Saratov JOURNAL of Medical and Scientific Research

diagnostics

Successful treatment of pulmonary tuberculosis in old age (clinical case)

Year: 2020, volume 16 Issue: №1 Pages: 176-180
Heading: Тhematic supplement Article type: Case report
Authors: Morozova T.I., Salina T.Yu., Semenov S.V.
Organization: Regional Hospital for War Veterans, Saratov, Saratov State Medical University
Summary:

Elderly people are a high-risk group for developing tuberculosis, with difficulties in diagnosis and treatment with an uncertain prognosis. We present a clinical case of tuberculosis with a favorable outcome in a patient aged 86 with a large numerous comorbid pathologies, including an organic brain disease with intellectual and behavioral disorders. This clinical observation demonstrates an atypical course of tuberculosis in the elderly, a slow reverse dynamics of the process and a cure with large residual changes in the lungs.

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Some features of pathogenesis of the course, diagnosis and treatment of radicular and myelopathic syndromes of cervical osteochondrosis (review)

Year: 2020, volume 16 Issue: №1 Pages: 64-68
Heading: neurosurgery Article type: Review
Authors: Chekhonatskiy А.А., Komleva N.E., Chekhonatskiy V.A., Bubashvili A.l.
Organization: KSMA — branch of the Russian Medical Academy of Continuous Professional Education, Saratov Scientific Research Institute of Agricultural Hygiene, Saratov State Medical University
Summary:

The review of the literature data on the peculiarities of the pathogenesis of radicular and myelopathic syndromes of cervical osteochondrosis is presented. The issues of differentiated diagnosis of radiculopathic and myelopathic syndromes are considered. The characteristic of various methods of treatment is given. The efficiency and possibility of using electrostimulation of the spinal cord for the treatment of radicular and myelopathic syndromes of cervical osteochondrosis have been studied.

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Evaluation of retinal neuroarchitectonics in presence of optic nerve head drusen

Year: 2019, volume 15 Issue: №2 Pages: 490-494
Heading: Ophtalmology Article type: Review
Authors: Kabanova EA, Ioyleva EE, Zinovyeva AV.
Organization: Moscow State Medical Stomatological University n.a. A. I. Evdokimov, The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:

Purpose: assessment of retinal neuroarchitectonics in presence of optic nerve head (ONH) drusen. Materials and Methods. 108 patients (216 eyes) with bilateral drusen of the optic disc aged 18–60 years were examined, and the control group consisted of 28 healthy subjects. All patients underwent optical coherence tomography (OCT) using Cirrus HD-OCT 5000–7544 device (Carl Zeiss Meditec Inc.). Results. Three types of ONH drusen localization relative to the Bruch membrane were identifed: superfcial, deep and difuse. Difuse localization of the drusen was determined in 48.6 % of cases, deep — in 40.3 %, superfcial — in 11.1 %. Deep optic disc drusen were more common in a young age (35.5±13.1 years), difuse — in medium age (42.0±13.2 years), superfcial — at an older age (51.7±12.8 years). With superfcial and difuse drusen of the optic disc, a signifcant (p<0.05) decrease in the thickness of the ganglion cell (GC) layer in all studied sectors, a decrease in the minimum and average GC thickness was found, as well as a signifcant (p<0.05) decrease in the average thickness and cubic volume of the neuroepithelium. With deep drusen opacities, the changes in GC were less pronounced and statistically insignifcant. Conclusion. analysis of the obtained data showed that deep drusen of the optic disc are the initial stage of congenital pathology, difuse drusen are a developed stage, and superfcial drusen of the optic disc characterize the development of fnal stage.

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Migraine and epilepsy: comorbidity and problems in diagnostics

Year: 2019, volume 15 Issue: №1 Pages: 154-158
Heading: Neurology Article type: Review
Authors: Kalinin V.A., Poverennova I.E., Yakunina A.V., Myakinina A.E.
Organization: Samara State Medical University
Summary:

The purpose of this review is to carry out the analysis of published data on comorbidity of migraine and epilepsy. The review is based on results of epidemiological and genetic studies. Clinical manifestations of two diseases are in many respects similar, which sometimes leads to considerable difficulties in diagnostics. Differential diagnosis is based on careful analysis of clinical manifestations, electroencephalography and neuroimaging data. Genetic forms of epilepsy are often accompanied by migrainous headaches. The unity of some pathophysiological mechanisms of epilepsy and migraine predefines comorbidity and directions of diagnostics and treatment for both diseases. Nevertheless, there is a number of questions which demand more precise answers to improve diagnostics and treatment.

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Characteristics of clinical findings and diagnostics of acute cerebral venous circulation disorder in immediate period following neurosurgical intervention for peripheral lung cancer metastasis into brain

Year: 2019, volume 15 Issue: №1 Pages: 67-71
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Bazhanov S.P., Ulyanov V.Yu., Matveeva O.V., Tolkachev V.S., Shuvalov S.D.
Organization: Saratov State Medical University
Summary:

A rare case of cerebral venous circulation disorder in a female patient with peripheral cancer metastasis of the right lung upper lobe to the area of precentral and postcentral gyri of the left cerebrum hemisphere in the immediate post- surgical period is present. It has been shown that the diagnostics of impaired circulation throuth the superficial cerebral veins is rather complicated due to the lack of clinical symptoms specificity and poor sensitivity of neurovisualization methods.

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The methods of deep periprosthetic infection diagnostics in the area of knee joint

Year: 2018, volume 14 Issue: №3 Pages: 607-610
Heading: Traumatology and Orthopedics Article type: Review
Authors: Shpinyak S.P., Babushkina I.V., Maksyushina T.D., Galashina E.A., Chibrikova Yu.A., Bondarenko A.S., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The data on the methods and promising areas of investigations potent to improve diagnostic tactics in patients with infectious complications after total knee replacement is presented.

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The capacity of the thrombin generation test in the diagnostics of hemostasis system disorders in patients with osteoarthritis

Year: 2018, volume 14 Issue: №3 Pages: 602-606
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shakhmartova S.G., Vorobyova I.S., Puchinyan D.M.
Organization:
Summary:

Aim: to determine the diagnostic significance of thrombin generation test parameters in the diagnostics of hemostatic disorders in patients with osteoarthritis of large joints in preoperative period. Material and Methods. 137 subjects have been investigated, among whom there were 115 hip and knee osteoarthritis patients, submitted for primary arthroplasty (68) and re-prosthetics (47); control group — 22 conventionally healthy blood donors. All subjects underwent plasma hemostasis study and thrombin generation test with two activators — RB (TF 2 pmol/ml) and RC-low (TF 5 pmol/ ml). Osteoarthritis patients were divided into two groups according to the results of thrombin generation test. The 1st group included patients with an adequate response to the stronger activator (t-lagR >t-lag ow, tt-peak^tt-peak^^), the 2nd —with an inversion response (t-lagRBlow). Results. In trie control group and group 1 patients, the thrombin formation process is more pronounced when using an activator with a high TF(RC-low) content than when using an activator with a lowTF (RB) content, which is regarded as an adequate reaction of thrombin formation to the action of a stronger agonist. Patients of the 2nd group inresponse to the action of the activator with a high content of TF was observed inhibition of the reaction of formation of thrombin, which was reflected in the slowdown in the speed of the generation of this enzyme and reduce its quantity. Conclusion. The use of two activators with different concentrations of tissue factor in the test of thrombin generation allows the nature of the response of the hemocoagulation system to initiate the process of thrombin formation to identify patients with adequate and inadequate response.

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Complex diagnostics and treatment potential of deep implant- associated infection of knee joint

Summary:

The review of open access literature on the issues of complex diagnostics and treatment potential of implant-associated infection of the knee joint area was given in the article. We describe clinical signs, the potential of laboratory diagnostics of deep implant-associated infection from the point of view of sensitivity and specificity as well as main methods of surgical treatment of the pathology.

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Pediatric flatfoot: etiopathogenesis and diagnostics

Year: 2018, volume 14 Issue: №3 Pages: 389-395
Heading: Traumatology and Orthopedics Article type: Review
Authors: Zatravkina T.Yu., Rubashkin S.A., Dokhov M.M.
Organization:
Summary:

Longitudinal flatfoot is heterogeneous group of conditions, characterized by a decrease of longitudinal arch height. In mobile flatfoot, this decrease is dynamic, it occurs under vertical load and proceeds asymptomatically. Specialists should pay attention to the "pathological" flatfoot developing with pain syndrome or causing severe gait disturbance. The review analyzes the fundamental and current opinions of local and foreign researchers on the development of flatfoot in children. Literatural data of age dynamics of foot development, epidemiology of flatfoot in childhood, the influence of flatfoot on the foot and gait biomechanics and basic diagnostic methods are presented.

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A rare case of Loeffler endocarditis associated with eosinophilic granuloma-tosis with polyangiitis

Year: 2017, volume 13 Issue: №4 Pages: 823-828
Heading: Internal Diseases Article type: Case report
Authors: Skryabina E.N., Safonova V.N., Agareva Т.А.
Organization: Saratov State Medical University
Summary:

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare disease that affects small and medium-sized blood vessels of different organs, characterized by asthma, prominent peripheral blood eosinophilia. Cardiac involvement was reported in 20-50% and it is the major cause of mortality. A case of EGPA in a 43-year-old female, who had endocarditis, associated with thrombus formation in left ventricle, thromboembolic syndrome and recurrent stroke has been reported. The described case has showed that it is of crucial importance to perform the full cardiac imaging even in asymptomatic patients with suspected EGPA. The early identification of cardiac involvement may lead to better prognosis.

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