和讨论。IgE非依赖性AD发展的预测因素为遗传易感性[比值比(OR)2.42;95%置信区间(CI)1.12-5.25]、人工喂养[比值比4.04;95%CI 1.46-11.20]、合并症[比值比1.42;95%CI 0.57-3.52]、迟发[比值比1.67;95%CI 0.81-3.41]。根据SCORAD指数,大多数患者(75.7%)患有中度AD,无季节性。皮疹的特征与AD病程的年龄段相对应:以红斑鳞状和地衣化灶为主。首次显示了儿童IgE非依赖性特应性皮炎的特征。风险因素在儿童IgE非依赖性特应性皮炎发生中的作用首次得到证实。结论每五分之一的AD儿童都可以诊断出IgE独立型AD。对危险因素的研究将有助于预测这种疾病的发展。
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引用次数: 0
Cardiorespiratory fitness and body fat percentage in young adults 年轻人的心肺健康和体脂百分比
Pub Date : 2023-03-27 DOI: 10.22363/2313-0245-2023-27-1-83-89
H. Soni, S. Kacker, J. Sorout, N. Saboo
Relevance. Maximal oxygen consumption (VO2max) is the maximum amount of oxygen an individual can breathe in and utilize it to produce energy aerobically. The global epidemic of overweight and obesity -’globesity’ is emerging as a public health problem in many parts of the world. Almost 30-65 % of adult urban Indians is either overweight or obese or has abdominal obesity. Recently, cardiovascular ailments are increasing in the younger generation. Low levels of cardiovascular fitness and unfavorable cardiovascular risk profiles are detected in them. Total body fatness and aerobic capacity are frequently used in association with each other and it is often implied that these parameters are strongly inter-related. Both body fatness and status aerobic fitness have been shown to be risk factors for future health outcomes. The aim of this study was to assess the correlation of cardio-respiratory fitness with body fat percentage in young adults. Materials and Methods. This was a pilot study conducted in a group of 100 subjects of age group 18 to 25 years. Ethical clearance was obtained from institutional ethical committee and written informed consent were taken from all subjects participated in the study. Following parameters were taken (a) anthropometric parameters, (b) body fat percentage, (c) physical activity level and (d) VO2max. Results and Discussion. The mean ± SD for age, height, weight, global physical activity questionnaire (GPAQ score) and VO2max was found to be higher in male participants as compared to female participants while BMI was almost equal in both the genders but body fat percentage was higher in female participants. There was positive non-significant correlation of VO2max with body mass index and global physical activity in female subjects but positive significant in male subjects. And moderate negative correlation between body fat percentage and VO2max in male and female subjects but not significant (p 0.05). Conclusion. Body fat percentage was negatively correlated with maximum oxygenconsumption (VO2 max).
关联最大耗氧量(VO2max)是一个人可以吸入并利用它有氧产生能量的最大氧气量。超重和肥胖的全球流行——“肥胖”正在世界许多地方成为一个公共卫生问题。近30-65%的成年城市印度人要么超重,要么肥胖,要么腹部肥胖。最近,年轻一代的心血管疾病越来越多。在他们身上检测到低水平的心血管健康和不利的心血管风险状况。全身脂肪度和有氧能力经常相互关联使用,并且经常暗示这些参数之间存在强烈的相关性。身体肥胖和有氧健身状态已被证明是未来健康结果的风险因素。本研究的目的是评估年轻人的心肺健康与体脂百分比的相关性。材料和方法。这是一项试点研究,由100名年龄在18至25岁之间的受试者组成。从机构伦理委员会获得伦理许可,并从所有参与研究的受试者那里获得书面知情同意书。采用以下参数:(a)人体测量参数,(b)体脂百分比,(c)体力活动水平和(d)VO2max。结果和讨论。男性参与者的年龄、身高、体重、全球体育活动问卷(GPAQ评分)和VO2max的平均±SD高于女性参与者,而BMI在两性中几乎相等,但女性参与者的体脂百分比更高。女性受试者的VO2max与体重指数和整体体力活动呈正相关,但与男性受试者呈正相关。男女受试者体脂率与VO2max呈中度负相关,但无显著性差异(p0.05)。体脂百分比与最大耗氧量呈负相关。
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引用次数: 0
Adaptability of the tongue during orthodontic apparatus treatment 正畸器械治疗中舌头的适应性
Pub Date : 2023-03-27 DOI: 10.22363/2313-0245-2023-27-1-101-109
M. B. Vasilyeva, N. Guseynov
To date, most dentoalveolar deformities are associated with bad habits such as thumb sucking, tongue sticking out, and so on. According to the authors, protrusion of the tongue is normal in newborns, in which the tongue lies between the gingival pads, and the lower jaw is stabilized by the facial muscles during swallowing. With the eruption of temporary teeth, this physiological phenomenon disappears. The authors pointed out that there are such concepts as «simple tongue push» and «complex tongue push». The first relates to open bite push-outs. The second is observed in children with an open bite, as well as with respiratory complications and / or with a history of chronic diseases of the nasopharynx. The act of swallowing in the physiological sense is divided into 3 stages: oral, pharyngeal and esophageal. Each stage is characterized by different positions of the tongue in the oral cavity. Orthodontic hardware treatment of such patients is aimed at eliminating these habits, as well as correcting the bite. Although many studies have been conducted since 1965, to this day, aimed at studying the tongue protrusion in infantile swallowing, as well as in various malocclusion deformities, the authors found that these studies have shortcomings. For each patient, the shape, size, as well as the trajectory of movements may vary due to anatomical features (short frenulum of the tongue). In this review article, the authors consider such concepts as the adaptive ability of the tongue during infantile swallowing, as well as its trajectory of movements when using various methods of hardware treatment; various orthodontic devices for the treatment of tongue misalignments, their components and their purposes are described. The current classification, main characteristics of this pathological condition and its connection with the dentoalveolar system are considered. Based on the study, it can be concluded that there are several directions in the treatment of infantile swallowing. One of these areas is hardware treatment in the form of the use of plates with a flap for the tongue.
迄今为止,大多数牙槽畸形都与不良习惯有关,如吮拇指、伸出舌头等。根据作者的说法,舌头突出在新生儿中是正常的,舌头位于牙龈垫之间,吞咽时下颌由面部肌肉稳定。随着临时牙齿的长出,这种生理现象就消失了。作者指出,有“简单舌推”和“复杂舌推”这样的概念。第一个问题与开口咬合推出有关。第二种情况见于有开放性咬伤、呼吸道并发症和/或有鼻咽部慢性疾病史的儿童。生理意义上的吞咽行为分为口腔、咽部和食道3个阶段。每个阶段的特点是舌头在口腔中的不同位置。这类患者的正畸硬体治疗旨在消除这些习惯,以及矫正咬伤。虽然从1965年至今,已经进行了许多研究,旨在研究婴儿吞咽中的舌头突出,以及各种错颌畸形,但作者发现这些研究存在不足。对于每位患者,其形状、大小以及运动轨迹可能因解剖特征(舌系带短)而异。在这篇综述文章中,作者考虑了以下概念:婴儿吞咽过程中舌头的适应能力,以及使用各种硬件治疗方法时舌头的运动轨迹;描述了用于治疗舌头错位的各种正畸装置,其组成部分及其用途。目前的分类,主要特点的病理条件及其与牙槽系统的联系进行了讨论。根据本研究,婴幼儿吞咽症的治疗有几个方向。其中一个领域是使用带舌瓣的板的形式进行硬件治疗。
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引用次数: 0
Stages of plastic surgery’s development 整形外科发展的各个阶段
Pub Date : 2023-03-27 DOI: 10.22363/2313-0245-2023-27-1-119-130
M. Subotyalov
The article is devoted to the analysis of the main stages in the development of the history of plastic surgery as one of the important sections of surgery that deals with aesthetic aspects of human health and has always been an integral part of medicine. The purpose of the article is to identify and characterize the main periods of the formation and development of plastic surgery. While writing the article, comparative historical and analytical methods of historical and medical research were used. The main results consist in presenting the stages of development of plastic surgery, starting from the era of the Ancient World, and ending with Modern times. A description of the contribution to plastic surgery of the most prominent representatives of this field is presented. In conclusion, it is concluded that there are three periods of plastic surgery development: the empirical period (II century BC - mid-XIX century), the period of formation of the foundations of plastic surgery (mid-XIX century - 1950s), the modern period (1960s - present).
本文致力于分析整形外科历史发展的主要阶段,整形外科是外科学的重要组成部分,涉及人类健康的美学方面,一直是医学的组成部分。本文的目的是确定和描述整形外科形成和发展的主要时期。在撰写这篇文章时,使用了历史和医学研究的比较历史和分析方法。主要成果包括介绍整形外科的发展阶段,从古代开始,到现代结束。介绍了该领域最杰出的代表对整形外科的贡献。总之,整形外科的发展有三个时期:经验时期(公元前二世纪-十九世纪中期)、整形外科基础形成时期(十九世纪中期-1950年代)和现代时期(1960年代-现在)。
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引用次数: 0
Morphological features of various variants of the course of scleroatrophic lichen of the vulva 外阴硬化性萎缩性地衣病程不同变异的形态学特征
Pub Date : 2023-03-27 DOI: 10.22363/2313-0245-2023-27-1-17-38
E. Kolesnikova, A. V. Zharov, S. Todorov, Gregoriy A. Penzhoyan, Natalya V. Mingaleva
Relevance. Most of the scientific papers presented in the literature indicate morphological features of the stages of development of sclerotic lichen of the vulva, or in comparison with other vulvar skin lesions. At the same time, data on the features of morphological examination of vulvar biopsies, depending on the clinical variants of the course of sclerotic lichen of the vulva, is currently insufficient. The aim of the study - to determine the presence or absence of distinctive morphological features of the sclerotic lichen of the vulva, depending on the clinical variants of its course. Materials and Methods. The study included 292 patients with sclerotic lichen of the vulva (20-70 years old). Based on the scale of assessment of objective and subjective clinical signs of sclerotic lichen of the vulva developed by us, 3 clinical groups: 101 patients with an atrophic variant of the course, 154 with a sclerosing variant and 37 patients with a scleroatrophic variant of the course of sclerotic lichen of the vulva. In addition to clinical laboratory, instrumental and immunological studies, all patients underwent incisional biopsy of the vulva followed by morphological examination of biopsies. Results and Discussion. The features of the results of morphological examination of various clinical variants of the course of sclerotic lichen of the vulva are described and presented in the form of images. The characteristic morphological signs for each clinical group, as well as common signs characteristic of all variants of the course of this pathology, were revealed. Morphological examination of vulvar tissues is informative only to confirm the diagnosis of «Sclerotic lichen of the vulva», to determine the stage of the disease, as well as to exclude the malignant process, while for a clear differentiation of variants of the clinical course of sclerotic lichen of the vulva, conventional morphological examination is not enough, which requires further studies using immunohistochemical and molecular genetic methods. Conclusion. The revealed differences in morphological parameters of various variants of the course of sclerotic lichen of the vulva are insufficiently specific, which excludes the possibility of accurate morphological verification of the variants of the course of sclerotic lichen of the vulva and confirms the expediency of using clinical classification of variants of the course of sclerotic lichen of the vulva based on objective and subjective clinical signs.
关联文献中发表的大多数科学论文都表明了外阴硬化性地衣发育阶段的形态学特征,或者与其他外阴皮肤病变相比。同时,根据外阴硬化性地衣病程的临床变异,目前关于外阴活检形态学检查特征的数据还不够。该研究的目的是根据其病程的临床变异,确定外阴硬化性地衣是否存在独特的形态学特征。材料和方法。该研究包括292名外阴硬化性地衣患者(20-70岁)。根据我们开发的外阴硬化性地衣的客观和主观临床症状评估量表,分为3个临床组:101例外阴硬化性苔藓病程萎缩型患者、154例外阴硬化型患者和37例外阴硬化症苔藓病程硬化性萎缩型患者。除了临床实验室、仪器和免疫学研究外,所有患者都接受了外阴切口活检,然后进行了活检的形态学检查。结果和讨论。描述了外阴硬化性地衣病程的各种临床变异的形态学检查结果的特征,并以图像的形式呈现。揭示了每个临床组的特征性形态学体征,以及该病理过程中所有变体的常见体征特征。外阴组织的形态学检查仅用于确认“外阴硬化性地衣”的诊断、确定疾病分期以及排除恶性过程,而对于明确区分外阴硬化性苔藓临床病程的变异,常规的形态学检查是不够的,这需要使用免疫组织化学和分子遗传学方法进行进一步的研究。结论所揭示的外阴硬化性地衣过程的各种变体的形态参数的差异是不够特异的,其排除了对外阴硬化性地衣过程的变体进行准确形态学验证的可能性,并证实了基于客观和主观临床体征对外阴硬化型地衣过程的变种进行临床分类的方便性。
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引用次数: 0
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RUDN Journal of Medicine
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