Saratov JOURNAL of Medical and Scientific Research

Original article

Honorary members of the Imperial Nikolaev University (Saratov) in the pre-revolutionary period

Year: 2020, volume 16 Issue: №3 Pages: 819-825
Heading: Scientific schools and memorable dates Article type: Original article
Authors: Erugina M.V., Zavyalov A.l., Dolgov А.А., Uranov D.E.
Organization: Saratov State Medical University
Summary:

The article is dedicated to prominent Russian scientists, elected by the Council as honorary members of the Imperial Nikolaev University (Saratov) in the pre-revolutionary period (1909-1917); their biographies are briefly highlighted. Their contribution to the development and organization of Russian science is described.

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Saratov Scientific Research Institute of Traumatology and Orthopedics contribution to the research of biomechanical problems in musculoskeletal system (on I. D. Kovaleva's 100th anniversary)

Year: 2020, volume 16 Issue: №3 Pages: 814-819
Heading: Scientific schools and memorable dates Article type: Original article
Authors: Grishin S.E., Puchinyan D.M., Ulyanov V.Yu., Ostrovskij V.V., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The study follows the career of the head of biomechanical laboratory in Saratov Scientific Research Institute of Traumatology and Orthopedics Irina D. Kovaleva, the oldest employee of the institute who worked over 60 years in it. I. D. Kovaleva's contribution to biomechanical rationalization of Russian designs of hip joint endoprosthesis was great. The results of her research were implemented into endoprostheses designed by Shersher and Saratov Scientific Research Institute of Traumatology and Orthopedics, and overacetabular prosthesis. The novelty of her research was proven by the USSR inventor's certificates, patents of Russia and foreign countries including USA, UK, France, and West Germany.

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Peritoneal fluid cells reactivity in modeling of aseptic inflammation

Year: 2020, volume 16 Issue: №3 Pages: 810-813
Heading: Рathophysiology Article type: Original article
Authors: Godovalov А.Р., Morozov I.A., Karpunina T.N.
Organization: Perm State University of Medicine n.a. Academician Ye.A. Vagner of Ministry of Health of the Russian Federation
Summary:

The aim of investigation was to evaluate the characteristics of the response of rat peritoneal leukocytes and mast cells (MC) when using experimental aseptic inflammation. Material and Methods: Rats of the 1st group (n=7) were intra-peritoneally injected with 1 % thioglycolate broth, animals ofthe2nd(n=7)— the same broth, diluted 1:10. Control group rats (n=8) received an equal volume of saline. After removing animals from the experiment in the peritoneal fluid, the number of leukocytes was counted and their viability was evaluated. MC degranulation was detected by toluidine blue technique. All MCs were divided according to the degree of degranulation. Results: A model of aseptic inflammation of the peritoneum was reproduced. It was found that the number of leukocytes of peritoneal fluid, especially the number of non-viable cells, increases by more than 2 times with an increase in the concentration of the eluting agent (p<0.05). In experimental animals, the number of MCs with signs of degranulation increased to 89.5±2.2% compared with their level in the control group (49.0±3.9%; p<0.05). Conclusion: With the introduction of thioglycolate broth into the rats peritoneal cavity, an adequate model of inflammation is reproduced, suitable for studying the activity of different types of cells and humoral factors. The clinical picture of inflammation varies depending on the degree of degranulation of MC, which confirms their participation in the development of the pathological process.

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Analysis of the provision of specialized medical care to patients with coloproctological diseases at the regional level

Summary:

Objective: analysis of the regional incidence of diseases and needs of medical care on the profile of coloproctology. Material and Methods. A study of the dynamics of regional coloproctological morbidity was monitored over a 15-year period from 2004 to 2018. Results. Diseases related to the coloproctology profile were recorded in 47171 cases in 2018, however, only 30900 outpatient coloproctological procedures were performed in the region, in which 10324 rigid rectoscopes were performed, and 4582 fibrocolonoscopy. The average value of the regional primary coloproctological incidence rate was 21.57±0.54 per thousand people. The total decrease in the incidence rate for the entire study period was 21.0%. The share of cancer in the total coloproctological morbidity is 9.3-21.0%. The total increase in the incidence of colon cancer over the entire study period was 89.0%. The proportion of benign neoplasms in the total coloproctological morbidity slightly varied from 4.4% to 6.1%. The incidence rate of benign diseases of the colon practically did not change + 5.45%. Conclusion. The volume of specialized medical care provided by the regional coloproctological service to patients with diseases of the colon does not correspond to the needs for it. To improve the quality and availability of medical care, it is necessary to reliably predict the need for it and optimize the structure of the specialized service itself.

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The use of hospital resuscitation and intensive care beds in provision of medical care in a city

Year: 2020, volume 16 Issue: №3 Pages: 800-804
Heading: public health Article type: Original article
Authors: Klyukovkin K.S., Kochorova L.V., Kozhin S.A., Okulov M.V.
Organization: Pavlov First Saint Petersburg State Medical University
Summary:

Objective: To identify the shortcomings and reserves of the use of the resuscitation and intensive care bed Fund on the example of the health care system of a city. Material and Methods. The use of resuscitation and intensive care beds in 75 hospitals in Saint Petersburg was analyzed. The data were statistically processed, average values, extensive and intensive indicators were calculated with an assessment of the reliability of their difference, indicators of a dynamic series, and a correlation analysis was performed. Results: The availability of beds in Saint Petersburg in 2015-2019 decreased from 775.7 to 706.9 per 100 thousand population, while the share of intensive care and intensive care beds is stable (4.5-6.1%). This does not correspond to an increase in emergency hospitalization by 14.5%, the number of operations by 14.0%, and high-tech operations by 54.5%). The need for anaesthetic and resuscitation care has increased: from 1387 to 1524 cases per 100 thousand population, while the average number of days of employment of such beds has not changed significantly (in 2015, 245±4.8, in 2019, 241±5.5 (f<2). The availability of intensive care and intensive care beds affects the reduction of hospital mortality (p=-0.7, p<0.05). Conclusion: Intensive care and intensive care beds in Saint Petersburg, despite their intensive use, work effectively, while reserves have been identified that can be used in emergency situations and adverse epidemiological conditions.

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Hygienic assessment of the content of heavy metals in food of farming and personal help facilities in the territories of ecologically unfavorable areas

Year: 2020, volume 16 Issue: №3 Pages: 793-799
Heading: Hygiene Article type: Original article
Authors: Chekhomov S.Yu., Eliseeva Yu.V., Pichugina N.N., Eliseev Yu.Yu.
Organization: Saratov State Medical University
Summary:

Objective: Comparative study of heavy metal contamination of local food products produced in ecologically unfavorable areas by farmers and personal subsidiary farms. Material and Methods: Sampling of local food products was carried out in the summer and autumn periods of 2017-19 on the territories of farms and personal subsidiary farms in a number of districts of the Saratov region. Determination of the content of metals in food samples: lead, cobalt and arsenic was performed using adsorption inversion voltammetry on the analyzer "IVA-5". The mercury content was determined by the method of flame-free atomic absorption spectrometry of cold steam on the analyzer "RA 915 M". Results: It is found out that the median concentration of mercury and cadmium in foods by Engels, Fedorovsky, Saratov, Balakovo and Marks areas, regardless of the form of business ownership, and determine the 90-percentile was closest to the remote control. Bread and meat were the most vulnerable local products when combined with heavy metal contamination. Conclusion: Median concentrations of heavy metals in food samples grown on the territories of farms and private farms and used as local food had no significant differences in their quantitative contamination.

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Clinical significance of cystatin С and TGF-01 in the assessment of renal function in the surgical treatment of renal cell carcinoma

Year: 2020, volume 16 Issue: №3 Pages: 786-792
Heading: Urology Article type: Original article
Authors: Tarasenko A.I., Rossolovsky A.N., Berezinets O.L., Durnov D.A., Chekhonatskaya M.L., Loiko V.S., Bobylev D.A., Maslyakova G.N.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

Objective: to evaluate the possibility of using cystatin С and TGF-p as prognostic markers of renal impairment and unfavorable oncological results of surgical treatment of renal cell carcinoma (RCC). Material and Methods. We examined 60 patients with RCC. Patients were divided into 3 groups: with RCC after nephrectomy (group 1); after laparo-scopic nephrectomy (group 2); after laparoscopic resection of the tumor (group 3). All patients before the operation on the 7th-10th day, after 1-3 years of postoperative follow-up, the concentrations of cystatin С and TGF-p in the blood serum were studied by solid-phase ELISA. Results. The majority of patients in the groups showed a significant decrease in glomerular filtration rate (GFR) compared to the control, and 3 years after nephrectomy, most patients had stage C3A chronic kidney disease (CKD). The Cystatin С content in all groups of patients with RCC had a statistically significant increase compared to the control (2664, 3103, and 2709 ng/ml in groups 1.2 and 3 versus 143 ng/ml, respectively) (p<0.05). Conclusion. In the majority of patients with RCC, postoperative initiation and progression of "surgical" CKD occurs, which persists 3 years after surgical treatment. Cystatin С can be considered as a predictor of high antitumor activity in patients with RCC, and requires monitoring in the long-term postoperative period.

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Morphological changes of the bladder wall of fetuses with antenatally detected syndrome "megacystis"

Year: 2020, volume 16 Issue: №3 Pages: 779-785
Heading: Urology Article type: Original article
Authors: Deryugina L.A., Napsheva A.M., Medvedeva A.V., Rozhkova D.V., Maslyakova G.N.
Organization: Saratov State Medical University
Summary:

Objective: To determine the morphological features of the structure of the wall of the urinary bladder of the fetus with antenatally identified syndrome "megacystis". Material and Methods: Morphological investigations of the bladder wall of 11 fetuses of 12-21 weeks of gestation with diagnosed "megacystis" syndrome, obtained as a result of the termination of pregnancies, were carried out. The study was carried out using survey method, histochemical and immunohisto-chemical staining methods. Results: In all cases, the structure of the bladder wall with diagnosed syndrome "megacystis" sharply differed from the norm. The changes affected all layers, but the most pronounced pathological processes developed in the muscle layer, which did not differentiate into layers, the process was accompanied by a violation of the course of muscle fibers. Detrusor hypotrophy was observed in fetuses up to 18 weeks of gestation, the thickness of which decreased on average by 1,8 times. In fetuses with a gestational age of 21 weeks, the hypertrophic variant of the detrusor prevailed with an increase in its thickness by 2,6 times. In all cases, there was a significant depletion of the muscle wall with blood vessels up to 6% of the norm and a decrease in the number of nerve fibers to 24%. Conclusion. The study allowed to distinguish two variants of changes in the bladder at the syndrome "megacystis": "hypertrophic variant", characterized by an increase in the thickness of the muscle layer, and "hypotrophic variant", characterized by a decrease in the thickness of the muscle layer, which fits into the diagnostic concept of "detrusor dysplasia".

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The choice of performing tactics of dorsal decompressive-stabilizing interventions on the lumbar spine for the prevention of degenerative disease of an adjacent segment

Year: 2020, volume 16 Issue: №3 Pages: 762-768
Heading: neurosurgery Article type: Original article
Authors: Byvaltsev V.A., Kalinin А.А., Pestryakov Yu.Ya., Spiridonov A.V.
Organization: Clinical Hospital "Russian Railways Medicine", Irkutsk State Medical University, Krasnoyarsk Regional Clinical Hospital, Russian Railways
Summary:

Purpose: Comparative analysis of the results of dorsal decompressive-stabilizing interventions (DDSI) on the lumbar spine for substantiating the method of prevention of adjacent segment degenerative disease (ASDd). Material and Methods: 79 patients were included in the retrospective research, 2 groups were identified: in group I (n=41) single-level research, in group II (n=38) two-level DDSI, with rigid stabilization of the spinal motion segment, in the presence of signs of its degeneration was made. Clinical outcomes, instrumental data and surgical complications were evaluated. Results: It was a decrease of pain syndrome in the postoperative period, an improvement in the quality of life in two groups (p<0.001). In the inter-group comparison of the visual analog scale (VAS) — back, legs, ODI, SF-36 in group II, the results at discharge were lower than in group I (p<0.001), after 3.6.12 months there is a comparable improvement in a quality of life and a decrease in pain by VAS in both groups (p>0.05). In the distant period (24, 36 months), clinical results are better in-group II (p<0.05). The number of late surgical complications and revision interventions is higher in a group II (17.1 and 4.0%) (p<0.05). Conclusion: Preventive rigid stabilization of adjacent segment with signs of initial degeneration improves long-term results, reduces the number of repeated operations, despite the larger volume of primary medical intervention.

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Comparative analysis of surgical outcomes for achondroplasic children receiving PRP-therapy (a case-control study)

Year: 2020, volume 16 Issue: №3 Pages: 757-761
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Timaev M.Kh., Sertakova A.V., Alieva A.V.
Organization: Saratov State Medical University
Summary:

Objective: To assess surgical outcomes in achondroplasic pediatric patients receiving PRP-therapy (Platelet-Rich Plasma therapy) for lengthening long bones. Material and Methods: 27 achondroplasic patients had been examined and operated in the pediatric trauma orthopedic department of the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n. a. V.I. Rasumovsky in 2014-2018, their mean age 4.7±2.1 у. o. (4-11 у. o. range). The examination involved conventional clinical examination as well as X-ray examination. All patients were divided into 2 groups, the division criteria being intraoperative application of PRP-therapy (autoplasma therapy or plasmolifting). Group 1 (n=14) was made up of patients who had underwent transosseous compression distraction osteosynthesis with no PRP employed while all patients of Group 2 (n=13) had received PRP injections. Results: The distraction consolidation index (DCI) in Group 1 (n=14) was 72±7 days/cm (good and satisfactory results) and the average length of the grown distraction was 4.5±2.5 cm. In PRP-therapy employed Group 2 DCI was 65±10 days/cm (good results) and the distraction length was 6.5±2.5 cm. In patients of Group 1 sectioned, lateral and central forms of the distraction prevailed while in patients who had received PRP-therapy spindle and cylinder forms of the distraction were observed. Conclusion: PRP-therapy employed in all stages of the elective distraction at limb osteotomy allows significant DCI improvement as well as activation of bone tissue remodeling in the osteotomy area, the geometric type of trabeculae formation being more beneficial.

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