Pub Date : 2023-11-09DOI: 10.33667/2078-5631-2023-24-94-96
M. S. Petrova
The new coronavirus infection COVID‑19 both by itself and restrictive measures related to the pandemic (prolonged isolation, compliance with sanitary and epidemiological restrictions, etc.) have a pronounced negative impact on the psycho-emotional state of patients. The article presents the results of a study of the initial psychological state of patients who have undergone a new coronavirus infection COVID‑19, justifies the use of various psychocorrective methods in the conditions of patients’ stay in a sanatorium-resort organization.
{"title":"Substantiation for inclusion of psychocorrective methods in comprehensive program of medical rehabilitation of patients who have suffered COVID‑19 in conditions of sanatorium-resort organization","authors":"M. S. Petrova","doi":"10.33667/2078-5631-2023-24-94-96","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-24-94-96","url":null,"abstract":"The new coronavirus infection COVID‑19 both by itself and restrictive measures related to the pandemic (prolonged isolation, compliance with sanitary and epidemiological restrictions, etc.) have a pronounced negative impact on the psycho-emotional state of patients. The article presents the results of a study of the initial psychological state of patients who have undergone a new coronavirus infection COVID‑19, justifies the use of various psychocorrective methods in the conditions of patients’ stay in a sanatorium-resort organization.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":" 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135241551","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 : 2023-11-09DOI: 10.33667/2078-5631-2023-28-13-18
L. S. Oreshko, S. S. Ledentsova, P. V. Seliverstov, S. P. Salikova, E. S. Ivanyuk
The review presents modern ideas about the pathophysiology of the anemia syndrome associated with celiac disease. Brief information is provided about the main proteins involved in iron metabolism and their role in maintaining homeostasis. Attention is paid to the multifactorial pathogenetic mechanisms of anemia in celiac disease, the state of the duodenal mucosa and ultrastructural changes in the villi of enterocytes with signs of atrophy, which play a key role in the regulation of iron absorption, and also provides information on the mechanisms of the development of functional iron deficiency and its role in the pathogenesis of anemia of chronic diseases.
{"title":"Pathophysiology of anemic syndrome in celiac disease and its therapeutic treatment","authors":"L. S. Oreshko, S. S. Ledentsova, P. V. Seliverstov, S. P. Salikova, E. S. Ivanyuk","doi":"10.33667/2078-5631-2023-28-13-18","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-28-13-18","url":null,"abstract":"The review presents modern ideas about the pathophysiology of the anemia syndrome associated with celiac disease. Brief information is provided about the main proteins involved in iron metabolism and their role in maintaining homeostasis. Attention is paid to the multifactorial pathogenetic mechanisms of anemia in celiac disease, the state of the duodenal mucosa and ultrastructural changes in the villi of enterocytes with signs of atrophy, which play a key role in the regulation of iron absorption, and also provides information on the mechanisms of the development of functional iron deficiency and its role in the pathogenesis of anemia of chronic diseases.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":" 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135242652","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 : 2023-11-09DOI: 10.33667/2078-5631-2023-24-71-73
A. P. Nogerov, L. S. Kruglova, A. G. Stenko, N. E. Manturova
Many methods of therapy for GR are currently insufficiently studied in terms of a high evidence base, and the data are contradictory, which determinesthe relevance of research aimed at developing and studying the effectiveness and safety of new methods that can influence the main links in thepathogenesis of pathological scars. The aim of our study was to scientifically substantiate and develop a combined method of therapy for patients withsevere hypertrophic scars lasting up to 1 year using a neodymium laser and pneumokinetic therapy with 5-fluorouracil and durant corticosteroid basedon a study of hemodynamic processes. The study group included 34 patients with hypertrophic scars who underwent two procedures of pneumokinetictherapy with GCS and 5-FU, with an interval of two months. After another one month, laser therapy with a neodymium laser (1064nm) was performed.The results of the LDF study confirmed the early results obtained on the initial changes in the microcirculatory bed in hypertrophic scars, as well as dataon the high efficiency of the developed method of pneumokinetic therapy of GCS + 5-FU and the sequential use of a neodymium laser (1064 nm).
{"title":"Innovative complex method of therapy of hypertrophic skin scars","authors":"A. P. Nogerov, L. S. Kruglova, A. G. Stenko, N. E. Manturova","doi":"10.33667/2078-5631-2023-24-71-73","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-24-71-73","url":null,"abstract":"Many methods of therapy for GR are currently insufficiently studied in terms of a high evidence base, and the data are contradictory, which determinesthe relevance of research aimed at developing and studying the effectiveness and safety of new methods that can influence the main links in thepathogenesis of pathological scars. The aim of our study was to scientifically substantiate and develop a combined method of therapy for patients withsevere hypertrophic scars lasting up to 1 year using a neodymium laser and pneumokinetic therapy with 5-fluorouracil and durant corticosteroid basedon a study of hemodynamic processes. The study group included 34 patients with hypertrophic scars who underwent two procedures of pneumokinetictherapy with GCS and 5-FU, with an interval of two months. After another one month, laser therapy with a neodymium laser (1064nm) was performed.The results of the LDF study confirmed the early results obtained on the initial changes in the microcirculatory bed in hypertrophic scars, as well as dataon the high efficiency of the developed method of pneumokinetic therapy of GCS + 5-FU and the sequential use of a neodymium laser (1064 nm).","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":" 21","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135241006","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 : 2023-11-09DOI: 10.33667/2078-5631-2023-24-97-102
A. A. Vasilkova, S. E. Nazaryan, A. S. Reshkovich
The purpose of the study. To identify gender differences in the dynamics of the development of professionally significant skills during sports activities. Results. Male judoists demonstrate greater speed and accuracy of their own movements, and also improve this skill faster than female judoists. It was also revealed that the development of the ability to anticipate the opponent’s movements proceeds more slowly (over the year, the value of the indicator in the group of men improved by 1.59 times, p < 0.05) than the development of the accuracy of perception of their own movements, which is noticeable after six months of training.
{"title":"Analysis of dynamics of professionally significant qualities development during athletic activities in case of male and female judoists","authors":"A. A. Vasilkova, S. E. Nazaryan, A. S. Reshkovich","doi":"10.33667/2078-5631-2023-24-97-102","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-24-97-102","url":null,"abstract":"The purpose of the study. To identify gender differences in the dynamics of the development of professionally significant skills during sports activities. Results. Male judoists demonstrate greater speed and accuracy of their own movements, and also improve this skill faster than female judoists. It was also revealed that the development of the ability to anticipate the opponent’s movements proceeds more slowly (over the year, the value of the indicator in the group of men improved by 1.59 times, p < 0.05) than the development of the accuracy of perception of their own movements, which is noticeable after six months of training.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":" 15","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135192780","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 : 2023-11-09DOI: 10.33667/2078-5631-2023-28-7-12
E. S. Ivanyuk, P. V. Seliverstov, S. P. Salikova, V. P. Kutsenko
Today, constipation is one of the most important medical and social problems of world health. Its prevalence, according to various estimates, exceeds 30%. There is no doubt that this pathology precedes the occurrence of a number of diseases and not only of the gastrointestinal tract. For example, studies conducted at La Trobe University in Australia have shown a link between chronic constipation and the development of cardiovascular diseases. In the management of a patient suffering from chronic constipation, in addition to knowledge about the regulation of intestinal secretion and motility, recognition and possible elimination of the cause of its development, the choice of therapy tactics, taking into account concomitant diseases, especially in the presence of pathology from the cardiovascular system, is of great importance. In the treatment regimens, it is customary to use drugs with a laxative effect and different mechanisms of their action, allowing achieving a rapid positive effect in a short time.
{"title":"Role of chronic constipation in development of cardiovascular pathology","authors":"E. S. Ivanyuk, P. V. Seliverstov, S. P. Salikova, V. P. Kutsenko","doi":"10.33667/2078-5631-2023-28-7-12","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-28-7-12","url":null,"abstract":"Today, constipation is one of the most important medical and social problems of world health. Its prevalence, according to various estimates, exceeds 30%. There is no doubt that this pathology precedes the occurrence of a number of diseases and not only of the gastrointestinal tract. For example, studies conducted at La Trobe University in Australia have shown a link between chronic constipation and the development of cardiovascular diseases. In the management of a patient suffering from chronic constipation, in addition to knowledge about the regulation of intestinal secretion and motility, recognition and possible elimination of the cause of its development, the choice of therapy tactics, taking into account concomitant diseases, especially in the presence of pathology from the cardiovascular system, is of great importance. In the treatment regimens, it is customary to use drugs with a laxative effect and different mechanisms of their action, allowing achieving a rapid positive effect in a short time.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":" 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135286569","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 : 2023-11-09DOI: 10.33667/2078-5631-2023-24-84-89
A. A. Khotko, N. N. Murashkin
Purpose of the study. To establish patterns of changes in the duration of the remission period in patients suffering from severe psoriasis after discontinuation of targeted therapy. Materials and methods. The work was carried out in the design of an open randomized interventional prospective study and was carried out in two successive stages. To calculate indicators of the expected duration of the remission period, Kaplan – Meier ‘survival’ analysis was used with the construction of ‘survival’ tables and curves assessing the significance of differences using the Mantel – Cox log-rank test. Significant factors presumably influencing the increase in the cumulative risk of relapse were determined by multivariate Cox regression. Results. The longest period of remission was typical for patients who were prescribed systemic therapy with guselkumab – 33.5 weeks, the second longest period of remission was ustekinumab – 29.1 weeks, the third – secukinumab – 24.7 weeks. The average duration of remission after discontinuation of adalimumab used for a year was 17.4 weeks. The worst disease-free period was recorded for apremilast – 6.9 weeks (p < 0.001 for all comparisons). Significant predictors of early onset of psoriasis relapse were the following factors: the presence of a family history, failure to achieve the PASI 75 indicator by the 16th week of treatment, delayed prescription of targeted therapy (more than 3 years after the diagnosis of ‘severe psoriasis vulgaris’), high values of the PASI index at the time of initiation of systemic therapy and long duration of illness. Conclusions. Resumption of systemic treatment was required in 25.8 %, 35.3 %, and 12.1 % of patients within the first 6 months after discontinuation of ustekinumab, secukinumab, and guselkumab, respectively. When patients received adalimumab, re-prescription of targeted therapy was required in 33.3 % of cases 4 months after discontinuation, and when prescribed apremilast – in 64.5 % of cases already 2 months after discontinuation. Among all systemic drugs examined, the IL‑23 inhibitor (guselkumab) was associated with the longest period of psoriasis remission after discontinuation of targeted treatment. The identified predictors of early disease relapse indicate the importance of personalized targeted therapy and open up the possibility of prognostic assessment of the expected duration of the disease-free period after discontinuation of systemic treatment.
{"title":"Analysis of duration of remission of psoriasis after discontinuation of targeted therapy: Search for predictors of early relapse of disease","authors":"A. A. Khotko, N. N. Murashkin","doi":"10.33667/2078-5631-2023-24-84-89","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-24-84-89","url":null,"abstract":"Purpose of the study. To establish patterns of changes in the duration of the remission period in patients suffering from severe psoriasis after discontinuation of targeted therapy. Materials and methods. The work was carried out in the design of an open randomized interventional prospective study and was carried out in two successive stages. To calculate indicators of the expected duration of the remission period, Kaplan – Meier ‘survival’ analysis was used with the construction of ‘survival’ tables and curves assessing the significance of differences using the Mantel – Cox log-rank test. Significant factors presumably influencing the increase in the cumulative risk of relapse were determined by multivariate Cox regression. Results. The longest period of remission was typical for patients who were prescribed systemic therapy with guselkumab – 33.5 weeks, the second longest period of remission was ustekinumab – 29.1 weeks, the third – secukinumab – 24.7 weeks. The average duration of remission after discontinuation of adalimumab used for a year was 17.4 weeks. The worst disease-free period was recorded for apremilast – 6.9 weeks (p < 0.001 for all comparisons). Significant predictors of early onset of psoriasis relapse were the following factors: the presence of a family history, failure to achieve the PASI 75 indicator by the 16th week of treatment, delayed prescription of targeted therapy (more than 3 years after the diagnosis of ‘severe psoriasis vulgaris’), high values of the PASI index at the time of initiation of systemic therapy and long duration of illness. Conclusions. Resumption of systemic treatment was required in 25.8 %, 35.3 %, and 12.1 % of patients within the first 6 months after discontinuation of ustekinumab, secukinumab, and guselkumab, respectively. When patients received adalimumab, re-prescription of targeted therapy was required in 33.3 % of cases 4 months after discontinuation, and when prescribed apremilast – in 64.5 % of cases already 2 months after discontinuation. Among all systemic drugs examined, the IL‑23 inhibitor (guselkumab) was associated with the longest period of psoriasis remission after discontinuation of targeted treatment. The identified predictors of early disease relapse indicate the importance of personalized targeted therapy and open up the possibility of prognostic assessment of the expected duration of the disease-free period after discontinuation of systemic treatment.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":" 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135240860","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 : 2023-11-09DOI: 10.33667/2078-5631-2023-28-29-32
V. A. Akhmedov
The obesity epidemic in the world is accompanied by a significant increase in the number of cases of non-alcoholic fatty liver disease (NAFLD). One of the directions is bariatric surgery. The review article presents an analysis of the short-term and long-term effectiveness of the use of bariatric surgery methods in patients with NAFLD. Aspects of the influence of bariatric surgery on biochemical and histological parameters of liver fibrosis, changes in insulin resistance and lipid profile, intestinal microbiome involved in the homeostasis of the intestine-liver axis are noted. The role of gene polymorphisms in the progression of NAFLD, as well as protection from fibrotic changes in patients with postoperative period is presented.
{"title":"Prospects of bariatric surgery in management of patients with non-alcoholic fatty liver disease","authors":"V. A. Akhmedov","doi":"10.33667/2078-5631-2023-28-29-32","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-28-29-32","url":null,"abstract":"The obesity epidemic in the world is accompanied by a significant increase in the number of cases of non-alcoholic fatty liver disease (NAFLD). One of the directions is bariatric surgery. The review article presents an analysis of the short-term and long-term effectiveness of the use of bariatric surgery methods in patients with NAFLD. Aspects of the influence of bariatric surgery on biochemical and histological parameters of liver fibrosis, changes in insulin resistance and lipid profile, intestinal microbiome involved in the homeostasis of the intestine-liver axis are noted. The role of gene polymorphisms in the progression of NAFLD, as well as protection from fibrotic changes in patients with postoperative period is presented.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":" 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135242977","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 : 2023-11-09DOI: 10.33667/2078-5631-2023-24-90-93
A. V. Tamrazova, A. B. Yakovlev, P. I. Fedina
Green nail syndrome is a bacterial nail disease caused by Pseudomonas aeruginosa, which is characterized by discoloration of the nail plate, onycholysis and proximal paronychia. Despite the prevalence of the pathology and the increase in incidence, today there are no clinical recommendations for the management of patients with chloronychia. This article discusses the etiology, pathogenesis, risk factors, and therapeutic options for managing these patients.
{"title":"Green nail syndrome caused by Pseudomonas aeruginosa (literature review)","authors":"A. V. Tamrazova, A. B. Yakovlev, P. I. Fedina","doi":"10.33667/2078-5631-2023-24-90-93","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-24-90-93","url":null,"abstract":"Green nail syndrome is a bacterial nail disease caused by Pseudomonas aeruginosa, which is characterized by discoloration of the nail plate, onycholysis and proximal paronychia. Despite the prevalence of the pathology and the increase in incidence, today there are no clinical recommendations for the management of patients with chloronychia. This article discusses the etiology, pathogenesis, risk factors, and therapeutic options for managing these patients.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":" 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135192784","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 : 2023-11-09DOI: 10.33667/2078-5631-2023-28-37-43
A. V. Borsukov, D. Yu. Venidiktova, A. D. Smirnova, M. A. Yakusheva
Objective . Evaluation of a single vector of ultrasound assessment of changes in the liver parenchyma, taking into account the correct use of such physical concepts as stiffness, elasticity, elasticity, density. Material and methods . On the basis of the Problem Research Laboratory ‘Diagnostic Research and Minimally Invasive Technologies’ a study was conducted with the participation of 112 patients of a multidisciplinary hospital. Multiparametric ultrasound examination (B-mode, quantitative liver steatometry, 2D shear wave elastography, complex format ‘liver protocol’) was performed by ultrasound doctors (n = 24) of the following groups: half-a-year residents in the specialty ‘ultrasound diagnostics’ (n = 9; 37.6%), doctors working in a multidisciplinary hospital of a medical organization of the regional center with work experience up to 5 years (n = 4; 16.6%), 6–10 years (n = 4; 16.6%), 11–20 years old (n = 3; 12.6%), 21 years or more (n = 4; 16.6%), of which 1 (4.2%) professor, 1 (4.2%) doctor of medical sciences, 3 (12.5%) candidates of medical sciences. An analysis of the protocols of ultrasound examination was carried out. Results. The correct description of changes in the liver according to B-mode data, quantitative steatometry, 2D shear wave elastography and ‘liver protocol’ correct formulations were given by 9 (37.5%) specialists. In all cases, most of the correct protocols were provided by doctors from groups of 6–10 years of experience and 21 years of experience or more. Conclusions . In the community of specialists in ultrasound diagnostics there is no agreement on a correct and unified approach to the description of diffuse liver changes using multiparametric ultrasound. To increase the level of knowledge, complex multidisciplinary interaction is necessary in the format of scientific and educational programs organized jointly with specialists in the field of medical physics.
{"title":"Stiffness, elasticity, resilience, density as clinical interpretation of physical properties of liver tissue","authors":"A. V. Borsukov, D. Yu. Venidiktova, A. D. Smirnova, M. A. Yakusheva","doi":"10.33667/2078-5631-2023-28-37-43","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-28-37-43","url":null,"abstract":"Objective . Evaluation of a single vector of ultrasound assessment of changes in the liver parenchyma, taking into account the correct use of such physical concepts as stiffness, elasticity, elasticity, density. Material and methods . On the basis of the Problem Research Laboratory ‘Diagnostic Research and Minimally Invasive Technologies’ a study was conducted with the participation of 112 patients of a multidisciplinary hospital. Multiparametric ultrasound examination (B-mode, quantitative liver steatometry, 2D shear wave elastography, complex format ‘liver protocol’) was performed by ultrasound doctors (n = 24) of the following groups: half-a-year residents in the specialty ‘ultrasound diagnostics’ (n = 9; 37.6%), doctors working in a multidisciplinary hospital of a medical organization of the regional center with work experience up to 5 years (n = 4; 16.6%), 6–10 years (n = 4; 16.6%), 11–20 years old (n = 3; 12.6%), 21 years or more (n = 4; 16.6%), of which 1 (4.2%) professor, 1 (4.2%) doctor of medical sciences, 3 (12.5%) candidates of medical sciences. An analysis of the protocols of ultrasound examination was carried out. Results. The correct description of changes in the liver according to B-mode data, quantitative steatometry, 2D shear wave elastography and ‘liver protocol’ correct formulations were given by 9 (37.5%) specialists. In all cases, most of the correct protocols were provided by doctors from groups of 6–10 years of experience and 21 years of experience or more. Conclusions . In the community of specialists in ultrasound diagnostics there is no agreement on a correct and unified approach to the description of diffuse liver changes using multiparametric ultrasound. To increase the level of knowledge, complex multidisciplinary interaction is necessary in the format of scientific and educational programs organized jointly with specialists in the field of medical physics.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":" 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135285716","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 : 2023-11-09DOI: 10.33667/2078-5631-2023-28-19-22
S. N. Styazhkina, T. R. Spiridonov, E. D. Novikova, T. O. Eltsov
The most frequent complication of endoscopic papillosphincterotomy (EPST) is acute pancreatitis. This complication is supposed to be based on mechanical, chemical, hydrostatic, enzymatic and thermal impact on pancreatic ducts and parenchyma. According to different literature data, the incidence of post-EPST pancreatitis (PEP) varies from 30 to 40%, and the mortality rate is 2–10%. The aim of the investigation was to expand information about peculiarities of early diagnostics and prevention of post-EST pancreatitis at the present stage. To reach the set goal we analyzed 559 case histories of patients with diagnosed cholelithiasis, 319 of them underwent EPST. During the study it was found out, that elevated neutrophils/ lymphocytes ratio over 4.96 (p = 0.001), high LDH level over 250 IU/ml (p = 0,010), as well as C-reactive to albumin index over 0,180 (p = 0.001) are reliable markers of early diagnosis. Also, indirect diagnostic markers of PEEP are biochemical signs of cholestasis and cytolysis of hepatocytes, as well as hyperglycemia combined with glucosuria. We consider the inclusion of intraoperative injections of papillotomy wound margins with epinephrine in combination with subsequent Somatostatin administration in combination with rectal diclofenac and intravenous hydration with Reamberin to be the most effective strategy for PEP prevention. Thus, we can conclude that despite the ongoing research and the search for effective algorithms for the prevention and early diagnosis of PEP, their data often contradict each other or simply do not confirm their effectiveness. The problem of prevention and diagnosis of PEP remains complex and requires further study. There are discrepancies, sometimes significant ones, in the current literature, which provides grounds for the development and research of new methods of early diagnosis and prevention.
{"title":"Peculiarities of pharmacological prevention strategy of pancreatic complications after endoscopic papillosphincterotomy for choledocholithiasis","authors":"S. N. Styazhkina, T. R. Spiridonov, E. D. Novikova, T. O. Eltsov","doi":"10.33667/2078-5631-2023-28-19-22","DOIUrl":"https://doi.org/10.33667/2078-5631-2023-28-19-22","url":null,"abstract":"The most frequent complication of endoscopic papillosphincterotomy (EPST) is acute pancreatitis. This complication is supposed to be based on mechanical, chemical, hydrostatic, enzymatic and thermal impact on pancreatic ducts and parenchyma. According to different literature data, the incidence of post-EPST pancreatitis (PEP) varies from 30 to 40%, and the mortality rate is 2–10%. The aim of the investigation was to expand information about peculiarities of early diagnostics and prevention of post-EST pancreatitis at the present stage. To reach the set goal we analyzed 559 case histories of patients with diagnosed cholelithiasis, 319 of them underwent EPST. During the study it was found out, that elevated neutrophils/ lymphocytes ratio over 4.96 (p = 0.001), high LDH level over 250 IU/ml (p = 0,010), as well as C-reactive to albumin index over 0,180 (p = 0.001) are reliable markers of early diagnosis. Also, indirect diagnostic markers of PEEP are biochemical signs of cholestasis and cytolysis of hepatocytes, as well as hyperglycemia combined with glucosuria. We consider the inclusion of intraoperative injections of papillotomy wound margins with epinephrine in combination with subsequent Somatostatin administration in combination with rectal diclofenac and intravenous hydration with Reamberin to be the most effective strategy for PEP prevention. Thus, we can conclude that despite the ongoing research and the search for effective algorithms for the prevention and early diagnosis of PEP, their data often contradict each other or simply do not confirm their effectiveness. The problem of prevention and diagnosis of PEP remains complex and requires further study. There are discrepancies, sometimes significant ones, in the current literature, which provides grounds for the development and research of new methods of early diagnosis and prevention.","PeriodicalId":499576,"journal":{"name":"Medicinskij alfavit","volume":" 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135285723","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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