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Thrombodynamics and Quantitative phase imaging of platelets in the assessment of hemostasis in pregnant women with protein C / protein S deficiency 蛋白C /蛋白S缺乏症孕妇止血的血小板动力学和定量相成像评估
Pub Date : 2023-11-05 DOI: 10.33667/2078-5631-2023-19-49-54
I. A. Vasilenko, S. A. Gasparyan, S. M. Akhmedova, I. A. Orfanova, N. A. Vasilenko
Relevance . A hypercoagulable state caused by hereditary or acquired deficiency of antithrombotic factors can contribute to disruption of the uteroplacental circulation with the development of serious pregnancy complications, which requires effective monitoring of hemostasis during the use of pathogenetic anticoagulant therapy. The purpose of the study is to improve methods for diagnosing and monitoring hemostatic disorders in pregnant women with thrombophilia (protein C/protein S deficiency) and complicated pregnancy based on the use of an integral thrombodynamic test and quantitative phase imaging of platelets. Material and methods . 45 pregnant women were examined in the first and second trimester: 20 women with normal pregnancy (comparison group) and 25 (main group) with thrombophilia (protein S/protein C deficiency). 16 pregnant women (subgroup 1A) received a full course of preconception preparation with the prescription of LMWH, 9 pregnant women (subgroup 1B) did not complete the course in full for various reasons. To study hemostasis, along with routine methods (determination of APTT, TT, PT, Fibrinogen, INR and D-dimer), an integral assessment of coagulation using the Thrombodynamics method and quantitative phase imaging (QPI) of platelets in real time were performed. Results . It was found that routine methods are not sufficiently informative; statistically significant changes against the background of thrombophilia and during treatment with LMWH were noted only based on the results of assessing the level of fibrinogen and D-dimer. In the complex of thrombodynamics indicators, the most sensitive parameters were the steady-state clot growth rate (Vst), clot size at 30 minutes of the study (CS) and clot density (D). The QPI method revealed features of the morphological structure of platelets with a predominance in pregnant women with protein S/protein C deficiency of the activated cell population with an increase in the median values of diameter and perimeter by 14 and 20 %, respectively (p < 0.05). The effectiveness of LMWH therapy was assessed by normalization of the analyzed parameters. Conclusion . Timely and adequate correction of hemostasis disorders, carried out while monitoring coagulation and platelet parameters, taking into account all clinical data, can significantly reduce the risk of complications for the mother and fetus.
的相关性。遗传性或获得性抗血栓因子缺乏引起的高凝状态可导致子宫胎盘循环中断,并伴有严重的妊娠并发症,这需要在使用致病性抗凝治疗期间有效监测止血情况。本研究的目的是改进基于血小板积分血栓动力学试验和定量相成像的诊断和监测合并血栓病(蛋白C/蛋白S缺乏症)和复杂妊娠的孕妇止血障碍的方法。材料和方法。45例孕妇在妊娠早期和中期进行了检查:20例正常妊娠(对照组)和25例血栓形成(蛋白S/蛋白C缺乏)(主要组)。16例孕妇(1A亚组)接受低分子肝素处方的全程孕前准备,9例孕妇(1B亚组)因各种原因未完成全程准备。为了研究止血,在常规方法(测定APTT、TT、PT、纤维蛋白原、INR和d -二聚体)的基础上,采用血栓动力学方法和实时血小板定量相成像(QPI)对凝血进行综合评估。结果。发现常规方法不能提供足够的信息;仅根据纤维蛋白原和d -二聚体水平的评估结果,在血栓性疾病背景下和低分子肝素治疗期间,统计学上有显著变化。在血栓动力学指标复合体中,最敏感的参数是稳态血块生长速率(Vst)、研究30分钟时的血块大小(CS)和血块密度(D)。QPI方法揭示了血小板形态结构的特征,在活化细胞群中蛋白S/蛋白C缺乏的孕妇中占优势,直径和周长的中位数分别增加了14%和20% (p <0.05)。通过分析参数的归一化评估低分子肝素治疗的有效性。结论。在监测凝血和血小板参数的同时,考虑到所有临床数据,及时、充分地纠正止血障碍,可显著降低母胎并发症的风险。
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引用次数: 0
The role of lipotropic factors in the correction of metabolic disorders in women during the perimenopausal period 促脂因子在纠正围绝经期妇女代谢紊乱中的作用
Pub Date : 2023-11-05 DOI: 10.33667/2078-5631-2023-19-7-15
S. V. Orlova, E. A. Nikitina
In women during perimenopause, changes in metabolic parameters are detected, such as weight gain, which triggers a cascade of pathological reactions leading to the formation of metabolic disorders (lipid, carbohydrate metabolism) and endothelial dysfunction, during the development of which a deficiency of sex hormones plays a certain role in the onset of menopause. There is a connection between hormonal changes and an increase in the amount of abdominal and/or visceral fat, which is accompanied by a weakening of oxidative processes in adipose tissue, a decrease in energy consumption and a predisposition to the development of metabolic syndrome. As a nutritional correction, it is advisable to introduce into the diet lipotropic substances that help catalyze the breakdown of fats and ensure the processes of hydroxylation and methylation of toxic substances in the liver, such as methionine, inositol and choline. Each of the lipotropic substances affects the mobilization of fats, and their combination can provide a synergistic effect and increase the natural metabolic function of the liver.
在围绝经期的妇女中,可以检测到代谢参数的变化,例如体重增加,这引发了一系列病理反应,导致代谢紊乱(脂质、碳水化合物代谢)和内皮功能障碍的形成,在发展过程中,性激素的缺乏在更年期的开始中起着一定的作用。荷尔蒙变化与腹部和/或内脏脂肪量增加之间存在联系,这伴随着脂肪组织氧化过程的减弱、能量消耗的减少和代谢综合征的易感性。作为一种营养矫正,建议在饮食中引入促脂物质,这些物质有助于催化脂肪的分解,并确保肝脏中有毒物质(如蛋氨酸、肌醇和胆碱)的羟基化和甲基化过程。每一种类脂物质都影响脂肪的动员,它们的组合可以提供协同作用,增加肝脏的自然代谢功能。
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引用次数: 0
Prognosis of pregnancy and perinatal outcomes in the presence of polycystic ovary syndrome 多囊卵巢综合征的妊娠预后及围产儿结局
Pub Date : 2023-11-05 DOI: 10.33667/2078-5631-2023-19-39-43
S. A. Kulakova, A. I. Gomon
Aim . To determine prognostic criteria for pregnancy complications and perinatal pathology in women with polycystic ovary syndrome. Materials and methods . A prospective study of 100 pregnant women with polycystic ovary syndrome at the St. Joasaph Belgorod Regional Clinical Hospital. Depending on the type of ART method, 2 groups were formed. The first group (n=50) of women – pregnancy occurred by induction of ovulation with chlorthyanisene clomiphene citrate (CC). The second group (n=50) – with the help of In vitro fertilisation (IVF). Research methods – clinical, laboratory, instrumental. Result . It was revealed that the main conditions for the probability of the formation of polycystic ovary syndrome and infertility are: the presence of childhood infections in the anamnesis, low birth weight of mothers. Disorders of the reproductive system in polycystic ovary syndrome (PCOS) are detected by menstrual cycle disorders, late menarche, inflammatory diseases of the genitals, primary and secondary infertility. Extragenital pathology is diagnosed in 100 % of women with PCOS and appears in the form of obesity, infectious and inflammatory diseases, infectious and inflammatory pathologies. With PCOS, miscarriage, preeclampsia, isthmic-cervical insufficiency, gestational diabetes mellitus, fetal growth retardation, chronic placental insufficiency are noted. The onset of pregnancy by stimulating ovulation of CC has an unfavorable course relative to IVF: the risk of miscarriage and isthmic-cervical insufficiency is higher. The average weight of full-term babies, the method of their birth turned out to be IVF, is greater than ovulation stimulation. The probability of perinatal damage against the background of ovulation stimulation exceeds IVF by about 1.5 times. In the early period of gestation and in conditions of PCOS, there is a hormonal imbalance: a fascination with TBG and a decrease in the secretion of PAMG in peripheral blood at 7–8 and 10–12 weeks. In women with polycystic ovary syndrome, the probability of termination of pregnancy in the first trimester is characterized by the presence of chorionitis, a decrease in the volume of the amniotic cavity, tachycardia of the embryo. Signs of placental insufficiency were detected in the II and III trimesters. In pregnant women with PCOS, hemostatic disorders are observed – a shortening of the activated recalcification time and blood clotting time and an increase in fibrinogen and prothrombin index. Pregnancy on the background of PCOS is accompanied by activation of free radical oxidation and the development of oxidative stress. Conclusion . To predict placental insufficiency, the risk of miscarriage, perinatal pathology of the nervous system in pregnant women with PCOS, it is necessary to assess the level of glycodelin, TBG, PAMG‑1, β-HCG.
的目标。目的:探讨多囊卵巢综合征患者妊娠并发症及围产期病理的预后标准。材料和方法。在圣约瑟夫别尔哥罗德地区临床医院对100名患有多囊卵巢综合征的孕妇进行前瞻性研究。根据ART方法的类型分为两组。第一组(n=50)妇女-通过氯氰胺柠檬酸克罗米芬(CC)诱导排卵发生妊娠。第二组(n=50) -借助体外受精(IVF)。研究方法-临床,实验室,仪器。结果。结果显示,多囊卵巢综合征和不孕症的形成概率的主要条件是:在记忆中存在儿童期感染,母亲出生体重低。多囊卵巢综合征(PCOS)的生殖系统紊乱可以通过月经周期紊乱、月经初潮推迟、生殖器炎症性疾病、原发性和继发性不孕症来检测。100%的多囊卵巢综合征女性都被诊断为生殖器外病变,表现为肥胖、感染性和炎症性疾病、感染性和炎症性病理。与多囊卵巢综合征,流产,先兆子痫,缺血性宫颈功能不全,妊娠糖尿病,胎儿生长迟缓,慢性胎盘功能不全。与体外受精相比,通过刺激CC排卵来怀孕有一个不利的过程:流产和缺血性宫颈功能不全的风险更高。足月婴儿的平均体重大于促排卵,他们的出生方法是体外受精。在排卵刺激的背景下,围产期损伤的概率超过IVF约1.5倍。在妊娠早期和多囊卵巢综合征的情况下,存在激素失衡:在7-8周和10-12周时,外周血中TBG和PAMG分泌减少。在患有多囊卵巢综合征的妇女中,妊娠早期终止妊娠的可能性以绒毛膜炎、羊膜腔体积减少、胚胎心动过速为特征。胎盘功能不全的迹象被发现在II和III个月。在PCOS孕妇中,观察到止血障碍-活化的再钙化时间和凝血时间缩短,纤维蛋白原和凝血酶原指数升高。PCOS背景下的妊娠伴随着自由基氧化的激活和氧化应激的发展。结论。为了预测PCOS孕妇胎盘功能不全、流产风险、围产期神经系统病理,有必要评估糖苷、TBG、PAMG‑1、β-HCG的水平。
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引用次数: 0
Comparative analysis of prevalence of metabolic types of urolithiasis in Stavropol Region 斯塔夫罗波尔地区尿石症代谢型患病率的比较分析
Pub Date : 2023-10-29 DOI: 10.33667/2078-5631-2023-18-39-42
R. S. Frantsev, K. S. Makarov, Yu. P. Redko, I. V. Pavlenko
Relevance. The treatment and prophylaxis of urolithiasis are one of the urgent problems of modern medicine. In Russia in recent decades a tendency to the increase in urolithiasis prevalence has been noted, and the incidence of urolithiasis varies in different regions. This may be due to lifestyle features and chemical composition of water in different regions of the country. The aim of the study. To analyze the chemical composition of concrements in patients treated for urolithiasis in the Stavropol Region. Methods. Using infrared (IR) spectroscopy 565 concrements were studied. Analysis of the obtained data showed that calcium-oxalate stones were the most common (72.80 %), followed by urate stones (19.40 %) and then phosphate stones (6.09 %). Cystine (0.70 %) and xanthine type stones (0.17 %) are the least common. Conclusions. The preventive measures aimed at restriction of the consumption of food containing high oxalates and purines, as well as use of water low in calcium and with alkaline reaction will decrease the incidence of urolithiasis at the regional level.
的相关性。尿石症的治疗和预防是现代医学亟待解决的问题之一。近几十年来,俄罗斯尿石症发病率呈上升趋势,不同地区尿石症的发病率各不相同。这可能是由于该国不同地区的生活方式特征和水的化学成分。研究的目的。目的:分析斯塔夫罗波尔地区尿石症患者的水泥化学成分。方法。利用红外光谱对565种混凝土进行了研究。对所得资料的分析显示,草酸钙结石最常见(72.80%),其次是尿酸结石(19.40%)和磷酸盐结石(6.09%)。胱氨酸(0.70%)和黄嘌呤型结石(0.17%)最不常见。结论。采取预防措施,限制食用草酸盐和嘌呤含量高的食物,以及使用低钙碱性水,可在区域一级减少尿石症的发病率。
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引用次数: 0
Comorbid patient with osteoporosis at doctor's appointment. What factors should be considered in selection of therapy 骨质疏松症合并症患者在医生预约。在选择治疗方法时应考虑哪些因素
Pub Date : 2023-10-29 DOI: 10.33667/2078-5631-2023-18-34-38
V. I. Strukov, M. Yu. Sergeeva-Kondrachenko, O. P. Vinogradova, A. G. Denisova, I. Ya. Moiseeva, D. V. Vikhrev, P. A. Poluboyarinov, E. S. Panina, E. V. Petrova, A. V. Fedorov, S. S. Burmistrova
Relevance. Osteoporosis is a systemic disease of the skeleton, which is characterized by a decrease in bone mass per unit volume and a violation of the microarchitectonics of bone tissue, which leads to an increase in bone fragility and an increased risk of fractures. Target. The problems of comorbidity of osteoporosis and polypharmacy in the treatment of this disease are considered. Materials and methods. On the basis of the Center for Osteoporosis of the Penza Institute for Postgraduate Medical Education, a branch of the Russian Medical Academy of Continuing Postgraduate Education of Russia, we conducted an open, prospective, randomized study of the comorbid status of age-related patients with osteoporosis in order to improve the diagnosis and pathogenetic therapy of the disease. More than 1400 women took part in the study.The results of a study of the comorbid status of age-related patients with osteoporosis are presented. The expediency of antiresorptive therapy in comorbid patients with osteoporosis is discussed. Conclusions. The characteristics of osteoprotectors of a new generation based on the bioactive component of gonadotropic action are given, and the prospects of these agents in the implementation of a personalized approach in the treatment of osteoporosis, taking into account comorbidity and polypharmacy, are evaluated. Particular attention is paid to the problem of osteosarcopenia and its solution with the help of these osteoprotectors.
的相关性。骨质疏松症是一种骨骼全身性疾病,其特点是单位体积骨量减少,骨组织的微结构受到破坏,从而导致骨脆性增加,骨折风险增加。目标。讨论了骨质疏松症的合并症和多种药物治疗的问题。材料和方法。我们以俄罗斯继续研究生教育俄罗斯医学院附属奔萨研究生医学教育研究所骨质疏松症研究中心为基础,对年龄相关性骨质疏松症患者的合并症状况进行了开放性、前瞻性、随机化研究,以提高该病的诊断和病理治疗水平。超过1400名女性参与了这项研究。一项研究的结果与年龄相关的骨质疏松症患者的合并症状态提出。本文讨论了骨质疏松合并症患者抗吸收治疗的可行性。结论。基于促性腺激素作用的生物活性成分,给出了新一代骨保护剂的特点,并评估了这些药物在考虑合并症和多药治疗的情况下实施骨质疏松症个性化治疗方法的前景。特别关注的问题是骨少症及其解决的帮助下,这些骨保护剂。
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引用次数: 0
Three-dimensional vector ECG analysis in the diagnosis of the left anterior fascicular block 三维矢量心电图分析在左前束传导阻滞诊断中的应用
Pub Date : 2023-10-28 DOI: 10.33667/2078-5631-2023-15-28-34
Yu. E. Teregulov, E. A. Atsel, S. F. Ganieva, E. T. Teregulova, M. S. Maksimova, A.  Yu. Teregulov, Z. A. Kamaletdinova
The relevance of the study is due to the complexity of the differential diagnosis of left anterior fascicular block (LAFB) with myocardial infarction and left ventricular hypertrophy based on a standard ECG. Aim. Determination of the criteria for LAFB according to the data of three- dimensional vectorcardiography with an analysis of the rate of formation of the vector loop. Material and research methods. The study included 85 patients who underwent a 12-lead ECG study. 2 groups of patients were selected. The main group of 56 patients with LAFB, mean age was 63.3±16.6 (M±δ) years, 34 men and 22 women. The control group included 29 healthy individuals, the mean age was 21.4±2.5 (M± δ) years, 12 men and 17 women. All patients underwent synchronous recording of 12 standard ECG leads in the IS «Unified Cardiologist of the Republic of Tatarstan» and reconstruction of a three-d imensional vectorcardiogram using the McFee-Parungao system with an analysis of the vector loop formation rate using EasyECG Rest ATES Medica software (Russia). Results and conclusions. It is shown that for LAFB the movement of the vector loop counterclockwise is typical in the frontal plane; the presence of 2 extrema, the second is directed upwards, to the right and back. On the graph of the rate of formation of a spatial vector loop, 2 peaks are recorded with a decrease in the rate in the final part of the QRS loop by 2–2.5 times relative to the first peak, which reflects a slowdown in myocardial excitation in the output section of the left ventricle.
这项研究的相关性是由于基于标准心电图的左前束传导阻滞(LAFB)与心肌梗死和左心室肥厚的鉴别诊断的复杂性。的目标。根据三维矢量心动图的数据,分析矢量环路的形成速率,确定LAFB的诊断标准。材料和研究方法。该研究包括85名患者,他们接受了12导联心电图研究。选择两组患者。主要组56例LAFB患者,平均年龄63.3±16.6 (M±δ)岁,男性34例,女性22例。对照组29例,平均年龄21.4±2.5 (M±δ)岁,男性12例,女性17例。所有患者在IS«鞑靼斯坦共和国统一心脏病专家»中同步记录12个标准心电图导联,并使用McFee-Parungao系统重建三维矢量心电图,并使用EasyECG Rest ATES Medica软件(俄罗斯)分析矢量环路形成率。结果和结论。结果表明:对于LAFB,矢量环在锋面呈典型的逆时针方向运动;两个极值的存在,第二个是向上的,向右和向后。在空间矢量环路形成速率图上,记录到2个峰值,QRS环路最后部分的速率相对于第一个峰值下降了2 - 2.5倍,这反映了左心室输出部分心肌兴奋的减慢。
{"title":"Three-dimensional vector ECG analysis in the diagnosis of the left anterior fascicular block","authors":"Yu. E. Teregulov, E. A. Atsel, S. F. Ganieva, E. T. Teregulova, M. S. Maksimova, A.  Yu. Teregulov, Z. A. Kamaletdinova","doi":"10.33667/2078-5631-2023-15-28-34","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-15-28-34","url":null,"abstract":"The relevance of the study is due to the complexity of the differential diagnosis of left anterior fascicular block (LAFB) with myocardial infarction and left ventricular hypertrophy based on a standard ECG. Aim. Determination of the criteria for LAFB according to the data of three- dimensional vectorcardiography with an analysis of the rate of formation of the vector loop. Material and research methods. The study included 85 patients who underwent a 12-lead ECG study. 2 groups of patients were selected. The main group of 56 patients with LAFB, mean age was 63.3±16.6 (M±δ) years, 34 men and 22 women. The control group included 29 healthy individuals, the mean age was 21.4±2.5 (M± δ) years, 12 men and 17 women. All patients underwent synchronous recording of 12 standard ECG leads in the IS «Unified Cardiologist of the Republic of Tatarstan» and reconstruction of a three-d imensional vectorcardiogram using the McFee-Parungao system with an analysis of the vector loop formation rate using EasyECG Rest ATES Medica software (Russia). Results and conclusions. It is shown that for LAFB the movement of the vector loop counterclockwise is typical in the frontal plane; the presence of 2 extrema, the second is directed upwards, to the right and back. On the graph of the rate of formation of a spatial vector loop, 2 peaks are recorded with a decrease in the rate in the final part of the QRS loop by 2–2.5 times relative to the first peak, which reflects a slowdown in myocardial excitation in the output section of the left ventricle.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136160872","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}
引用次数: 2
Method of dynamic one-stage Dopplerography of coronary and cerebral blood flow with analysis of efficiency of antler balneotherapy in patients with arterial hypertension 动态一期冠状动脉和脑血流多普勒成像方法及鹿角按摩治疗高血压的疗效分析
Pub Date : 2023-10-28 DOI: 10.33667/2078-5631-2023-15-36-40
V. A. Avkhimenko, A. B. Trivozhenko, O. V. Grebenyuk
Integration of highly sensitive Doppler methods of assessment of coronary and cerebral blood circulation into process of functional and diagnostic audit of results of recovery treatment of patients with an arterial hypertension allows to estimate positive tendencies at normalization of processes regional perfusion. Use of the designated technologies showed reliable decrease in peak velocity in middle cerebra artery without increase in vascular resistance at the persons which passed a therapeutic course of antler reindeer breeding. Peak velocity in an middle cerebra artery before the designated treatment was within 92–115 cm/ c (Me 105 [96,3–104,5]), after the therapeutic procedures was registered in a big way 78–98 cm / c (Me 90 [82,4–94,3]). The designated phenomenon indicated improvement of regional cerebral oxygenation and natural reduction of volume of brain perfusion. At the same time, Doppler parameters in coronary arteries at the patients who completed the analyzed course of recovery treatment were transformed minimum, without reliable distinctions that presumably.
将高灵敏度的多普勒冠状动脉和脑血循环评估方法整合到动脉高血压患者恢复治疗结果的功能和诊断审计过程中,可以在过程区域灌注正常化时估计出积极倾向。使用指定的技术,在经过鹿角驯鹿饲养治疗过程的人的大脑中动脉峰值速度下降而血管阻力不增加。在指定治疗前,大脑中动脉的峰值流速在92-115 cm/ c (me105[96,3 - 104,5]),在治疗过程中大幅度登记后,峰值流速在78-98 cm/ c (me90[82,4 - 94,3])。该现象提示局部脑氧合改善,脑灌注量自然减少。同时,完成康复治疗分析过程的患者冠状动脉多普勒参数变化最小,没有可靠的区别。
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引用次数: 0
Advance Thermography diagnostics: automatic algorithm to find out acute sinusitis 先进的热成像诊断:自动算法发现急性鼻窦炎
Pub Date : 2023-10-28 DOI: 10.33667/2078-5631-2023-15-49-58
I. M. Dolgov, Yu. V. Karamyshev, I. S. Zheleznyak, A. A. Karamysheva, A. I. Makhnovsky, D. N. Khriupkovskiy
Development of medical imaging techniques (including medical thermography) provided an opportunity to mine data that can be explored for the development of clinical decision support systems. Aim. Find out quantitative thermography criteria for acute rhinosinusitis and implement these criteria into automated analysis protocols to create a diagnostic complex suitable for use by professionals of any medical speciality. Material, methods. After necessary adaptation, facial thermography by mean of thermography camera ТВС300-меd LLC “СТК СИЛАР” Russia, (384x288 pixel, 30 mK) was performed in 100 healthy volunteers and 305 patients with suspected acute rhinosinusitis (in 173 of them diagnosis was supported). Resulted thermograms were processed in “cloud service” TVision (LLC “Dignosys”, Russia). Point and regions of interest (ROI), namely, point in the middle of the line, connected inner edge of eyebrows (Тср) and ROI, covered the projections of maxillary sinuses were marked automatically. Difference between temperature in Тср point and mean temperature in each ROI (ΔТr/ΔТl), as well as mean temperature between ROI were calculated (ΔTпаз). Result. The best results ( sensitivity 82%, specificity 74%, accuracy 78%) were received when complex of ΔТr/ΔТl ≤0 and module |ΔTпаз| ≥0,5°C (both or at least one criterion) was applied. Based on these data, automatic algorithm of thermography acute rhinosinusitis diagnostics was created to use in primary medical care routine as clinical decision support systems.
医学成像技术(包括医学热成像)的发展为临床决策支持系统的开发提供了挖掘数据的机会。的目标。找出急性鼻窦炎的定量热成像标准,并将这些标准实施到自动分析协议中,以创建适合任何医学专业人员使用的诊断复合体。材料、方法。对100名健康志愿者和305例疑似急性鼻窦炎患者(其中173例诊断得到支持)进行面部热像仪ТВС300-меd LLC“СТК СИЛАР”俄罗斯(384x288像素,30 mK)的调整后进行面部热像仪。生成的热像图在“云服务”TVision (LLC“Dignosys”,Russia)中处理。感兴趣点和感兴趣区域(ROI),即线中间的点,连接眉毛内缘(Тср)和感兴趣区域,覆盖上颌窦的投影被自动标记。计算Тср点温度与各ROI平均温度之差(ΔТr/ΔТl)以及ROI间平均温度之差(ΔTпаз)。结果。当配合物ΔТr/ΔТl≤0,模组|ΔTпаз|≥0,5°C(两种或至少一种标准)时,获得最佳结果(灵敏度82%,特异性74%,准确性78%)。基于这些数据,建立了急性鼻窦炎热成像诊断的自动算法,作为临床决策支持系统用于初级医疗常规。
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引用次数: 0
Role of vaccination against COVID‑19 COVID - 19疫苗接种的作用
Pub Date : 2023-10-28 DOI: 10.33667/2078-5631-2023-18-15-18
L. A. Fomina, M. P. Sorokina
Several vaccines from SARS-COV-2 are used in Russia, which have successfully passed all the stages of testing and showed their effectiveness. Purpose. The study was aimed to clarify the manifestations and course, severity of COVID-19 in SARS-CoV-2 vaccinated and unvaccinated patients. Materials and methods. 62 patients treated in an infectious hospital with a positive test for SARS-CoV-2 were examined. When selecting groups, the pseudorandomization method was used. Clinical symptoms of the disease, anamnesis data, results of pulse oximetry, computed tomography of the chest, clinical blood analysis, transaminase levels and hemostasis indicators were found out in all the examined patients. Results. The study showed that unvaccinated patients were hospitalized in a more serious condition, with significantly more pronounced volume of lung tissue damage and hypoxia. In the group of unvaccinated patients, there was a significantly higher incidence of liver damage and an increased risk of thrombosis. Unvaccinated patients had a significantly lower percentage of comorbid pathologies, and the vaccinated group was dominated by patients Conclusions. Vaccination from coronavirus infection does not exclude the development of the disease, but significantly reduces the frequency of its severe course.
俄罗斯使用了几种SARS-COV-2疫苗,这些疫苗已成功通过所有阶段的测试并显示出其有效性。目的。本研究旨在明确接种和未接种SARS-CoV-2疫苗的患者COVID-19的表现、病程、严重程度。材料和方法。对62名在感染性医院接受SARS-CoV-2检测阳性的患者进行了检查。在选择组时,采用伪随机方法。所有被检查患者的临床症状、记忆资料、脉搏血氧仪、胸部计算机断层扫描结果、临床血液分析、转氨酶水平和止血指标。结果。研究表明,未接种疫苗的患者住院情况更严重,肺组织损伤和缺氧的数量明显更明显。在未接种疫苗的患者组中,肝损伤发生率明显较高,血栓形成风险增加。未接种疫苗的患者共病病理比例明显较低,接种疫苗组以患者为主。预防冠状病毒感染的疫苗并不能排除该病的发展,但可以显著降低其严重病程的频率。
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引用次数: 0
Smoking and alcohol consumption impact on development and distribution of ulcerative colitis in adult patients among West Siberia Region population 吸烟和饮酒对西西伯利亚地区成年患者溃疡性结肠炎的发展和分布的影响
Pub Date : 2023-10-28 DOI: 10.33667/2078-5631-2023-18-19-22
G. R. Bikbavova, M. A. Livzan, D. V. Tikhonravova, T. V. Tretyakova, T. Yu. Panova
Despite the prolonged history of study of ulcerative colitis (UC) its precise aetiology is still unknown. Smoking impact on UC development has been revealed several decades ago and is being discussed due to the exact mechanism of tobacco smoke components to affect colonic mucosa hasn’t been discovered. Alcohol consumption role in UC development isn’t completely understood as well. Researches into the potential risk factors including pernicious habits are of interest as it allows the development of preventive measures and early diagnosis. Objective. To evaluate the correlation between smoking, alcohol consumption and UC development in adult patients among West Siberia region population Material and methods. It has been conducted a case-control study from 2017 to 2022. The case series and matched controls included 157 UC patients and 56 healthy respondents respectively. Information was obtained through a written questionnaire. Results. Ulcerative colitis development odds in patients who quit smoking is 3.8 times higher. Disease debut in 48 % of patients occurred 5 or more years after quitting smoking. Extensive colitis was observed more often in patients with smoking history and left-sided colitis predominated in nonsmoking patients. There's no correlation between smoking history duration and UC distribution. Average amount of wine consumed in controls was almost three times higher than in UC patients. Conclusions. Smoking is not only considered as a trigger that can potentially cause UC regardless the number of cigarettes. Extensive colitis has been observed more often in smoking patients and the ones who quit smoking. Wine consumption up to 20 ml per day may have a protective effect against UC.
尽管溃疡性结肠炎(UC)的研究历史很长,但其确切的病因仍不清楚。吸烟对UC发展的影响在几十年前就被发现了,由于烟草烟雾成分影响结肠粘膜的确切机制尚未被发现,因此一直在讨论中。酒精消费在UC发展中的作用也没有被完全理解。对包括不良习惯在内的潜在危险因素的研究是有意义的,因为它可以制定预防措施和早期诊断。目标。目的:评价西西伯利亚地区成年患者吸烟、饮酒与UC发展的相关性。2017 - 2022年进行病例对照研究。病例系列和匹配对照分别包括157名UC患者和56名健康应答者。信息是通过书面问卷获得的。结果。戒烟者患溃疡性结肠炎的几率是戒烟者的3.8倍。48%的患者首次发病发生在戒烟后5年或更长时间。广泛结肠炎多见于有吸烟史的患者,左侧结肠炎多见于不吸烟的患者。吸烟史持续时间与UC分布无相关性。对照组的平均葡萄酒消费量几乎是UC患者的三倍。结论。吸烟不仅被认为是可能导致UC的诱因,与香烟的数量无关。广泛结肠炎在吸烟患者和戒烟者中更为常见。每天饮用20毫升的葡萄酒可能对UC有保护作用。
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Medicinskij alfavit
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