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Spontaneous hematomas in hospital patients with new coronavirus infection 新型冠状病毒感染住院患者自发性血肿的研究
Pub Date : 2023-01-01 DOI: 10.32000/2072-1757-2023-3-82-87
M. Plotnikov, A. V. Maksimov, A. Teregulov, R. M. Mullakhmetov
Treatment of the new coronavirus infection (NCVI) is associated with high risks of hemorrhagic complications. This is due to the use of anticoagulants to prevent coagulopathy and thrombotic complications, which are the most frequent and severe complications of NCVI. The article presents the results of a retrospective analysis of 80 cases of spontaneous hematomas in patients with NCVI who were treated in a temporary infectious diseases hospital of the Republic of Clinical Hospital. Verification of the diagnosis was carried out using clinical data, ultrasound diagnostics, and computed tomography. The mean age of the patients was 62.4 ± 14.47 years. The most common localizations of spontaneous hematoma were: abdominal wall — 31.3%, retroperitoneal hematoma — 26.3%, chest hematoma — 16.3%, lower or upper limb — 8.8%, neck — 3.8%, combined hematomas — 5%. The number of small hematomas was 87.5%, large – 12.5%. The highest incidence of spontaneous hematomas (74%) and mortality (22%) was recorded in the group of patients receiving therapeutic doses of anticoagulants. X-ray endovascular diagnosis of the source of bleeding and its embolization was performed in 15 patients. The use of therapeutic doses in patients with NCVI is accompanied by a high risk of developing spontaneous hematomas and, as a result, increases the risk of death. X-ray endovascular embolization of spontaneous hematomas is an effective and safe method of treatment in patients with NCVI.
新型冠状病毒感染的治疗与出血性并发症的高风险相关。这是由于使用抗凝剂来预防凝血功能障碍和血栓形成并发症,这是最常见和最严重的NCVI并发症。本文对在中华人民共和国临床医院临时传染病医院收治的80例非传染性vi患者自发性血肿进行回顾性分析。通过临床资料、超声诊断和计算机断层扫描对诊断进行验证。患者平均年龄62.4±14.47岁。自发性血肿最常见的部位为:腹壁- 31.3%,腹膜后血肿- 26.3%,胸部血肿- 16.3%,下肢或上肢- 8.8%,颈部- 3.8%,合并血肿- 5%。小血肿占87.5%,大血肿占12.5%。接受治疗剂量抗凝剂的患者自发性血肿发生率最高(74%),死亡率最高(22%)。对15例患者行血管内x线诊断出血源及栓塞术。在NCVI患者中使用治疗剂量时,发生自发性血肿的风险很高,因此增加了死亡风险。自发性血肿的x线血管内栓塞治疗是一种安全有效的治疗方法。
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引用次数: 0
To the 200th anniversary of teaching Pediatrics and to the 90th anniversary of Pediatric Faculty of Kazan State Medical University. Contribution of Kazan scientists to the development of Russian pediatrics 为喀山国立医科大学儿科学建校200周年和儿科学院建校90周年,喀山科学家对俄罗斯儿科发展的贡献
Pub Date : 2023-01-01 DOI: 10.32000/2072-1757-2023-1-105-110
S. Malcev, O. I. Pikuza, E. Generalova, F. Rizvanova
The study of the history of Russian pediatrics development contributes, on the one hand, to the preservation of continuity and traditions, and on the other hand, serves as a foundation for further study of topical problems of pediatrics. The purpose — to analyze the contribution of Kazan scientists to the development of Russian pediatrics. Material and methods. A review of periodic and monographic literature was carried out. Results. The article presents information about the contribution of Kazan scientists to the development of Russian pediatrics. The development of the Kazan school of pediatricians and pediatric infectologists is consistently traced — from the birth of the pediatric school in Kazan in the 19th century to the present time. The contribution of outstanding representatives of the Kazan school to the national pediatrics is described, and the continuity between pediatricians of different generations is also noted. Conclusion. The research of Kazan scientists has always corresponded to the most pressing problems of pediatrics and was designed to solve them.
俄罗斯儿科学发展史的研究,一方面有助于保持连续性和传统,另一方面,作为儿科学专题问题进一步研究的基础。目的-分析喀山科学家对俄罗斯儿科发展的贡献。材料和方法。对定期文献和专题文献进行了回顾。结果。文章介绍了喀山科学家对俄罗斯儿科发展的贡献。从19世纪喀山儿科学校的诞生到现在,喀山儿科医生和儿科感染学家学校的发展一直被追踪。描述了喀山学派杰出代表对全国儿科的贡献,并注意到不同世代的儿科医生之间的连续性。结论。喀山科学家的研究总是与儿科最紧迫的问题相对应,并旨在解决这些问题。
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引用次数: 0
Clinical and instrumental diagnostics of early changes in the atlantoaxial area in ankylosing spondylitis 强直性脊柱炎寰枢区早期病变的临床和仪器诊断
Pub Date : 2023-01-01 DOI: 10.32000/2072-1757-2023-3-68-73
A. Garaeva, S. Lapshina, V. Anisimov, R. Abdrakipov, E. Sukhorukova, Z. Gabdullina, E. S. Zamanova, D. Abdulganieva, E. Bogdanov
The purpose — to assess the early imaging changes in the atlantoaxial area and to compare them with clinical and laboratory characteristics in patients with ankylosing spondylitis (AS). Material and methods. 20 patients with AS were examined, the average age is 44.2 ± 12.66 y. o. Activity (ASDAS(CRP)): very high — 85%, high — 5%, low — 10%. X-ray stage of sacroiliitis: 2 — 60%, 3 — 15%, 4 — 25%. Functional deficiency (FD): 3 — 55%, 2 — 20%, 1 — 25%. The duration of illness was 176 [2; 360] months. The extended clinical examination included: assessment of neurological status, presence of components of neuropathic pain (NP) and central sensitization (CS), assessment of quality of life, degree of functional disorders. Magnetic resonance imaging (MRI) of the craniovertebral junction was performed with the measurement of 5 craniometric parameters (CMP) for the presence of translocation of the dens axis. Results. Neck pain syndrome — 75%: inflammatory — 95%, non-inflammatory — 80% (NP — 65%, CS — 50%). VAS: 5.75 ± 2.09. FD: BASMI — 3.86 [2; 7], BASFI — 4,84 [0,7; 8,7]. 75% — limitation of neck rotation, 65% — increase in the distance of the trestle-wall. CMP: 100% — decrease in the retroflex angle, 20% — increase in the anterior atlantodental index, 15% — translocation relative to the Chamberlain line, 10% increase in pB-C2, 5% — decrease in the posterior atlantodental index. A correlation was revealed between the CMP with the X-ray stage (rSp = 0.629; p = 0.021), BASMI (rSp = 0.575; p = 0.04) and the psychological component SF-36 (rSp = 0.570; p = 0.042). The angle of retroflexion with the duration of the disease (rSp = -0.580; p = 0.038), CRP (rSp = 0.624; p = 0.023). Conclusions. All patients with AS had pathological MRI changes in the form of initial manifestations of translocation of the dens, which had nonspecific clinical manifestations. Changes in craniovertebral transition to MRI did not correlate with disease activity (ASDAS (CRP)), but were associated with the level of CRP, duration of the disease, X-ray stage of sacroiliitis and functional indices (BASMI).
目的:评估强直性脊柱炎(AS)患者寰枢椎区的早期影像学变化,并将其与临床和实验室特征进行比较。材料和方法。20例AS患者,平均年龄44.2±12.66岁。ASDAS(CRP):非常高- 85%,高- 5%,低- 10%。骶髂炎x线分期:2 ~ 60%,3 ~ 15%,4 ~ 25%。功能缺陷(FD): 3 - 55%, 2 - 20%, 1 - 25%。病程176 [2];360个月。扩展临床检查包括:神经状态评估,神经性疼痛成分(NP)和中枢致敏(CS)的存在,生活质量评估,功能障碍程度。对颅椎交界处进行磁共振成像(MRI),测量5个颅侧参数(CMP),以确定齿轴移位的存在。结果。颈痛综合征- 75%:炎性- 95%,非炎性- 80% (NP - 65%, CS - 50%)。Vas: 5.75±2.09。Fd: basmi - 3.86 [2;[7], basfi - 4,84 [0,7;8、7]。75% -限制颈部旋转,65% -增加支架墙的距离。CMP: 100% -旋回角减少,20% -前寰牙指数增加,15% -相对于Chamberlain线易位,pB-C2增加10%,后寰牙指数减少5%。CMP与x线分期呈正相关(rSp = 0.629;p = 0.021), BASMI (rSp = 0.575;p = 0.04),心理成分SF-36 (rSp = 0.570;P = 0.042)。后屈角度随病程的延长(rSp = -0.580;p = 0.038), CRP (rSp = 0.624;P = 0.023)。结论。所有AS患者的MRI病理改变均以牙齿移位为首发表现,无特异性临床表现。颅椎转移到MRI的变化与疾病活动性(ASDAS (CRP))无关,但与CRP水平、疾病持续时间、骶髂炎x线分期和功能指数(BASMI)相关。
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引用次数: 0
Treating diaphyseal fracture of shin bones in children and adolescents 儿童及青少年胫骨骨干骨折的治疗
Pub Date : 2023-01-01 DOI: 10.32000/2072-1757-2023-3-36-40
P. Andreyev, A. Skvortsov, I. Tsoy, R. F. Khasanov
The report is based on the study of the results of treatment of 102 patients with diaphyseal fractures of shin bones [DFSB], aged 4–17 y. o., treated in the children’s Department of Traumatology and Orthopedics of Children’s Republic Clinical Hospital of the Republic of Tatarstan. In 18 patients with stable fractures of shin bones, the fracture was repositioned and fixed with a plaster cast. 31 patients with unstable fractures underwent bypass polysynostosis after a closed manual reposition of a fracture of shin bones with a plaster cast. Osteosynthesis with elastic nails (TEN) was performed in 32 patients after closed reposition. 21 patients were treated with extra-focal transosseous osteosynthesis. The authors developed an algorithm for the treatment of patients with shin bones fractures in children and adolescents.
该报告基于对在鞑靼斯坦共和国儿童共和国临床医院创伤和矫形科治疗的102名4-17岁胫骨干骺端骨折患者的治疗结果的研究。在18例胫骨稳定骨折患者中,骨折复位并用石膏石膏固定。31例不稳定骨折患者在胫骨骨折用石膏石膏封闭复位后行旁路多缝术。32例患者在闭式复位后行弹性钉(TEN)固定。21例患者行局外经骨骨融合术。作者开发了一种治疗儿童和青少年胫骨骨折患者的算法。
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引用次数: 0
On the issue of providing medical assistance to patients with community-acquired pneumonia in rural hospitals of Stavropol Territory 关于在斯塔夫罗波尔地区农村医院向社区获得性肺炎患者提供医疗援助的问题
Pub Date : 2023-01-01 DOI: 10.32000/2072-1757-2023-1-59-62
N. E. Afanasiev, O. Pozdnyakova
A retrospective analysis of medical documentation of 1134 patients with community-acquired pneumonia in round-the-clock hospitals in the Shpakovsky district of Stavropol Territory was carried out. The sensitivity of the main bacterial pathogens of the disease, such as Streptococcus pneumonia, Enterobacteriacea spp., Staphylococcus aureus, Streptococcus spp., Haemophilus influenza, was determined in 65.0% of patients. The search for epidemiologically significant pathogens of the respiratory tract infectious pathology, such as Mycoplasma pneumoniae, Chlamydia pneumoniae, was not carried out during the analyzed period. The wrong choice of starting antibiotic therapy was made in 34% of cases. In half of the hospitalized patients the antibiotic therapy effectiveness was reviewed. Evaluation of the antibacterial therapy results showed a violation of the management tactics in patients with community-acquired pneumonia and its inconsistency with clinical recommendations. The identified problems of therapy in patients with community-acquired pneumonia led to long periods of hospitalization and increased health care costs.
对斯塔夫罗波尔州什帕科夫斯基区24小时医院1134名社区获得性肺炎患者的医疗记录进行了回顾性分析。65.0%的患者对肺炎链球菌、肠杆菌、金黄色葡萄球菌、链球菌、流感嗜血杆菌等主要病原菌的敏感性进行了检测。分析期间未发现具有流行病学意义的呼吸道感染病理病原菌,如肺炎支原体、肺炎衣原体。34%的病例错误地选择了开始抗生素治疗。对半数住院患者的抗生素治疗效果进行了回顾。对社区获得性肺炎患者抗菌治疗结果进行评价,发现抗菌治疗违反了社区获得性肺炎患者的管理策略,与临床建议不一致。社区获得性肺炎患者的治疗问题导致了长时间的住院治疗和医疗费用的增加。
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引用次数: 0
Neurotoxic complications of chemotherapy in children with acute lymphoblastic leukemia 急性淋巴细胞白血病儿童化疗的神经毒性并发症
Pub Date : 2023-01-01 DOI: 10.32000/2072-1757-2023-4-139-142
O. Koryakina, D. S. Cherepanova
Modern therapy of acute lymphoblastic leukemia in children shows high efficiency. However, the outcome of the disease is often determined by the toxicity of chemotherapy drugs. In particular, neurotoxicity, which is characteristic of most anticancer drugs, can lead to severe neurological disorders, which significantly aggravates the course of the underlying disease and determines the formation of disability. The article presents two clinical cases that demonstrate severe chemoinduced neurological disorders in children. In the first case, damage to the central nervous system due to intraventricular administration of methotrexate is described. The second case demonstrates a severe degree of chemoinduced polyneuropathy with vincristine. Both children received the status of a patient in need of palliative care because of the complications received. The presence of such cases in practice dictates the need to develop new diagnostic methods aimed at early detection of neurotoxic complications, as well as to identify groups with high risk of the formation of chemoinduced neurological disorders.
现代治疗儿童急性淋巴细胞白血病疗效显著。然而,这种疾病的结果往往是由化疗药物的毒性决定的。特别是大多数抗癌药物所具有的神经毒性,可导致严重的神经系统疾病,从而显著加重基础疾病的病程,并决定残疾的形成。本文提出了两个临床病例,证明严重的化学诱导的神经系统疾病的儿童。在第一种情况下,损害中枢神经系统由于脑室内施用甲氨蝶呤被描述。第二个病例显示了一个严重程度的化学诱导的多神经病变与长春新碱。由于所接受的并发症,这两个孩子都接受了需要姑息治疗的病人的身份。实践中此类病例的存在表明,需要开发新的诊断方法,旨在早期发现神经毒性并发症,并确定形成化学诱导神经系统疾病的高风险群体。
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引用次数: 0
Role of nailfold capillaroscopy in assessing microvasculature in rheumatic diseases 甲襞毛细血管镜在风湿病微血管评估中的作用
Pub Date : 2023-01-01 DOI: 10.32000/2072-1757-2023-3-40-43
I. F. Fayrushina
Nailfold capillaroscopy (NFC) is a non-invasive and safe tool for microvasculature assessment. Since its recent inclusion to classification criteria for systemic sclerosis (American College of Rheumatology (ACR) / European League Against Rheumatism (EULAR), 2013) and monitoring disease progression, the importance of NFC in rheumatology has increased. Given its growing use by a variety of physicians worldwide, both in daily practice to differentiate primary and secondary Raynaud’s syndrome, and in the context of research to predict the progression of the disease and evaluate the treatment effectiveness, the description of the acquisition and analysis of capillaroscopic images remains relevant. This report provides information on the interpretation of NFC changes, particularly in systemic sclerosis and other rheumatic diseases.
甲襞毛细血管镜检查(NFC)是一种无创、安全的微血管评估工具。自从最近被纳入系统性硬化症的分类标准(美国风湿病学会(ACR) /欧洲抗风湿病联盟(EULAR), 2013年)和监测疾病进展以来,NFC在风湿病学中的重要性有所增加。鉴于其越来越多地被世界各地的各种医生使用,无论是在日常实践中区分原发性和继发性雷诺综合征,还是在预测疾病进展和评估治疗效果的研究背景下,对毛细血管镜图像的获取和分析的描述仍然是相关的。本报告提供了解释NFC变化的信息,特别是在系统性硬化症和其他风湿病中。
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引用次数: 0
Headache in patients with connective tissue dysplasia 结缔组织发育不良患者的头痛
Pub Date : 2023-01-01 DOI: 10.32000/2072-1757-2023-4-41-46
D. Mansurov, D. Khaibullina
Headache in patients with connective tissue dysplasia (CTD) is an urgent problem of modern medicine. The article discusses different types of headache in patients with connective tissue dysplasia. The most well studied are differentiated forms of connective tissue dysplasia (Ehlers — Danlos syndrome, Marfan syndrome, etc.) and, accordingly, variants of cephalgia in them are described. A significant problem is the dissection of the carotid and vertebral arteries, which are variants of acute cerebrovascular accident. The interrelation of primary and secondary headaches with CTD syndrome is shown. The variety of clinical manifestations of headaches and connective tissue dysplasia in the same patient makes it difficult to diagnose, which can contribute to the chronicity of cephalalgia, the appointment of inadequate therapy and the development of complications. Further study of headache options in patients with CTD will improve the provision of medical care to this category of patients.
结缔组织发育不良(CTD)患者的头痛是现代医学亟待解决的问题。本文讨论结缔组织发育不良患者不同类型的头痛。研究最充分的是结缔组织发育不良的分化形式(Ehlers - Danlos综合征,Marfan综合征等),因此,描述了其中的头痛症变异。一个重要的问题是颈动脉和椎动脉的剥离,这是急性脑血管意外的变体。原发性和继发性头痛与CTD综合征的相互关系显示。同一患者的头痛和结缔组织发育不良的临床表现多种多样,难以诊断,这可能导致头痛的慢性,预约治疗不充分和并发症的发生。进一步研究CTD患者的头痛选择将改善对这类患者的医疗服务。
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引用次数: 0
Prospects for using immunostimulating agents with nonspecific antiviral activity in the complex treatment of children with chronic adenoiditis 具有非特异性抗病毒活性的免疫刺激剂在儿童慢性腺样体炎复杂治疗中的应用前景
Pub Date : 2023-01-01 DOI: 10.32000/2072-1757-2023-2-79-84
E. Pokrovskaya, S. V. Khaliullina, V. Krasnozhen, E. Mannanova
The article presents the results of studies on using inosine pranobex in children with pharyngeal tonsils hypertrophy of the 3rd degree after surgical intervention to prevent the development of pharyngeal tonsillitis relapses and compensatory hypertrophy of palatine tonsils in the postoperative period. 355 children aged 3 to 7 years old with a diagnosis of pharyngeal tonsil hypertrophy of the 3rd degree were examined. Laboratory methods of examination included qualitative studies to detect DNA of lymphotropic herpesviruses (EBV, CMV, HHV-6) in flushes from the nasopharyngeal mucosa. As a result of the conducted research, it was revealed that the inclusion of inosine pranobex in the complex treatment of children with chronic adenoiditis with verified herpesvirus infection is clinically effective and helps to reduce the risk of recurrence of pharyngeal tonsil hypertrophy and compensatory palatine tonsil hypertrophy.
本文介绍了肌苷pranobex在手术干预后3度咽扁桃体肥大患儿中预防咽扁桃体炎复发和术后期腭扁桃体代偿性肥大的研究结果。对355名3 ~ 7岁诊断为咽部扁桃体三度肥大的儿童进行了检查。实验室检测方法包括定性检测鼻咽粘膜潮红中嗜淋巴疱疹病毒(EBV、CMV、HHV-6)的DNA。本研究结果表明,肌苷pranobex纳入慢性腺样体炎合并疱疹病毒感染患儿的综合治疗在临床上是有效的,并有助于降低咽扁桃体肥大和代偿性腭扁桃体肥大的复发风险。
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引用次数: 0
Rational and effective pharmacotherapy as an actual opportunity for reducing financial costs. Review of clinical cases 合理有效的药物治疗是降低财务成本的实际机会。临床病例回顾
Pub Date : 2023-01-01 DOI: 10.32000/2072-1757-2023-3-134-137
A. Z. Nigmedzyanova, L. Kulagina, E. R. Kadyseva, R. V. Davletshina
The article presents clinical cases of pharmacotherapy errors; in case of rational approach to prescribing medication therapy, it is possible to reduce financial costs without deteriorating the quality of medical assistance.
本文介绍了药物治疗错误的临床案例;如果采取合理的处方治疗方法,就有可能在不降低医疗援助质量的情况下减少财政费用。
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引用次数: 0
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中国实用医药
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