Pub Date : 2022-10-29DOI: 10.25207/1608-6228-2022-29-5-94-107
K. Melkonian, K. I. Popandopulo, S. B. Bazlov, T. Rusinova, O. Moskalyuk, I. Bykov
Background. With the introduction of synthetic mesh implants into clinical practice, the recurrence rate of postoperative ventral hernias was signifi cantly reduced. The extensive use of synthetic implants led to the development of specifi c complications. The development of biological implants, based on extensively purifi ed decellularized collagen matrix of xenogeneic origin is highly relevant due to the fact that, unlike synthetic analogues, they have a biological origin and biodegrade in a natural way, gradually being replaced with newly formed connective tissue. The use of bioprostheses reduces the risk of complications.Objectives. To conduct a comparative evaluation of the biomechanical characteristics of acellular dermal matrix, obtained by detergent-enzymatic decellularization, and commercially distributed Permacol™ matrix.Methods. Acellular dermal matrix (ADM) was created by using samples of native skin of pig of Landras breed aged 4 months. The dermis was processed by means of detergent-enzymatic method. In order to evaluate and compare the mechanical properties of acellular dermal matrix, the biological samples were divided into 2 groups of 15 samples each. The fi rst group included acellular dermal matrix samples, the second group — native samples of pigs unprocessed dermis. The control group consisted of samples of PermacolTM Surgical Implant, xenotransplant for hernioplasty approved for use in the Russian Federation (Covidien, France). All samples were tested wet using universal testing instrument Instron 1122. MedCalc Statistical Software (Belgium) was used for statistical processing of the study results.Results. In the present study, pig dermis was processed using a detergent-enzymatic method to produce ADM. Routine histological examination confi rmed the removal of all cellular elements, and at the same time it was proven that the native structure of the dermis remained intact during its processing. The mechanical characteristics of xenogenic ADM were further determined. Its tensile strength was 9.1 ± 0.6 MPa (910 N/cm2 ), elongation to break was 21.1 ± 2.3%, and elastic modulus was 50.0 ± 1.6 MPa. These characteristics largely corresponded to the strength characteristics of native pig dermis and far exceeded the necessary physiological parameters. PermacolTM control was tested in two directions (longitudinal and transverse). In the longitudinal direction, the sample had higher mechanical characteristics: strength — 12.0 ± 1.7 MPa, elongation to break — 29.7 ± 2.4%, stiffness modulus — 47.2 ± 6.5 MPa. In the transverse direction, all indicators were 1.5–2 times lower.Conclusion. The developed xenogeneic biological implant in the form of ADM demonstrates rather good characteristics of plasticity, tensile strength and elasticity, to be used as a biological endoprosthesis for plasty of hernia defects of the abdominal wall of any size and shape.
{"title":"Comparative Evaluation of Biomechanical Characteristics of Acellular Dermal Matrix for Hernioplasty","authors":"K. Melkonian, K. I. Popandopulo, S. B. Bazlov, T. Rusinova, O. Moskalyuk, I. Bykov","doi":"10.25207/1608-6228-2022-29-5-94-107","DOIUrl":"https://doi.org/10.25207/1608-6228-2022-29-5-94-107","url":null,"abstract":"Background. With the introduction of synthetic mesh implants into clinical practice, the recurrence rate of postoperative ventral hernias was signifi cantly reduced. The extensive use of synthetic implants led to the development of specifi c complications. The development of biological implants, based on extensively purifi ed decellularized collagen matrix of xenogeneic origin is highly relevant due to the fact that, unlike synthetic analogues, they have a biological origin and biodegrade in a natural way, gradually being replaced with newly formed connective tissue. The use of bioprostheses reduces the risk of complications.Objectives. To conduct a comparative evaluation of the biomechanical characteristics of acellular dermal matrix, obtained by detergent-enzymatic decellularization, and commercially distributed Permacol™ matrix.Methods. Acellular dermal matrix (ADM) was created by using samples of native skin of pig of Landras breed aged 4 months. The dermis was processed by means of detergent-enzymatic method. In order to evaluate and compare the mechanical properties of acellular dermal matrix, the biological samples were divided into 2 groups of 15 samples each. The fi rst group included acellular dermal matrix samples, the second group — native samples of pigs unprocessed dermis. The control group consisted of samples of PermacolTM Surgical Implant, xenotransplant for hernioplasty approved for use in the Russian Federation (Covidien, France). All samples were tested wet using universal testing instrument Instron 1122. MedCalc Statistical Software (Belgium) was used for statistical processing of the study results.Results. In the present study, pig dermis was processed using a detergent-enzymatic method to produce ADM. Routine histological examination confi rmed the removal of all cellular elements, and at the same time it was proven that the native structure of the dermis remained intact during its processing. The mechanical characteristics of xenogenic ADM were further determined. Its tensile strength was 9.1 ± 0.6 MPa (910 N/cm2 ), elongation to break was 21.1 ± 2.3%, and elastic modulus was 50.0 ± 1.6 MPa. These characteristics largely corresponded to the strength characteristics of native pig dermis and far exceeded the necessary physiological parameters. PermacolTM control was tested in two directions (longitudinal and transverse). In the longitudinal direction, the sample had higher mechanical characteristics: strength — 12.0 ± 1.7 MPa, elongation to break — 29.7 ± 2.4%, stiffness modulus — 47.2 ± 6.5 MPa. In the transverse direction, all indicators were 1.5–2 times lower.Conclusion. The developed xenogeneic biological implant in the form of ADM demonstrates rather good characteristics of plasticity, tensile strength and elasticity, to be used as a biological endoprosthesis for plasty of hernia defects of the abdominal wall of any size and shape.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44288512","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 : 2022-09-28DOI: 10.25207/1608-6228-2022-29-5-80-93
E. N. Shubrov, A. G. Baryshev, K. V. Triandafilov, V. A. Aladina, V. V. Fedyushkin, R. K. Amirova
Background. Despite a variety of existing methods of surgical treatment for sacrococcygeal pilonidal cyst, a universal technique has not been developed yet, due to the large number of postoperative complications and recurrences.Objectives. To improve the treatment outcomes of patients with pilonidal cysts through developing and implementing a new method for closure of the postoperative wound defect of the sacrococcygeal region.Methods. We conducted a randomized trial, involving 60 patients with sacrococcygeal pilonidal cyst. The control and main groups consisted of 30 people each. The study was carried out in the Purulent Surgery Unit of the Regional Clinical Hospital No. 1 — Research Institute, Krasnodar. The inclusion of patients in the trial was organized within 2019–2022 period. The duration of each patient’s follow-up period was equal to the hospitalization duration. The control group underwent the surgical treatment in the Moszkowicz (Moshkovich) modifi cation. The main group was treated by means of our own developed method. Postoperative wound complications were assessed according to Clavien—Dindo classifi cation. Statistical data processing was performed using Microsoft Excel 2013 with the add-ins Analysis package and AtteStat for statistical data.Results. The control and main groups included 30 participants each. The gender, age and body mass index (BMI) were not defi ned as statistically signifi cant. When analyzing the primary data, the treatment median time accounted for 10.5 (9.0; 13.8) days in the control group and 7.0 (7.0; 8.0) days in the main group, a signifi cant difference according to the Mann—Whitney test (p < 0.001). The number of postoperative complications (suture failure, wound abscess, necrosis of skin fl aps) in the control group was 16 cases, and in the main group — 1 case (signifi cance of differences under the chi-squared test p < 0.001). The number of recurrences in the control group comprised 7 cases, while in the main group there was 1 case (signifi cance of differences under the chi-squared test p = 0.023).Conclusion. The application of surgical treatment for pilonidal cysts in the authors’ modifi cation made it possible to reduce the time of hospitalization, the number of such postoperative complications as suture failure, wound abscess and necrosis of skin fl aps. The number of recurrences has also decreased significantly.
{"title":"Analysis of the Outcomes of a New Method for Plastic Surgery for Postoperative Wound Of Sacrococcygeal Region after Excision of the Pilonidal Cyst: Randomized Trial.","authors":"E. N. Shubrov, A. G. Baryshev, K. V. Triandafilov, V. A. Aladina, V. V. Fedyushkin, R. K. Amirova","doi":"10.25207/1608-6228-2022-29-5-80-93","DOIUrl":"https://doi.org/10.25207/1608-6228-2022-29-5-80-93","url":null,"abstract":"Background. Despite a variety of existing methods of surgical treatment for sacrococcygeal pilonidal cyst, a universal technique has not been developed yet, due to the large number of postoperative complications and recurrences.Objectives. To improve the treatment outcomes of patients with pilonidal cysts through developing and implementing a new method for closure of the postoperative wound defect of the sacrococcygeal region.Methods. We conducted a randomized trial, involving 60 patients with sacrococcygeal pilonidal cyst. The control and main groups consisted of 30 people each. The study was carried out in the Purulent Surgery Unit of the Regional Clinical Hospital No. 1 — Research Institute, Krasnodar. The inclusion of patients in the trial was organized within 2019–2022 period. The duration of each patient’s follow-up period was equal to the hospitalization duration. The control group underwent the surgical treatment in the Moszkowicz (Moshkovich) modifi cation. The main group was treated by means of our own developed method. Postoperative wound complications were assessed according to Clavien—Dindo classifi cation. Statistical data processing was performed using Microsoft Excel 2013 with the add-ins Analysis package and AtteStat for statistical data.Results. The control and main groups included 30 participants each. The gender, age and body mass index (BMI) were not defi ned as statistically signifi cant. When analyzing the primary data, the treatment median time accounted for 10.5 (9.0; 13.8) days in the control group and 7.0 (7.0; 8.0) days in the main group, a signifi cant difference according to the Mann—Whitney test (p < 0.001). The number of postoperative complications (suture failure, wound abscess, necrosis of skin fl aps) in the control group was 16 cases, and in the main group — 1 case (signifi cance of differences under the chi-squared test p < 0.001). The number of recurrences in the control group comprised 7 cases, while in the main group there was 1 case (signifi cance of differences under the chi-squared test p = 0.023).Conclusion. The application of surgical treatment for pilonidal cysts in the authors’ modifi cation made it possible to reduce the time of hospitalization, the number of such postoperative complications as suture failure, wound abscess and necrosis of skin fl aps. The number of recurrences has also decreased significantly.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43280913","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 : 2022-09-12DOI: 10.25207/1608-6228-2022-29-5-14-28
T. A. Krivolutskaya, A. N. Emelyanova, A. Emelyanov, Y. Vitkovsky
Background. Toll-like receptors (TLR) play a key role in the innate immune system, as they are the fi rst to recognize a foreign agent and initiate the human body defense mechanism. At present, the role of toll-like receptors in predicting infectious diseases requires further investigation.Objectives. To study TLR3 (Phe412Leu), TLR9 (A2848G) and TLR9 (T1237C) polymorphisms in healthy individuals and chickenpox patientsMethods. An observational cohort study involved 201 conscripted soldiers of Caucasian race, aged between 18 and 24, who was born in) and served in Zabaykalsky Krai. All of them agreed to participate voluntarily. The main group was represented by 105 males who received treatment at a military hospital with a diagnosis of chickenpox in 2019. The control group consisted of 96 healthy conscripts. The study was carried out on the basis of Chita State Academy of Medicine, Russia, and included a physical examination, anthropometry, determination of SNP genes by PCR. Amplifi cation of TLR3 and TLR9 gene fragments was carried out by means of thermocycler BIS-М111. IBM SPSS Statistics 25.0 (International Business Machines Corporation, License No. Z125-3301-14, USA) was used for statistical processing of the results.Results. A total of 354 people were screened, 87 of them did not meet the inclusion criteria and 19 refused to participate in the study. 134 males were excluded in the process, 47 of which appeared to have an exacerbation of chronic diseases, 21 were not of Caucasian race, 64 were not born in Zabaykalsky Krai, and 2 did not meet the age criteria. Totally, the study included 201 conscripted soldiers. The study groups were established as follows: chickenpox patients (n = 105) and healthy individuals (controls, n = 96). The -412Leu allele was 1.8 times less frequent in the chickenpox group, with a frequency of 0.138, compared with 0.250 in healthy controls (Ȥ 2 = 8.11; p = 0.004). In the main group, allele -412Phe prevailed with a frequency of 0.862, whereas in the control group its frequency was 0.750 (χ2 = 8.11; p = 0.004). In patients group, the genoype Phe412Phe prevailed (75.2%), the genotype Leu412Leu was less common — 2.9% (Ȥ 2 = 7.09; p = 0.03). In the group of healthy individuals, the distribution of genotypes was as follows: Phe412Phe — 60.4%, Phe412Leu — 30.2%, Leu412Leu — 9.4% (Ȥ 2 = 7.09; ɪ = 0.03). Carriers of allele -412Phe (OR = 2.08 [CI95%: 1.25–3.47]) and genotype Phe412Phe (OR = 2.08 [CI95%: 1.14–3.80]) are more likely to develop chickenpox. The probability of developing the disease for persons having the major allele A of the genotype TLR9 (Ⱥ2848G) is 0.29 [CI95%: 0.19– 0.43], for individuals with the mutant allele G of the genotype TLR9 (Ⱥ2848G) — 3.50 [CI95%: 2.32–5.29]. The prevalence of TLR9 (T1237C) in the main group was not signifi cantly different from that in the control group (p > 0.05). The probability of developing the disease for persons having the major allele A is 0.29 [95% CI 0.19–0.43], for carriers
{"title":"Gene Polymorphism of Toll-Like Receptors in Chickenpox Patients: Observational Cohort Study","authors":"T. A. Krivolutskaya, A. N. Emelyanova, A. Emelyanov, Y. Vitkovsky","doi":"10.25207/1608-6228-2022-29-5-14-28","DOIUrl":"https://doi.org/10.25207/1608-6228-2022-29-5-14-28","url":null,"abstract":"Background. Toll-like receptors (TLR) play a key role in the innate immune system, as they are the fi rst to recognize a foreign agent and initiate the human body defense mechanism. At present, the role of toll-like receptors in predicting infectious diseases requires further investigation.Objectives. To study TLR3 (Phe412Leu), TLR9 (A2848G) and TLR9 (T1237C) polymorphisms in healthy individuals and chickenpox patientsMethods. An observational cohort study involved 201 conscripted soldiers of Caucasian race, aged between 18 and 24, who was born in) and served in Zabaykalsky Krai. All of them agreed to participate voluntarily. The main group was represented by 105 males who received treatment at a military hospital with a diagnosis of chickenpox in 2019. The control group consisted of 96 healthy conscripts. The study was carried out on the basis of Chita State Academy of Medicine, Russia, and included a physical examination, anthropometry, determination of SNP genes by PCR. Amplifi cation of TLR3 and TLR9 gene fragments was carried out by means of thermocycler BIS-М111. IBM SPSS Statistics 25.0 (International Business Machines Corporation, License No. Z125-3301-14, USA) was used for statistical processing of the results.Results. A total of 354 people were screened, 87 of them did not meet the inclusion criteria and 19 refused to participate in the study. 134 males were excluded in the process, 47 of which appeared to have an exacerbation of chronic diseases, 21 were not of Caucasian race, 64 were not born in Zabaykalsky Krai, and 2 did not meet the age criteria. Totally, the study included 201 conscripted soldiers. The study groups were established as follows: chickenpox patients (n = 105) and healthy individuals (controls, n = 96). The -412Leu allele was 1.8 times less frequent in the chickenpox group, with a frequency of 0.138, compared with 0.250 in healthy controls (Ȥ 2 = 8.11; p = 0.004). In the main group, allele -412Phe prevailed with a frequency of 0.862, whereas in the control group its frequency was 0.750 (χ2 = 8.11; p = 0.004). In patients group, the genoype Phe412Phe prevailed (75.2%), the genotype Leu412Leu was less common — 2.9% (Ȥ 2 = 7.09; p = 0.03). In the group of healthy individuals, the distribution of genotypes was as follows: Phe412Phe — 60.4%, Phe412Leu — 30.2%, Leu412Leu — 9.4% (Ȥ 2 = 7.09; ɪ = 0.03). Carriers of allele -412Phe (OR = 2.08 [CI95%: 1.25–3.47]) and genotype Phe412Phe (OR = 2.08 [CI95%: 1.14–3.80]) are more likely to develop chickenpox. The probability of developing the disease for persons having the major allele A of the genotype TLR9 (Ⱥ2848G) is 0.29 [CI95%: 0.19– 0.43], for individuals with the mutant allele G of the genotype TLR9 (Ⱥ2848G) — 3.50 [CI95%: 2.32–5.29]. The prevalence of TLR9 (T1237C) in the main group was not signifi cantly different from that in the control group (p > 0.05). The probability of developing the disease for persons having the major allele A is 0.29 [95% CI 0.19–0.43], for carriers","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48403808","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 : 2022-09-11DOI: 10.25207/1608-6228-2022-29-5-63-79
Y. Savosin, S. K. Shafranova, T. Gaivoronskaya, M. Avdeeva, S. Vartanyan
Background. The incidence of invasive mycoses is reported to increase among patients with a history of new coronavirus infection COVID-19. Adhesion and damage of endothelial cells by zygomycetes lead to fungus angioinvasion, release of a large number of fungal proteases, lipases and mycotoxins, as well as vascular thrombosis, subsequent necrosis of tissues.Objectives. Improvement of the diagnosis and treatment for COVID-19 associated invasive mycosis.Methods. Examination and treatment of 143 patients with invasive mycosis of the maxillofacial area in the period from August 2021 to May 2022 at the Maxillofacial Unit of Regional Clinical Hospital of Emergency Medical Care, Krasnodar Krai, Russia. The diagnosis was confi rmed by cytological, culture-based methods, as well as pathomorphological study of surgical specimen. Follow-up monitoring was carried out in 1, 3, 6 months, with repeated CT and MRI investigations. The group under follow-up monitoring included 91 patients. The incidence of signs was determined via descriptive statistics methods in proportion of the total number of observations and expressed as a percentage. Statistika 12.5 and Excel 2010 (Windows 10) were used in the study, the graphical representation of the material was made in the same programs.Results. Manifestation of invasive mycoses of the maxillofacial area occurred during the early convalescent period of coronavirus infection in specialized infectious hospitals or within two weeks after discharge from the hospital. A typical clinical picture includes rhinocerebral zygomycosis with the development of fungal osteomyelitis of the upper jaw, nasal bones, zygomatic bone, ethmoidal labyrinth bones, sphenoid bone, frontal bone. 17 cases (11.9%) had a lethal outcome as a result of disseminated form of fungal infection caused by Mucorales (14 patients), Aspergillus (3 patients) with damage to the brain, lungs, kidneys and fatal massive necrotic lesions of the craniofacial area. An integrated approach embraced early antifungal therapy (Amphotericin B) as well as surgical debridement of the lesions and provided a positive effect in treatment.Conclusion. Invasive fungal infections require prompt diagnosis and early prescription of antifungal therapy (prior to histological confi rmation of diagnosis) to minimize consequences and prevent fatal outcome. Due to the nonspecifi c nature of clinical symptoms and diffi culties of early diagnosis of invasive zygomycosis and aspergillosis, it is necessary to be alert to potential invasive aggressive mycoses in immunocompromised patients who have a history of a new coronavirus infection COVID-19.
{"title":"Rhinocerebral Form of Invasive Mycosis in COVID-19 Patients: Clinical Course, Diagnosis, Treatment Experience","authors":"Y. Savosin, S. K. Shafranova, T. Gaivoronskaya, M. Avdeeva, S. Vartanyan","doi":"10.25207/1608-6228-2022-29-5-63-79","DOIUrl":"https://doi.org/10.25207/1608-6228-2022-29-5-63-79","url":null,"abstract":"Background. The incidence of invasive mycoses is reported to increase among patients with a history of new coronavirus infection COVID-19. Adhesion and damage of endothelial cells by zygomycetes lead to fungus angioinvasion, release of a large number of fungal proteases, lipases and mycotoxins, as well as vascular thrombosis, subsequent necrosis of tissues.Objectives. Improvement of the diagnosis and treatment for COVID-19 associated invasive mycosis.Methods. Examination and treatment of 143 patients with invasive mycosis of the maxillofacial area in the period from August 2021 to May 2022 at the Maxillofacial Unit of Regional Clinical Hospital of Emergency Medical Care, Krasnodar Krai, Russia. The diagnosis was confi rmed by cytological, culture-based methods, as well as pathomorphological study of surgical specimen. Follow-up monitoring was carried out in 1, 3, 6 months, with repeated CT and MRI investigations. The group under follow-up monitoring included 91 patients. The incidence of signs was determined via descriptive statistics methods in proportion of the total number of observations and expressed as a percentage. Statistika 12.5 and Excel 2010 (Windows 10) were used in the study, the graphical representation of the material was made in the same programs.Results. Manifestation of invasive mycoses of the maxillofacial area occurred during the early convalescent period of coronavirus infection in specialized infectious hospitals or within two weeks after discharge from the hospital. A typical clinical picture includes rhinocerebral zygomycosis with the development of fungal osteomyelitis of the upper jaw, nasal bones, zygomatic bone, ethmoidal labyrinth bones, sphenoid bone, frontal bone. 17 cases (11.9%) had a lethal outcome as a result of disseminated form of fungal infection caused by Mucorales (14 patients), Aspergillus (3 patients) with damage to the brain, lungs, kidneys and fatal massive necrotic lesions of the craniofacial area. An integrated approach embraced early antifungal therapy (Amphotericin B) as well as surgical debridement of the lesions and provided a positive effect in treatment.Conclusion. Invasive fungal infections require prompt diagnosis and early prescription of antifungal therapy (prior to histological confi rmation of diagnosis) to minimize consequences and prevent fatal outcome. Due to the nonspecifi c nature of clinical symptoms and diffi culties of early diagnosis of invasive zygomycosis and aspergillosis, it is necessary to be alert to potential invasive aggressive mycoses in immunocompromised patients who have a history of a new coronavirus infection COVID-19.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44608014","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 : 2022-09-10DOI: 10.25207/1608-6228-2022-29-5-44-62
M. Perova, D. D. Samochvalova, А. А. Khalafyan, V. A. Akinshina
Background. Currently accepted risk assessments of periodontitis progression are determinants of indirect stability: periodontal pockets, persistent bleeding of the gums, tooth mobility, local risk factors. In the era of case-oriented medicine, a relevant solution would be to choose periodontal therapy according to one-time consideration of the maximum available range of individual risk factors rather than on general clinical guidelines.Objectives. The study was aimed at determining the relative risk of periodontitis progression after active basic therapy using neural network modeling.Methods. A cohort retrospective study was performed on 109 patients of both sexes, aged 30 to 70 years, after basic treatment of chronic periodontitis (mild, moderate and severe) in the period from 1999 to 2016, who were on supportive periodontal therapy (SPT) for 5 years ≤SPT≤ 20 years. The authors considered data from objective examination of the periodontium and categorical indices (24 in total) assessed before treatment, 4–6 months after basic (active) treatment and 5 years ≤SPT≤ 20 years. Following the analysis of descriptive statistics, target quantitative indices were determined for prognostic modeling of treatment outcomes in periodontitis patients and calculating the residual risk of disease progression. Statistical processing of obtained data was carried out using the Statistica 13.3 package (Tibco, USA). Mean values of the indicators at different time points were compared by means of Wilcoxon’s and Signs criteria; Spearman’s rank correlation coefficient was used to evaluate relevance between predictors and target indicators. The level of statistical significance p = 0.05 was accepted in all cases of analysis. DataMining, an automated neural network of Statistica software, was used as a tool to build neural network models. The task of classifying the level of risk of disease progression was solved by means of ROC analysis. The prognostic potential of the model was assessed using sensitivity and specificity measures.Results. The heterogeneous dynamics of predictor variables describing the state of the periodontium was determined. The outcomes of regenerative periodontal surgery, regardless of gender, age of patients and comorbidities, significantly outperformed those of other approaches, due to the formation of a new dentogingival attachment, although to different extent. Another positive functional outcome was recorded in restoring the dentition integrity by implantation, without any mutually damaging effects. Since revealing the interrelationships between indicators is not equivalent to the predictive value, prognostic models were built for target indicators and stratification of the relative risk of periodontitis progression using automated neural networks. The networks with the best prognostic properties were selected out of 1000 automatically built and trained neural networks — double-layer perceptrons. The sensitivity of the relative risk prognostic m
{"title":"Assessment of Relative Risk for Periodontitis Progression Using Neural Network Modeling: Cohort Retrospective Study","authors":"M. Perova, D. D. Samochvalova, А. А. Khalafyan, V. A. Akinshina","doi":"10.25207/1608-6228-2022-29-5-44-62","DOIUrl":"https://doi.org/10.25207/1608-6228-2022-29-5-44-62","url":null,"abstract":"Background. Currently accepted risk assessments of periodontitis progression are determinants of indirect stability: periodontal pockets, persistent bleeding of the gums, tooth mobility, local risk factors. In the era of case-oriented medicine, a relevant solution would be to choose periodontal therapy according to one-time consideration of the maximum available range of individual risk factors rather than on general clinical guidelines.Objectives. The study was aimed at determining the relative risk of periodontitis progression after active basic therapy using neural network modeling.Methods. A cohort retrospective study was performed on 109 patients of both sexes, aged 30 to 70 years, after basic treatment of chronic periodontitis (mild, moderate and severe) in the period from 1999 to 2016, who were on supportive periodontal therapy (SPT) for 5 years ≤SPT≤ 20 years. The authors considered data from objective examination of the periodontium and categorical indices (24 in total) assessed before treatment, 4–6 months after basic (active) treatment and 5 years ≤SPT≤ 20 years. Following the analysis of descriptive statistics, target quantitative indices were determined for prognostic modeling of treatment outcomes in periodontitis patients and calculating the residual risk of disease progression. Statistical processing of obtained data was carried out using the Statistica 13.3 package (Tibco, USA). Mean values of the indicators at different time points were compared by means of Wilcoxon’s and Signs criteria; Spearman’s rank correlation coefficient was used to evaluate relevance between predictors and target indicators. The level of statistical significance p = 0.05 was accepted in all cases of analysis. DataMining, an automated neural network of Statistica software, was used as a tool to build neural network models. The task of classifying the level of risk of disease progression was solved by means of ROC analysis. The prognostic potential of the model was assessed using sensitivity and specificity measures.Results. The heterogeneous dynamics of predictor variables describing the state of the periodontium was determined. The outcomes of regenerative periodontal surgery, regardless of gender, age of patients and comorbidities, significantly outperformed those of other approaches, due to the formation of a new dentogingival attachment, although to different extent. Another positive functional outcome was recorded in restoring the dentition integrity by implantation, without any mutually damaging effects. Since revealing the interrelationships between indicators is not equivalent to the predictive value, prognostic models were built for target indicators and stratification of the relative risk of periodontitis progression using automated neural networks. The networks with the best prognostic properties were selected out of 1000 automatically built and trained neural networks — double-layer perceptrons. The sensitivity of the relative risk prognostic m","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47628432","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 : 2022-08-29DOI: 10.25207/1608-6228-2022-29-4-53-74
A. V. Shulepov, I. Shperling, Yu. V. Yurkevich, N. V. Shperling, M. V. Vinogradov, A. S. Kourov, P. A. Romanov, S. B. Vasiliev
Background. The possibility of local application of autologous blood plasma (ABP) in soft tissue injuries is currently of particular interest.Objectives. Evaluation of the effects of peri-wound (perifocal) administration of ABP on red blood parameters, microcirculation and oxygen supply of soft tissues of the limb in experimental explosive wound (EW) in rats.Methods. EW was simulated on male Wistar rats (n=146) using a firecracker with a pyrotechnic mixture (patent RU No. 2741238 dated 22.01.2021). Animals were divided into 4 groups: control (2), comparison (1), main (1). The volume of blood loss in explosive wounds was 8 and 15% of the estimated circulating blood volume (CBV) of the animal. Blood was drawn from the rat tail to obtain ABP. 3 hours after the injury, ABP or 0.9% sodium chloride solution was injected intramuscularly into the explosive wound area at a rate of 2.0 ml/kg of animal weight. After 3, 7, 14, 28 days, the number of red blood cells, haemoglobin content, haematocrit were determined in the blood, and microcirculation and oxidative metabolism parameters were determined in the skeletal muscles of the injured area. The data were processed using Microsoft Excel 2013 (Microsoft, USA) and Statistica 10.0 (StatSoft Inc., USA).Results. Blood loss of 8% of the CBV in injured animals did not lead to changes in the quantitative composition of peripheral red blood. After an explosive wound with a blood loss of 15% of the CBV, there was a moderate decrease in the number of red blood cells (from 8.3×1012/l to 6.5×1012/l, p < 0.02), haemoglobin level (from 149.5 g/l to 118 g/l, p < 0.01), haematocrit (from 43.8% to 33.6%, p < 0.01) with recovery by day 7 of observation. The explosive soft tissue wound was characterized by marked post-traumatic microcirculatory disorders irrespective of the amount of blood loss. Perifocal intramuscular administration of ABP in animals with an explosive wound and blood loss of 15% CBV reduced the severity of post-traumatic microcirculatory and oxidative metabolic disorders mainly in the early post-traumatic period, as evidenced by an increase in the perfusion variation coefficient Kv by 1.2–1.3 times (p < 0.05), tissue oxygen consumption U by 20–22% (p < 0.05) and fluorescent oxygen consumption by FPC by 48% (p < 0.05).Conclusion. With an experimental explosive wound of the soft tissues of the thigh in rats, a single early (3 hours after the injury) peri-wound intramuscular administration of ABP reduces the severity of local post-traumatic microcirculatory and metabolic disorders in skeletal muscle.
{"title":"Microcirculatory Status and Metabolic Activity of Tissues after Local Administration of Autologous Plasma on the Model of Explosive Soft Tissue Wound in Rats","authors":"A. V. Shulepov, I. Shperling, Yu. V. Yurkevich, N. V. Shperling, M. V. Vinogradov, A. S. Kourov, P. A. Romanov, S. B. Vasiliev","doi":"10.25207/1608-6228-2022-29-4-53-74","DOIUrl":"https://doi.org/10.25207/1608-6228-2022-29-4-53-74","url":null,"abstract":"Background. The possibility of local application of autologous blood plasma (ABP) in soft tissue injuries is currently of particular interest.Objectives. Evaluation of the effects of peri-wound (perifocal) administration of ABP on red blood parameters, microcirculation and oxygen supply of soft tissues of the limb in experimental explosive wound (EW) in rats.Methods. EW was simulated on male Wistar rats (n=146) using a firecracker with a pyrotechnic mixture (patent RU No. 2741238 dated 22.01.2021). Animals were divided into 4 groups: control (2), comparison (1), main (1). The volume of blood loss in explosive wounds was 8 and 15% of the estimated circulating blood volume (CBV) of the animal. Blood was drawn from the rat tail to obtain ABP. 3 hours after the injury, ABP or 0.9% sodium chloride solution was injected intramuscularly into the explosive wound area at a rate of 2.0 ml/kg of animal weight. After 3, 7, 14, 28 days, the number of red blood cells, haemoglobin content, haematocrit were determined in the blood, and microcirculation and oxidative metabolism parameters were determined in the skeletal muscles of the injured area. The data were processed using Microsoft Excel 2013 (Microsoft, USA) and Statistica 10.0 (StatSoft Inc., USA).Results. Blood loss of 8% of the CBV in injured animals did not lead to changes in the quantitative composition of peripheral red blood. After an explosive wound with a blood loss of 15% of the CBV, there was a moderate decrease in the number of red blood cells (from 8.3×1012/l to 6.5×1012/l, p < 0.02), haemoglobin level (from 149.5 g/l to 118 g/l, p < 0.01), haematocrit (from 43.8% to 33.6%, p < 0.01) with recovery by day 7 of observation. The explosive soft tissue wound was characterized by marked post-traumatic microcirculatory disorders irrespective of the amount of blood loss. Perifocal intramuscular administration of ABP in animals with an explosive wound and blood loss of 15% CBV reduced the severity of post-traumatic microcirculatory and oxidative metabolic disorders mainly in the early post-traumatic period, as evidenced by an increase in the perfusion variation coefficient Kv by 1.2–1.3 times (p < 0.05), tissue oxygen consumption U by 20–22% (p < 0.05) and fluorescent oxygen consumption by FPC by 48% (p < 0.05).Conclusion. With an experimental explosive wound of the soft tissues of the thigh in rats, a single early (3 hours after the injury) peri-wound intramuscular administration of ABP reduces the severity of local post-traumatic microcirculatory and metabolic disorders in skeletal muscle.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47401321","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 : 2022-08-29DOI: 10.25207/1608-6228-2022-29-4-94-106
A. Burlutskaya, A. V. Statova, O. V. Dolbneva, I. I. Borlakova, J. V. Pisotskaya, D. V. Ustyuzhanina
Background. Eosinophilic esophagitis (Ee) is a chronic immune-mediated disease of the esophagus, which is characterized by symptoms of esophageal dysfunction and marked eosinophilic infiltration of the mucous membrane (MM) of the organ. Currently, interest in the problem of eosinophilic esophagitis in the global medical scientific community is steadily growing. Eosinophilic esophagitis has no pathognomonic symptoms, which causes a great difficulty for diagnosis.Clinical case description. The paper describes two clinical cases of eosinophilic esophagitis in patient T. (4 years 10 months) and patient M. (5 years 2 months). Patient T. was admitted to the gastroenterology department of the Children’s Regional Clinical Hospital (CRCH), with complaints of hiccups, flatulence, intermittent abdominal pain, coughing when swallowing. The medical history showed that the child has been ill since the beginning of March 2021, when pain appeared in the epigastric region and along the esophagus when eating. Parents sought help in the Central District Hispital, where surgical and ENT pathologies were excluded. The child was referred to the gastroenterological department of the CRCH, where, according to the results of esophagogastroduodenoscopy (EGDS), the diagnosis of “Erosive reflux — esophagitis” was made. After stopping the erosive process the patient underwent repeated EGDS with biopsy, and was diagnosed with “Eosinophilic esophagitis”. Prescribed treatment: hypoallergenic diet, topical glucocorticosteroids (fluticasone propionate), proton pump inhibitors (PPIs), antacids. As a result of the treatment, no improvement was noted — it was decided to transfer the patient to budesonide therapy in the form of a viscous suspension, after which a persistent positive effect was observed. In the second case, the girl M. was admitted to the gastroenterological department of the Children’s Clinical Hospital with complaints of constant nausea after eating and abdominal pain. The medical history showed that the child has been sick since she was 1. The examination also revealed moderate eosinophilia, an increase in the level of alkaline phosphatase. Fibrogastroduodenoscopy with biopsy revealed endoscopic signs of EoE. A diagnosis of eosinophilic esophagitis was made. Treatment: hypoallergenic diet, glucocorticosteroids, PPI, antacids, antiemetic drugs. The treatment brought about certain positive dynamics. Conclusion. The presented clinical cases show the difficulty of diagnosing eosinophilic esophagitis, since the symptoms of this disease are not very specific.
{"title":"Eosinophilic Esophagitis in Children: Clinical Cases","authors":"A. Burlutskaya, A. V. Statova, O. V. Dolbneva, I. I. Borlakova, J. V. Pisotskaya, D. V. Ustyuzhanina","doi":"10.25207/1608-6228-2022-29-4-94-106","DOIUrl":"https://doi.org/10.25207/1608-6228-2022-29-4-94-106","url":null,"abstract":"Background. Eosinophilic esophagitis (Ee) is a chronic immune-mediated disease of the esophagus, which is characterized by symptoms of esophageal dysfunction and marked eosinophilic infiltration of the mucous membrane (MM) of the organ. Currently, interest in the problem of eosinophilic esophagitis in the global medical scientific community is steadily growing. Eosinophilic esophagitis has no pathognomonic symptoms, which causes a great difficulty for diagnosis.Clinical case description. The paper describes two clinical cases of eosinophilic esophagitis in patient T. (4 years 10 months) and patient M. (5 years 2 months). Patient T. was admitted to the gastroenterology department of the Children’s Regional Clinical Hospital (CRCH), with complaints of hiccups, flatulence, intermittent abdominal pain, coughing when swallowing. The medical history showed that the child has been ill since the beginning of March 2021, when pain appeared in the epigastric region and along the esophagus when eating. Parents sought help in the Central District Hispital, where surgical and ENT pathologies were excluded. The child was referred to the gastroenterological department of the CRCH, where, according to the results of esophagogastroduodenoscopy (EGDS), the diagnosis of “Erosive reflux — esophagitis” was made. After stopping the erosive process the patient underwent repeated EGDS with biopsy, and was diagnosed with “Eosinophilic esophagitis”. Prescribed treatment: hypoallergenic diet, topical glucocorticosteroids (fluticasone propionate), proton pump inhibitors (PPIs), antacids. As a result of the treatment, no improvement was noted — it was decided to transfer the patient to budesonide therapy in the form of a viscous suspension, after which a persistent positive effect was observed. In the second case, the girl M. was admitted to the gastroenterological department of the Children’s Clinical Hospital with complaints of constant nausea after eating and abdominal pain. The medical history showed that the child has been sick since she was 1. The examination also revealed moderate eosinophilia, an increase in the level of alkaline phosphatase. Fibrogastroduodenoscopy with biopsy revealed endoscopic signs of EoE. A diagnosis of eosinophilic esophagitis was made. Treatment: hypoallergenic diet, glucocorticosteroids, PPI, antacids, antiemetic drugs. The treatment brought about certain positive dynamics. Conclusion. The presented clinical cases show the difficulty of diagnosing eosinophilic esophagitis, since the symptoms of this disease are not very specific.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45881938","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 : 2022-08-29DOI: 10.25207/1608-6228-2022-29-4-14-31
E. V. Zhdanova, E. V. Rubtsova
Background. Early identification of risk factors (RF) associated with cardiovascular diseases (CVD) is essential for the prevention of CVDs and their complications. CVD risk factors can be identified using Artificial Intelligence (AI) systems, which are capable of learning, analyzing and drawing conclusions. The advantage of AI systems consists in their capacity to process large amounts of data over a short period of time and produce ready-made information. Objectives. Evaluation of the efficiency of implementing an AI software application by a general practitioner for identifying CVD risk factors.Methods. The study included data from 1778 electronic medical histories of patients aged over 18, assigned to an outpatient and polyclinic department of Muravlenkovskaya Gorodskaya Bolnitsa (Muravlenko municipal hospital), Yamalo-Nenets Autonomous Okrug (Russia). The study was conducted in four stages. The first stage involved a preliminary training of the Artificial Intelligence (AI) system under study using numerous CVD risk assessment scales. The Webiomed predictive analytics and risk management software by K-SkAI, Russia, was selected as a platform for this purpose. The second stage included an analysis of medical data to identify CVD risk factors according to the relative risk scale for patients under 40 and the SCORE scale for patients over 40. At the third stage, a specialist analyzed the previous and new information received about each patient. According to the results of the third stage, four risk groups for CVD (low, medium, high and very high) were formed. At the fourth stage, newly diagnosed patients with a high risk of CVD, who had not been previously subject to regular medical check-up, were directed for additional clinical, laboratory and instrumental follow-up examination and consultations of relevant specialists. Statistical data in absolute terms and as a percentage were obtained. Statistical processing of the results was carried out by a computer program aimed at medical decision support. Content visualization was performed in spreadsheets and charts.Results. Based on the data obtained, the AI system under study divided all patients into CVD risk groups and identified uncounted factors. The AI system confirmed a high and very high risk of CVD according to SCORE (Systematic COronary Risk Evaluation) in 623 people, who were already receiving appropriate cardiological assistance. The RFs that had not previously been taken into account in the diagnosis were recorded in 41 (11.5%) patients from the very highrisk group and in 37 (12.7%) high-risk patients. The AI system identified a high risk of CVD in 29 people who had not been previously under care of a general practitioner or other specialists due to their infrequent visits to health care facilities. These patients were detected by the AI system following periodic and preliminary medical check-ups (35%), full in-patient treatment for other diseases (31%), when seeking help of other speci
{"title":"Implementing an Artificial Intelligence System in the Work of General Practitioner in the Yamalo-Nenets Autonomous Okrug: Pilot Cross-sectional Screening Observational Study","authors":"E. V. Zhdanova, E. V. Rubtsova","doi":"10.25207/1608-6228-2022-29-4-14-31","DOIUrl":"https://doi.org/10.25207/1608-6228-2022-29-4-14-31","url":null,"abstract":"Background. Early identification of risk factors (RF) associated with cardiovascular diseases (CVD) is essential for the prevention of CVDs and their complications. CVD risk factors can be identified using Artificial Intelligence (AI) systems, which are capable of learning, analyzing and drawing conclusions. The advantage of AI systems consists in their capacity to process large amounts of data over a short period of time and produce ready-made information. Objectives. Evaluation of the efficiency of implementing an AI software application by a general practitioner for identifying CVD risk factors.Methods. The study included data from 1778 electronic medical histories of patients aged over 18, assigned to an outpatient and polyclinic department of Muravlenkovskaya Gorodskaya Bolnitsa (Muravlenko municipal hospital), Yamalo-Nenets Autonomous Okrug (Russia). The study was conducted in four stages. The first stage involved a preliminary training of the Artificial Intelligence (AI) system under study using numerous CVD risk assessment scales. The Webiomed predictive analytics and risk management software by K-SkAI, Russia, was selected as a platform for this purpose. The second stage included an analysis of medical data to identify CVD risk factors according to the relative risk scale for patients under 40 and the SCORE scale for patients over 40. At the third stage, a specialist analyzed the previous and new information received about each patient. According to the results of the third stage, four risk groups for CVD (low, medium, high and very high) were formed. At the fourth stage, newly diagnosed patients with a high risk of CVD, who had not been previously subject to regular medical check-up, were directed for additional clinical, laboratory and instrumental follow-up examination and consultations of relevant specialists. Statistical data in absolute terms and as a percentage were obtained. Statistical processing of the results was carried out by a computer program aimed at medical decision support. Content visualization was performed in spreadsheets and charts.Results. Based on the data obtained, the AI system under study divided all patients into CVD risk groups and identified uncounted factors. The AI system confirmed a high and very high risk of CVD according to SCORE (Systematic COronary Risk Evaluation) in 623 people, who were already receiving appropriate cardiological assistance. The RFs that had not previously been taken into account in the diagnosis were recorded in 41 (11.5%) patients from the very highrisk group and in 37 (12.7%) high-risk patients. The AI system identified a high risk of CVD in 29 people who had not been previously under care of a general practitioner or other specialists due to their infrequent visits to health care facilities. These patients were detected by the AI system following periodic and preliminary medical check-ups (35%), full in-patient treatment for other diseases (31%), when seeking help of other speci","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48938588","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 : 2022-08-29DOI: 10.25207//1608-6228-2022-29-4-123-131
A. N. Anipchenko, E. V. Chernogorova, A. A. Allakhverdyan, N. N. Anipchenko
Background. Fluoroscopy of the esophagus and stomach provides a reliable assessment of the specific radiological criteria for achalasia (of cardia), which underlie the classification of the disease by stages. The stage of achalasia is one of the key factors to determine the management of treatment, including the choice of a specific type of surgical intervention. However, no methodological standards for performing and interpreting fluoroscopy of the esophagus and stomach in achalasia have been developed.Objectives. Creation of a unified protocol for performing and interpreting fluoroscopy of esophagus and stomach in achalasia and development of an algorithm for diagnosing achalasia based on fluoroscopy of the esophagus and stomach, which will help to determine the appropriate surgery.Methods. The developed algorithm was applied in a study of 104 patients. The examination was carried out using Duodiagnost X-ray machine by Philips, equipped with a remote control. The X-ray technician’s workplace was tooled with a personal computer, a digital identifier (ID) and a digitizer-scanning device. Drystardt 5000B film (by AGFA) was used for X-ray examinations. The description of X-ray examination was carried out by a radiologist in a separate office equipped with two workstations.Results. A protocol for fluoroscopy of the esophagus and stomach in patients with achalasia and a checklist for the description of fluoroscopy in achalasia have been developed. Conclusion. The developed algorithm for diagnosing achalasia of cardia based on fluoroscopy of the esophagus and stomach showed its high efficiency for clarifying the stage of the disease, and, consequently, choosing the right treatment and method of surgical intervention, as well as for providing objective control over the dynamics of the disease after surgery. In addition, the introduction of the developed algorithm into the widespread practice of radiologists will ensure continuity at all stages of treatment of patients with achalasia in different medical institutions: from diagnosis to dynamic monitoring of the patient’s condition after surgical treatment in specialized centers.
{"title":"Current Role and Potential of Oesophogeal and Gastric Fluoroscopy in the Choice of Surgical Treatment for Achalasia of Cardia","authors":"A. N. Anipchenko, E. V. Chernogorova, A. A. Allakhverdyan, N. N. Anipchenko","doi":"10.25207//1608-6228-2022-29-4-123-131","DOIUrl":"https://doi.org/10.25207//1608-6228-2022-29-4-123-131","url":null,"abstract":"Background. Fluoroscopy of the esophagus and stomach provides a reliable assessment of the specific radiological criteria for achalasia (of cardia), which underlie the classification of the disease by stages. The stage of achalasia is one of the key factors to determine the management of treatment, including the choice of a specific type of surgical intervention. However, no methodological standards for performing and interpreting fluoroscopy of the esophagus and stomach in achalasia have been developed.Objectives. Creation of a unified protocol for performing and interpreting fluoroscopy of esophagus and stomach in achalasia and development of an algorithm for diagnosing achalasia based on fluoroscopy of the esophagus and stomach, which will help to determine the appropriate surgery.Methods. The developed algorithm was applied in a study of 104 patients. The examination was carried out using Duodiagnost X-ray machine by Philips, equipped with a remote control. The X-ray technician’s workplace was tooled with a personal computer, a digital identifier (ID) and a digitizer-scanning device. Drystardt 5000B film (by AGFA) was used for X-ray examinations. The description of X-ray examination was carried out by a radiologist in a separate office equipped with two workstations.Results. A protocol for fluoroscopy of the esophagus and stomach in patients with achalasia and a checklist for the description of fluoroscopy in achalasia have been developed. Conclusion. The developed algorithm for diagnosing achalasia of cardia based on fluoroscopy of the esophagus and stomach showed its high efficiency for clarifying the stage of the disease, and, consequently, choosing the right treatment and method of surgical intervention, as well as for providing objective control over the dynamics of the disease after surgery. In addition, the introduction of the developed algorithm into the widespread practice of radiologists will ensure continuity at all stages of treatment of patients with achalasia in different medical institutions: from diagnosis to dynamic monitoring of the patient’s condition after surgical treatment in specialized centers.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43813906","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 : 2022-08-29DOI: 10.25207/1608-6228-2022-29-4-32-52
P. Galenko-Yaroshevsky, K. V. Tseluiko, I. Pavlyuchenko, V. K. Leontiev, A. Zadorozhny, V. Popkov, S. Lebedeva, A. Zelenskaya, M. Zadorozhny, V. Y. Zobenko
Background. The development of periodontitis is strongly linked with both periodontopathogenic microflora and antioxidant-proxidant system disorders, which determines the need for the combined use of antimicrobial and antioxidant agents.Objectives. A comparative evaluation of the antioxidant-prooxidant system of red blood cells in rats with experimental periodontitis against the background of the traditional drug therapy and its combination with Soderm®-Forte and new injectable form of Rexod®.Methods. The authors conducted a comparative study of the effect of traditional drug therapy (TDT) and its combination with Soderm®-Forte gel containing silver nanoparticles, recombinant human superoxide dismutase (Rexod®) and new injectable form (NIF) of Rexod® on the condition of the antioxidant-prooxidant system of red blood cells in rats with experimental periodontitis (EP). The experiments were performed on Wistar male rats of 210–230 g. EP was induced by ligature method. The rats were randomly divided into 5 comparable groups of 12 animals: group 1 — with intact periodontium; group 2 — with EP; group 3 — with EP, where TDT was used, including oral irrigation with chlorhexedine (0.05% solution) and application of Septo-Pack dento-gingival dressing; group 4 — with EP, TDT and Soderm®-Forte gel (applied into the periodontal pockets of the lower incisors); group 5 — with EP, TDT in combination with Soderm®-Forte gel and NIF of Rexod®, which was injected intraperitoneally at a dose of 8000 U/kg. Treatment of rats with EP (groups 3–5) was carried out for 12 days. The observation period for all animals lasted 42 days. The biochemical tests and the antioxidant-prooxidant index were used to assess the condition of antioxidant-prooxidant system. Statistical analysis of the obtained results was carried out with parametric and non-parametric methods of Microsoft Excel (Microsoft, USA), Analysis package and AtteStat, as well as Statistica 8.0 (StatSoft, USA) software.Results. The application of TDT against the developed EP caused a moderate positive correction of the indicators of Antioxidant protection system (APS). The enrichment of TDT for the EP animals with Soderm®-Forte and especially Soderm®-Forte in combination with NIF of Rexod® to enhance the APS potential caused more significant positive dynamics of the balance in the antioxidant-prooxidant system compared to TDT.Conclusion. The combination of TDT with Soderm®-Forte and NIF of Rexod® has the most significant positive corrective effect on the condition of antioxidant-prooxidant system of red blood cells in rats with EP in comparison with the complex of TDT with Soderm®-Forte and TDT used separately.
{"title":"Effect of Traditional Drug Therapy and its Combination with Soderm®-Forte and New Injectable Form of Rexod® on the Antioxidant-prooxidant Red Blood Cell System in Rats with Experimental Periodontitis","authors":"P. Galenko-Yaroshevsky, K. V. Tseluiko, I. Pavlyuchenko, V. K. Leontiev, A. Zadorozhny, V. Popkov, S. Lebedeva, A. Zelenskaya, M. Zadorozhny, V. Y. Zobenko","doi":"10.25207/1608-6228-2022-29-4-32-52","DOIUrl":"https://doi.org/10.25207/1608-6228-2022-29-4-32-52","url":null,"abstract":"Background. The development of periodontitis is strongly linked with both periodontopathogenic microflora and antioxidant-proxidant system disorders, which determines the need for the combined use of antimicrobial and antioxidant agents.Objectives. A comparative evaluation of the antioxidant-prooxidant system of red blood cells in rats with experimental periodontitis against the background of the traditional drug therapy and its combination with Soderm®-Forte and new injectable form of Rexod®.Methods. The authors conducted a comparative study of the effect of traditional drug therapy (TDT) and its combination with Soderm®-Forte gel containing silver nanoparticles, recombinant human superoxide dismutase (Rexod®) and new injectable form (NIF) of Rexod® on the condition of the antioxidant-prooxidant system of red blood cells in rats with experimental periodontitis (EP). The experiments were performed on Wistar male rats of 210–230 g. EP was induced by ligature method. The rats were randomly divided into 5 comparable groups of 12 animals: group 1 — with intact periodontium; group 2 — with EP; group 3 — with EP, where TDT was used, including oral irrigation with chlorhexedine (0.05% solution) and application of Septo-Pack dento-gingival dressing; group 4 — with EP, TDT and Soderm®-Forte gel (applied into the periodontal pockets of the lower incisors); group 5 — with EP, TDT in combination with Soderm®-Forte gel and NIF of Rexod®, which was injected intraperitoneally at a dose of 8000 U/kg. Treatment of rats with EP (groups 3–5) was carried out for 12 days. The observation period for all animals lasted 42 days. The biochemical tests and the antioxidant-prooxidant index were used to assess the condition of antioxidant-prooxidant system. Statistical analysis of the obtained results was carried out with parametric and non-parametric methods of Microsoft Excel (Microsoft, USA), Analysis package and AtteStat, as well as Statistica 8.0 (StatSoft, USA) software.Results. The application of TDT against the developed EP caused a moderate positive correction of the indicators of Antioxidant protection system (APS). The enrichment of TDT for the EP animals with Soderm®-Forte and especially Soderm®-Forte in combination with NIF of Rexod® to enhance the APS potential caused more significant positive dynamics of the balance in the antioxidant-prooxidant system compared to TDT.Conclusion. The combination of TDT with Soderm®-Forte and NIF of Rexod® has the most significant positive corrective effect on the condition of antioxidant-prooxidant system of red blood cells in rats with EP in comparison with the complex of TDT with Soderm®-Forte and TDT used separately.","PeriodicalId":33483,"journal":{"name":"Kubanskii nauchnyi meditsinskii vestnik","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41766256","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：