Saratov JOURNAL of Medical and Scientific Research

Kuligin A.V.

Saratov State Medical University n.a. V.I. Razumovsky, Department of Emergency, Anaesthesiology and Resuscitation, Assistant Professor, Doctor of Medical Science

Sequential application of recombinant factors of blood coagulation system in intensive therapy of massive bleeding due to amniotic fluid embolism

Year: 2020, volume 16 Issue: №2 Pages: 433-437
Heading: Obstetrics and Gynecology Article type: Case report
Authors: Kuligin A.V., Lushnikov A.V., Zeulina Е.Е.
Organization: Saratov State Medical University
Summary:

Amniotic fluid embolism (AFE) is one of the most severe complications of pregnancy, childbirth and early postnatal period, being associated with high risk of maternal mortality. AFE manifests as significant coagulopathy with hypocoag-ulation and activation of fibrinolytic system. In recent years, coagulopathy caused by amniotic fluid entry into maternal circulation is successfully treated with recombinant coagulation factors, including prothrombin complex concentrate, and activated blood coagulation factor Vila (Eptacog alfa activated). Authors present a case of successful sequential use of the above-mentioned blood coagulation factors for combined treatment of coagulopathic syndrome in patient with AFE, which clinically manifested during early postoperative period after delivery with caesarean section. The aim of this article is to demonstrate that above-mentioned drugs are not identical and to prove that all of them should be used only when clinical indications are present, confirmed by results of laboratory studies.

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Forming value orientations on healthy lifestyle among students

Year: 2017, volume 13 Issue: №2 Pages: 284-288
Heading: Sociology of Medicine Article type: Author's opinion
Authors: Bugaeva I.O., Kloktunova N.A., Kuligin A.V., Solovyova V.A.
Organization: Saratov State Medical University, Saratov state university
Summary:

This work contains the model of forming the students' value priorities on healthy lifestyle based on the following levels: influence of the government, influence of the educational institution, influence of surrounding community, and self-motivation. The analysis of government motivation system used in Russia is given as well as how this policy integrated into the activities of the educational institution (on example of Saratov State Medical University n.a. V. I. Razumovsky).

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Study of Zn-hydroxyapatite crystals formation and growth on dentine base at ultrasonic influence

Year: 2017, volume 13 Issue: №2 Pages: 260-265
Heading: Stomatology Article type: Original article
Authors: Kazakova L.N., Tereschuk O.S., Kuligin A.V., Suetenkov D.Ye., Pichkhidze S.Ya., Garievskaya A.V.
Organization: Saratov State Medical University, Yuri Gagarin State Technical University of Saratov
Summary:

The objective: the study analyses the features of spontaneous growth of hydroxyapatite crystals on dentinal substrate using (by the use of) artificially grown Zn-hydroxyapatite combined with ultrasonic treatment. Material and Methods. A dynamic study of dentinal substrate structure was conducted in a certain time interval after standard primary surface treatment of dentin micro-sections, divided into control and experimental groups. Dentin surfaces in the second group were covered by finely dispersed Zn-hydroxyapatite in combination with ultrasonic treatment. The investigation was performed by use of analytical complex based on scanning electron microscope with high resolution SEM Mira II LMU (Tescan) and energy dispersive analysis system. Results. There were revealed the structural changes of dentinal substrate surface overtime period due to directional growth of Zn-hydroxyapatite crystals. Conclusion. The conducted study showed the possibility of formation of the stable structures in the dentinal substrate when using Zn-hydroxyapatite in combination with ultrasonic treatment.

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Stereotypes of medical professions

Year: 2016, volume 12 Issue: №4 Pages: 602-605
Heading: Sociology of Medicine Article type: Review
Authors: Bugaeva I.O., Kloktunova N.A., Kuligin A.V., Magomedova M.S., Dzukaev G.N., Solovyova V.A.
Organization: Saratov State Medical University, Saratov state university
Summary:

The article presents the analysis of the Russian and foreign literature concerning the main stereotypes about specialists of medical profession. Their short characteristics as well as main reasons of their emergence and estimation of their relevance are given. The impact of such ideas on attitudes of population has been also assessed.

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Evaluation of latent period of temperature sensitivity in traditional and unilateral spinal anesthesia

Year: 2015, volume 11 Issue: №3 Pages: 263-267
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Lakhin R.E., Panov V.A., Schegolev A.V., Kuligin A.V.
Organization: Military Medical Academy n.a. S. M. Kirov, Saratov State Medical University
Summary:

Objective: evaluation of the differences in the level of temperature, sensory and motor blockade during the various techniques of spinal anesthesia. Materials and Methods. Prospectively the randomized study included 70 patients. In the group with conventional spinal anesthesia (n=35) 15mg of bupivacaine injected quickly. In the group with unilateral spinal anesthesia (n=35) 7.5mg of bupivacaine administered slowly, at a rate of 1 ml per minute. We studied the level of temperature and time, sensory and motor blockade. The data are statistically processed. Results. Reduced thermal sensitivity recorded in an average of 48 seconds as a unilateral spinal anesthesia group and the control group. Subarachnoid administration of 7.5 mg of hyperbaric bupivacaine resulted in the development of a complete motor blockade underlying lower extremity in only 16 patients (45.7%). Conclusion. Using lower dosages of bupivacaine for unilateral spinal anesthesia lowers the threshold concentration of the local anesthetic in the subarachnoid space, resulting in slower motor neuron blockade and it is not total in more than 50% of cases.

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Low dose spinal anesthesia for knee arthroscopy

Year: 2015, volume 11 Issue: №2 Pages: 126-128
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Lakhin R.E., Schegolev A.V., Panov V.A., Kuligin A.V.
Organization: Military Medical Academy n.a. S. M. Kirov, Saratov State Medical University
Summary:

Objective: to evaluate the nature of unilateral spinal anesthesia using various modes of administration of low doses of hyperbaric bupivacaine. Materials and Methods. Prospectively, the randomized study included 56 patients undergoing knee arthroscopy. In the control group bupivacaine of 5mg was administered simultaneously, in the main group — fractionally by 2.5 mg. The development of thermal and pain blocks from different sides was investigated. The data were statistically processed. Results. In the control group, the positioning of the patient usually began after the entire dose of anesthetic had been administered. In the case of temperature paresthesia in the area of the sacral segments of the full anesthesia throughout underlying limb was not always achieved. In 6 cases of block was not sufficient. In the main group patient positioning was performed after the administration of 2.5 mg of anesthetic and evaluate temperature paresthesia and in 2 cases the total dose was increased to 7.5 mg. The successful development of sensory block at fractional administration was significantly higher than in the single-step introduction. Conclusion. Temperature paresthesia occurs within the first minute and is an early predictor of developing spinal anesthesia. The area of arising paresthesia shows preferential distribution of the anesthetic. In the application of low dose local anesthetic the desired upper level of anesthesia via the patient positioning and dose adjustment may be achieved.

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Assessment of efficiency of the strengthening mode of ultrasonic visualization of needles for peripheral regional anaesthesia

Year: 2014, volume 10 Issue: №4 Pages: 612-616
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Kuligin A.V., Panov V.A., Lakhin R.E., Shchegolev A.V., Yatsenko D.V., Kotikova M.N.
Organization: Military Medical Academy n.a. S. M. Kirov, Saratov State Medical University
Summary:

Research goal: optimization of peripheral regional anaesthesia under ultrasound. Material and Methods. Study has been performed by SonoSite Edge (SonoSite, Bothell, США) on a lineal transducer machine for fixed terms 38-mm (13-6 MHz) of overall gain and depth. The study included 2 sonographic needles and 2 non-sonographic needles. Ultrasound images were obtained and analyzed by an experienced anaesthesiologist. Results. In this study improved ultrasound imaging needle for peripheral regional anaesthesia using technology SonoMBe compared with a conventional scanning mode has been demonstrated. Conclusions. SonoMBe technology increases the echogenicity of needles for peripheral regional anaesthesia that allows the use of this technology gain in the performance of nerve block and plexus block anesthesia

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History review on blood transfusion in Saratov

Year: 2014, volume 10 Issue: №1 Pages: 153-156
Heading: Scientific schools Article type: Short message
Authors: Sadchikov D.V., Kuligin A.V., Osipova O.V., Averyanov E.G., Volkova E.V.
Organization: Saratov Regional Station of Blood Transfusion, Saratov State Medical University
Summary:

The article presents the history review on the development of blood transfusion in Saratov, the organization and activity of regional station of blood transfusion during the war and the post-war years.

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Actual problems of integrated system of specialists training

Year: 2012, volume 8 Issue: №3 Pages: 871-875
Heading: Pedagogics and Education Article type: Author's opinion
Authors: Sadchikov D.V., Kuligin А.V.
Organization: Saratov State Medical University
Summary:

The present system of education requires reformation. We have to achieve a new level of educational work. An optimal decision is the module education, as the functional system based on professional standard as on a backbone factor. However, the benefits of module education are useful most of all at a post-graduate stage. Therefore, in training of doctors we have to use 3-stage system (under-graduate, graduate and post-graduate stages) with 2-system approach (topographo-anatomic and functional). This methodology complies best to contemporary requirements for high-qualified doctors and creates necessary conditions for continuous professional progress.

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The assessment of the effect of interrelations of blood cells on the outcome of massive blood loss

Year: 2012, volume 8 Issue: №1 Pages: 059-062
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Sadchikov D.V., Khozhenko А.О., Kuligin А.V.
Organization: Saratov State Medical University
Summary:

Aim. We have carried out a research aiming to study the relations of quantitative and qualitative parameters of blood cells in patients with massive blood loss. Material and methods. We have analyzed 93 patients with severe blood loss due to hemorrhage from upper parts of gastrointestinal tract. We have assessed the number of blood cells and the number of anisocytes, poekilocytes and reticulocytesaswell as criteria of effectiveness of treatment and outcomes. Re-sults. Parallel to the decrease of erythrocyte-leukocyte ratio and the increase of the amount of defective erythrocytes, the number of infectious complications increases. Conclusion. The character of typical reaction of system of blood to the acute blood loss manifesing by interrelated changes of erythrocyte-leukocyte ratio and quantitative parameters of red blood cells may affect the effectiveness of treatment

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