2015, volume 11
Achondrogenesis type II (Langer — Saldino syndrome) at a newborn: Clinical case.
Heading: Pediatrics Article type: Case report
Authors: Chernenkov Yu.V., Nechaev V.N., Stasova Yu.V., Tereshenko V.A.
Organization: Saratov State Medical University
The aim of the article is to present clinical experience of conducting the patient with a genetic syndrome of Langer — Saldino in branch of resuscitation and intensive therapy of newborns of Perinatal Center of Saratov. It is necessary to notice that the described pathology is a rare autosomal dominant disease shown by plural developmental anomalies and determines great attention from the practical point of view. The given syndrome concerns mortality diseases leading to lethal outcomes on early terms of prenatal development, or in the nearest neonatal period from respiratory insufficiency.
Algorithm of surgical treatment of pain and spastic syndromes in patients after spinal cord injury
Heading: neurosurgery Article type: Original article
Authors: Ninel V.G., Smolkin А.А., Shchukovsky V.V., Korshunova G.A.
Organization:
Objective: to develop an algorithm for surgical treatment of pain and spasticity in patients with consequences of spinal cord injury. Materials and Methods. The basis of the algorithm initiated a retrospective study of results of surgical treatment of 273 patients with pain and spastic syndromes after spinal cord injury, which consistently met neuromodula-tion techniques and destructive surgery. Results. The developed algorithm tested in 166 patients with pain and spastic syndromes provided positive results in 88.6% of cases with spastic and in 80.4% of observations for pain and spastic-pain syndromes. Conclusion. The proposed algorithm allows systematizing neuromodulation methods and so-called «radical» destructive operations in the treatment of pain and spasticity, and thereby improving the results of rehabilitation of patients with consequences of spinal cord injury.
Changes in cerebral blood flow and psychometric indicators in veterans with early forms of chronic brain ischemia
Heading: Neurology Article type: Original article
Authors: Vasilenko Т.М., Davydova E.V.
Organization: Head of Chelyabinsk Regional Clinical Therapeutic Hospital for War Veterans
The goal is to study the cerebral blood flow and psychometric characteristics in veterans of Afghanistan with early forms of chronic brain ischemia. Material and Methods. The study included 74 veterans of the Afghan war aged from 45 to 55 years: group 1, 28 people with NPNKM; Group 2-28 patients with circulatory encephalopathy stage 1; group 3-18 healthy persons. Doppler examination of cerebral vessels was carried out on the unit «Smart-lite». Reactive and personal anxiety of patients was assessed using the scale of Spielberger, evaluation of the quality of life through the test SAN. Determining the level of neuroticism and psychoticism was conducted by the scale of neuroticism and psy-choticism. Results: The study of cerebral blood flow in the Afghan war veterans showed signs of insolvency of carotid and carotid-basilar anastomoses, hypoperfusion phenomenon with the depletion of autoregulation, violation of the outflow of venous blood at the level of the microvasculature, accompanied by cerebral arteries spasm. More than 40% of patients with early forms of chronic brain ischemia had high personal anxiety, low levels of well-being and activity, with maximum expression of dyscirculatory hypoxia. Conclusion. Readaptation of veterans of Afghanistan is accompanied by the changes in psychometric performance and the formation of the earliest forms of brain chronic ischemia associated with inadequate hemodynamics providing increased functional activity of the brain and the inefficiency of compensatory-adaptive reactions.
Measurement of the lateral ventricles width by ultrasound investigation in the second trimester of pregnancy
Heading: Radiology Article type: Short message
Authors: Kozlova O.I., Medvedev M.V.
Organization: Institute of Continuous Education, Federal Medical Biological Agency
Purpose: to assess reproducibility of measurement of the width of lateral ventricles of the fetal brain by ultrasound investigation in the second trimester of pregnancy. Material and Methods. The volume of the 34 normal fetal brains at 18-21 weeks of gestation was retrospectively evaluated. Two experienced specialists measured the width of lateral ventricles from each fetus twice. Results. Intra-operator differences of the first specialist constituted 0,136±0,065mm, of the second specialist — 0,156±0,066mm. Inter — operator differences counted 0,191±0,062mm. Conclusion. Measurement of the width of lateral ventricles is highly reproducible, it should be performed by ultrasound investigation in the second trimester of pregnancy.
Clinical and immunological aspects of the course of myocardial infarction associated with diabetes mellitus during hospital treatment
Heading: Internal Diseases Article type: Original article
Authors: Skorodumova Е.А., Kostenko V.A., Siverina A.V., Fedorov A.N.
Organization: Institute for Emergency Medical Care n.a. I.I. Dzhanelidze
The aim of the study was to provide the data on the course of myocardial infarction (Ml) associated with diabetes mellitus (DM) in hospital. Material and methods. 102 patients with Ml were included in two cohorts, first with DM, second — without DM. Groups were compatible by gender, age and standard therapy. Results. Angiocoronarography data have revealed that patients of group 1 were characterized by multiple vessels lesion due to "rescue" angioplasty with stenting performed 5 times. Patients with DM demonstrated in-hospital higher rate of both acute (by Killip) and chronic (by NYHA) heart failure of advanced degrees as well as recurrent Ml, early postinfarction angina pectoris, heart rhythm disorders and hematomas due to injections. Conclusion. The previously mentioned results lead to higher mortality in this group. Significant elevation of CRP, interleukin-6 and epidermal growth factor levels proved more activated systemic inflammatory response in patients with Ml and DM playing key role in pathogenesis of complications of the disease.
Perspectives of anatomical and clinical criteria use in revascularization of patients with stable coronary artery disease
Heading: Internal Diseases Article type: Author's opinion
Authors: Genkal E.N., Posnenkova О.М., Kiselev A.R., Korotin A.S., Gridnev V.I., Dovgalevsky P.Ya.
Organization: Saratov Institute of Cardiology, Russia, Saratov State Medical University
The aim of the study is to describe the development of the algorithm for the data analysis of Russian coronary artery disease (CAD) Registry. The algorithm allows determining the need in percutaneous coronary intervention (PCI) and evaluation the validity of PCI in patients with stable CAD on the basis of appropriate use criteria for coronary revascularization by the American College of Cardiology. Two measures propose for clinical decision support and automated assessment of PCI appropriateness «The need in PCI in patients with stable CAD» and «PCI validity in patients with stable CAD».
Assessment of health care quality among penitentiary employees with hypertension in the Saratov region
Heading: Internal Diseases Article type: Original article
Authors: Balashov S.V., Balashova M.E., Popova Yu.V.
Organization: Saratov State Medical University, Saratov Institute of Cardiology, Russia, Center of Medical and Social Rehabilitation of Medical Unit no.64 of Russian Federal Penitentiary Service
The aim of the study is to assess the quality of health care among penitentiary employees with hypertension in the Saratov region from 2003 to 2013. Material and Methods. The data from 62 employees with hypertension (43 men and 19 women) who followed up in the dispensary of Branch of Center of Medical and Social Rehabilitation of Medical Unit no.64 of Russian Federal Penitentiary Service in 2013 were evaluated. We analyzed retrospectively the quality of health care in every calendar year from 2003 to 2013 according to the following categories: control of blood pressure (BP), control of physical activity, control of smoking, control of weight, control of diet, control of cholesterol. To assess the quality of care we used clinical indicators implemented in the Federal Hypertension Register. Results. During the overall period (2003-2013) counseling on physical activity, smoking, weight and eating was optimal. However, only physical activity was controlled effectively in patients. The measures on control of BP and cholesterol needed improvement. Conclusion. Despite relatively good quality of the majority of health care measures among hypertensive patients in the Center of Medical and Social Rehabilitation, the effectiveness of these measures has been found out to be insufficient. It may be due to poor patients' adherence to recommendations.
Sclerotic disease, integrative diagnosis, chronic forms and treatment of diseases
Heading: Internal Diseases Article type: Review
Authors: Kats Ya.A., Parkhoniuk E.V., Skriptsova S.A.
Organization: Saratov State Medical University
The aim of the article is to determine the importance of an integrative approach to identify and analyze the phases or stages of the example of chronic sclerotic disease (CSD). The proposed concept of CSD is to use the diagnostic methods before sclerotic period, based on an analysis of indicators of intensity of the functional systems responsible for collagen formation and collagen lysis taking into account the potential of genetically caused features of sclerosis. Thus, special attention is paid to pre-disease stage including the history and molecular genetic studies which predict the nature of the possible diseases and determine the risk of formation of CSD. The proposed methodology and techniques, as well as obtained with their help data define the possibility of risk groups identification, the direction and volume of the survey.
Evaluation of latent period of temperature sensitivity in traditional and unilateral spinal anesthesia
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
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.
Myeloprotective efficiency of combination of pyrimidine and 3-hydroxypyridine derivatives in experimental antineoplastic chemotherapy
Heading: Parmacology Article type: Original article
Authors: Siprov A.V., Masyagin V.A.
Organization: Mordovia State University n.a. N. P. Ogaryov
The aim of the study is comparative assessment of the influence of separated and combined use of pyrimidine and 3-hydroxypyridine derivatives — xymedon and mexidol on the bone marrow hemopoiesis and peripheral blood quantitative indicators in rats with Walker-256 carcinoma at the doxorubicin and paclitaxel chemotherapy. Materials and Methods. Experiments have been carried out on 83 Wistar female rats of weight 150-250 grams. Doxorubicin in a dose of 4mg/kg and paclitaxel in a dose of 6mg/kg were administered intraperitoneally on the 11th day of experiment. Xymedon (100mg/kg) and mexidol (50mg/kg) were administered separately and in combination with each other, starting with the 11th day of experiment for 10 Says. We estimated myelograms and peripheral blood changes on the 14th and 22d day of the experiment. Results. Xymedon normalized differentiation of granulocytopoiesis cells more effectively than mexidol and reduced severity of erythrocytopenia on the 14th day of the experiment. Combination of xymedon and mexidol accelerated granulocytes differentiation more effectively than separated use of these medicines. It was accompanied by more effective increase of neutrophils number in peripheral blood. Despite the increase of poly-chromatophil normocytes number in bone marrow to the 22d day, the erythrocytes number in blood was not differed from one at separated use of these medicines. Conclusion. Myeloprotective effect of xymedon exceeds the effect of mexidol one. The combination of xymedon and mexidol accelerates granulocytes differentiation more effectively than separated use of these medicines.