Pub Date : 2023-06-22DOI: 10.25207/1608-6228-2023-30-3-44-55
K. I. Popandopulo, K. A. Isakhanian, S. B. Bazlov, P. S. Ushkvarok, A. A. Babenko
Background. Intra-abdominal hypertension complicates the course of secondary diffuse peritonitis in at least 60–70% of cases. Abdominal decompression is an essential component in the complex of therapeutic measures in patients with secondary diffuse peritonitis. However, no clear criteria for choosing the method and timing of abdominal decompression have been developed so far. The effectiveness of its use in various forms of peritonitis remains controversial.Objectives — to study the dynamics of intra-abdominal pressure in the early postoperative period when using various methods of abdominal decompression in patients with secondary diffuse peritonitis.Methods. The work was performed on the basis of an observational clinical study under the auspices of Regional Clinical Emergency Hospital over a period from January 2021 to December 2022. The authors studied intra-abdominal pressure in 74 patients with secondary diffuse peritonitis in the early postoperative period. In 39 (52.7%) patients (group 1), decompression was carried out in the form of prolonged nasogastric intubation. 15 (20.3%) patients (group 2) underwent nasointestinal intubation. Group 3 was represented by 10 patients (13.5%) which were affected by open abdomen technology and vacuum assisted closure (VAC). Group 4 included patients with vacuum-assisted laparostoma who underwent nasointestinal intubation. The severity of peritonitis was assessed using WSES cIAIs Score and Mannheim Peritonitis Index. The dynamics of intra-abdominal pressure was determined through the urinary catheter using the Uno Meter Abdo Pressure® Kit (Unomedical, Russia) before surgery and within 5 days of the postoperative period. Statistical analysis was based on non-parametric Wilcoxon test for comparing the values of the same group at different periods of observation. Mann-Whitney U-test was used to compare absolute values in different groups.Results. Nasogastric tube did not provide an acceptable reduction in intra-abdominal pressure, especially in patients with severe forms of peritonitis. Prolonged nasointestinal intubation contributed to a steady decrease in intra-abdominal pressure throughout the postoperative period, while simultaneous intubation resulted in an increase in intra-abdominal hypertension after a decline in values one day after surgery. The best results of intra-abdominal pressure dynamics were observed in case of vacuum-assisted laparostomy and its combination with nasointestinal intubation. Throughout the postoperative period, the intra-abdominal pressure did not exceed 15–17 mmHg. This method can be used only in treatment of the most severe forms of peritonitis, with indications for sanitation relaparotomy and in case of threatened abdominal compression syndrome.Conclusion. The data obtained enable the process of choosing surgical tactics and method of abdominal decompression to be optimized with respect to the severity of peritonitis and intra-abdominal hypertension.
{"title":"Effect of Different Methods of Abdominal Decompression on the Dynamics of Intra-Abdominal Pressure in the Early Postoperative Period in Patients with Secondary Diffuse Peritonitis: Observational Study","authors":"K. I. Popandopulo, K. A. Isakhanian, S. B. Bazlov, P. S. Ushkvarok, A. A. Babenko","doi":"10.25207/1608-6228-2023-30-3-44-55","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-3-44-55","url":null,"abstract":"Background. Intra-abdominal hypertension complicates the course of secondary diffuse peritonitis in at least 60–70% of cases. Abdominal decompression is an essential component in the complex of therapeutic measures in patients with secondary diffuse peritonitis. However, no clear criteria for choosing the method and timing of abdominal decompression have been developed so far. The effectiveness of its use in various forms of peritonitis remains controversial.Objectives — to study the dynamics of intra-abdominal pressure in the early postoperative period when using various methods of abdominal decompression in patients with secondary diffuse peritonitis.Methods. The work was performed on the basis of an observational clinical study under the auspices of Regional Clinical Emergency Hospital over a period from January 2021 to December 2022. The authors studied intra-abdominal pressure in 74 patients with secondary diffuse peritonitis in the early postoperative period. In 39 (52.7%) patients (group 1), decompression was carried out in the form of prolonged nasogastric intubation. 15 (20.3%) patients (group 2) underwent nasointestinal intubation. Group 3 was represented by 10 patients (13.5%) which were affected by open abdomen technology and vacuum assisted closure (VAC). Group 4 included patients with vacuum-assisted laparostoma who underwent nasointestinal intubation. The severity of peritonitis was assessed using WSES cIAIs Score and Mannheim Peritonitis Index. The dynamics of intra-abdominal pressure was determined through the urinary catheter using the Uno Meter Abdo Pressure® Kit (Unomedical, Russia) before surgery and within 5 days of the postoperative period. Statistical analysis was based on non-parametric Wilcoxon test for comparing the values of the same group at different periods of observation. Mann-Whitney U-test was used to compare absolute values in different groups.Results. Nasogastric tube did not provide an acceptable reduction in intra-abdominal pressure, especially in patients with severe forms of peritonitis. Prolonged nasointestinal intubation contributed to a steady decrease in intra-abdominal pressure throughout the postoperative period, while simultaneous intubation resulted in an increase in intra-abdominal hypertension after a decline in values one day after surgery. The best results of intra-abdominal pressure dynamics were observed in case of vacuum-assisted laparostomy and its combination with nasointestinal intubation. Throughout the postoperative period, the intra-abdominal pressure did not exceed 15–17 mmHg. This method can be used only in treatment of the most severe forms of peritonitis, with indications for sanitation relaparotomy and in case of threatened abdominal compression syndrome.Conclusion. The data obtained enable the process of choosing surgical tactics and method of abdominal decompression to be optimized with respect to the severity of peritonitis and intra-abdominal hypertension.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46826700","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 : 2023-06-22DOI: 10.25207/1608-6228-2023-30-3-15-24
O. V. Lazareva, S. V. Barinov, E. Shifman, L. D. Popova, L. L. Shkabarnya, Y. Tirskaya, T. V. Kadtsyna, Yu.I. Chulovsky
Background. Suppurative septic postpartum complications occupy a leading position in the structure of causes of maternal mortality. Information about the characteristics of pathogenic microflora in various forms of complications and analysis of its resistance to antibacterial drugs determine the choice of rational therapy for this pathology.Objectives — to characterize the isolated pathogenic microflora in obstetric patients with suppurative septic postpartum complications.Methods. A retrospective cohort study was conducted at the Department of Obstetrics and Gynecology No. 2 of the Omsk State Medical University and the Department of Gynecology of the Omsk Regional Clinical Hospital. The study included 123 cesarean section patients treated from January 2013 to December 2022 who were divided into three groups: Group A — uncomplicated course of postpartum endometritis, n = 55; Group B — complicated forms of postpartum endometritis, n = 48: B1 — local complications (suture failure following cesarean section; parametritis) n = 29; B2 — pelvic peritonitis, n = 19; Group C — septic complications following critical obstetric conditions, n = 20. The pathogenic microflora of uterine and abdominal cavities was examined; the extent of contamination with a pathogen and sensitivity to antibacterial drugs were determined. The isolated microorganisms were identified using a MicroTax bacteriological analyzer (Austria), Vitek2 Compact (France) and routine methods; a disk diffusion method was employed to determine the sensitivity of microorganisms to antibacterial drugs. Calculations were performed using licensed Microsoft Office Excel 2013 and Statistica 10 programs (StatSoft Inc., USA). Nonparametric nominal data were compared using Pearson’s chi-squared test with p-value determination.Results. The pathogenic microflora was dominated by S. epidermidis, E. faecalis, E. coli, and E. faecium. In 2018–2022, a statistically significant decrease was observed in the isolation rate of S. epidermidis (p = 0.016), E. faecalis (p < 0.001), and E. faecium (p = 0.05). The highest resistance was exhibited by bacteria to the following antibiotics: S. epidermidis — cephalosporins (30.16%); E. faecalis — fluoroquinolones (33.33%); E. coli — cephalosporins (65.91%) and β-lactamase-resistant penicillins (40.91%); E. faecium — aminopenicillins (64.10%) and fluoroquinolones (50.0%); А. baumannii — fluoroquinolones, cephalosporins, carbapenems (100%), and aminoglycosides (84.2%). A contamination assessment revealed a high titer of isolated microorganisms in 60.53% of cases. We found a statistically significantly higher isolation rate of S. еpidermidis (p < 0.001), E. faecium (p = 0.01), and A. baumannii (p = 0.02) in the setting of pelvic peritonitis as compared to uncomplicated endometritis. In the case of suppurative septic complications due to critical obstetric conditions, the isolation rate was higher for S. еpidermidis (p <0.001), E. coli (p = 0.04), E. faecium (p = 0.005), A.
{"title":"Characterization of Pathogenic Microflora Causing Suppurative Septic Postpartum Complications: a Retrospective Cohort Study","authors":"O. V. Lazareva, S. V. Barinov, E. Shifman, L. D. Popova, L. L. Shkabarnya, Y. Tirskaya, T. V. Kadtsyna, Yu.I. Chulovsky","doi":"10.25207/1608-6228-2023-30-3-15-24","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-3-15-24","url":null,"abstract":"Background. Suppurative septic postpartum complications occupy a leading position in the structure of causes of maternal mortality. Information about the characteristics of pathogenic microflora in various forms of complications and analysis of its resistance to antibacterial drugs determine the choice of rational therapy for this pathology.Objectives — to characterize the isolated pathogenic microflora in obstetric patients with suppurative septic postpartum complications.Methods. A retrospective cohort study was conducted at the Department of Obstetrics and Gynecology No. 2 of the Omsk State Medical University and the Department of Gynecology of the Omsk Regional Clinical Hospital. The study included 123 cesarean section patients treated from January 2013 to December 2022 who were divided into three groups: Group A — uncomplicated course of postpartum endometritis, n = 55; Group B — complicated forms of postpartum endometritis, n = 48: B1 — local complications (suture failure following cesarean section; parametritis) n = 29; B2 — pelvic peritonitis, n = 19; Group C — septic complications following critical obstetric conditions, n = 20. The pathogenic microflora of uterine and abdominal cavities was examined; the extent of contamination with a pathogen and sensitivity to antibacterial drugs were determined. The isolated microorganisms were identified using a MicroTax bacteriological analyzer (Austria), Vitek2 Compact (France) and routine methods; a disk diffusion method was employed to determine the sensitivity of microorganisms to antibacterial drugs. Calculations were performed using licensed Microsoft Office Excel 2013 and Statistica 10 programs (StatSoft Inc., USA). Nonparametric nominal data were compared using Pearson’s chi-squared test with p-value determination.Results. The pathogenic microflora was dominated by S. epidermidis, E. faecalis, E. coli, and E. faecium. In 2018–2022, a statistically significant decrease was observed in the isolation rate of S. epidermidis (p = 0.016), E. faecalis (p < 0.001), and E. faecium (p = 0.05). The highest resistance was exhibited by bacteria to the following antibiotics: S. epidermidis — cephalosporins (30.16%); E. faecalis — fluoroquinolones (33.33%); E. coli — cephalosporins (65.91%) and β-lactamase-resistant penicillins (40.91%); E. faecium — aminopenicillins (64.10%) and fluoroquinolones (50.0%); А. baumannii — fluoroquinolones, cephalosporins, carbapenems (100%), and aminoglycosides (84.2%). A contamination assessment revealed a high titer of isolated microorganisms in 60.53% of cases. We found a statistically significantly higher isolation rate of S. еpidermidis (p < 0.001), E. faecium (p = 0.01), and A. baumannii (p = 0.02) in the setting of pelvic peritonitis as compared to uncomplicated endometritis. In the case of suppurative septic complications due to critical obstetric conditions, the isolation rate was higher for S. еpidermidis (p <0.001), E. coli (p = 0.04), E. faecium (p = 0.005), A. ","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46323129","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 : 2023-06-22DOI: 10.25207/1608-6228-2023-30-3-65-75
E. A. Chabanets, A. Kade, A. Trofimenko, G. G. Kim, V. Krutova
Background. Transcranial electrical stimulation is a promising method for correction of malnutrition-induced hyperlipidemia, in the absence of indications for drug hypolipidemic therapy in young and middle-aged patients with low and moderate cardiovascular risk. Objectives — to study the effect of transcranial electrical stimulation on lipid metabolism in a high-fructose/high-fat (HFHF) diet in rats.Methods. An experimental randomized trial was performed to study the effect of transcranial electrical stimulation on lipid metabolism in a high-calorie diet enriched with fructose and saturated animal fat in rats. The experiments involved 180 outbred male rats and were carried out on the basis of the vivarium of Kuban State Medical University. The animals were divided into three groups: group 1 (control group, n = 60) — followed a standard diet; group 2 (comparison group, n = 60) — followed a HFHF diet; group 3 (experimental group, n = 60) — underwent transcranial electrical stimulation against the background of a HFHF diet. According to the target reference point of the study, the groups were divided into three equal subgroups of 20 rats each: subgroup A — day 30, subgroup B — day 60, and subgroup C — day 90 (biomaterial sampling and euthanasia were carried out on those days). In the obtained blood samples, the following lipid metabolism parameters were evaluated: total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and atherogenic index. Statistical analysis was performed using Microsoft Office Excel 2021 (Microsoft, USA), GraphPadPrism 9 (GraphPad Software, USA) and Statistica 13.3 (StatSoft, USA).Results. On the 30th day of the study, it was noted that in group 3, the concentration of low-density lipoprotein cholesterol was 14.9% lower and the atherogenic index was 30.8% lower (p < 0.05) than in group 2, while total cholesterol concentration, triglycerides, and high-density lipoprotein cholesterol had no statistically significant differences (p > 0.05). On the 60th day of the study, in group 3, when compared to group 2, the concentration of total cholesterol was 18.7% lower, low-density lipoprotein cholesterol was 42.9% lower, high-density lipoprotein cholesterol was 16.7% higher, and the atherogenic index was 56.3% lower (p < 0.05), while triglycerides had no statistically significant differences (p > 0.05). On the 90th day of the study, in group 3, when compared to group 2, the concentration of total cholesterol was 29.2% lower, the concentration of triglycerides was 36.0% lower, low-density lipoprotein cholesterol was 42.8% lower, and the atherogenic index was 57.0% lower (p < 0.05), while the concentration of high-density lipoprotein cholesterol had no statistically significant differences (p > 0.05).Conclusion. High-fructose/high-fat diet leads to a progressive increase in the serum concentration of low-density lipoprotein cholesterol, total cholesterol, triglycerides, as well as to a m
{"title":"Antiatherogenic Potential of Transcranial Electrical Stimulation in a High-Fructose/High-Fat Diet: Experimental Randomized Trial","authors":"E. A. Chabanets, A. Kade, A. Trofimenko, G. G. Kim, V. Krutova","doi":"10.25207/1608-6228-2023-30-3-65-75","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-3-65-75","url":null,"abstract":"Background. Transcranial electrical stimulation is a promising method for correction of malnutrition-induced hyperlipidemia, in the absence of indications for drug hypolipidemic therapy in young and middle-aged patients with low and moderate cardiovascular risk. Objectives — to study the effect of transcranial electrical stimulation on lipid metabolism in a high-fructose/high-fat (HFHF) diet in rats.Methods. An experimental randomized trial was performed to study the effect of transcranial electrical stimulation on lipid metabolism in a high-calorie diet enriched with fructose and saturated animal fat in rats. The experiments involved 180 outbred male rats and were carried out on the basis of the vivarium of Kuban State Medical University. The animals were divided into three groups: group 1 (control group, n = 60) — followed a standard diet; group 2 (comparison group, n = 60) — followed a HFHF diet; group 3 (experimental group, n = 60) — underwent transcranial electrical stimulation against the background of a HFHF diet. According to the target reference point of the study, the groups were divided into three equal subgroups of 20 rats each: subgroup A — day 30, subgroup B — day 60, and subgroup C — day 90 (biomaterial sampling and euthanasia were carried out on those days). In the obtained blood samples, the following lipid metabolism parameters were evaluated: total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and atherogenic index. Statistical analysis was performed using Microsoft Office Excel 2021 (Microsoft, USA), GraphPadPrism 9 (GraphPad Software, USA) and Statistica 13.3 (StatSoft, USA).Results. On the 30th day of the study, it was noted that in group 3, the concentration of low-density lipoprotein cholesterol was 14.9% lower and the atherogenic index was 30.8% lower (p < 0.05) than in group 2, while total cholesterol concentration, triglycerides, and high-density lipoprotein cholesterol had no statistically significant differences (p > 0.05). On the 60th day of the study, in group 3, when compared to group 2, the concentration of total cholesterol was 18.7% lower, low-density lipoprotein cholesterol was 42.9% lower, high-density lipoprotein cholesterol was 16.7% higher, and the atherogenic index was 56.3% lower (p < 0.05), while triglycerides had no statistically significant differences (p > 0.05). On the 90th day of the study, in group 3, when compared to group 2, the concentration of total cholesterol was 29.2% lower, the concentration of triglycerides was 36.0% lower, low-density lipoprotein cholesterol was 42.8% lower, and the atherogenic index was 57.0% lower (p < 0.05), while the concentration of high-density lipoprotein cholesterol had no statistically significant differences (p > 0.05).Conclusion. High-fructose/high-fat diet leads to a progressive increase in the serum concentration of low-density lipoprotein cholesterol, total cholesterol, triglycerides, as well as to a m","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48311923","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 : 2023-06-22DOI: 10.25207/1608-6228-2023-30-3-25-33
N. I. Axmedjanova, I. A. Axmedjanov, Z. A. Ismoilova, G. N. Gapparova
Background. An increase in a quantity of children with acute renal insufficiency associated with infectious diseases, including COVID-19 is a growing problem in nephrology. Such insufficiency is often expressed in pyelonephritis. Due to a lack of specific signs or obvious clinical symptoms and their correct interpretation, acute renal insufficiency against the background of COVID-19 is first identified in the period of steady worsening of the kidney functioning. An accurate non-invasive diagnostic test is yet to be fully developed, therefore, determination of the mechanisms of complications is considered to be challenging and can contribute to the formation of irreversible renal injury.Objective — to determine and evaluate characteristics of the renal status in children with acute pyelonephritis against the background of COVID-19.Methods. A retrospective observational cohort clinical study of 65 children with acute pyelonephritis was carried out. The study also included a control group of 20 healthy children, who were observed during routine health checkup. The patients were observed at the Nephrology Unit, Samarkand Regional Pediatric Multidisciplinary Medical Center, Uzbekistan. Laboratory examination was carried out on the basis of Clinical Diagnostic Laboratory, Samarkand Regional Pediatric Multidisciplinary Medical Center, Uzbekistan, and Laboratory of Innova Clinic, Uzbekistan. The study was conducted from January 2021 to December 2022 and involved participants with the history of COVID-19 before treatment. Thus, two cohorts were formed: group 1 comprised 30 children with acute pyelonephritis and without a history of COVID-19; group 2 consisted of 35 patients with acute pyelonephritis against the background of COVID-19. In order to evaluate the renal status, examination of the glomeruli, proximal and distal tubules was carried out. The study included investigation of “urinary syndrome” indicators — leukocyturia of neutrophil origin, microhematuria, proteinuria, and bacteriuria. The obtained laboratory data were analyzed using variance and given in SI System — the International System of Units. The calculations were carried out using StatPlus 7 (AnalystSoft Inc., USA).Results. Renal function is decreased in an acute period due to reduced functionality of concentration and distal tubule, which were more significantly affected in group 2. Inflammatory changes in the renal tissue due to the toxic effects of coronavirus infection underlie the abnormalities detected. The history of COVID-19 is reckoned from the date of admission and ranges from 3 weeks to 2 months. Renal insufficiency in children with COVID-19 history is manifested irrespective of their clinical polymorphism, due to impairment of its tubular structures (reabsorption, acidogenesis and ammoniogenesis, osmotic concentration) and glomerular filtration. A statistically significant reduction in acidogenesis (p = 0.001) was recorded in patients with acute COVID-associated pyelonephritis
{"title":"Evaluation of Kidney Functioning in Children with Renal Complications During COVID-19 Pandemic: A Retrospective Observational Cohort Clinical Study","authors":"N. I. Axmedjanova, I. A. Axmedjanov, Z. A. Ismoilova, G. N. Gapparova","doi":"10.25207/1608-6228-2023-30-3-25-33","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-3-25-33","url":null,"abstract":"Background. An increase in a quantity of children with acute renal insufficiency associated with infectious diseases, including COVID-19 is a growing problem in nephrology. Such insufficiency is often expressed in pyelonephritis. Due to a lack of specific signs or obvious clinical symptoms and their correct interpretation, acute renal insufficiency against the background of COVID-19 is first identified in the period of steady worsening of the kidney functioning. An accurate non-invasive diagnostic test is yet to be fully developed, therefore, determination of the mechanisms of complications is considered to be challenging and can contribute to the formation of irreversible renal injury.Objective — to determine and evaluate characteristics of the renal status in children with acute pyelonephritis against the background of COVID-19.Methods. A retrospective observational cohort clinical study of 65 children with acute pyelonephritis was carried out. The study also included a control group of 20 healthy children, who were observed during routine health checkup. The patients were observed at the Nephrology Unit, Samarkand Regional Pediatric Multidisciplinary Medical Center, Uzbekistan. Laboratory examination was carried out on the basis of Clinical Diagnostic Laboratory, Samarkand Regional Pediatric Multidisciplinary Medical Center, Uzbekistan, and Laboratory of Innova Clinic, Uzbekistan. The study was conducted from January 2021 to December 2022 and involved participants with the history of COVID-19 before treatment. Thus, two cohorts were formed: group 1 comprised 30 children with acute pyelonephritis and without a history of COVID-19; group 2 consisted of 35 patients with acute pyelonephritis against the background of COVID-19. In order to evaluate the renal status, examination of the glomeruli, proximal and distal tubules was carried out. The study included investigation of “urinary syndrome” indicators — leukocyturia of neutrophil origin, microhematuria, proteinuria, and bacteriuria. The obtained laboratory data were analyzed using variance and given in SI System — the International System of Units. The calculations were carried out using StatPlus 7 (AnalystSoft Inc., USA).Results. Renal function is decreased in an acute period due to reduced functionality of concentration and distal tubule, which were more significantly affected in group 2. Inflammatory changes in the renal tissue due to the toxic effects of coronavirus infection underlie the abnormalities detected. The history of COVID-19 is reckoned from the date of admission and ranges from 3 weeks to 2 months. Renal insufficiency in children with COVID-19 history is manifested irrespective of their clinical polymorphism, due to impairment of its tubular structures (reabsorption, acidogenesis and ammoniogenesis, osmotic concentration) and glomerular filtration. A statistically significant reduction in acidogenesis (p = 0.001) was recorded in patients with acute COVID-associated pyelonephritis","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46760450","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 : 2023-06-22DOI: 10.25207/1608-6228-2023-30-3-85-94
I. Veshkurtseva, A. Izvin, N. Kuznetsova, S. A. Kudymov, A. Y. Sinyakov, T. Kuznetsova
Background. Patients with hemophilia are protected from thrombosis by a deficiency of one of coagulation factors, therefore thrombotic complications are rare in them. Currently, few descriptions of spontaneous venous thrombosis in adult hemophiliacs can be found in the literature. Even fewer data of thromboembolic complications are reported in pediatric practice. At present, no clear recommendations are given for the management of thrombotic complications in children with hemophilia, which requires further study of this issue to develop prevention and treatment regimens, including otogenic sinus thrombosis in this category of patients.Case description. A 7-year-old boy was transferred from the Somatic Hospital to the Intensive Care Unit of Regional Clinical Hospital No. 2 in Tyumen (Russia) with an Otorhinolaryngology Unit. He was diagnosed with non-perforative form of acute right-sided suppurative otitis media, acute right-sided mastoiditis, thrombosis of the right sigmoid sinus. The anamnesis shows that the child is diagnosed with hemophilia A, of moderate severity (factor VIII level — 5%), for which he has been receiving factor VIII replacement therapy for the last year. Upon admission, a general blood test revealed no abnormalities, with a slight increase in acute-phase parameters: C-reactive protein, fibrinogen, signs of hypocoagulation. Due to negative dynamics, the child underwent anthromastoidotomy against the background of intensive replacement therapy. Surgery revealed the presence of granulation tissue with hemorrhagic thrombi in the antrum and aditus. In the postoperative period, replacement therapy was accompanied with antibacterial and anticoagulant therapy.Conclusion. The management of patients with otogenic sinus thrombosis against the background of hereditary factor VIII deficiency is a difficult task. On the one hand, it requires surgical intervention and anticoagulant therapy in order to prevent further thrombosis, on the other hand — intensive replacement therapy in order to reduce the risks of hemorrhagic complications. The described case demonstrates the need for an interdisciplinary approach to the diagnosis and treatment of a patient with otogenic thrombosis of lateral sinus against the background of hemophilia A. The approach is to minimize the risks of intraoperative complications and insure a favorable outcome.
{"title":"Otogenic Sinus Thrombosis and Hemophilia: A Clinical Case","authors":"I. Veshkurtseva, A. Izvin, N. Kuznetsova, S. A. Kudymov, A. Y. Sinyakov, T. Kuznetsova","doi":"10.25207/1608-6228-2023-30-3-85-94","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-3-85-94","url":null,"abstract":"Background. Patients with hemophilia are protected from thrombosis by a deficiency of one of coagulation factors, therefore thrombotic complications are rare in them. Currently, few descriptions of spontaneous venous thrombosis in adult hemophiliacs can be found in the literature. Even fewer data of thromboembolic complications are reported in pediatric practice. At present, no clear recommendations are given for the management of thrombotic complications in children with hemophilia, which requires further study of this issue to develop prevention and treatment regimens, including otogenic sinus thrombosis in this category of patients.Case description. A 7-year-old boy was transferred from the Somatic Hospital to the Intensive Care Unit of Regional Clinical Hospital No. 2 in Tyumen (Russia) with an Otorhinolaryngology Unit. He was diagnosed with non-perforative form of acute right-sided suppurative otitis media, acute right-sided mastoiditis, thrombosis of the right sigmoid sinus. The anamnesis shows that the child is diagnosed with hemophilia A, of moderate severity (factor VIII level — 5%), for which he has been receiving factor VIII replacement therapy for the last year. Upon admission, a general blood test revealed no abnormalities, with a slight increase in acute-phase parameters: C-reactive protein, fibrinogen, signs of hypocoagulation. Due to negative dynamics, the child underwent anthromastoidotomy against the background of intensive replacement therapy. Surgery revealed the presence of granulation tissue with hemorrhagic thrombi in the antrum and aditus. In the postoperative period, replacement therapy was accompanied with antibacterial and anticoagulant therapy.Conclusion. The management of patients with otogenic sinus thrombosis against the background of hereditary factor VIII deficiency is a difficult task. On the one hand, it requires surgical intervention and anticoagulant therapy in order to prevent further thrombosis, on the other hand — intensive replacement therapy in order to reduce the risks of hemorrhagic complications. The described case demonstrates the need for an interdisciplinary approach to the diagnosis and treatment of a patient with otogenic thrombosis of lateral sinus against the background of hemophilia A. The approach is to minimize the risks of intraoperative complications and insure a favorable outcome.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47679285","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 : 2023-04-23DOI: 10.25207/1608-6228-2023-30-2-44-53
S. D. Mazunina, S. B. Petrov, K. Melkonian, D. V. Veselova
Background. Artificial neural network models can be used to analyze and predict structural components within the value dimension of the main processes in an outpatient clinic as indicators of patient satisfaction.Objective — to form and test the methodology for analyzing and predicting structural components within the value dimension of the main processes in an outpatient clinic, as indicators of patient satisfaction with availability and quality of medical care, using artificial intelligence.Methods. The results of questionnaires administered to 525 patients were used to analyze their satisfaction with GP appointments. A network ensemble consisting of radial basis network and multilayer perceptron was chosen as the basis for a neural network model. The model testing involved five outpatient clinics in Kirov. The total number of respondents comprised 217 patients. Statistical processing included data description and analysis. Qualitative attributes were represented by relative values (P, %). The statistical significance of differences in qualitative data was assessed using the Chi-square test. The correlation between the observed and predicted data was assessed by means of nonparametric Spearman correlation analysis. The value of p <0.05 was chosen as the significance level ( p). Statistical data processing was performed using Statistica 13.0.Results. Analysis of the value dimensions of satisfaction showed a predominance of “pre-appointment” stage: work of a registrar (85.29% significance in the receiving medical services), waiting time for an appointment with a doctor (66.76% respondents noted its significance), duration of waiting directly at the office (important for 69.11% of respondents). “Appointment” stage was formed according to the common procedure of a GP appointment (interview, examination, recommendations) and was assessed from the value perspective of the patient. The priority components included sufficiency of appointment duration (significant in 88.27% of cases), satisfaction with examination (significant in 85.14% of cases), as well as completeness and informativeness of consultation (significant in 89.9% of cases). A strong direct correlation between the observed and predicted data (ρxy = 0.9; p < 0.05) was found out. Statistically significant differences between the observed and predicted levels of general patient satisfaction were not revealed in all medical organizations.Conclusion. The suggested neural network models can be used as the basis when creating information management systems that monitor meeting the effectiveness criteria for a new model of a medical organization; as well as an essential support for administrative decisions related to organizing the optimal patient management.
{"title":"Analysis of Value Dimensions in Public Satisfaction with Primary Health Care: Prospective Observational Study","authors":"S. D. Mazunina, S. B. Petrov, K. Melkonian, D. V. Veselova","doi":"10.25207/1608-6228-2023-30-2-44-53","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-2-44-53","url":null,"abstract":"Background. Artificial neural network models can be used to analyze and predict structural components within the value dimension of the main processes in an outpatient clinic as indicators of patient satisfaction.Objective — to form and test the methodology for analyzing and predicting structural components within the value dimension of the main processes in an outpatient clinic, as indicators of patient satisfaction with availability and quality of medical care, using artificial intelligence.Methods. The results of questionnaires administered to 525 patients were used to analyze their satisfaction with GP appointments. A network ensemble consisting of radial basis network and multilayer perceptron was chosen as the basis for a neural network model. The model testing involved five outpatient clinics in Kirov. The total number of respondents comprised 217 patients. Statistical processing included data description and analysis. Qualitative attributes were represented by relative values (P, %). The statistical significance of differences in qualitative data was assessed using the Chi-square test. The correlation between the observed and predicted data was assessed by means of nonparametric Spearman correlation analysis. The value of p <0.05 was chosen as the significance level ( p). Statistical data processing was performed using Statistica 13.0.Results. Analysis of the value dimensions of satisfaction showed a predominance of “pre-appointment” stage: work of a registrar (85.29% significance in the receiving medical services), waiting time for an appointment with a doctor (66.76% respondents noted its significance), duration of waiting directly at the office (important for 69.11% of respondents). “Appointment” stage was formed according to the common procedure of a GP appointment (interview, examination, recommendations) and was assessed from the value perspective of the patient. The priority components included sufficiency of appointment duration (significant in 88.27% of cases), satisfaction with examination (significant in 85.14% of cases), as well as completeness and informativeness of consultation (significant in 89.9% of cases). A strong direct correlation between the observed and predicted data (ρxy = 0.9; p < 0.05) was found out. Statistically significant differences between the observed and predicted levels of general patient satisfaction were not revealed in all medical organizations.Conclusion. The suggested neural network models can be used as the basis when creating information management systems that monitor meeting the effectiveness criteria for a new model of a medical organization; as well as an essential support for administrative decisions related to organizing the optimal patient management.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44286649","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 : 2023-04-17DOI: 10.25207/1608-6228-2023-30-2-64-75
E. Bibik, I. S. Oleynik, A. Pankov, K. Frolov, V. Dotsenko, S. Krivokolysko
Background. In the majority of cases, contemporary pharmacological correction mainly focuses on the most effective analgesia. Therefore, the search for and research into new analgesic drugs are a priority in modern pharmacology.Objective — to establish the level of analgesic activity in eight novel heterocyclic compounds of 1,4-dihydropyridine derivatives synthesized in a classic test of orofacial trigeminal pain in animal experiments.Methods. An experimental preclinical randomized trial of the analgesic activity in 1,4-dihydropyridine derivatives was carried out. The experiment was conducted on 100 white male outbred rats in the laboratory of the Fundamental and Clinical Pharmacology Department, St. Luke Lugansk State Medical University, Lugansk People’s Republic. Novel 1,4-dihydropyridine derivatives were preliminarily investigated in a virtual biological screening by means of Swiss Target Prediction tool (Swiss Institute of Bioinformatics, Switzerland). The laboratory animals were divided into a control group (rats were exposed to acute pain syndrome by injecting 0.1 ml of 5% formalin solution into the vibrissae area without pharmacological correction), a comparison group (rats which received metamizole sodium (OOO Farmstandard) at a dose of 7 mg/kg 1.5 hour prior to acute pain syndrome modeling in the vibrissae area), and eight experimental groups (1.5 hours before formalin administration, novel 1,4-dihydropyridine derivatives under study at a dose of 5 mg/ kg were intragastrically injected). 10, 15 and 20 minutes after simulating acute pain, the number of scratching movements of the forelegs around orofacial region per minute was counted. Statistical processing of the results involved methods of mathematical statistics for quantitative variability and was carried out using Statistica 12.5 (IBM, USA).Results. Animals treated with 1,4-dihydropyridine derivatives d02-133 and d02-172 under the experimental conditions showed a significant (13–21 times) decrease in scratching movements frequency by the 10th minute of observation in comparison with the control group. By 15th minute, the analgesic activity of the cyanothioacetamide derivatives increased 14 and 11 times as compared to these indicators of the reference group. After 20 minutes, the analgesic activity of these compounds in terms of inhibiting nociceptive impulses, as compared to the control group, was also high, as the number of scratching movements in the vibrissae area in animals of these experimental groups was 8–9 times lower than in control group. The orofacial trigeminal pain test detected the most exhibited analgesic activity in novel cyanothioacetamide derivatives d02-139, d02-133, and d02-172, which appeared to be higher than that of metamizole sodium.Conclusion. It was found that novel original derivatives of 1,4-dihydropyridine showed a high degree of analgesic activity.
背景。在大多数情况下，当代的药物矫正主要集中在最有效的镇痛上。因此，寻找和研究新的镇痛药物是现代药理学研究的重点。目的:建立8种新型1,4-二氢吡啶衍生物杂环化合物在口面三叉神经痛动物实验中的镇痛活性。对1,4-二氢吡啶衍生物的镇痛活性进行了临床前随机试验。实验在卢甘斯克人民共和国圣卢克·卢甘斯克国立医科大学基础与临床药理学实验室以100只雄性远交系白种大鼠为实验对象。利用Swiss Target Prediction工具(Swiss Institute of Bioinformatics, Switzerland)对新型1,4-二氢吡啶衍生物在虚拟生物筛选中进行了初步研究。实验动物分为对照组(大鼠在触须部位注射0.1 ml 5%福尔马林溶液，不进行药理校正，暴露于急性疼痛综合征)、对照组(大鼠在触须部位急性疼痛综合征建模前1.5小时注射剂量为7 mg/kg的甲硝唑钠(OOO农场标准))和8个实验组(给药前1.5小时，正在研究的新型1,4-二氢吡啶衍生物以5mg / kg的剂量灌胃)。模拟急性疼痛后10、15、20分钟，统计每分钟前腿在口面部周围的抓抓动作次数。结果的统计处理涉及定量变异的数理统计方法，使用Statistica 12.5 (IBM, USA)进行。在实验条件下，1,4-二氢吡啶衍生物d02-133和d02-172在观察第10分钟时，与对照组相比，抓痕运动频率显著降低(13-21倍)。到第15分钟，氰硫乙酰胺衍生物的镇痛活性比对照组的这些指标增加了14倍和11倍。20分钟后，与对照组相比，这些化合物在抑制伤害性冲动方面的镇痛活性也很高，实验组动物在触须区域的抓挠动作次数比对照组低8-9倍。经口面三叉痛试验发现，新型氰硫乙酰胺衍生物d02-139、d02-133和d02-172的镇痛活性最高，明显高于安咪唑钠。发现1,4-二氢吡啶的新颖原始衍生物表现出高度的镇痛活性。
{"title":"Novel 1,4-Dihydropyridine Derivatives as Potential Agents with Analgesic Activity IN Orofacial Trigeminal Pain Test: Experimental Preclinical Randomized Trial","authors":"E. Bibik, I. S. Oleynik, A. Pankov, K. Frolov, V. Dotsenko, S. Krivokolysko","doi":"10.25207/1608-6228-2023-30-2-64-75","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-2-64-75","url":null,"abstract":"Background. In the majority of cases, contemporary pharmacological correction mainly focuses on the most effective analgesia. Therefore, the search for and research into new analgesic drugs are a priority in modern pharmacology.Objective — to establish the level of analgesic activity in eight novel heterocyclic compounds of 1,4-dihydropyridine derivatives synthesized in a classic test of orofacial trigeminal pain in animal experiments.Methods. An experimental preclinical randomized trial of the analgesic activity in 1,4-dihydropyridine derivatives was carried out. The experiment was conducted on 100 white male outbred rats in the laboratory of the Fundamental and Clinical Pharmacology Department, St. Luke Lugansk State Medical University, Lugansk People’s Republic. Novel 1,4-dihydropyridine derivatives were preliminarily investigated in a virtual biological screening by means of Swiss Target Prediction tool (Swiss Institute of Bioinformatics, Switzerland). The laboratory animals were divided into a control group (rats were exposed to acute pain syndrome by injecting 0.1 ml of 5% formalin solution into the vibrissae area without pharmacological correction), a comparison group (rats which received metamizole sodium (OOO Farmstandard) at a dose of 7 mg/kg 1.5 hour prior to acute pain syndrome modeling in the vibrissae area), and eight experimental groups (1.5 hours before formalin administration, novel 1,4-dihydropyridine derivatives under study at a dose of 5 mg/ kg were intragastrically injected). 10, 15 and 20 minutes after simulating acute pain, the number of scratching movements of the forelegs around orofacial region per minute was counted. Statistical processing of the results involved methods of mathematical statistics for quantitative variability and was carried out using Statistica 12.5 (IBM, USA).Results. Animals treated with 1,4-dihydropyridine derivatives d02-133 and d02-172 under the experimental conditions showed a significant (13–21 times) decrease in scratching movements frequency by the 10th minute of observation in comparison with the control group. By 15th minute, the analgesic activity of the cyanothioacetamide derivatives increased 14 and 11 times as compared to these indicators of the reference group. After 20 minutes, the analgesic activity of these compounds in terms of inhibiting nociceptive impulses, as compared to the control group, was also high, as the number of scratching movements in the vibrissae area in animals of these experimental groups was 8–9 times lower than in control group. The orofacial trigeminal pain test detected the most exhibited analgesic activity in novel cyanothioacetamide derivatives d02-139, d02-133, and d02-172, which appeared to be higher than that of metamizole sodium.Conclusion. It was found that novel original derivatives of 1,4-dihydropyridine showed a high degree of analgesic activity.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43768196","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 : 2023-04-17DOI: 10.25207/1608-6228-2023-30-2-102-115
V. V. Fedyushkin, A. G. Baryshev, S. Pyatakov, S. Gumenyuk, O. Alukhanyan, V. M. Bensman
Background. Radical surgeries for phlegmons, abscesses, necrotizing infection are often followed by extensive wounds which require an individual approach to their rapid closure by means of plastic surgery methods. In such a case, the optimal wound therapy is primary healing with the use of vacuum therapy.Cases description. The study involved three clinical trials of patients with acute purulent-necrotic diseases of soft tissues of various localizations, volumes and grades, for which vacuum therapy was used as a part of complex therapy. Surgical interventions are proved to be urgently performed in acute purulent-necrotic diseases. Early reconstructive skin and bone plastic surgery aimed at closing post-operative wound defects is also very important.Conclusion. In the demonstrated clinical cases, the purulent process was stopped and wound therapy was performed by means of primary healing, which undoubtedly ensures medical and social rehabilitation of such patients. Notably, vacuum drainage is not an independent method, but an important component in the complex active surgical treatment of purulent wounds.
{"title":"Vacuum Therapy in Complex Treatment of Purulent-Necrotic Diseases of Soft Tissues: Clinical Cases","authors":"V. V. Fedyushkin, A. G. Baryshev, S. Pyatakov, S. Gumenyuk, O. Alukhanyan, V. M. Bensman","doi":"10.25207/1608-6228-2023-30-2-102-115","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-2-102-115","url":null,"abstract":"Background. Radical surgeries for phlegmons, abscesses, necrotizing infection are often followed by extensive wounds which require an individual approach to their rapid closure by means of plastic surgery methods. In such a case, the optimal wound therapy is primary healing with the use of vacuum therapy.Cases description. The study involved three clinical trials of patients with acute purulent-necrotic diseases of soft tissues of various localizations, volumes and grades, for which vacuum therapy was used as a part of complex therapy. Surgical interventions are proved to be urgently performed in acute purulent-necrotic diseases. Early reconstructive skin and bone plastic surgery aimed at closing post-operative wound defects is also very important.Conclusion. In the demonstrated clinical cases, the purulent process was stopped and wound therapy was performed by means of primary healing, which undoubtedly ensures medical and social rehabilitation of such patients. Notably, vacuum drainage is not an independent method, but an important component in the complex active surgical treatment of purulent wounds.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46760111","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 : 2023-04-17DOI: 10.25207/1608-6228-2023-30-2-54-63
K. Shelygin, Y. Sumarokov
Background. Assessing the dynamic characteristics of basic public health indicators is essential to ensure the sustainable human development, quality of life and health care system performance in the Arctic and Subarctic regions of Russia. The study is based on the need for constant monitoring of the medical and demographic situation in order to provide timely correction of measures for improving the health care system performance.Objective — to assess the trends in basic medical and demographic indicators characterizing the population health of the Arkhangelsk Oblast. Target population: population of the Arkhangelsk Oblast, no impacts, no outcomes.Methods. Criteria for sample or group formation: the research was performed by means of a continuous method based on the study of population of medical and demographic events. The main inclusion criterion was the availability of information about a medical and demographic event in the Arkhangelsk Oblast in the Russian Fertility and Mortality database (RusFMD), the database of the Federal State Statistics Service (Rosstat). Estimated parameters: life expectancy, infant mortality, disability, morbidity, natural population growth and chronicity rates related to the population of the Arkhangelsk Oblast excluding the Nenets Autonomous Okrug. The study was conducted between 2021 and 2022. The following measurement methods were used: autoregressive and integrated moving average, Irwin method to identify abnormal values, linear regression, time series dynamics, and method of chain substitutions. The research was performed by means of a continuous method based on studying the population of medical and demographic events.Results. Natural population growth and chronicity rates showed a stable negative trend, which indicated a decrease in the reproduction potential of the population, and an increase in chronic forms of diseases. Life expectancy, primary morbidity, and primary disability demonstrated a positive trend, but with a tendency to exhaust the positive potential. Infant mortality was the only indicator that consistently showed a positive trend. No additional results of the research were reported.Conclusion. The results of the study demonstrated the deterioration in population health of the Arkhangelsk Oblast, which may be due to a decline in living standards and quality of life as well as to a decrease in health care system performance and a rise in its dysfunctionality. The study has no limitations.
{"title":"Dynamic Characteristics of Medical and Demographic Indicators of Public Health in Arkhangelsk Oblast in the First Twenty Years of the XXI Century: Retrospective Analytical Descriptive Study","authors":"K. Shelygin, Y. Sumarokov","doi":"10.25207/1608-6228-2023-30-2-54-63","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-2-54-63","url":null,"abstract":"Background. Assessing the dynamic characteristics of basic public health indicators is essential to ensure the sustainable human development, quality of life and health care system performance in the Arctic and Subarctic regions of Russia. The study is based on the need for constant monitoring of the medical and demographic situation in order to provide timely correction of measures for improving the health care system performance.Objective — to assess the trends in basic medical and demographic indicators characterizing the population health of the Arkhangelsk Oblast. Target population: population of the Arkhangelsk Oblast, no impacts, no outcomes.Methods. Criteria for sample or group formation: the research was performed by means of a continuous method based on the study of population of medical and demographic events. The main inclusion criterion was the availability of information about a medical and demographic event in the Arkhangelsk Oblast in the Russian Fertility and Mortality database (RusFMD), the database of the Federal State Statistics Service (Rosstat). Estimated parameters: life expectancy, infant mortality, disability, morbidity, natural population growth and chronicity rates related to the population of the Arkhangelsk Oblast excluding the Nenets Autonomous Okrug. The study was conducted between 2021 and 2022. The following measurement methods were used: autoregressive and integrated moving average, Irwin method to identify abnormal values, linear regression, time series dynamics, and method of chain substitutions. The research was performed by means of a continuous method based on studying the population of medical and demographic events.Results. Natural population growth and chronicity rates showed a stable negative trend, which indicated a decrease in the reproduction potential of the population, and an increase in chronic forms of diseases. Life expectancy, primary morbidity, and primary disability demonstrated a positive trend, but with a tendency to exhaust the positive potential. Infant mortality was the only indicator that consistently showed a positive trend. No additional results of the research were reported.Conclusion. The results of the study demonstrated the deterioration in population health of the Arkhangelsk Oblast, which may be due to a decline in living standards and quality of life as well as to a decrease in health care system performance and a rise in its dysfunctionality. The study has no limitations.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45190820","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 : 2023-04-17DOI: 10.25207/1608-6228-2023-30-2-76-88
I. Oleshchenko, T. Iureva, D. Zabolotskii
Background. The use of regional blockades for the purpose of analgesia is widely used in all fields of medicine, however, the analgesic efficacy of the pterygopalatine blockade, as an independent method of treating pain of various genesis, has not been studied enough. Therefore, there is a need to analyze the results of clinical trials to evaluate the analgesic efficacy of the pterygopalatine blockade as an independent method of anesthesia.Objective — to investigate the analgesic effect of pterygopalatine blockade as a monotherapy in patients with pain of various origins of oculotemporal area, conducting a meta-analysis of published results of randomized clinical trials.Methods. The methodology involved a systematic literature search by means of PubMed, MEDLINE, EMBASE, and Cochrane Library search engines. The search covered the period of the past 10 years and had the following criteria: a double-blind, randomized, controlled study of the use of pterygopalatine blockade with a local anesthetic versus placebo. For each included study, a standardized magnitude of the analgesic effect of pterygopalatine blockade compared to placebo was calculated, with pain assessing in 15, 30, and 60 minutes after the blockade was performed. Meta-analyses were conducted for each endpoint. Meta-analysis was performed using Stata 11.0 application programs ((The Cochrane Collaboration, Oxford, United Kingdom).Results. Five randomized controlled trials involving 269 patients met the inclusion criteria, and involved analyzing the pterygopalatine blockade with local anesthetic (n=140) against placebo (n=129). In 15 minutes after pterygopalatine blockade was performed, the difference in mean pain intensity compared to the control group was -2.5 points, the mean level was lower in the pterygopalatine blockade group, MD=-2.5 [95% CI -3.7; -1.7]. After 30 minutes: -2.7 points, MD=-2.7 [95% CI -4.5; -1.5], after 60 minutes: -1.7 points, MD=-1.7 [95% CI -4.0; -0.5]. The relative risk of adverse effects, such as nasopharyngeal symptoms, after performing a pterygopalatine blockade with a local anesthetic accounted for (RR =1.31 [95% CI 0.5–3.04]). In this regard, the incidence of complications and their variants that can be caused by pterygopalatine blockade is a matter for further clinical research.Conclusion. The results obtained in the meta-analysis testify to the analgesic effect of the pterygopalatine blockade as a monotherapy in patients with pain of different origins oculotemporal area in 15, 30, and 60 minutes after its performance. These data may be relevant when choosing a method for first-line anesthetic management of pain syndrome of oculotemporal area.
背景。局部阻断镇痛的应用已广泛应用于医学的各个领域，然而翼状腭氨酸阻断作为一种独立治疗各种原因疼痛的方法，其镇痛效果的研究还不够。因此，有必要对临床试验结果进行分析，以评价翼腭氨酸阻断剂作为独立麻醉方法的镇痛效果。目的:通过对已发表的随机临床试验结果进行荟萃分析，探讨翼状腭碱阻滞剂作为单一疗法对不同来源的眼颞区疼痛患者的镇痛效果。方法包括通过PubMed, MEDLINE, EMBASE和Cochrane图书馆搜索引擎进行系统的文献检索。这项研究涵盖了过去10年的时间，并有以下标准:一项双盲、随机、对照研究，将翼腭碱阻断剂与局部麻醉剂与安慰剂联合使用。对于每一项纳入的研究，计算翼状腭碱阻断剂与安慰剂相比镇痛效果的标准化程度，并在阻断后15分钟、30分钟和60分钟评估疼痛。对每个终点进行meta分析。meta分析采用Stata 11.0应用程序(The Cochrane Collaboration, Oxford, United Kingdom)。5项随机对照试验纳入269例患者，符合纳入标准，并分析了局麻药(n=140)与安慰剂(n=129)的翼状腭氨酸阻断。翼状腭碱阻断治疗后15分钟，平均疼痛强度与对照组的差异为-2.5分，翼状腭碱阻断组的平均水平较低，MD=-2.5 [95% CI -3.7;-1.7]。30分钟后:-2.7分，MD=-2.7 [95% CI -4.5;-1.5分]，60分钟后:-1.7分，MD=-1.7 [95% CI -4.0;-0.5]。用局麻药进行翼腭肽阻断后出现鼻咽症状等不良反应的相对风险(RR =1.31 [95% CI 0.5-3.04])。因此，翼状腭氨酸阻断术引起的并发症及其变异的发生率有待于进一步的临床研究。meta分析的结果证实了翼状腭碱阻滞剂作为单一疗法对不同来源的眼颞区疼痛患者在15、30和60分钟后的镇痛效果。这些数据可能与选择眼颞区疼痛综合征的一线麻醉治疗方法有关。
{"title":"The Analgetic Efficacy of Pterygopalatine Blockade for Pain Treatment in Adults: a Systematic Review and Meta-Analysis","authors":"I. Oleshchenko, T. Iureva, D. Zabolotskii","doi":"10.25207/1608-6228-2023-30-2-76-88","DOIUrl":"https://doi.org/10.25207/1608-6228-2023-30-2-76-88","url":null,"abstract":"Background. The use of regional blockades for the purpose of analgesia is widely used in all fields of medicine, however, the analgesic efficacy of the pterygopalatine blockade, as an independent method of treating pain of various genesis, has not been studied enough. Therefore, there is a need to analyze the results of clinical trials to evaluate the analgesic efficacy of the pterygopalatine blockade as an independent method of anesthesia.Objective — to investigate the analgesic effect of pterygopalatine blockade as a monotherapy in patients with pain of various origins of oculotemporal area, conducting a meta-analysis of published results of randomized clinical trials.Methods. The methodology involved a systematic literature search by means of PubMed, MEDLINE, EMBASE, and Cochrane Library search engines. The search covered the period of the past 10 years and had the following criteria: a double-blind, randomized, controlled study of the use of pterygopalatine blockade with a local anesthetic versus placebo. For each included study, a standardized magnitude of the analgesic effect of pterygopalatine blockade compared to placebo was calculated, with pain assessing in 15, 30, and 60 minutes after the blockade was performed. Meta-analyses were conducted for each endpoint. Meta-analysis was performed using Stata 11.0 application programs ((The Cochrane Collaboration, Oxford, United Kingdom).Results. Five randomized controlled trials involving 269 patients met the inclusion criteria, and involved analyzing the pterygopalatine blockade with local anesthetic (n=140) against placebo (n=129). In 15 minutes after pterygopalatine blockade was performed, the difference in mean pain intensity compared to the control group was -2.5 points, the mean level was lower in the pterygopalatine blockade group, MD=-2.5 [95% CI -3.7; -1.7]. After 30 minutes: -2.7 points, MD=-2.7 [95% CI -4.5; -1.5], after 60 minutes: -1.7 points, MD=-1.7 [95% CI -4.0; -0.5]. The relative risk of adverse effects, such as nasopharyngeal symptoms, after performing a pterygopalatine blockade with a local anesthetic accounted for (RR =1.31 [95% CI 0.5–3.04]). In this regard, the incidence of complications and their variants that can be caused by pterygopalatine blockade is a matter for further clinical research.Conclusion. The results obtained in the meta-analysis testify to the analgesic effect of the pterygopalatine blockade as a monotherapy in patients with pain of different origins oculotemporal area in 15, 30, and 60 minutes after its performance. These data may be relevant when choosing a method for first-line anesthetic management of pain syndrome of oculotemporal area.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44923480","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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