Saratov JOURNAL of Medical and Scientific Research

2017, volume 13

The influence of premorbid background on the course of urolithiasis

Year: 2017, volume 13 Issue: №2 Pages: 280-283
Heading: Urology Article type: Original article
Authors: Osnovin O.V., Popkov V.M., Fomkina O.A.
Organization: Saratov State Medical University

Aim: to analyze the correlation between the unfavorable factors at newborn patients and children and the peculiarities of the course of urolithiasis in adults. Material and Methods. The data were received from questioning of 286 patients and their relatives, analysis of case histories and past medical histories. The material was statistically worked out. Results. The early development of urolithiasis (at patients under 30) was associated with the threat of termination of pregnancy, prematurity, excretory and digestive disorders at childhood in case of severe anamnesis of urolithiasis, and also malnutrition. Bilateral lesions of the urinary system were determined to be associated with artificial feeding and prematurity, digestive diseases and complicated anamnesis of urolithiasis, malnutrition, deprived living conditions and low income. Stones in calyces occurred at patients with different complications at birth. More frequent cases of stone formation in renal pelvis were observed at premature and malnutrition patients and patients with cardiovascular diseases occurred during the childhood. Stones in ureters were considered as a result of respiratory diseases effect. Conclusion. Unfavorable factors occurred at birth and childhood, factors concerned with deprived social conditions and psychological problems influence the onset and the course of urolithiasis.

Keywords: premorbid background, urolithiasis

Modern surgical aspects in blood loss management in total knee arthroplasty

Year: 2017, volume 13 Issue: №2 Pages: 273-279
Heading: Traumatology and Orthopedics Article type: Review
Authors: Chugaev D.V., Kornilov N.N., Sorokin Е.Р., Stafeev D.V.
Organization: North-West State Medical University n.a. I.I. Mechnikov, Department of Neuropathology Assistant Professor, Candidate of Medical Science, Vreden Russian Research Institute of Traumatology and Orthopaedics

The frequency of knee arthroplasty in knee arthritis is forcing the orthopedic community to take measures to optimize this surgical intervention. Despite the fact that this is a routine operation, it is often accompanied by significant blood loss. Large intraoperative blood loss leads to the development of postoperative post-hemorrhagic anemia which is an extremely unfavorable effect in the course of wound healing, moreover, it affects the length of stay of a patient in clinic and the cost of treatment. The analysis of the literature on the issue of patient blood loss management tells of divergent efforts of experts in related fields of medicine and complex multi-disciplinary research on this topic, often — with contradictory conclusions. It can be noted that nowadays there is no accurate, reliable and scientifically proven sound algorithm of blood loss management in primary total knee arthroplasty in modern Russian and foreign literature.

Keywords: blood loss management, blood transfusion, drain, knee replacement, tourniquet

A comprehensive evaluation of cervical spine surgery outcomes

Year: 2017, volume 13 Issue: №2 Pages: 266-273
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ostrovsky W, Schanitsyn IN, Bajanov SP, Fedonnikov AS.
Organization: Saratov State Medical University

Aim: study of diagnostic value of different assessment scales to evaluate outcomes of surgeries in degenerative and post-injury deformities of cervical spine. Material and Methods. Between January and December 2015, 110 consecutive patients with degenerative and traumatic lesions of cervical spine were selected for surgery and results of treatment were followed. Preoperatively and 12 months postoperatively the patients filled in a questionnaire that included a VAS, Odom's scale, NDI, modified JOAand the Zung Depression Scale. To assess the results of the intervention, the concept of "effect size" was used. Distribution of different scores classified according to Odom's criteria as excellent/good and fair/poor. Results. All scores improved in all group of patients. For VAS, NDI and modified JOA scores the effect size was largest. NDI, JOAand ZDS seemed to correlate well with the classification of outcome by Odom. Conclusion. It is suggested many scales to assess the outcomes of the cervical spine surgery based on different criteria; nevertheless, there are no generally accepted and validated methods that can be used to analysis the outcome of cervical spine surgery. We conclude that investigated

Keywords: cervical spine, myelopathy, outcome scores, radiculopathy, surgical treatment

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

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.

Keywords: crystal, dentine, hydroxyapatite, ultrasound

The role of biomarkers in early diagnostics of inflammatory diseases of intestine in newborns

Year: 2017, volume 13 Issue: №2 Pages: 256-259
Heading: Pediatrics Article type: Review
Authors: Chernenkov Yu.V., Pozgaleva N.V. Panina OS.
Organization: Saratov State Medical University

Information on noninvasive biomarkers and methods for studying inflammatory bowel diseases in newborns has been summarized. It is based on the analysis of data taken from foreign and Russian literature. The need for additional study of factors affecting the level of fecal protein production in newborns is substantiated.

Keywords: newborn, inflammatory bowel disease, calprotectin, biomarker

Analysis of status of preterm infants with bronchopulmonary dysplasia

Year: 2017, volume 13 Issue: №2 Pages: 251-255
Heading: Pediatrics Article type: Original article
Authors: Chernenkov Yu.V., Nechaev V.N., Nesterova D.l.
Organization: Saratov State Medical University

Objective: the combination frequency of BPD in premature infants, assessment of the degree of functional lesion of the respiratory tract and the efficiency of respiratory support. Material and Methods. The survey included 36 women and 38 preterm infants (two twins). Results. In 99% of the surveyed women pregnancy was complicated by chronic intrauterine fetal hypoxia, 2.1% — RH-conflict. At 43.2% of cases acute respiratory viral infection during pregnancy was revealed, 15.3% of bad obstetric history, 5% of women who had bad habits (smoking, alcohol intake). In 2015 there were 5 deaths (13.2%). 14 children (36.8%) were transferred to other hospitals for further treatment, the remaining 19 (50%) were discharged from the hospital. One child — full-term, the other— premature. At 87.7% of children with BPD, the diagnosis was RDS, in 4.2% — aspiration of meconium, 8.1% — congenital pneumonia. 15 children (30.5%) received therapy with surfactant once, including 9 newborns (23.7%) received medication twice. All newborns were carried out intensive care, including respiratory support. Mechanical ventilation in 14 children had been conducting for 8.4±2.3 day, in 13 cases for 17.3±3.8 day, in 11 cases for 23.4±4.1 day. Nasal CPAP was conducted in 23 newborns: from 4 to 6.8±1.9 day, 13 — less of 16.8±2.9 per day, 6 children have had more than 23.2±3.8 day. Conclusion. There is necessity for prevention during pregnancy with glucocorticoids, the prolongation of pregnancy; preterm neonates — surfactant therapy; adequate provision of resuscitation care in the delivery room and respiratory support. The reduction of time of mechanical ventilation and the expansion of the indications for non-invasive methods of respiratory therapy reduced the incidence of BPD, the severity of the disease and improve the prognosis.

Keywords: respiratory therapy, prevention of BPD, premature infants, bronchopulmonary dysplasia (BPD)

Issues on health status and rehabilitation of young children born with extremely low and very low weight

Year: 2017, volume 13 Issue: №2 Pages: 245-251
Heading: Pediatrics Article type: Review
Authors: Scherbatyuk E.S., Khmilevskaya S.A., Zryachkin N.I.
Organization: Saratov State Medical University

The review presents literature data on the catamnesis of children born with extremely low and very low weight, identification of the most common pathological conditions, of the incidence rate and the main causes of disability in childhood, the rationale for the need for early initiation of rehabilitation actions aimed at preventing and correction of these conditions. The article highlights difficulties in assessment of physical and neuropsychological development of deeply premature babies, related to the heterogeneity of contingent of the children being surveyed and the difference in the tests used to determine these parameters. It was noted that for a comprehensive assessment of their health they also need to determine quality of life using the developed scales. The author substantiated the need to improve the system of medical support for such children at all phases of nursing and rehabilitation process and perforce to introduce a personal approach with differentiated programs of medical examination and rehabilitation in the wide practice.

Keywords: catamnesis, deeply premature babies, health status, infectious diseases, quality of life, rehabilitation

Diagnostic value of bio-markers in the prognosis of postoperative relapses and metastases in patients with breast cancer

Year: 2017, volume 13 Issue: №2 Pages: 239-244
Heading: Oncology Article type: Original article
Authors: Cheburkayeva M.Yu., Zakharova N.B., Fedorov V.E., Teryoshkina N.E., Gergenreter Yu.S.
Organization: Regional Oncology center №2, Saratov State Medical University

Purpose: to improve the diagnosis of relapse and metastasis of breast cancer in the postoperative period. Material and methods. 123 women were examined. Of these, 30 practically healthy women made up a control group, 20 women had benign breast diseases, 73 had breast cancer. The patients with ВС before the surgical intervention were divided into groups according to the stage of the disease. The 1st group consisted of 30 practically healthy women. In the second group — 20 women with fibroadenomas of the breast. In the third group — 33 women with l-ll stages of breast cancer without regional metastases. The 4th group consisted of 22 women with stage II breast cancer with regional metastases, in the 5th group — 18 patients with stage III breast cancer. After surgery, 68 patients were re-examined and divided into 2 analytical groups. The 6th group included women without clinical manifestations of relapses and metastases in the postoperative period — 44 (64.7%). Group 7 consisted of 24 (35.3%) women who had metastasis and local recurrences of the disease in the postoperative period. To determine the content of fetal proteins (Ca-15-3, Ca-125, REA), IL-8 and VEGF, commercial sets of reagents for solid-phase enzyme-linked immunosorbent assays were used. Results. Analysis of the data obtained showed that the most significant increase in serum and plasma VEGF levels occurred in breast cancer patients with clinical signs of metastasis and recurrence of the disease. Of fetal proteins, a significant increase in blood content showed Ca15-3 and CEA. Conclusion. We can assume that in patients with breast cancer only in the postoperative period, the rise in VEGF was associated with the growth of tumor tissue and the development of invasion and metastasis.

Keywords: biomarker, breast cancer, metastases, postoperative period, recurrence

Manifestations of pathomorphosis at pregnant women with heart diseases

Year: 2017, volume 13 Issue: №2 Pages: 233-238
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Kazachkova E.A., Kazachkov E.L., Vorobiev I.V.
Organization: South Ural State Medical University

Purpose: to study the structure of heart defects in pregnant women, the features of the medico-social portrait, the course of pregnancy and perinatal outcomes in patients with heart defects in the light of pathomorphosis. Material and Methods. A retrospective clinical and anamnestic analysis of the medical documentation of 165 patients delivered in the maternity hospital of the Municipal Health Care Institution of the City Clinical Hospital No. 6 in Chelyabinsk in 1991-1994 was conducted, (group 1)and a prospective cohort study of 168 patients who were delivered to this hospital between 2011 and 2014 (group 2) in accordance with a modified WHO classification for assessing the risk of cardiovascular complications for the mother and offspring, the characteristics of the medico-social portrait, The course of pregnancy and perinatal outcomes in patients with heart defects in the light of the doctrine of pathomorphosis. Results. It is established that over the past 20 years, there have been significant changes in the structure of heart diseases, the medical and social characteristics of patients with this disease, complications of gestation, which must be taken into account when choosing the optimal tactics for pregravid preparation, pregnancy in women with heart defects. Conclusion. The significant changes in the structure and frequency of heart defects observed in modern pregnant women with heart defects, in the features of the medical and social portrait of these patients, and also during pregnancy, childbirth and perinatal outcomes, can be treated as pathomorphosis in the clinical (narrow) sense.

Keywords: heart disease, pathomorphosis, pregnancy

Systemic inflammatory response and cytokine profile at burn injury in dynamics

Year: 2017, volume 13 Issue: №2 Pages: 229-232
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Morrison V.V., Bozhedomov A.Yu., Simonyan M.A., Morrison A.V.
Organization: Leningrad Regional Clinical Hospital, Saratov State Medical University

The aim of the article is to study the dynamics of indices of systemic inflammation in correlation with the following factors: the outcome of the disease, disturbances in proinflammatory cytokines rate and vascular endothelial dysfunction markers rate at burn injury in dynamics. Material and Methods. 152 patients with burn injuries over 30 units by Frank's index were under the study. The research on the level of interleukins, endothelial vessels growth factor, macrophage chemotactic protein, level of endothelin and C-reactive protein was performed with quantitative immuno-enzymatic detection. The amount of circulating of desquamated endothelial cells was accounted by phase-contrast microscopy. Results. Proinflammatory cytokines rate and vascular endothelial dysfunction markers rate significantly increase reaching their maximum indices to the 7-15th day of burn injury and indicating the expressiveness of systemic inflammatory response syndrome. Conclusion. The received data have become important in the determination of increased number of criteria of systemic inflammatory response syndrome depending on the outcomes of the burn injury and endothelial dysfunction development.

Keywords: burn injury, endothelial dysfunction, systemic inflammatory response