Saratov JOURNAL of Medical and Scientific Research

Saratov State Medical University

www.sgmu.ru

The prospects for application of biomarker "vascular endothelial growth factor" in predicting the treatment outcomes of bladder cancer

Year: 2018, volume 14 Issue: №2 Pages: 268-272
Heading: Urology Article type: Original article
Authors: Zakharova N.B., Ponukalin A.N., Skriptsova S.A.
Organization: Saratov State Medical University
Summary:

Purpose: assessment of the diagnostic value of Vascular Endothelial Growth Factor (VEGF) in predicting the outcome treatment of patients with muscle-invasive bladder cancer. Material and Methods. The study involved 264 people: 204 patients with RMP; 60 people aged 21 to 60 years were the comparison group. Patients with RMP are divided into stages of the disease. With non-muscle-invasive ВС (NIRMP) under TA-1NxMo there were 75 patients. Out of 129 patients with muscle-invasive ВС (MIRE) within the body (pT2aN0M0-T2bN0M0) was diagnosed in 69 of people. In 60 patients, the tumor sprouted paravesical tissue and surrounding organs (rt3a-bn0m0-41; pT36N1M0-11; pT4N1M0-5; T4N1M1-3); 19 patients had metastases to the iliac lymph nodes are installed only after the operation. Metastases were found in three patients out of 19 in addition to the lymphonoduses in the lungs. Tumors had the following gradations: G1-97; G2-37; G3-58. All patients NMIN (n=75) completed a TUR of the bladder wall with the tumor. MERE patients underwent radical cystectomy (n=117), open resection of the bladder (n=12), palliative surgery (n=3). The period of follow-up after surgical treatment was 3.5±0.5years. Quantitative determination of VEGF in blood serum was performed by solid-phase ELISA. Results. Despite the fact that the increase in VEGF level of blood serum in groups of patients with NIMRE and MIRE has significant differences both before and in the postoperative period, it is associated with the aggressiveness of tumor growth, development of metastases and recurrences of the disease. Conclusion. The increase in the content of VEGF serum suitable for use as an indicator: the risk of relapse within the first year after TUR in patients NMIN; development of relapses and metastases in pre and postoperative periods in MERE patients.

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Efficacy of surgical treatment of renal form of hyperparathyroidism

Year: 2018, volume 14 Issue: №2 Pages: 265-267
Heading: Surgery Article type: Original article
Authors: Kovalenko Yu.V., Tolstokorov A.S., Rossolovsky A.N., Kravchenya A.R., Manakhov G.A.
Organization: Saratov State Medical University
Summary:

Objective: to study the efficacy of surgical treatment of primary hyperparathyroidism in risk of uronephrolithiasis progression. Material and Methods. The research involved 55 patients, the biochemical and clinical parameters before and after treatment with retrospective-prospective method of analysis were studied and analyzed. Results. It is established that the surgical treatment of patients with uronephrolithiasis is proved to be effective in 96,4% of the cases, as it allows to eliminate the classic symptoms of primary hyperparathyroidism, and urolithiasis. Improvement of laboratory hormonal and biochemical indices of mineral metabolism, and, consequently, reducing the severity of risk factors of urolithiasis is marked. Conclusion. Surgical treatment of renal forms of primary hyperparathyroidism is a pathogeneti-cally reasonable method. Parathyroidectomy performed in an adequate amount prevents relapses and progression of diseases that are the consequence of primary hyperparathyroidism.

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Comparative analysis of clinical outcomes of various methods of anterior cruciate ligament arthroplasty in knee joint in complete rupture of the ligament.

Year: 2018, volume 14 Issue: №2 Pages: 251-259
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shormanov A.M., Norkin A.l., Klimov S.S., Chibrikova Ju.A., Ulyanov V.Yu., Bakhteeva N.Kh.
Organization: Saratov State Medical University
Summary:

The aim is to carry out the analysis of outcomes of anterior cruciate ligament arthroplasty undertaken by various methods in patients with complete ligament rupture. Material and Methods. 104 patients diagnosed with complete rupture of anterior cruciate ligament (ACL) in knee joint who underwent knee joint arthroplasty fulfilled by various methods were the object of the present study. Clinical outcomes of the treatment were estimated by clinical signs of ACL failure, the degree of functional impairment of knee joint (IKDC 2000) and motor pathology assessed instrumentally. Results. Significantly better function restoration in knee joint occurring as early as 3 months postoperatively has been stated in the group of patients with two-bundle ACL arthroplasty by synthetic implant "DONA-M" on the basis of IKDC subjective knee indices. Negative Lachman test and Pivot shift test were demonstrated as early as 3 months postoperatively by all patients after two-bundle ACL arthroplasty with synthetic implant "DONA-M", reduced support asymmetry 6 months postoperatively was stated in all patient groups as well as run path and surface area in patients with single-bundle ACL arthroplasty by synthetic implant "DONA-M". Conclusion. The use of single- and double-bundle ACL arthroplasty with synthetic implant and ACL arthroplasty with autograft of semitendinosus (ST) and gracilis allows providing equally full-fledge restoration of injured knee joint, without statistically significant differences between the groups, in great majority of patients up to 12 months of follow-up period which is proved by normalized knee joint function, the absence of ACL failure and motor pathology signs estimated instrumentally. Key words: knee joint, anterior cruciate ligament (ACL), co

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Optimization of surgical treatment tactics at a customary shoulder dislocation

Year: 2018, volume 14 Issue: №2 Pages: 240-243
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Norkin A.l., Klimov S.S., Levchenko K.K., Shormanov A.M., Alieva A.M., Katerusha A.M., Amanova M.M., Ulyanov V.Yu.
Organization: Saratov State Medical University
Summary:

 Saratov Journal of Medical Scientific Research 2018; 14 (2): 240-243. The aim: the optimization of surgical treatment tactics at a customary shoulder dislocation, based on "on-track Hill-Sachs / off-track Hill-Sachs" concept. Material and Methods. The research group consists of 42 patients aged from 19 to 52 years with chronic recurrent anterior shoulder instability, who underwent a surgical treatment to restore previous shoulder anatomic and topographic correlations. Patients were divided into two subgroups according to diagnostic arthroscopy results. The first subgroup includes 14 patients with impaction visualized (off-track Hill-Sachs), the second one — 28 patients with head shoulder stability (on-track Hill-Sachs). Patients of the first subgroup underwent open surgical intervention according to Bristow — Latarjetand shoulder arthroscopic repair was carried out in the second group. Results. One month after the surgical treatment median total estimated figure exceeded by 1.8 times in patients of the first subgroup and by 1.2 times, by Rowe, in patients of the second subgroup and decreased by 2.1 times in patients of the first subgroup and by 1.7 times, by DASH, in the second subgroup in comparison with the indices before the operation, that was illustrative of a good treatment result. Six months after the operation median total estimated figure exceeded by 1.2 times, by Rowe, in patients both of the first subgroup and the second subgroup and decreased by 2 and 2.1 times, by DASH, in patients of the first and the second group, relatively in comparison with the indices found one month after the operation, that was illustrative of an excellent treatment result in the late postoperative period. Conclusion. Patients with anterior shoulder instability caused by a glenoid fossa deficiency less than 25% in combination with off-track Hill-Sachs lesion, the most convenient way is the replacement of the bone loss by coracoid process transposition. In patients with on-track Hill-Sachs lesion arthroscopic repair is preferable.

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Use of adhesive systems in dentistry: past and present

Year: 2018, volume 14 Issue: №2 Pages: 234-239
Heading: Stomatology Article type: Review
Authors: Aslanyan M.A., Eremin O.V., Trufanova Yu.Yu., Aslanyan Mel.A., Eremin А.О., Bykova О.A., Zavyalov A.I.
Organization: Saratov State Medical University
Summary:

In recent decades, in the sphere of minimally invasive approach to preparing hard dental tissues, adhesive dentistry has made significant progress, revolutionizing many aspects of restorative dentistry. The attitude towards cavity preparation has changed due to adhesive systems as there is no necessary to prepare cavities with additional retention points to ensure mechanical adhesion with the filling material. Thus, the introduction of adhesive systems contributes to the preservation of more non-demineralized enamel and dentin in the preparation of hard dental tissues in accordance with the principle of "biological expediency". To achieve a better connection with the hard tissues of the tooth, a number of adhesive systems has been developed. The complexity of achieving a better connection is due to the heterogeneity of the structure and composition of the hard dental tissues, the hydrophilicity of the exposed dentin surface, smear layer formed during the preparation of the cavity and the characteristics of the adhesive system, such as its physical and chemical properties and the way it interacts with enamel and dentin. With the development of technologies, adhesive systems have evolved from systems that do not involve the etching of hard dental tissues to systems with preliminary total etching and self-etching adhesive systems.

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Organization and work of the department of catamnesis of Clinical Perinatal Center of the Saratov region

Year: 2018, volume 14 Issue: №2 Pages: 226-223
Heading: Pediatrics Article type: Original article
Authors: Chernenkov Yu.V., Nechaev V.N.
Organization: Saratov State Medical University
Summary:

Objective: to examine the catamnesis of infants born with very low and extremely low birth weight, as well as undergoing critical conditions in the early neonatal period. To assess the health status of children observed, recommendations for further rehabilitation and prognosis. Material and Methods. At the department of catamnesis 4373 children were observed (total 21343 admissions), 62% of them were preterm infants. Children with extremely low body weight and very low body weight (157 patients, 20.3%) were evaluated for physical development, somatic and psychoneuro-logical status. Results. Analyzing the structure of morbidity observed in children hematologic violations are revealed in the form of anemia of prematurity moderate and severe degree in 15 patients (11.4%), slowing growth and development 25 (19.4%), respiratory disorders (19 children, 14.5%). In the assessment of physical development, growth disharmony revealed in 20.9%, weight disharmony in 29.4% of patients. Neuro-psychological development corresponded to the postconceptual age at 49.2% of children. Breastfeeding saved in 44.6%, mixed and in vitro were transferred in 55.4%. In a group of children follow-up observations identified numerous pathological conditions and high morbidity, requiring subsequent mandatory correction. Many of the children belong to the Group of infectious diseases patients (28.4%), with lots of somatic pathology (78.1%). A direct impact of the dynamics of body weight during the first months after birth was revealed in figures physical development of a child and the incidence in the future. The most vulnerable preterm infants from multiple pregnancies, small for gestational body weight deficiency which recovers slowly and have them marked lower psychomotor development. Conclusion. Improving rehabilitation technology, previously early steps, the integrated use of various methods and means, phases taking into accountthe stage of the disease process and individual approach to a child significantly improve the efficiency and effectiveness of rehabilitation therapy.

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Norm and disease. Monomorbidity, comorbidity and methodology for their diagnostics

Year: 2018, volume 14 Issue: №2 Pages: 209-216
Heading: Internal Diseases Article type: Review
Authors: Kats Y.A., Parkhoniuk E.V., Skriptsova S.A.
Organization: Saratov State Medical University
Summary:

The absence of a single classification and generally accepted terminology of comorbidity leads to a different understanding of the issues of diagnosis of comorbidity. Comorbidity is a complex system in which the patient is both an integral object and part of this system, which includes diseases complexes. As it is known, the success of solving diagnostic problems, especially in the presence of comorbidity ultimately determines the consistency and validity of the findings, and, consequently, the effectiveness of the diagnosis as a whole. Previously, we proposed an integrative method which, preserving the system approach and the method of comparison, suggests using the sum of data from genetic, constitutional, immunological, anthropological and other types of examination to obtain the most complete representation not only of the nature of the disease, but, first of all, the patient himself. Proceeding from the foregoing, the present review focuses not only on the features of compiling a "patient diagnosis" in the presence of comorbidity but also on the sequence in which the pathological conditions should be considered and reflected in the main diagnosis in the presence of several active processes.

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Clinical case of favourable outcome at a patient with eosinophilic granulomatosis with polyangiitis complicated by severe heart disease

Year: 2018, volume 14 Issue: №2 Pages: 207-209
Heading: Internal Diseases Article type: Case report
Authors: Alexandrova O.L., Skryabina E.N., Nikitina N.M., Romanova I.A., Alexandrova N.L.
Organization: Saratov State Medical University
Summary:

The aim of the article is to present a clinical case of rapid generalization of eosinophilic granulomatosis with polyangiitis. The course of disease with multiple organ lesions and the heart being affected the most is described. Remission is achieved by combined therapy with corticosteroids and cyclophosphamide.

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Public knowledge of risk factors, signs and treatment of stroke: Analysis of the survey results in 2014 and 2017

Year: 2018, volume 14 Issue: №1 Pages: 177-185
Heading: Neurology Article type: Original article
Authors: Shchanitsyn I.N., Razdorskaya V.V., Kolokolov O.V., Lukina E.V., Loi'ko V.S,
Organization: Center of Medical Inspection, Moscow, Saratov State Medical University
Summary:

Aim. This study was conducted to establish levels of knowledge in the general population, and also to determine the impact of educational sessions on stroke knowledge. Material and Methods. Two groups (2014 and 2017 years) completed a stroke knowledge questionnaire (435 respondents). Results. Overall, most of respondents could list 2 or more risk factors, but only 50% in 2014 could list 3 warning signs. More than 80% would call emergency number in response to stroke, but only 25% had heard of thrombolytic therapy. Overall stroke knowledge scores decreased in 2017 despite the public awareness in the media. Conclusion. Currently the knowledge of stroke risk factors, warning signs, and treatment is poor in Saratov. Our study demonstrates that more educational campaigns should be conducted for improve knowledge of stroke symptoms, and therapy.

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"Benign" multiple sclerosis: a variant of favorable disease course and the result of effective treatment

Year: 2018, volume 14 Issue: №1 Pages: 153-156
Heading: Neurology Article type: Review
Authors: Makarov N.S., Kolokolov O.V.
Organization: Saratov State Medical University
Summary:

The article provides an overview of data on isolated demyelination syndromes that may precede multiple sclerosis, and on the peculiarities of the so-called "benign" form of multiple sclerosis. Clinical and anamnestic criteria for establishing the fact of a "benign" form of multiple sclerosis are presented, as well as trends in the number of these patients in the general population of patients with multiple sclerosis, including in connection with the improvement of treatment methods for this disease.

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