Saratov JOURNAL of Medical and Scientific Research

2020, volume 16

Possibility of complex diagnostics of initial stages of osteoar-throsis

Year: 2020, volume 16 Issue: №2 Pages: 494-499
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Romakina N.A., Gladkova Е.М., Titova Yu.I., Gladkova Yu.K.
Organization: Saratov State Medical University

Objective: To evaluate capabilities of magnetic resonance imaging including T2 relaxometry in combination with laboratory studies of biological markers for diagnostics of hyaline cartilage pathology in the initial stages of knee joint osteoarthritis (OA). Material and Methods: 37 patients of both sexes aged 35-50 years suffering from intermittent pain and discomfort in their knee joints (the main group). The control group was made up of 20 persons of the same age without clinical manifestations of joint pathology. Instrumental research included radiography, ultrasonography, and magnetic resonance imaging of knee joints, including T2 relaxometry measurement. The cartilage oligomeric matrix protein (COMP) content and daily urinary losses of C-terminal telopeptides of collagen type II Urine CartiLaps (CTX II) were determined. Inflammatory activity was evaluated by serum interleukin-1 (3 (11-1(3) with multiplex analysis and C-reactive protein concentration. Results: The increased content of cartilage extracellular matrix biopolymers in the biological fluids (serum COMP, urine excretion Urine CartiLaps (CTX II)) and inflammatory activity was found in patients of the main group compared to those in patients of the control group. Correlation between the COMP concentration and T2 relaxometry digital data (in CU) was characterized as positive strong (R = 0.83), and between COMP and articular cartilage thickness (in mm) on ultrasound data as negative medium (R = -0.63). Interconnections of the same kind were found between the level of daily excretion CTX II and articular cartilage morphometry findings with ultrasound (R = -0.59). Conclusion: Structural changes in the extracellular matrix in early stages of OA can be objectified using T2 cartilage relaxometry and determining COMP as well as CTX II in biological media.

Keywords: metabolism of cartilage, multiplex assay, osteoarthrosis, T2 relaxometry

Surgical management of thoracolumbar fracture-dislocation (clinical case)

Year: 2020, volume 16 Issue: №2 Pages: 488-494
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Likhachev S.V., Zaretskov V.V., Ivanov D.V., Shulga A.E., Arsenievich V.B., Stepukhovich S.V., Mizyurov S.A.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University

The article presents a clinical case history of successful two-stage surgical reconstruction of a rare injury — a simple thoracolumbar fracture-dislocation (Type С AOSpine classification). The optimal arrangement of the stabilizing system at the stage of surgical intervention planning was designed using computer biomechanical simulation. The functional outcome was optimal ensuring complete reconstruction of the lost anatomy with no complication in post-operative period observed.

Keywords: computer biomechanical simulation, spine fracture-dislocation, spondylodesis, thoracolumbar spine

A case study of total joint replacement for intra-articular comminuted metacarpophalangeal fracture (clinical case)

Year: 2020, volume 16 Issue: №2 Pages: 485-487
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Goryakin M.V., Ulyanov V.Yu.
Organization: Saratov State Medical University

An actual case of total metacarpophalangeal joint replacement with prosthetic ceramic-on-ceramic implant for un-united articular fracture of the base of the second finger proximal phalanx is presented.

Keywords: endoprosthesis, incomplete fracture, metacarpophalangeal joint

Thrombinogenesis in patients with aseptic instability of knee endoprosthesis and periprosthetic infection

Year: 2020, volume 16 Issue: №2 Pages: 478-484
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Girkalo M.V., Shakhmartova S.G., Shpinyak S.P., Mandrov A.V., Kozadaev M.N., Puchinyan D.M.
Organization: Saratov State Medical University

Objective: To evaluate thrombinogenesis in patients with periprosthetic infection and aseptic loosening of endoprosthesis after primary knee arthroplasty. Material and Methods: 28 of 52 examined patients who suffered from the loosening of knee endoprosthesis components and 24 from periprosthetic infection; 18 healthy individuals were also engaged into the study. Thrombinogenesis was analyzed with thrombin generation assay in an automated Ceveron alpha coagulometer (Technoclone, Austria) using RB and RC-low activators containing 2 and 5 pmol/ml of tissue factor respectively. Each of the main groups of patients was divided into two subgroups: in patients of the 1st subgroups RC-low activator aggravate thrombinogenesis while in the 2nd subgroups it inhibited the process as compared to the effects of RB activator. Results: In the 1st subgroup of patients with aseptic loosening RC-low activator caused chronometric hyperthrombinogenesis, and in the 2nd — both chronometric and structural ones. In patients with periprosthetic infection the effects of RB and RC-low activators were comparable. Conclusion: In patients with aseptic loosening of the implant and stopped periprosthetic infection that developed after primary knee replacement, the thrombin generation test reveals normal, paradoxical and inert types of thrombinogenesis.

Keywords: aseptic instability, knee replacement, periprosthetic infection, thrombin generation test, thrombogenesis

Prognostic factors in clinical management of root resorption (review)

Year: 2020, volume 16 Issue: №2 Pages: 474-477
Heading: Stomatology Article type: Review
Authors: Savina Е.А., Eremin A.V., Eremin O.V.
Organization: Saratov State Medical University

A literature review is devoted to root resorption of a permanent tooth. Literature data, eLibrary Internet resources and PubMed National Library of Medicine databases databases for 2010-2020 (34 sources) were used to collect the research material. Timely diagnosis using cone beam computed tomography, which provides visualization in the three-dimensional space of root resorption, allows a conservative adequate endodontic intervention and improves the medical effectiveness of the treatment.

Keywords: external inflammatory resorption, invasive cervical resorption, root resorption

Seizures as a manifestation of syndrome of inappropriate antidiuretic hormone secretion

Year: 2020, volume 16 Issue: №2 Pages: 468-473
Heading: Neurology Article type: Case report
Authors: Kozhokaru А.В., Gracheva S.A., Orlova A.S.
Organization: Central State Medical Academy of the ADP of the Russian Federation, First Moscow State Medical University n.a. I.M. Sechenov, State Research Center— Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency

Differential diagnostics of epileptic paroxysms is often complicated and requires a multidisciplinary approach. Clinical presentation of epileptic and non-epileptic paroxysms is polymorphic and correct diagnosis requires clear understanding of semiotics and etiology of these conditions. The article presents a clinical case of a complicated course of the intermediate period of TBI with SIADH and seizures which mimic posttraumatic epileptic seizures.

Keywords: hyponatremia, symptomatic epilepsy, syndrome of inappropriate antidiuretic hormone secretion, traumatic brain injury

Dynamics of changes of microperimetry parameters of retina by closure of macular hole with preservation of internal limiting membrane

Year: 2020, volume 16 Issue: №2 Pages: 463-467
Heading: Ophtalmology Article type: Original article
Authors: Pavlovsky О.А., Fayzrakhmanov R.R., Larina Е.А., Sukhanova A.V.
Organization: National Medical and Surgical Center n. a. N. I. Pirogov

Objective: To evaluate the medical effectiveness of the macular hole closure (MH) technique, which is based on the limiting of the internal limiting membrane (ILM) peeling. Material and Methods: The results of surgical treatment of 80 patients (80 eyes) diagnosed with MH were analyzed. Patients are divided into two groups: group 1-patients who had a standard peeling; group 2-patients who were operated on using the original method with partial peeling of the macular area. All patients underwent visometry, biomicroscopy, ophthalmoscopy, and OCT-examination. Results: By the 30th day after surgical treatment, a statistically significant excess of light sensitivity parameters was detected in the nasal part of the pattern used: the upper-nasal and lower-nasal quadrants, where peeling was not performed (p=0.032) and (p=0.034), respectively. In the 1st observation group, the recovery of the fixation point was observed during the early and late operating period and at 12 months was 58.3% (p=0.041). In group 2 patients, by the time of 1 month after surgery, the recovery of the fixation point occurred in 88.7%. Conclusion: When conducting the method of limited peeling, the ILM is preserved, which reduces the risk of intraoperative damage to the retina layers. A higher functional result was obtained in comparison with the group where the standard method was used.

Keywords: macular hole, microperimetry, peeling of the internal limiting membrane

Oxidative stress and methods of its correction in corneal burns (review)

Year: 2020, volume 16 Issue: №2 Pages: 459-463
Heading: Ophtalmology Article type: Review
Authors: Kolesnikov A.V., Kirsanova I.V., Sokolova A.I., Ban E.M.
Organization: Ryazan State Medical University n.a. I.L.Pavlov

The article presents actual ideas about the role of oxidative stress in the pathogenesis of corneal burns and methods of its correction. Corneal burns are rather common ophthalmic pathology. Corneal burns are difficult to treat, so they often lead to a decrease in visual acuity and, as a result, disability of young people. Despite the high antioxidant protection of the eye structures, under the influence of damaging environmental factors on the cornea (ultraviolet, chemicals, high temperatures, etc.), there is an increase in the concentration of free radicals with a decrease in the level of antioxidants — oxidative stress develops, aggravating damage to the cornea. Medicaments with antioxidant properties have shown their efficacy in the treatment of corneal burns.

Keywords: antioxidants, corneal burn, oxidative stress

Functional heart capacity in athletes with different levels of blood pressure in the Republic of Sakha (Yakutia)

Year: 2020, volume 16 Issue: №2 Pages: 452-458
Heading: Cardiology Article type: Original article
Authors: Mestnikova E.N., Zakharova F.A., Pinigina I.A., Makharova N.V.
Organization: Republican Center for Sports Training of National Teams of the Republic of Sakha (Yakutia)

Objective: to evaluate the reserve capacity of the heart in athletes with different levels of blood pressure in the Republic of Sakha (Yakutia). Material and Methods. 205 males of Yakut nationality aged 18 to 30 years old were examined (average age was 22.2±4.04), 147 of them were professional athletes, 58 control persons. Anthropometry was performed in all subjects, measurement of office blood pressure levels, ambulatory monitoring of blood pressure, echocardiography, bioimpedansometry, genetic research. Results. In our study, the masked hypertension was detected in 40.8% of the athletes, and more often observed in athletes with the "master of sports" qualification (x2=5.68, df=1, p=0.013)and does not depend on the orientation of the training activity (kind of sport) (x2=2.09, df=1, p=0.107). Despite the same sports experience and orientation of training activity, athletes with masked hypertension have low values of heart stroke volume (p=0.033) and, accordingly, heart stroke index (p=0.041), a high double product, and high left ventricle (LV) wall thickness, LV myocardial mass index and a decrease in the end-diastolic volume of the left ventricle compared with athletes with a normal blood pressure level. Conclusion. In athletes with masked hypertension, a decrease in the reserve capacity of the heart and a less economical mode of work at rest were noted, as evidenced by the indicators of central hemodynamics and the structural and functional parameters of the LV.

Keywords: heart of an athlete, hemodynamics, masked hypertension, myocardial remodeling

Features of lower respiratory tract microbiocenosis in patients with a combination of occupational copd and type 2 diabetes mellitus

Year: 2020, volume 16 Issue: №2 Pages: 446-451
Heading: Internal Diseases Article type: Original article
Authors: Lyubavina N.A., Makarova E.V., Berezina N.A., Saltsev S.G., Menkov N.V., Paramonova J.A.
Organization: Privolzhskiy Research Medical University, Nizhny Novgorod Research Institute of Hygiene and Occupational Pathology, City Clinical Hospital №10 of the Kanavinsky District of Nizhny Novgorod

The aim of the study was to determine the features of the lower respiratory tract microbiocenosis in patients with a combination of professional chronic obstructive pulmonary disease (COPD) and diabetes mellitus type 2 (T2DM). Material and Methods: The study included 123 patients with occupational COPD, 61 of them had T2DM. General clinical examination, investigation of fasting glucose and HbA1c levels, pulmonary function testing, microbiological examination of sputum were carried out in all patients. Results: The risk of detecting microbial associations increased by 4.5 times, and the relative risk of isolation of Haemophilus spp. was 3.1 [95%CI 2.0-5.0], enterobacteria and enterococcus — 5.5 [95%CI 1.3-24.2] in patients with professional COPD and diabetes mellitus type 2. The number of microorganisms in sputum cultures correlated with the severity of bronchial obstruction and the level of glycemic control: a relationship was found between the total microbial load and the value of HbA1 с (/=0.71, p<0.001), as well as the value of FEV1 (r= -0.53, p<0.001). Conclusion: Increased proportion of gram-negative microorganisms was found in patients suffering from occupational COPD combined with T2DM. Deterioration of glycemic control leads to higher microbial colonization of the respiratory tract in COPD patients.

Keywords: type 2 diabetes, occupational COPD, microbiocenosis