Saratov JOURNAL of Medical and Scientific Research

2015, volume 11

Clinical case of ultrasound diagnosis of placenta accreta vera

Year: 2015, volume 11 Issue: №2 Pages: 156-159
Heading: Radiology Article type: Case report
Authors: Voityuk E.G., Altynnik N.A., Medvedev M.V.
Organization: Institute of Continuous Education, Federal Medical Biological Agency

The present article describes the case of prenatal diagnosis of placenta praevia vera by the ultrasound investigation in pregnant women with severe obstetric anamneses. The delivery was performed by cesarean section in a planned manner to conduct conserving surgery. The diagnosis of true placenta accreta was confirmed intraoperatively

Keywords: placenta, placenta accreta vera, ultrasound diagnostics

Assessment of hemodynamic parameters of uterus during physiological pregnancy

Year: 2015, volume 11 Issue: №2 Pages: 151-156
Heading: Radiology Article type: Original article
Authors: Chekhonatskaya M.L., Petrosyan N.O.
Organization: Saratov State Medical University

The aim of the article is to analysis of the hemodynamic parameters of the uterus and cervix during the second and third trimesters of pregnancy. Material and methods. It was conducted dynamic ultrasound in 240 women with physiological course for singleton pregnancies in the period from 12 weeks of gestation until term labor. Results. For the second trimester of pregnancy redistribution of total uterine blood flow in the direction of increasing blood flow in more of the body than the cervix has been considered to be typical. From the third trimester of pregnancy until term labor a significant increase of blood supply to the cervix has been found; there has been a tendency to increase the capacity of the vascular channel and the reduction in peripheral resistance vessels of cervix. Conclusions. Early detection of disorders of uterine and cervical hemodynamics allows to predict the occurrence of various pathological conditions.

Keywords: uterine hemodynamics, pregnancy, cervix uteri hemodynamics

The study of acute toxicity and antihypoxic activity of new metal complexes of iron

Year: 2015, volume 11 Issue: №2 Pages: 146-150
Heading: Clinical Pharmacology Article type: Original article
Authors: Shakhmardanova S.A.
Organization: Moscow State Humanitarian University of Economics

The Purpose: to determine the acute toxicity of new metal complexes of iron derived vinylimidazole and to reveal their antihypoxic activity in comparison with Acyzol and other known antihypoxic etomersol and hypoxen. Material and methods. Antihypoxic activity was studied in experiments on nonlinear white mice-males 4 models of acute hypoxia (hypobaric, hypoxia with hypercapnia, hemic, histotoxic). Rates of acute toxicity (LD16, LD LD ) were calculated graphically by the method of Miller and Tainter. Changes in oxidative metabolism in mice under the influence of the most active compounds were assessed by the values of oxygen consumption and rectal temperature. Results. The studied metal complexes of iron are small and moderately toxic. The connection under the code of Tetravim on the severity of antihypoxic effect (the increase in life expectancy male mice compared to control groups on 20-127%) in the range of doses studied (5-250 mg/kg, i/p) is superior to other derivatives of vinylimidazole known and antihypoxic: etomersol (25-100mg/kg, i/p) and hypoxen (50-150 mg/kg, i/p). Conclusion. The obtained data on the pharmacological activity of Tetravim require further clarification of the mechanism of antihypoxic effect and clinical trials with the aim of putting it on the drugs market as a promising antihypoxic agent.

Keywords: oxygen, iron, hypoxia, antihypoxic

Risk factors and progression of the left ventricular myocardial hypertrophy

Year: 2015, volume 11 Issue: №2 Pages: 141-145
Heading: Internal Diseases Article type:
Authors: Lazutkina A.Yu., Gorbunov V.V.
Organization: Chita Regional Directorate of Medical Supply on Trans-Baikal Railway, Chita State Medical Academy

Tftea/mofthis workisto study the left ventricular myocardial hypertrophy. Materials and methods: In the study that was held in period from 2008 to 2013 years and covers group of 7959 workers of locomotive brigades of Transbaika-lian railway. In stated period each individual was additionally searched for the risk factors and lesions in target-organs in time of medical examinations undergoing. Results: During the study in group (7959 observations with the terminal outcomes) 597 cases of the left ventricular myocardial hypertrophy were found and statistically analyzed. It has been found that arterial hypertension, age, retinopathy, diabetes mellitus, thickening of the intima — media complex of more than 0.9 mm/atherosclerotic plaques of the carotid arteries, body mass index >25.0, and atherosclerosis of the aorta, hyperglycemia and stress led to the development of the left ventricular myocardial hypertrophy. Conclusions: This causative and effect conditionality should be considered in the prevention and treatment of the left ventricular myocardial hypertrophy.

Keywords: lesions of target organs, myocardial hypertrophy

The influence of CCPA and RF on the five-year outcomes in patients with early rheumatoid arthritisиве

Year: 2015, volume 11 Issue: №2 Pages: 135-141
Heading: Internal Diseases Article type: Original article
Authors: Ermakova Yu.A., Karateev D.E., Luchikhina E.L., Demidova N.V.
Organization: Moscow V.A. Nasonova Research Institute of Rheumatology

Objective: to study the influence of CCPA and RF on 5-year outcomes in patients with early rheumatoid arthritis (RA). Subjects and methods. 204 patients with early RA (0,05. From 2 to 5 years — 33,5±20,8 (25,3±14,2), 40,8±26,8 (31,9±20,2), 48,0±28,8 (37,2±22,6), 55,6±30,5 (44,0±24,5), respectively, p

Keywords: CCPA- and RF-positive patients, genetically engineered biological agents, rheumatoid artritis

A prospective 6-month study of adherence to treatment of patients with cardiovascular diseases of regional hospital of the Saratov region

Year: 2015, volume 11 Issue: №2 Pages: 129-135
Heading: Internal Diseases Article type: Original article
Authors: Bulaeva Y.V., Naumova Е.А., Semenova O.N.
Organization: Saratov State Medical University

The aim of the study was to examine the degree of influence of the complex of factors on adherence to long —term drug therapy. Material and Methods. The survey of hospitalized patients with diseases of cardiovascular system has been performed in the therapeutic department of the district hospital of the Saratov region. The questionnaire included socio-demographic indicators, the presence of comorbidity. After 6 months follow-up calls to patients were performed. The relationship between the characteristics were analyzed using one-factor analysis. Results. 100 patients (54% of those invited to the study) completed the survey. After 6 months 86 (80%) patients has managed to be in contact, 44 (51 %) — continue taking drugs after discharge. Continued drug therapy patients, who considered theoretically correct constant mode of therapy (p

Keywords: adherence to therapy, a regional town

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

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.

Keywords: bupivacaine, mode of administration, spinal anesthesia

Changes in the lipid composition of blood under the influence of a single submaximal exercise capacity (experimental research).

Year: 2015, volume 11 Issue: №2 Pages: 123-125
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Ermolaeva E.N.
Organization: South Ural State Medical University

In acute physical exercise, there is a change in oxygen delivery working tissues, blood gas transport function and efficiency of the use of oxygen by cells in the process of metabolism, which is the basis for compensation for physical activities. Lipid metabolism plays an important role in the energy supply of muscle activity. The aim of our research is to study the effect of a single submaximal exercise capacity by changing the lipid profile of peripheral blood. Materials and Methods. The study was performed on 18 white rats. Model of acute exercise: animals swam 4 minutes with a load weighing 20% of body weight. Blood sampling was performed by intracardiac way, right after exercise. The blood lipid profile was determined. Results. In the experiment reported an increase in triglycerides, total cholesterol, very low-density lipoproteins, but the atherogenic ratio is maintained at the control values, due to a significant increase in the level of high-density lipoprotein. Conclusion. Acute submaximal exercise capacity by untrained body has an atherogenic effect. Working muscles during physical activity is a major consumer of free fatty acids, which are the source of atherogenic lipoprotein form of the very low and low density.

Keywords: acute physical activity, lipid metabolism

Forensic medical evaluation age-related changes aorta and pair large arteries

Year: 2015, volume 11 Issue: №2 Pages: 118-122
Heading: Forensic medicine Article type: Original article
Authors: Efimov А.А., Savenkova E.N.
Organization: Saratov State Medical University

Objective: differentiation of age-dependence indices of aorta, carotid, brachial, femoral arteries and drawing the mathematical model for forensic age determinations on their basis. Material and methods. Objects were: aorta, fragments of right and left carotid, brachial and femoral arteries taken in a complex of 186 male and female corpses, died at the age of 17-94. Research methods consisted of organometrical, histological, micrometrical, correlative and regressive analysis. The Results. Correlative and regressive analysis of 35 indicators of aorta, carotid, brachial and femoral arteries was conducted. All material was divided into figures with a significant correlation with age and performance of age-independent. The mathematical model was composed for calculation of age. Conclusion. Indicated involution of arterial wall and compiled on the basis of a mathematical model for determination the age could be taken as the basis for forensic method of age determination.

Keywords: age, arteries, morphology

The structure of thyroid gland in its pathology

Year: 2015, volume 11 Issue: №2 Pages: 113-117
Heading: Macro- and Micromorphology Article type: Original article
Authors: Khayrullin R.M., Kalmin O.V., Kalmin O.O.
Organization: Penza State University

Objective: to identify the microscopic features of the structure of the thyroid gland in different forms of its pathology. Materials and Methods. The study is based on the thyroid glands of 199 patients of both sexes aged 21 to 74 years. Results. At the micro-macrofollicular nontoxic goiter was found flattened thyroid epithelium with flattened normochromic nucleus, the small size of cells and nuclei, low nuclear-cytoplasmic index, intrafollicular moderate epithelial proliferation, homogeneous colloid and moderate diffuse lymphoid infiltration. At the micro-macrofollicular toxic goiter detected cubic epithelium with rounded normochromic kernel, smallest size of cells and nuclei, nuclear-cytoplasmic minimum index intrafollicular focal proliferation of the epithelium, colloid mesh boundary with severe vacuolization, focal lymphoid infiltration and hemorrhage. When diffuse toxic goiter detected cubic form cells of medium size with a fairly high nuclear-cytoplasmic index, rounded normochromic kernel, rare intrafollicular epithelial proliferation, homogeneous colloid with an edge vacuolization. With the prevalence of autoimmune thyroiditis was observed flattened epithelium with rounded normochromic nucleus, the small size of cells and nuclei, found the average nuclear-cytoplasmic index, homogeneous colloid and extensive lymphoid infiltration with light propagation centers. Adenoma of the thyroid gland epithelium was found with a cubic cell shape, round hyperchromatic nucleus, the large size of cells and nuclei, high nuclear-cytoplasmic index intrafollicular diffuse proliferation of epithelial and dense colloid. When thyroid cancer found the prevalence of papillary structures with short broad papillae formed polymorphic cells with round hyperchromatic nucleus, there is the largest size of cells and nuclei, nuclear-cytoplasmic maximum index expressed intrafollicular diffuse proliferation of the epithelium. Conclusions. Each form of thyroid disease, along with well-known typical microscopic manifestations is a characteristic regional feature of the microstructure.

Keywords: microstructure, morphometry, thyroid gland, thyroid pathology