Pub Date : 2023-07-11DOI: 10.29413/abs.2023-8.3.21
Y. Churina, D. Shlyk, R. Rzayev, V. Balaban, P. Tsarkov
Background. Reliable data on the efficacy and safety of fistulectomy with primary sphincter repair for the treatment of high transsphincteric anal fistulas are deficient.The aim. To compare the efficacy and safety of fistulectomy with advancement muco-muscular flap (F) and fistulectomy with primary sphincter reconstruction (SR) for the treatment of high anorectal fistulas.Methods. A cohort of 92 consecutive patients with transsphincteric anal fistula involving 1/3 to 2/3 of the sphincteric complex were included in prospective randomized study. The primary endpoint was the recurrence rate. The duration of surgery, blood loss, pain intensity, postoperative complications, the duration of wound healing, incontinence, quality of life were registered.Results. Forty-six patients were randomized in each group. A statistically significant difference was obtained for operative time (Group “F” – 45 (20–160) min, Group “SR” – 33 (10–55) min). The blood loss was 3 (1–20) and 2 (1–10) ml in Groups “F” and “SR”, respectively (p = 0.482). The return to work in Groups “SR” and “F” occurred after 7 (2–14) and 8 (4–20) days, respectively (p = 0.005). The pain syndrome was significantly greater in Group “F” (p < 0.05) on days 1 and 7. Recurrence rate was in 23.9 % (11 cases) in Group “F” and in 6.5 % (3 cases) in Group “SR” (p = 0.042). Incontinence was in 7 (15.2 %) people in Group “F”, in 10 patients (21.7 %) – in Group “SR” (p = 0.591). There was no statistically significant difference in postoperative complications.Conclusion. Findings can expand the indications for the treatment of high transsphincteric anorectal fistulas involving from 1/3 to 2/3 of the sphincter complex without statistically significant risk for functional results.
{"title":"Outcomes of surgery for high transsphincteric anal fistulas: prospective randomized trial","authors":"Y. Churina, D. Shlyk, R. Rzayev, V. Balaban, P. Tsarkov","doi":"10.29413/abs.2023-8.3.21","DOIUrl":"https://doi.org/10.29413/abs.2023-8.3.21","url":null,"abstract":"Background. Reliable data on the efficacy and safety of fistulectomy with primary sphincter repair for the treatment of high transsphincteric anal fistulas are deficient.The aim. To compare the efficacy and safety of fistulectomy with advancement muco-muscular flap (F) and fistulectomy with primary sphincter reconstruction (SR) for the treatment of high anorectal fistulas.Methods. A cohort of 92 consecutive patients with transsphincteric anal fistula involving 1/3 to 2/3 of the sphincteric complex were included in prospective randomized study. The primary endpoint was the recurrence rate. The duration of surgery, blood loss, pain intensity, postoperative complications, the duration of wound healing, incontinence, quality of life were registered.Results. Forty-six patients were randomized in each group. A statistically significant difference was obtained for operative time (Group “F” – 45 (20–160) min, Group “SR” – 33 (10–55) min). The blood loss was 3 (1–20) and 2 (1–10) ml in Groups “F” and “SR”, respectively (p = 0.482). The return to work in Groups “SR” and “F” occurred after 7 (2–14) and 8 (4–20) days, respectively (p = 0.005). The pain syndrome was significantly greater in Group “F” (p < 0.05) on days 1 and 7. Recurrence rate was in 23.9 % (11 cases) in Group “F” and in 6.5 % (3 cases) in Group “SR” (p = 0.042). Incontinence was in 7 (15.2 %) people in Group “F”, in 10 patients (21.7 %) – in Group “SR” (p = 0.591). There was no statistically significant difference in postoperative complications.Conclusion. Findings can expand the indications for the treatment of high transsphincteric anorectal fistulas involving from 1/3 to 2/3 of the sphincter complex without statistically significant risk for functional results.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86628554","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}
Pub Date : 2023-05-05DOI: 10.29413/abs.2023-8.2.25
S. Popov, A. Mukhomedzyanov, M. Sirotina, B. Kurbatov, V. N. Azev, G. Sufianova, M. S. Khlestkina, L. Maslov
Background. Mortality from acute myocardial infarction with ST-segment elevation in cardiac hospitals ranges from 4.5 to 7 %, and these data has not decreased in recent years. The most common cause of death in patients is cardiogenic shock, the likelihood of which directly depends on infarct size. It is quite clear that there is an urgent need to create drugs to limit the size of infarction and prevent the occurrence of cardiogenic shock.The aim. To evaluate the role of reactive oxygen species and redox-sensitive protein kinases in the infarction-limiting effect of opioid peptide deltorphin II in cardiac reperfusion in rats.Materials and methods. Coronary occlusion (45 min) and reperfusion (120 min) were performed in rats anesthetized with α-chloralose. The selective δ2-opioid receptor agonist deltorphin II, a hydroxyl radical scavenger 2-mercaptoprpionyl glycine (2-MPG), a superoxide radical scavenger tempol, the protein kinase Cδ (PKCδ) inhibitor rottlerin, the PI3-kinase inhibitor wortmannin, the inhibitor of ERK1/2 kinase PD98059 were injected before of reperfusion of the heart.Results. Deltorphin II contributed to a two-fold decrease in infarction size. Injection of 2-MPG, tempol, rottlerin, wortmannin, PD98059 alone had no effect on infarction size in rats. 2-MPG and tempol did not affect the infarction-reducing effect of deltorphin II. Rottlerin, wortmannin, and PD98059 eliminated the cardioprotective effect of deltorphin II.Conclusion. The infarction-reducing effect of deltorphin II does not depend on the production of superoxide radical and hydroxyl radical. Superoxide radical and hydroxyl radical do not play a significant role in reperfusion injury of the heart after coronary occlusion (45 min). PKCδ, PI3-kinase, and ERK1/2 kinase are involved in the infarction-limiting effect of deltorphin II in myocardial reperfusion.
{"title":"The role of reactive oxygen species and redoxsensitive protein kinases in the infarction-limiting effect of opioid peptide deltorphin II in cardiac reperfusion in rats","authors":"S. Popov, A. Mukhomedzyanov, M. Sirotina, B. Kurbatov, V. N. Azev, G. Sufianova, M. S. Khlestkina, L. Maslov","doi":"10.29413/abs.2023-8.2.25","DOIUrl":"https://doi.org/10.29413/abs.2023-8.2.25","url":null,"abstract":"Background. Mortality from acute myocardial infarction with ST-segment elevation in cardiac hospitals ranges from 4.5 to 7 %, and these data has not decreased in recent years. The most common cause of death in patients is cardiogenic shock, the likelihood of which directly depends on infarct size. It is quite clear that there is an urgent need to create drugs to limit the size of infarction and prevent the occurrence of cardiogenic shock.The aim. To evaluate the role of reactive oxygen species and redox-sensitive protein kinases in the infarction-limiting effect of opioid peptide deltorphin II in cardiac reperfusion in rats.Materials and methods. Coronary occlusion (45 min) and reperfusion (120 min) were performed in rats anesthetized with α-chloralose. The selective δ2-opioid receptor agonist deltorphin II, a hydroxyl radical scavenger 2-mercaptoprpionyl glycine (2-MPG), a superoxide radical scavenger tempol, the protein kinase Cδ (PKCδ) inhibitor rottlerin, the PI3-kinase inhibitor wortmannin, the inhibitor of ERK1/2 kinase PD98059 were injected before of reperfusion of the heart.Results. Deltorphin II contributed to a two-fold decrease in infarction size. Injection of 2-MPG, tempol, rottlerin, wortmannin, PD98059 alone had no effect on infarction size in rats. 2-MPG and tempol did not affect the infarction-reducing effect of deltorphin II. Rottlerin, wortmannin, and PD98059 eliminated the cardioprotective effect of deltorphin II.Conclusion. The infarction-reducing effect of deltorphin II does not depend on the production of superoxide radical and hydroxyl radical. Superoxide radical and hydroxyl radical do not play a significant role in reperfusion injury of the heart after coronary occlusion (45 min). PKCδ, PI3-kinase, and ERK1/2 kinase are involved in the infarction-limiting effect of deltorphin II in myocardial reperfusion.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90351638","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}
Pub Date : 2023-05-05DOI: 10.29413/abs.2023-8.2.24
E. Topolnitskiy, N. Shefer, E. Marchenko, T. I. Fomina, R. A. Mikhed, А. N. Tsydenova, A. Garin
The aim of investigation was to study experimentally the morphological features of tissue integration of two-layer titanium nickelide (TiNi) knitwear when replacing thoracoabdominal defects.Materials and methods. The experiments were carried out on 40 Wistar rats. The experimental animals were divided into two comparison groups: in Group A (n = 20) the defect was replaced using a two-layer knitted tape made of TiNi, in Group B (n = 20) a polypropylene mesh implant was used. The technique of the operation and the peculiarities of keeping the animals did not differ. Animals were taken out after 14, 30, 60 and 90 days of experiment. The macroscopic structural features at the site of implant fixation to tissues and at the sites of contact with underlying organs were studied, and the inflammatory process was assessed. The histological and electron microscopic study was carried out with an assessment of the features of tissue integration through the mesh structure of knitwear.Results. Thirty days after the surgery in four cases of Group B the appearance of the chest wall deformation at the site of implant fixation was noted, in one case the deformation site was located along the lateral edge of the abdominal wall. Among the animals of Group A no such changes were recorded. The histological and electron microscopy examination revealed that the porous structure of the TiNi wire, as well as the biomechanical and biochemical properties of the two-layer metal knitwear, ensure optimal integration of the endoprosthesis in the body tissues, forming an elastic frame close to natural. In Group B, on the contrary, the reaction of the body caused by the implanted polypropylene prosthesis was characterized by more pronounced fibrosis, and tissue integration through the mesh structure of the implant was not observed.Conclusion. Two-layer TiNi knitwear in the replacement of complex structures of the thoracoabdominal zone showed promising results, which opens up prospects for further clinical research.
{"title":"Features of the integration of two-layer metal knitwear made of titanium nickelide during the replacement of a thoracoabdominal defect in the experiment","authors":"E. Topolnitskiy, N. Shefer, E. Marchenko, T. I. Fomina, R. A. Mikhed, А. N. Tsydenova, A. Garin","doi":"10.29413/abs.2023-8.2.24","DOIUrl":"https://doi.org/10.29413/abs.2023-8.2.24","url":null,"abstract":"The aim of investigation was to study experimentally the morphological features of tissue integration of two-layer titanium nickelide (TiNi) knitwear when replacing thoracoabdominal defects.Materials and methods. The experiments were carried out on 40 Wistar rats. The experimental animals were divided into two comparison groups: in Group A (n = 20) the defect was replaced using a two-layer knitted tape made of TiNi, in Group B (n = 20) a polypropylene mesh implant was used. The technique of the operation and the peculiarities of keeping the animals did not differ. Animals were taken out after 14, 30, 60 and 90 days of experiment. The macroscopic structural features at the site of implant fixation to tissues and at the sites of contact with underlying organs were studied, and the inflammatory process was assessed. The histological and electron microscopic study was carried out with an assessment of the features of tissue integration through the mesh structure of knitwear.Results. Thirty days after the surgery in four cases of Group B the appearance of the chest wall deformation at the site of implant fixation was noted, in one case the deformation site was located along the lateral edge of the abdominal wall. Among the animals of Group A no such changes were recorded. The histological and electron microscopy examination revealed that the porous structure of the TiNi wire, as well as the biomechanical and biochemical properties of the two-layer metal knitwear, ensure optimal integration of the endoprosthesis in the body tissues, forming an elastic frame close to natural. In Group B, on the contrary, the reaction of the body caused by the implanted polypropylene prosthesis was characterized by more pronounced fibrosis, and tissue integration through the mesh structure of the implant was not observed.Conclusion. Two-layer TiNi knitwear in the replacement of complex structures of the thoracoabdominal zone showed promising results, which opens up prospects for further clinical research.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72832536","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}
Pub Date : 2023-05-05DOI: 10.29413/abs.2023-8.2.26
I. V. Kostyukova, O. Pasechnik, I. Mokrousov
Background. Tuberculosis (TB) infection remains relevant as one of the leading public health problems in Russia.The aim. To characterize the dynamics and trends of epidemiological manifestations of TB infection in the Omsk region.Materials and methods. An observational descriptive-evaluative epidemiological study was carried out in the Omsk region from 2009 to 2021. The data available in the Federal statistical observation forms NN 7, 8, and 33, and results of the bacteriological study of patients with respiratory TB were analyzed.Results. In the Omsk region, an improvement in the epidemiological situation was observed from 2009 to 2021. It was associated with a decrease in TB prevalence by 3.7 times (from 325.6 to 86.7), mortality – by 5.8 times (from 21.1 to 3.6), incidence – by 2.7 times (from 130.7 to 48.4 per 100,000). At the same time, proportion of microscopy/culture-positive patients infected with multidrug-resistant Mycobacterium tuberculosis strains increased from 9.2 to 29.8 % among all patients, and from 15.5 to 30.6 % among newly diagnosed patients. There was a trend towards an increase in the number of cases with primary extensive drug resistance of M. tuberculosis. The incidence of tuberculosis associated with HIV infection has increased 10 times and reached 15.6 per 100,000 population.Conclusions. In the Omsk region, there is a change in the structure of M. tuberculosis strains with a predominance of multiple and extensive drug resistance along with decrease in TB incidence and mortality. New approaches are needed to organize the system of epidemiological surveillance and control of TB infection.
{"title":"Epidemiological manifestations of tuberculosis infection in the Omsk region: dynamics and trends","authors":"I. V. Kostyukova, O. Pasechnik, I. Mokrousov","doi":"10.29413/abs.2023-8.2.26","DOIUrl":"https://doi.org/10.29413/abs.2023-8.2.26","url":null,"abstract":"Background. Tuberculosis (TB) infection remains relevant as one of the leading public health problems in Russia.The aim. To characterize the dynamics and trends of epidemiological manifestations of TB infection in the Omsk region.Materials and methods. An observational descriptive-evaluative epidemiological study was carried out in the Omsk region from 2009 to 2021. The data available in the Federal statistical observation forms NN 7, 8, and 33, and results of the bacteriological study of patients with respiratory TB were analyzed.Results. In the Omsk region, an improvement in the epidemiological situation was observed from 2009 to 2021. It was associated with a decrease in TB prevalence by 3.7 times (from 325.6 to 86.7), mortality – by 5.8 times (from 21.1 to 3.6), incidence – by 2.7 times (from 130.7 to 48.4 per 100,000). At the same time, proportion of microscopy/culture-positive patients infected with multidrug-resistant Mycobacterium tuberculosis strains increased from 9.2 to 29.8 % among all patients, and from 15.5 to 30.6 % among newly diagnosed patients. There was a trend towards an increase in the number of cases with primary extensive drug resistance of M. tuberculosis. The incidence of tuberculosis associated with HIV infection has increased 10 times and reached 15.6 per 100,000 population.Conclusions. In the Omsk region, there is a change in the structure of M. tuberculosis strains with a predominance of multiple and extensive drug resistance along with decrease in TB incidence and mortality. New approaches are needed to organize the system of epidemiological surveillance and control of TB infection.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82421603","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}
Pub Date : 2023-05-04DOI: 10.29413/abs.2023-8.2.20
G. S. Karapetyan, A. A. Shuyskiy
The problem of reverse shoulder arthroplasty with various deformities of the glenoid is relevant for modern traumatology and orthopedics. In addition to various defects, the methods of solving which can be eccentric reaming of the glenoid by milling cutters, bone autoplasty, augmentation, the use of individual implants, orthopedic traumatologists have to deal with a decrease in the mineral density of the bone tissue of the scapula.The aim of this study is to demonstrate the possibility of using hydroxyapatite paste together with bone autoplasty in revision shoulder arthroplasty in conditions of a massive defect and reduced glenoid bone density.Discussion. The article presents a case of surgical treatment of a patient with the consequences of a fracture of the proximal metaepiphysis of the humerus and local osteoporosis of the glenoid by the method of reverse shoulder arthroplasty in combination with the use of hydroxyapatite paste. A detailed description of the operation technique is given.Conclusion. The described clinical case demonstrates the effectiveness of the technique of using hydroxyapatite preparations for shoulder joint replacement.
{"title":"Our first experience with the use of hydroxyapatite paste to improve the integration of the glenoid component of a reverse prosthesis with a bone defect of the scapula (case report)","authors":"G. S. Karapetyan, A. A. Shuyskiy","doi":"10.29413/abs.2023-8.2.20","DOIUrl":"https://doi.org/10.29413/abs.2023-8.2.20","url":null,"abstract":"The problem of reverse shoulder arthroplasty with various deformities of the glenoid is relevant for modern traumatology and orthopedics. In addition to various defects, the methods of solving which can be eccentric reaming of the glenoid by milling cutters, bone autoplasty, augmentation, the use of individual implants, orthopedic traumatologists have to deal with a decrease in the mineral density of the bone tissue of the scapula.The aim of this study is to demonstrate the possibility of using hydroxyapatite paste together with bone autoplasty in revision shoulder arthroplasty in conditions of a massive defect and reduced glenoid bone density.Discussion. The article presents a case of surgical treatment of a patient with the consequences of a fracture of the proximal metaepiphysis of the humerus and local osteoporosis of the glenoid by the method of reverse shoulder arthroplasty in combination with the use of hydroxyapatite paste. A detailed description of the operation technique is given.Conclusion. The described clinical case demonstrates the effectiveness of the technique of using hydroxyapatite preparations for shoulder joint replacement.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86783459","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}
Pub Date : 2023-05-04DOI: 10.29413/abs.2023-8.2.15
M. B. Tatarinova, J. V. Aleksandrova, J. V. Kursakova, D. Popova
Surgical treatment is often accompanied by such complication as bleeding, and ophthalmic surgery is not an exception. The bleeding risk depends on many factors, the most significant are age, arterial hypertension, hepatic and renal impairment, prior stroke or treatment with oral anticoagulants.The aim. To evaluate the structure of patients taking novel oral anticoagulants (NOACs) with an assessment of activated partial thromboplastin time before ophthalmosurgical treatment.Materials and methods. 54 patients taking oral anticoagulants were included in the study. A retrospective analysis of medical histories of patients who had surgery for ocular pathology was carried out. The patients were divided into two groups: group 1 – 28 patients whose activated partial thromboplastin time (APTT) did not exceed 45 seconds; group 2 – 26 patients with APTT more than 45 seconds. The criterion for the numerical expression of APTT is the safety of performing regional anesthesia against the background of taking anticoagulant drugs. Statistical processing was performed using the Mann – Whitney test (p < 0.05).Results. A comparative analysis of the results showed that the patients of the group 2 had higher rates of APTT. At the same time, they were less likely to have acute cerebrovascular accident (11.5 % compared to 21 % of patients in the group 2) and prior acute myocardial infarction (19 % and 28 %, respectively). Among all the patients, women and slightly older patients prevailed.Conclusion. Patients with atrial fibrillation make up the majority of patients undergoing ophthalmosurgical treatment and taking NOACs. Surgical treatment method was phacoemulsification with intraocular lens implantation. Studying APTT before the surgery allowed us to identify a category of patients with high APTT, to prescribe the withdrawal of the drug before the surgery in order to create optimal conditions for surgical treatment.
{"title":"Preoperative management of ophthalmic patients taking oral anticoagulants","authors":"M. B. Tatarinova, J. V. Aleksandrova, J. V. Kursakova, D. Popova","doi":"10.29413/abs.2023-8.2.15","DOIUrl":"https://doi.org/10.29413/abs.2023-8.2.15","url":null,"abstract":"Surgical treatment is often accompanied by such complication as bleeding, and ophthalmic surgery is not an exception. The bleeding risk depends on many factors, the most significant are age, arterial hypertension, hepatic and renal impairment, prior stroke or treatment with oral anticoagulants.The aim. To evaluate the structure of patients taking novel oral anticoagulants (NOACs) with an assessment of activated partial thromboplastin time before ophthalmosurgical treatment.Materials and methods. 54 patients taking oral anticoagulants were included in the study. A retrospective analysis of medical histories of patients who had surgery for ocular pathology was carried out. The patients were divided into two groups: group 1 – 28 patients whose activated partial thromboplastin time (APTT) did not exceed 45 seconds; group 2 – 26 patients with APTT more than 45 seconds. The criterion for the numerical expression of APTT is the safety of performing regional anesthesia against the background of taking anticoagulant drugs. Statistical processing was performed using the Mann – Whitney test (p < 0.05).Results. A comparative analysis of the results showed that the patients of the group 2 had higher rates of APTT. At the same time, they were less likely to have acute cerebrovascular accident (11.5 % compared to 21 % of patients in the group 2) and prior acute myocardial infarction (19 % and 28 %, respectively). Among all the patients, women and slightly older patients prevailed.Conclusion. Patients with atrial fibrillation make up the majority of patients undergoing ophthalmosurgical treatment and taking NOACs. Surgical treatment method was phacoemulsification with intraocular lens implantation. Studying APTT before the surgery allowed us to identify a category of patients with high APTT, to prescribe the withdrawal of the drug before the surgery in order to create optimal conditions for surgical treatment.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82034903","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}
Pub Date : 2023-05-04DOI: 10.29413/abs.2023-8.2.19
E. Zabroda, A. Gordeev, V. Amelina, M. Bochkarev, S. Osipenko, L. Korostovtseva, Y. Sviryaev
Background. The model of sleep reactivity to stress considers sleep reactivity to stress as a link in the pathogenesis of insomnia disorder – the degree to which stress disturbs sleep, which manifests as difficulty in initiating and maintaining sleep.The aim. To study clinical and psychological features as well as subjective and objective sleep indexes of subjects with high level of sleep reactivity to stress.Materials and methods. The psychological status, subjective indexes of sleep and sleep reactivity to stress according to Ford Insomnia Response to Stress Test were studied among 18–75 year-old subjects without significant sleep disturbances and patients with chronic insomnia. Polysomnography was performed for objective evaluation of sleep parameters.Results. It was found that individuals with high levels of sleep reactivity to stress were characterized by high levels of anxiety, restlessness, and neuroticism. According to results of Pittsburg questionnaire, a lower quality of sleep was revealed. These findings were correlated with objective indexes of sleep according to polysomnographic studies: less deep sleep and its lower efficiency due to sleep disturbances.Conclusions. Individuals with high sleep reactivity to stress are characterized by greater anxiety combined with subjective and objective sleep disturbance like insomnia type.
{"title":"High sleep reactivity: clinical, psychological and polysomnographic features","authors":"E. Zabroda, A. Gordeev, V. Amelina, M. Bochkarev, S. Osipenko, L. Korostovtseva, Y. Sviryaev","doi":"10.29413/abs.2023-8.2.19","DOIUrl":"https://doi.org/10.29413/abs.2023-8.2.19","url":null,"abstract":"Background. The model of sleep reactivity to stress considers sleep reactivity to stress as a link in the pathogenesis of insomnia disorder – the degree to which stress disturbs sleep, which manifests as difficulty in initiating and maintaining sleep.The aim. To study clinical and psychological features as well as subjective and objective sleep indexes of subjects with high level of sleep reactivity to stress.Materials and methods. The psychological status, subjective indexes of sleep and sleep reactivity to stress according to Ford Insomnia Response to Stress Test were studied among 18–75 year-old subjects without significant sleep disturbances and patients with chronic insomnia. Polysomnography was performed for objective evaluation of sleep parameters.Results. It was found that individuals with high levels of sleep reactivity to stress were characterized by high levels of anxiety, restlessness, and neuroticism. According to results of Pittsburg questionnaire, a lower quality of sleep was revealed. These findings were correlated with objective indexes of sleep according to polysomnographic studies: less deep sleep and its lower efficiency due to sleep disturbances.Conclusions. Individuals with high sleep reactivity to stress are characterized by greater anxiety combined with subjective and objective sleep disturbance like insomnia type.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89170673","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}
Pub Date : 2023-05-04DOI: 10.29413/abs.2023-8.2.17
L. V. Zhdanova, M. L. Laperdina
The article presents a case of a fatal outcome of a 15-year-old teenager with cerebral vascular thrombosis, which developed in the post COVID-19 period. The young man came in with complaints of headache, vomiting, photophobia, hyperacusis. It was known that at an early age he had been operated on for the Arnold – Chiari anomaly, had a subdural-peritoneal shunt. Two weeks before hospitalization, he suffered a new coronavirus infection of mild severity, which was confirmed by a positive analysis of a smear from the oropharynx by polymerase chain reaction. Cephalgia was acute, stopped for a short time after the use of analgesics. During the examination, the patient laid with his eyes closed, asked for silence and blackout in the ward. Any movement of the head was accompanied by dizziness, headache, vomiting. During an objective examination, no pathological changes were found on the part of the internal organs. The neurological status was determined by photophobia, double vision, asymmetric face, asymmetry of the eye slits S > D, drooping of the left corner of the mouth, nystagmus, hyperacusis. There was no rigidity of the occipital muscles. Meningeal signs were negative. There were no pelvic disorders. According to the laboratory examination, lymphocytopenia, thrombocytosis, acceleration of ESR, moderate increase in ferritin, D-dimers were detected. Conducted neuroimaging methods (MSCT of the brain with intravenous contrast, brain MRI, ultrasound diagnostics of cerebral vessels) did not find any blood clots in intracranial and extracranial vessels. Low-positive values of IgM antibodies to cardiolipin were revealed. According to the results of polymerase chain reaction, polymorphism G20210A was detected in the prothrombin gene. The patient received high-dose glucocorticoids and heparin for treatment. Despite the therapy, a month and a half after hospitalization, the teenager died from thrombosis of the central venous sinuses (cavernous sinus on the left, transverse sinuses, jugular veins), which were confirmed on autopsy. This clinical case of venous sinus thrombosis in a teenager in the post COVID-19 period presented diagnostic difficulties, since accurate imaging methods did not detect the presence of a blood clot in the cerebral vessels.
{"title":"А clinical case of thrombosis in a teenager in the post COVID-19 period","authors":"L. V. Zhdanova, M. L. Laperdina","doi":"10.29413/abs.2023-8.2.17","DOIUrl":"https://doi.org/10.29413/abs.2023-8.2.17","url":null,"abstract":"The article presents a case of a fatal outcome of a 15-year-old teenager with cerebral vascular thrombosis, which developed in the post COVID-19 period. The young man came in with complaints of headache, vomiting, photophobia, hyperacusis. It was known that at an early age he had been operated on for the Arnold – Chiari anomaly, had a subdural-peritoneal shunt. Two weeks before hospitalization, he suffered a new coronavirus infection of mild severity, which was confirmed by a positive analysis of a smear from the oropharynx by polymerase chain reaction. Cephalgia was acute, stopped for a short time after the use of analgesics. During the examination, the patient laid with his eyes closed, asked for silence and blackout in the ward. Any movement of the head was accompanied by dizziness, headache, vomiting. During an objective examination, no pathological changes were found on the part of the internal organs. The neurological status was determined by photophobia, double vision, asymmetric face, asymmetry of the eye slits S > D, drooping of the left corner of the mouth, nystagmus, hyperacusis. There was no rigidity of the occipital muscles. Meningeal signs were negative. There were no pelvic disorders. According to the laboratory examination, lymphocytopenia, thrombocytosis, acceleration of ESR, moderate increase in ferritin, D-dimers were detected. Conducted neuroimaging methods (MSCT of the brain with intravenous contrast, brain MRI, ultrasound diagnostics of cerebral vessels) did not find any blood clots in intracranial and extracranial vessels. Low-positive values of IgM antibodies to cardiolipin were revealed. According to the results of polymerase chain reaction, polymorphism G20210A was detected in the prothrombin gene. The patient received high-dose glucocorticoids and heparin for treatment. Despite the therapy, a month and a half after hospitalization, the teenager died from thrombosis of the central venous sinuses (cavernous sinus on the left, transverse sinuses, jugular veins), which were confirmed on autopsy. This clinical case of venous sinus thrombosis in a teenager in the post COVID-19 period presented diagnostic difficulties, since accurate imaging methods did not detect the presence of a blood clot in the cerebral vessels.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78369764","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}
Pub Date : 2023-05-04DOI: 10.29413/abs.2023-8.2.23
S. Styazhkina, D. Zaitsev, A. Bagautdinov, M. R. Sharafutdinov, Z. A. Antropova, I. I. Zaripov, M. I. Kamalov
Treatment of patients with iatrogenic injuries of the biliary tract is the most difficult and important section in hepatobiliary surgery. When analyzing the causes, it was found that in 70–94 % of cases this type of injury is observed during cholecystectomy. We present a rare clinical case of the development of secondary biliary cirrhosis due to iatrogenic trauma of the biliary tract. This injury caused long-term suffering for the patient due to the further development of complications of cirrhosis, specifically of portal hypertension. The latter caused repeated recurrent profuse bleeding from varicose veins of the esophagus. The use of a minimally invasive transjugular intrahepatic portosystemic shunt procedure for the first time in the Udmurt Republic was of particular relevance in solving this problem. This procedure has become a key one in solving the abovementioned problems and will become the preventive measure for the cirrhosis progression in the future. It is also important to focus on prophylactic measures aimed at preventing iatrogenic injuries of the biliary tract, as this problem can cause irreversible complications. Prevention should include adequate examination and visualization of the bile ducts and gallbladder before surgery, their careful mobilization, compliance with the rules of operation with electrosurgical instruments, as well as the use of additional minimally invasive techniques such as choledoscopy, cholangiography and intraoperative ultrasound. Besides that, all manipulations should be carried out under strict control and clear visualization of instruments and anatomical structures of organs. The article provides a detailed description of the technique of transjugular intrahepatic portosystemic shunt surgery, as well as presents X-ray images obtained during this operation.
{"title":"The first TIPS surgery performed in the Udmurt Republic in a young patient with secondary biliary cirrhosis","authors":"S. Styazhkina, D. Zaitsev, A. Bagautdinov, M. R. Sharafutdinov, Z. A. Antropova, I. I. Zaripov, M. I. Kamalov","doi":"10.29413/abs.2023-8.2.23","DOIUrl":"https://doi.org/10.29413/abs.2023-8.2.23","url":null,"abstract":"Treatment of patients with iatrogenic injuries of the biliary tract is the most difficult and important section in hepatobiliary surgery. When analyzing the causes, it was found that in 70–94 % of cases this type of injury is observed during cholecystectomy. We present a rare clinical case of the development of secondary biliary cirrhosis due to iatrogenic trauma of the biliary tract. This injury caused long-term suffering for the patient due to the further development of complications of cirrhosis, specifically of portal hypertension. The latter caused repeated recurrent profuse bleeding from varicose veins of the esophagus. The use of a minimally invasive transjugular intrahepatic portosystemic shunt procedure for the first time in the Udmurt Republic was of particular relevance in solving this problem. This procedure has become a key one in solving the abovementioned problems and will become the preventive measure for the cirrhosis progression in the future. It is also important to focus on prophylactic measures aimed at preventing iatrogenic injuries of the biliary tract, as this problem can cause irreversible complications. Prevention should include adequate examination and visualization of the bile ducts and gallbladder before surgery, their careful mobilization, compliance with the rules of operation with electrosurgical instruments, as well as the use of additional minimally invasive techniques such as choledoscopy, cholangiography and intraoperative ultrasound. Besides that, all manipulations should be carried out under strict control and clear visualization of instruments and anatomical structures of organs. The article provides a detailed description of the technique of transjugular intrahepatic portosystemic shunt surgery, as well as presents X-ray images obtained during this operation.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87470654","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}
Pub Date : 2023-05-04DOI: 10.29413/abs.2023-8.2.18
A. Zavyalova, D. Lebedev, V. Novikova, N. N. Smirnova, L. A. Firsova
Body composition reflects the dynamic processes in a child’s development. The recommended restrictive diets for patients with advanced chronic kidney disease (CKD) contribute to a high risk of sarcopenic muscle wasting as diagnosed by bioimpedancemetry.The aim of the study. To assess BMI and body composition in children with CKD, to identify features of body composition in patients with different BMI Z-score values.Materials and methods. The physical development of 110 children with CKD of different stages was assessed. Patients were divided into two clusters: Group 1 (92 children) with BMI from 10.95 to 21.5 kg/m2, BMI Z-score did not exceed +2.0 (without obesity); Group 2 (18 children) – BMI from 24.11 to 37.2 kg/m2, Z-score BMI – more than +2.0 (obese). All underwent bioimpedancemetry, the proportion of fat and active cell mass was assessed. The comparison was carried out by nonparametric statistics methods.Results. Changes in body composition were revealed: children without obesity had severe protein-energy deficiency in 7 cases (7.6 %). The difference in the proportion of fat mass in children of different groups, Me [Q1; Q3]: Group 1 – 18.00 % [14.00; 22.00], Group 2 – 35.00 % [21.98; 41.00], (Mann – Whitney U-test: U = 279.5, p = 0.00001). In Group 1, the active cell mass was 53.50 % [51.00; 56.00], in Group 2 – 41.50 % [39.00; 47.00] (U = 174.5, p = 0.000001), there were no significant differences in other parameters of bioimpedancemetry.Conclusions. The proportion of active cell mass is lower in overweight children, with a significant predominance of the proportion of fat mass, which indicates the depletion of protein reserves due to their redistribution and possible insufficient alimentary intake in advanced stages of CKD.
{"title":"Component composition of the body in children with chronic kidney disease according to the results of bioimpedansometry","authors":"A. Zavyalova, D. Lebedev, V. Novikova, N. N. Smirnova, L. A. Firsova","doi":"10.29413/abs.2023-8.2.18","DOIUrl":"https://doi.org/10.29413/abs.2023-8.2.18","url":null,"abstract":"Body composition reflects the dynamic processes in a child’s development. The recommended restrictive diets for patients with advanced chronic kidney disease (CKD) contribute to a high risk of sarcopenic muscle wasting as diagnosed by bioimpedancemetry.The aim of the study. To assess BMI and body composition in children with CKD, to identify features of body composition in patients with different BMI Z-score values.Materials and methods. The physical development of 110 children with CKD of different stages was assessed. Patients were divided into two clusters: Group 1 (92 children) with BMI from 10.95 to 21.5 kg/m2, BMI Z-score did not exceed +2.0 (without obesity); Group 2 (18 children) – BMI from 24.11 to 37.2 kg/m2, Z-score BMI – more than +2.0 (obese). All underwent bioimpedancemetry, the proportion of fat and active cell mass was assessed. The comparison was carried out by nonparametric statistics methods.Results. Changes in body composition were revealed: children without obesity had severe protein-energy deficiency in 7 cases (7.6 %). The difference in the proportion of fat mass in children of different groups, Me [Q1; Q3]: Group 1 – 18.00 % [14.00; 22.00], Group 2 – 35.00 % [21.98; 41.00], (Mann – Whitney U-test: U = 279.5, p = 0.00001). In Group 1, the active cell mass was 53.50 % [51.00; 56.00], in Group 2 – 41.50 % [39.00; 47.00] (U = 174.5, p = 0.000001), there were no significant differences in other parameters of bioimpedancemetry.Conclusions. The proportion of active cell mass is lower in overweight children, with a significant predominance of the proportion of fat mass, which indicates the depletion of protein reserves due to their redistribution and possible insufficient alimentary intake in advanced stages of CKD.","PeriodicalId":32463,"journal":{"name":"Acta Biomedica Scientifica","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76882416","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}
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