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Analysis of morphometric parameters of children’s kidneys according to ultrasound data 根据超声波数据分析儿童肾脏的形态参数
Pub Date : 2023-12-25 DOI: 10.17021/1992-6499-2023-4-43-49
B. T. Kurtusunov, I. A. Usmanov, M. N. Trizno
Objective. To identify the features of morphometric indicators of children’s kidneys according to ultrasound data, depending on height and age.Materials and methods. Morphometric indicators of the kidneys of children, according to ultrasound examination protocols of 280 male and female children aged 0 to 16 years.Results. The study revealed that in all studied groups of children, the length of the left kidney was greater than the right. The most intensive increase in length occurs at heights of 60–90 cm and 150–170 cm. When analyzing gender differences in kidney growth in length, it was found that in both girls and boys the first “jump” in kidney growth is observed when the length of children is from 60 to 90 cm, and both buds grow at the same rate. The second “jump” in the increase in kidney length occurs at heights of 130–160 cm and 140– 170 cm. These changes in kidney length coincide with the intensive growth of the child in the first three years of life, and then with the onset and course of puberty. Based on the data obtained, it was revealed that the most significant increase in kidney parameters occurs in the first year of life. Thus, by the year of life, the length and width of the kidney increased by 20 %, and thickness by 10 %. By the 4th year of life, with average height (100 cm), length and width increased by another 20 %, and thickness by 32 % from the original.
目的根据超声波数据确定儿童肾脏形态指标的特征,具体取决于身高和年龄。根据 280 名 0 至 16 岁男女儿童的超声波检查方案,确定儿童肾脏的形态指标。研究显示,在所有研究的儿童群体中,左肾的长度都大于右肾。身高在 60-90 厘米和 150-170 厘米时,肾脏长度的增长最为明显。在分析肾脏长度增长的性别差异时发现,当儿童身高在 60 至 90 厘米之间时,男孩和女孩的肾脏都会出现第一次 "跳跃式 "增长,而且两个肾芽的增长速度相同。肾脏长度增长的第二次 "跳跃 "出现在身高 130-160 厘米和 140-170 厘米时。肾脏长度的这些变化与儿童出生后头三年的密集生长以及青春期的开始和进程相吻合。根据获得的数据显示,肾脏参数的最显著增长发生在出生后的第一年。因此,在出生后的第一年,肾脏的长度和宽度增加了 20%,厚度增加了 10%。到了第四年,平均身高(100 厘米)的肾脏长度和宽度又比原来增加了 20%,厚度增加了 32%。
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引用次数: 0
The use of prognostic scales to assess the effectiveness of the use of anti-cytokine drugs in patients with moderate and severe course of a new coronavirus infection 使用预后量表评估新型冠状病毒感染中度和重度病程患者使用抗细胞因子药物的效果
Pub Date : 2023-12-25 DOI: 10.17021/1992-6499-2023-4-67-75
S. V. Nagumanov, A. T. Abdrashitova, E. A. Popov
The aim. To analyze the effectiveness of the use of anti-cytokine drugs (tocilizumab, olokizumab and sarilumab) in a single-center retrospective cohort study based on the prediction of clinical outcomes using prognostic scales, with a single administration in patients with moderate to severe course of a new coronavirus infection.Materials and methods. The retrospective cohort study included three groups of patients with single administration of tocilizumab (65 patients), olokizumab (56 patients) and sarilumab (26 patients). All patients were treated in a repurposed infectious diseases hospital for patients with COVID-19 on the basis of Аlexandro-Mariinskaya Regional Clinical Hospital in the period January- August 2021. Upon admission to the hospital and 2 days after administration of the drug, patients were predicted the severity of the course and outcome using prognostic scales: 4C Mortality Score, COVID-GRAM, SHOCS-COVID.Results. A comparative analysis of the effectiveness of the use of anti-cytokine drugs using the 4C Mortality Score scale revealed a further deterioration in the prognosis of clinical outcome in the groups receiving tocilizumab (p = 0,002) and sarilumab (p = 0,031). When using the COVID-GRAM predictive scale, further deterioration of the prognosis was also noted in the tocilizumab (p = 0,004) and olokizumab (p = 0,005) groups. The SHOCS-COVID scale showed a further deterioration in the prognosis in the tocilizumab group (p = 0,001).Conclusion. The use of drugs based on monoclonal antibodies against IL-6 and its receptors in patients with moderate to severe COVID-19 did not reveal significant positive dynamics in changing the prognosis of clinical outcome 2 days after administration of these drugs.
目的在一项单中心回顾性队列研究中,根据预后量表对新冠状病毒感染中重度病程患者的临床结果进行预测,分析抗细胞因子药物(托珠单抗、奥洛珠单抗和沙利单抗)的使用效果。回顾性队列研究包括三组患者,分别使用托珠单抗(65 例)、奥洛珠单抗(56 例)和沙利单抗(26 例)。所有患者均于2021年1月至8月期间在Аlexandro-Mariinskaya地区临床医院基础上为COVID-19患者改建的传染病医院接受治疗。入院时和用药 2 天后,使用预后量表预测患者的病程严重程度和预后:4C 死亡率评分、COVID-GRAM、SHOCS-COVID。使用 4C 死亡率评分表对抗细胞因子药物的使用效果进行比较分析后发现,接受托珠单抗(p = 0.002)和沙利单抗(p = 0.031)治疗组的临床预后进一步恶化。在使用 COVID-GRAM 预测量表时,托西珠单抗组(p = 0.004)和奥利珠单抗组(p = 0.005)的预后也进一步恶化。SHOCS-COVID量表显示,托西珠单抗组的预后进一步恶化(p = 0,001)。结论:对中重度COVID-19患者使用抗IL-6及其受体的单克隆抗体药物,在用药2天后,临床预后并没有明显的积极变化。
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引用次数: 0
Influence of 60-day administration of tartrazine and infliction of a defect in the tibia on the histological structure and morphometric parameters of the rat’s thyroid gland 对大鼠甲状腺组织学结构和形态计量参数施加60天的酒石酸并造成胫骨缺损的影响
Pub Date : 2023-12-25 DOI: 10.17021/1992-6499-2023-4-58-66
V. N. Morozov, V. I. Luzin
Aim: to study the histological structure and histomorphometric parameters of the thyroid gland in rats in the period after the completion of the 60-day administration of tartrazine and the creation of a through defect in the tibiae.Material and methods. One hundred and fifty white male rats were divided into five groups: groups T1 and T2 - 60 days of exposure to tartrazine at a dosage of 750 and 1500 mg/kg; group K+D – 60-day administration of saline solution and infliction of a defect in the tibiae; groups T1+D and T2+D – 60-day exposure to tartrazine at a dosage of 750 and 1500 mg/kg and causing a defect in the tibia. The histological structure and histomorphometric parameters of the thyroid gland were studied on days 3, 10, 15, 24 and 45.Results. In the T1+D and T2+D groups, mainly small follicles, lined with cuboidal shaped cells, and in some of them - a flat or columnar shaped cells were detected in the center of the gland from days 3 to 15. Many thyrocytes had a vacuolated cytoplasm and an intensely stained nucleus. The heterogeneous colloid partially filled or was practically absent in the follicles cavity, anemia of the capillaries between them was determined. Singly areas of the organ parenchyma with a significant accumulation of lymphocytes were detected. Histomorphometric study showed a decrease in the internal diameter of the follicles, lumen-epithelial index and nucleo-cytoplasmic ratio and the raise in the height of the follicular epithelium and the area of the cytoplasm of follicular cells.Conclusion. Sixty-day administration of tartrazine to rats and artificial traumatic bone injury leads, in comparison with the data of control groups, to a more pronounced change in the histological picture and morphometric data of the thyroid gland. The intensity and duration of changes are dosedependent: in the T1+D group, most of the qualitative and quantitative changes are smoothed out by 45 days, and in the T2+D group, many of them remain, and the body does not adapt to them.
目的:研究大鼠在服用 60 天的酒石酸并在胫骨上造成贯通缺损后,甲状腺的组织学结构和组织形态学参数。150只白色雄性大鼠被分为五组:T1组和T2组--暴露于酒石酸60天,剂量分别为750毫克/千克和1500毫克/千克;K+D组--服用生理盐水60天,并造成胫骨缺损;T1+D组和T2+D组--暴露于酒石酸60天,剂量分别为750毫克/千克和1500毫克/千克,并造成胫骨缺损。在第3、10、15、24和45天对甲状腺的组织学结构和组织形态计量参数进行了研究。在T1+D组和T2+D组中,从第3天到第15天,腺体中心发现的主要是小滤泡,内衬是立方体状细胞,其中一些是扁平或柱状细胞。许多甲状腺细胞的细胞质呈空泡状,细胞核被浓染。滤泡腔内部分充满或几乎没有异质胶质,滤泡间的毛细血管贫血。在器官实质的单个区域检测到大量淋巴细胞聚集。组织形态计量学研究显示,卵泡内径、管腔上皮指数和细胞核-细胞质比率下降,卵泡上皮高度和卵泡细胞的细胞质面积增加。与对照组的数据相比,给大鼠服用60天的酒石酸和人工创伤性骨损伤会导致甲状腺的组织学图像和形态计量学数据发生更明显的变化。变化的强度和持续时间与剂量有关:在T1+D组中,大多数质和量的变化在45天后都已平滑消失,而在T2+D组中,许多变化仍然存在,机体无法适应这些变化。
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引用次数: 0
Effect of the neuropeptide compound His-Phe-Arg-Trp-Pro-Gly-Pro on the level of pro- and anti-inflammatory cytokines in conditions of stress-induced depression 神经肽化合物 His-Phe-Arg-Trp-Pro-Gly-Pro 对应激诱发抑郁症情况下促炎症和抗炎症细胞因子水平的影响
Pub Date : 2023-12-25 DOI: 10.17021/1992-6499-2023-4-103-110
A. Yasenyavskaya
Depression, being a heterogeneous disorder, is one of the most pressing problems in medicine, due to its high prevalence and the development of severe consequences, both medical and social. Currently, there is an urgent need to study the pathophysiological pathways that determine the development of depression in order to identify targets for the development of innovative multi-targeted drugs.Objective: to study the effect of the neuropeptide compound His-Phe-Arg-Trp-Pro-Gly-Pro on the level of pro- and anti-inflammatory cytokines in conditions of stress-induced depression.Materials and methods. The experiment was carried out on non-linear male rats 6 months old. age, in the amount of 50 individuals. A depressive-like state was modeled by providing constant sensory contact in rats and daily confrontations for 20 days, forming submissive and aggressive types of behavior.Results. It has been established that His-Phe-Arg-Trp-Pro-Gly-Pro in conditions of stress-induced depression helps restore the cytokine profile, reducing the level of proinflammatory cytokines (IL-1β, IL-6) and increasing the level of anti-inflammatory cytokines (IL-4 , IL-10).Conclusion. The results obtained allow us to consider stress-induced depression as an immune-mediated condition, which determines the need to develop new therapeutic and preventive methods taking into account immunological etiological and pathogenetic mechanisms. Analysis of key cytokines of neuroimmune interactions (IL-1β, IL-4, IL-6, IL-10) in animals exposed to a stress factor that induces the development of depression under the influence of the neuropeptide compound His-Phe-Arg-Trp-Pro-Gly- Pro showed that one of the ways to realize the action of this substance with a neuropeptide structure is to restore cytokine regulation.
抑郁症是一种异质性疾病,由于其发病率高,并在医疗和社会方面产生严重后果,因此是医学界最紧迫的问题之一。目的:研究神经肽化合物 His-Phe-Arg-Trp-Pro-Gly-Pro 对应激诱导抑郁症条件下促炎和抗炎细胞因子水平的影响。实验在 6 个月大的非线性雄性大鼠身上进行,每只大鼠 50 只。通过为大鼠提供持续的感官接触和为期 20 天的日常对抗来模拟类似抑郁的状态,形成顺从和攻击类型的行为。结果表明,His-Phe-Arg-Trp-Pro-Gly-Pro 在应激诱导的抑郁状态下有助于恢复细胞因子谱,降低促炎细胞因子(IL-1β、IL-6)的水平,提高抗炎细胞因子(IL-4、IL-10)的水平。根据研究结果,我们可以将压力诱导的抑郁症视为一种免疫介导的疾病,这就决定了有必要在考虑免疫学病因和发病机制的基础上开发新的治疗和预防方法。在神经肽化合物His-Phe-Arg-Trp-Pro-Gly-Pro的影响下,分析暴露于诱发抑郁症的应激因素的动物体内神经免疫相互作用的关键细胞因子(IL-1β、IL-4、IL-6、IL-10)表明,实现这种具有神经肽结构的物质的作用的方法之一是恢复细胞因子的调节。
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引用次数: 0
Diagnosis of acute myocardial infarction before surgery: high-sensitivity troponin T or amino-terminal fragment of pro-brain natriuretic peptide type B? 手术前急性心肌梗死的诊断:高敏肌钙蛋白 T 还是前脑钠尿肽 B 型氨基末端片段?
Pub Date : 2023-12-25 DOI: 10.17021/1992-6499-2023-4-76-87
O. V. Petrova, D. K. Tverdokhlebova, S. Shashin
Currently, there are data in the literature about the importance of the aminoterminal fragment of pro-brain natriuretic peptide type B in the diagnosis of patients with acute myocardial infarction.The aim. To study preoperative levels of aminoterminal fragment of pro-brain natriuretic peptide type B and high-sensitivity troponin T in patients with acute myocardial infarction and to assess the significance of aminoterminal fragment of pro-brain natriuretic peptide type B in patients with this pathology.Materials and methods. We retrospectively analyzed 50 medical records of patients diagnosed with acute myocardial infarction.The results. Study of preoperative levels of aminoterminal fragment of pro-brain natriuretic peptide type B in patients with acute myocardial infarction showed that the values of aminoterminal fragment of pro-brain natriuretic peptide type B at hospital admission ranged from 127 to 600 pg/ml; correlated with left ventricular ejection fraction (r =-0,42, p < 0,05), severity of acute heart failure (r =+0,57, p < 0,05), and outcome of acute myocardial infarction (r =+0,45, p < 0,05). Assessment of the value of aminoterminal fragment of pro-brain natriuretic peptide type B in patients with acute myocardial infarction on the basis of comparison with high-sensitivity troponin T revealed no advantages of its use in this pathology as a marker of acute cardiomyocyte damage: aminoterminal fragment of pro-brain natriuretic peptide type B has less diagnostic and prognostic value than high-sensitivity troponin T. Diagnosis of acute myocardial infarction before surgery: highly sensitive troponin T or aminoterminal fragment of pro-brain natriuretic peptide type B?
目前,有文献数据表明,B 型前脑钠尿肽的氨基端片段在急性心肌梗死患者的诊断中具有重要意义。研究急性心肌梗死患者术前的原脑钠肽 B 型氨端片段和高敏肌钙蛋白 T 的水平,并评估原脑钠肽 B 型氨端片段在该病症患者中的重要性。我们回顾性分析了 50 例急性心肌梗死患者的病历。对急性心肌梗死患者术前 B 型前脑钠肽氨端片段水平的研究表明,入院时 B 型前脑钠肽氨端片段的值在 127 至 600 pg/ml 之间;与左心室射血分数(r =-0.42,p < 0.05)、急性心力衰竭严重程度(r =+0.57,p < 0.05)和急性心肌梗死预后(r =+0.45,p < 0.05)相关。根据与高敏肌钙蛋白 T 的比较,评估了 B 型前脑钠尿肽氨端片段在急性心肌梗死患者中的价值,结果显示在这种病理情况下将其用作急性心肌细胞损伤的标志物没有任何优势:B 型前脑钠尿肽氨端片段的诊断和预后价值低于高敏肌钙蛋白 T。手术前诊断急性心肌梗死:高敏肌钙蛋白 T 还是前脑钠尿肽 B 型的氨端片段?
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引用次数: 0
Research of the application of elements of sports games in the process of therapeutic physical education activities 研究体育游戏元素在治疗性体育教育活动过程中的应用
Pub Date : 2023-12-25 DOI: 10.17021/1992-6499-2023-4-35-42
A. V. Dorontsev, L. N. Porubayko, N. Zinchuk, Yu. A. Lyamina
Recent studies have shown that the use of elements of team sports in physical education classes in a special medical group “B” (therapeutic physical education) remains one of the promising areas and, at the same time, a rather complex methodological problem, caused in many cases by concomitant diseases of students. When discussing the features and advantages of various team sports in the mode of practical exercises in therapeutic physical culture in universities, it is necessary to pay attention to the differentiated use of elements of sports games in accordance with the existing pathology.Purpose. Determine the most effective complexes of physical activity using elements of team sports.Materials and methods. The material for the work was the results of a current medical examination, motor tasks that make it possible to determine the level of development of physical qualities, and data from a functional test. The research was conducted at the departments of physical education of Astrakhan State Medical University and Kuban State Medical University and Astrakhan State University in the 2021/22 academic year. Based on functional tests, the level of physical fitness of those involved was analyzed, and hemodynamics were determined during physical activity classes using elements of team sports. The work used standard methods of mathematical analysis.Results. A reliable correlation was revealed between the use of elements of team sports and the level of increase in the regulatoryadaptive potential of the cardiovascular system, reduction of BMI, elements of team sports were identified that are advisable to recommend for the appropriate medical group. During the work, data were obtained on the effectiveness of using elements of sports games for students assigned to medical group “B”.Conclusions. It is advisable to use elements of basketball in the form of developing coordination abilities, mastering techniques of ball possession with changing parameters in space and time interval. In our opinion, this format allows you to vary the intensity of physical activity in accordance with the level of functional and physical fitness of students. In the same group, it is possible to use elements of volleyball and the game of volleyball itself according to simplified rules. The individual duration of rest breaks should allow the cardiorespiratory system to be restored to background levels.
最近的研究表明,在 "B "特殊医学组(治疗性体育教育)的体育课上使用团队运动要素仍然是一个很有前途的领域,同时也是一个相当复杂的方法问题,在许多情况下是由学生的并发症引起的。在讨论大学治疗性体育实践模式中各种团队运动的特点和优势时,有必要注意根据现有病理情况有区别地使用体育游戏元素。确定使用团队运动要素进行体育活动的最有效组合。这项工作的材料是当前体检结果、能够确定身体素质发展水平的运动任务以及功能测试数据。研究于 2021/22 学年在阿斯特拉罕国立医科大学、库班国立医科大学和阿斯特拉罕国立大学的体育系进行。在功能测试的基础上,分析了相关人员的体能水平,并在使用团队运动元素的体育活动课上测定了血液动力学。这项工作采用了标准的数学分析方法。结果表明,团队运动要素的使用与心血管系统调节适应潜能的提高、体重指数的降低之间存在可靠的相关性。在这项工作中,获得了关于被分配到医疗组 "B "的学生使用体育游戏元素的有效性的数据。在培养协调能力、掌握空间和时间间隔参数变化的控球技术时,最好使用篮球元素。我们认为,这种形式可以根据学生的机能和体能水平改变体育活动的强度。在同一小组中,可以根据简化规则使用排球元素和排球比赛本身。个别休息时间的长短应使心肺系统恢复到背景水平。
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引用次数: 0
Nasal cavity microbiota features among people who have had COVID-19 COVID-19 患者的鼻腔微生物群特征
Pub Date : 2023-12-25 DOI: 10.17021/1992-6499-2023-4-97-102
V. A. Romanov, I. V. Dukhanina, A. V. Afanas'ev, M. Y. Gul'neva, N. V. Semechkin
The new coronavirus infection of 2019 is accompanied by damage to a number of organs, tissues, systems of the human body, including the microbiome. However, some aspects of the influence of this infection on the state of the microbiota of individual biotopes in individuals vaccinated with the Gam-COVIDVac vaccine require further research.Purpose: to study the characteristics of the nasal microbiota in vaccinated Gam-COVID-Vac and non-vaccinated individuals who have had COVID-19.Materials and methods: 60 people aged 18 to 23 years old were examined, divided into 3 equal groups: group 1 – vaccinated, sick after vaccination, group 2 – not vaccinated, recovered, group 3 (control) – not sick and not vaccinated. In all examined persons, muconasal secretions from the nasal cavity were examined using conventional bacteriological methods.Results. In the group of unvaccinated and recovered patients, the coronavirus infection caused a significant change in the composition of the nasal cavity microbiota in the form of a significant increase in the number of opportunistic microorganisms (S. aureus, E. coli, Streptococcus spp;) relative to similar indicators in the control group (who had not recovered from the disease and were not vaccinated). In vaccinated and recovering individuals compared with the control group, the changes are unreliable.Conclusion: Transmission of COVID-19 in individuals vaccinated with the Gam-COVID-Vac vaccine does not lead to changes in the nasal microbiota. Significant changes in the microbiota with an increase in the number of opportunistic microorganisms were found in unvaccinated individuals who underwent COVID-19.
2019年最新冠状病毒感染伴随着对人体一些器官、组织、系统的损害,包括微生物群。然而,这种感染对接种Gam-COVIDVac疫苗的个体生物群微生物状态的影响的某些方面还需要进一步研究。目的:研究接种Gam-COVID-Vac疫苗和未接种COVID-19疫苗的个体鼻腔微生物群的特征。材料和方法:对 60 名 18 至 23 岁的人进行了检查,将其分为 3 组:第 1 组--已接种疫苗,接种后生病;第 2 组--未接种疫苗,已康复;第 3 组(对照组)--未生病,未接种疫苗。所有受检者的鼻腔粘液分泌物均采用常规细菌学方法进行检测。在未接种疫苗和康复患者组中,冠状病毒感染导致鼻腔微生物群的组成发生了显著变化,与对照组(未从疾病中康复且未接种疫苗)的类似指标相比,机会性微生物(金黄色葡萄球菌、大肠杆菌、链球菌属)的数量显著增加。与对照组相比,接种疫苗者和康复者的变化并不可靠:结论:在接种 Gam-COVID-Vac 疫苗的人群中传播 COVID-19 不会导致鼻腔微生物群发生变化。在未接种 COVID-19 疫苗的人群中,微生物群发生了显著变化,机会性微生物的数量有所增加。
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引用次数: 0
Predictors of late spontaneous miscarriages depending on the phenotype of abortion 晚期自然流产的预测因素取决于流产的表型
Pub Date : 2023-12-25 DOI: 10.17021/1992-6499-2023-4-88-96
T. V. Rachenkova, Y. Dudareva
The aim. Assessment of risk factors for late miscarriages depending on the clinical phenotype of abortion.Materials and methods. The study included 156 women. The main group consisted of 66 patients with late spontaneous abortion at a gestational age of 12,0–21,6 weeks, 47 of them with miscarriage on the background of isthmic-cervical insufficiency or premature rupture of amniotic fluid, 19 with late miscarriage against the background of blood discharge. Control group – 90 patients whose pregnancy ended in term delivery.Results. Analysis of the prevalence of extragenital pathology revealed a high incidence of anemia (31,8 %; p = 0,000), obesity (12,12 %, p = 0,013), and gastrointestinal diseases (12,12 %; p = 0,004) in women with late miscarriage. When analyzing gynecological pathology, it was revealed that surgical treatment of the cervix was 9,6 times more common in patients of the main group compared to the control group (10,6 and 1,1 %; p = 0,008; OR = 10,68 CI 1,28–89,04), the frequency of abnormalities in the development of the uterus – 7,5 times more often in the group with bleeding compared to the group of patients with isthmic-cervical insufficiency (15,8 and 2.1 %; p = 0,035; OR = 8,63 CI 0,84–88,97). Significant risk factors for late miscarriages are preterm birth (18,2 %, p = 0,000), non-developing pregnancy (18,2 %; p = 0,026), medical abortions (42,6 %; p = 0,003). When analyzing the course of pregnancy, prognostically unfavorable markers of miscarriage were identified: the threat of termination of a real pregnancy (53,0 %; p = 0,000), isthmic-cervical insufficiency (19,1 %: p = 0,000) and violations of the vaginal biocenosis (71,2 %, p = 0,000).Conclusion. Thus, the presence of extragenital pathology, aggravated obstetric anamnesis and complicated course of pregnancy is typical for patients with late spontaneous abortions, which requires monitoring of this category of patients at the stage of preconception preparation, treatment of extragenital pathology, as well as timely prevention, diagnosis and treatment of complications at different stages of pregnancy.
目的根据流产的临床表型评估晚期流产的风险因素。研究包括 156 名妇女。主组包括 66 名胎龄在 12.0-21.6 周的晚期自然流产患者,其中 47 名因宫颈峡部不全或羊水早破而流产,19 名因血性分泌物而晚期流产。对照组--90 名妊娠足月分娩的患者。对生殖器外病变发病率的分析表明,晚期流产妇女中贫血(31.8%;P = 0.000)、肥胖(12.12%;P = 0.013)和胃肠道疾病(12.12%;P = 0.004)的发病率较高。在分析妇科病理学时发现,与对照组相比,主要组患者接受宫颈手术治疗的比例高出 9.6 倍(分别为 10.6%和 1.1%;p = 0.008;OR = 10.68 CI 1.28-89.04),与宫颈峡部发育不全患者相比,出血组患者出现子宫发育异常的频率高出 7.5 倍(分别为 15.8%和 2.1%;p = 0.008)。1 %;P = 0.035;OR = 8.63 CI 0.84-88.97)。晚期流产的重要风险因素包括早产(18.2%,p = 0.000)、未发育妊娠(18.2%;p = 0.026)和药物流产(42.6%;p = 0.003)。在对妊娠过程进行分析时,发现了不利于流产的预后指标:威胁终止妊娠(53.0%;p = 0.000)、宫颈峡部不全(19.1%:p = 0.000)和阴道生物狭窄(71.2%,p = 0.000)。因此,晚期自然流产患者存在典型的生殖器外病变、产科病史加重和妊娠过程复杂的情况,这就要求在孕前准备阶段对这类患者进行监测,治疗生殖器外病变,并及时预防、诊断和治疗妊娠不同阶段的并发症。
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引用次数: 0
Features of cytomegalovirus infection in severely premature newborns 严重早产新生儿巨细胞病毒感染的特征
Pub Date : 2023-12-25 DOI: 10.17021/1992-6499-2023-4-50-57
O. V. Lebedeva, N. Pimenova, E. Kashirskaya, T. A. Berezhnova, E. Polyanina, T. A. Gasanova
Cytomegalovirus infection of newborns is one of the serious medical and social problems of neonatology and is often the cause of disability and mortality of the child population.The purpose of the work was to study the incidence and clinical characteristics of cytomegalovirus infection in very premature newborns.  Materials and methods. Data from 384 medical records of premature infants with a gestational age of less than 32 weeks were analyzed.Results. The variants of the clinical course of the disease are described, the results of laboratory studies are presented, as well as the methods of therapy used. Clinical cases with fatal outcome demonstrated. The results of the study showed that the postnatal form of the disease was 3 times more common than congenital and often occurred under the “mask” of another severe pathology, which made early diagnosis difficult. For timely diagnosis and treatment of cytomegalovirus infection in severely premature newborns, regular polymerase chain reaction examination is recommended.
新生儿巨细胞病毒感染是新生儿科严重的医学和社会问题之一,通常是导致儿童残疾和死亡的原因。这项工作的目的是研究极早产新生儿巨细胞病毒感染的发病率和临床特征。 材料和方法对 384 份胎龄小于 32 周的早产儿病历数据进行了分析。描述了该病临床过程的变异,介绍了实验室研究的结果以及采用的治疗方法。展示了致命的临床病例。研究结果表明,产后型该病的发病率是先天型的三倍,而且往往是在其他严重病症的 "掩盖 "下发生的,这给早期诊断带来了困难。为了及时诊断和治疗严重早产新生儿巨细胞病毒感染,建议定期进行聚合酶链反应检查。
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引用次数: 0
Problems of antibacterial therapy of hospital infections in the post-pandemic period of COVID-19 and ways to solve them COVID-19 大流行后医院感染的抗菌治疗问题及解决方法
Pub Date : 2023-12-24 DOI: 10.17021/1992-6499-2023-4-25-34
A. A. Galitsky, S. D. Mitrokhin, A. S. Shkoda, O. E. Orlova, S. Bochkareva, I. A. Kiseleva, M. Anurova, A. V. Aleshkin
Due to the coronavirus pandemic in Russia, a significant increase in the emergence of strains of microorganisms with multiple drug resistance was noted.Objective: improvement of the effectiveness of prophylactic and therapeutic measures aimed at prevention of hospital pathogens circulation in the intensive care unit by using bacteriophages active against multidrug-resistant strains of Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter baumannii.Materials and methods. The study was conducted on the basis of the Intensive Care Unit No. 2 of L.A. Vorohobov City Clinical Hospital No. 67 of Moscow Healthcare Department. Personalized selection of bacteriophages was carried out on the basis of G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology. The study included two groups of patients, a total of 20 people, who were on prolonged mechanical ventilation in the intensive care unit.Results. No toxic and allergic reactions were detected from the patients in all cases of bacteriophages application. Pathological changes of blood biochemical parameters were not observed in connection with the use of bacteriophages. Complete eradication of pathogens occurred in 60 % of cases.Conclusion. The effectiveness of treatment of various nosological forms of HAIs caused by MDR strains of hospital pathogens increased by 30%, and the effectiveness of the starting antibiotic therapy regimen was 70% and more as a result of the use of personalized phage therapy.
目的:通过使用对肺炎克雷伯氏菌、铜绿假单胞菌、金黄色葡萄球菌和鲍曼不动杆菌的多重耐药菌株具有活性的噬菌体,提高旨在预防重症监护病房医院病原体循环的预防和治疗措施的有效性。研究在莫斯科医疗保健部第 67 医院(L.A. Vorohobov City Clinical Hospital No. 67)第 2 重症监护室进行。噬菌体的个性化选择是在 G.N. Gabrichevsky 莫斯科流行病学和微生物学研究所的基础上进行的。研究包括两组患者,共 20 人,他们都在重症监护室接受长期机械通气。在所有使用噬菌体的病例中,患者均未发现中毒和过敏反应。使用噬菌体后,血液生化指标未出现病理变化。60%的病例完全根除了病原体。由于使用了个性化的噬菌体疗法,由医院病原体的MDR菌株引起的各种HAI的治疗效果提高了30%,起始抗生素治疗方案的效果提高了70%以上。
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引用次数: 0
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ASTRAKHAN MEDICAL JOURNAL
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