Saratov JOURNAL of Medical and Scientific Research

№1, 2021, volume 17

Method for modeling a skin wound in pigs in experiment

Year: 2021, volume 17 Issue: №1 Pages: 46-50
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Bogdanov S.B., Karakulev A.V., Bogdanova Yu.A., Sotnichenko A.S., Gilevich I.V., Melkonyan K.I., Alad’ina V.A.
Organization: Research Institute — Regional Clinical Hospital No. 1 n. a. Professors. V. Ochapovsky, Kuban State Medical University

Aim: development of an experimental model for studying the course of the wound process and the effectiveness of applying wound dressings both in clean conditions and on a purulent wound in one animal. Material and Methods. Pig wound modeling is used as an in vivo model. In the operating room, under general anesthesia in the lateral position, the laboratory animal is marked with the future burn surface. A hot steel contact pad applies a thermal injury to the skin of a given size and the required depth of thermal injury (IIIB and IV grades according to Vishnevsky’s classification). Then necrectomy was performed with primary and delayed plasty using the studied wound dressings. After this, non-viable tissues are removed with primary and delayed autodermoplasty and plastic wound dressings. The research subject — in vivo study included 4 Landrace pigs (animal weight from 18 to 24 Kg). Results. With burns IIIB Art. under the decellularized scaffolds, scar tissue was formed by the 12th day, under the recellularized ones by the 8th day, epithelialization of the wound occurred. With burns IV Art. granulation tissue without aseptic inflammation on the 8th day was formed. Conclusion. The developed method for modeling a wound in an experiment allows one animal to analyze the engraftment of wound coverings, both in early and in staged surgical treatment of burns.

Keywords: wound covering, experimental research model, burns

Pathomorphological and pathogenetic features of acute brain infarction in the middle cerebral artery circulation (review)

Year: 2021, volume 17 Issue: №1 Pages: 40-45
Heading: Neurology Article type: Review
Authors: Bazhanov S.P., Shuvalov S.D., Fomkina O.A., Ulyanov V.Yu., Ostrovsky V.V.
Organization: Saratov State Medical University

The article presents the data on pathomorphological and pathogenetic features of the acute brain infarction in the middle cerebral artery (MCA) circulation. We have analyzed more than 38 research papers published in 2010-2020 and distributed in PubMed,, Medscape, Cochrane Library, and Medical NDX databases. Due to the wide prevalence, huge socio-economic significance, as well as high mortality rates of patients with brain infarction in the MCA basin, the coverage of issues and further study of the pathomorphological and pathogenetic aspects of this disease is extremely important for the timely diagnosis of acute complications and the use of modern methods of complex treatment.

Keywords: cerebral herniation, cerebral infarction, dislocation syndrome

Clinical significance of the use of transcranial magnetic therapy in the comprehensive non-drug rehabilitation of newborns with perinatal injury of the central nervous system

Year: 2021, volume 17 Issue: №1 Pages: 33-39
Heading: Pediatrics Article type: Original article
Authors: Zakharov I.A., Panina O.S., Chernenkov Yu.V.
Organization: Saratov State Medical University

The aim is to assess the effectiveness of the use of transcranial magnetic therapy in the comprehensive non-drug rehabilitation of newborns with perinatal injury of the central nervous system. Material and Methods. The research includes 214 newborns with postconceptual age more than 30 week and perinatal injury of the central nervous system. Main group (n=79): children underwent standard pharmacotherapy in combination with comprehensive non-drug rehabilitation (which including dry immersion, music therapy and orolingual massage), and transcranial magnetic therapy; Comparison group (n=74): children underwent standard pharmacotherapy in combination with non-drug rehabilitation; Control group (n=61): children received conventional pharmacotherapy. Results. Hyperactivity syndrome was cured in 60% of children in main group, vegetative-visceral disorders — in 80% of children, CNS repressive syndrome signs disappeared in 67% of children, a significant (p<0.05) decrease in the resistance index was noticed, a decrease in elevated peripheral vascular resistance and physiologic reflex extension, especially the oral reflexes group. Odds ratio of the normalization of oral reflexes group by the tenth day for the main and control groups was 5,09 with 95% Cl [1.8-13.8], and for the main and the comparison group — 3.0 with 95% Cl [1.1-8.4]. Normalization of muscle tone and decrease in the resistance index by the tenth day in the main group was observed, respectively, 8 and 4 times more often than in control group. Odds ratio is 8.2 with 95% Cl [1.8-16.3] and 4.05 with 95% Cl [1.06-9.3], respectively. Conclusion. Non-drug rehabilitation methods combined with magnetic therapy produces sedative effect, provides the stimulation of respiratory movements, spontaneous motor activity, the resumption of proper reflex action. Thus it is recommended to be included in perinatal CNS injury newborns therapy.

Keywords: prematurity, perinatal lesions, non-drug rehabilitation, magnetotherapy

Pathomorphology of submacular hemorrhage (review)

Year: 2021, volume 17 Issue: №1 Pages: 28-32
Heading: Ophtalmology Article type: Review
Authors: Fayzrakhmanov R.R., Shishkin M.M., Bosov E.D., Sukhanova A.V., Mironov A.V.
Organization: Institute of Advanced Training of Physicians N. I. Pirogov National Medical Surgical Center, National Medical and Surgical Center n. a. N. I. Pirogov, S. Fyodorov Foundation to Promote the Development of Advanced Medical Technology

Submacular hemorrhage is a serious complication of various eye diseases, leading to persistent and often irreversible loss of vision. Age-related macular degeneration (AMD) is one of the main causes of this pathology. The formed hemorrhage has pronounced destructive changes in the photoreceptor and inner nuclear layers of the retina. Patho-morphological disorders are mediated by the complex effect of neurotoxic blood breakdown products, traction effects of fibrin filaments, and blocking of metabolic processes between the retinal pigment epithelium and the overlying layers of the retina. The literature review was carried out using the search engines PubMed, Embase, Cochrane Library, the analysis of literature sources on a given topic, published from 1959 to 2020, was completed. The authors concluded that the study of morphological changes in the retina after acute submacular hemorrhage requires compliance with the principle of multimodal imaging, which makes it possible to establish prognostic criteria for the restoration of visual functions, as well as to facilitate the choice of surgical treatment tactics. This problem is poorly understood and requires additional clinical studies.

Keywords: age-related macular degeneration, hemorrhagic retinal detachment, submacular hemorrhage

Experience of treatment of progressive choroidal nevus by transpupillary thermotherapy

Year: 2021, volume 17 Issue: №1 Pages: 23-28
Heading: Ophtalmology Article type: Original article
Authors: Gurko T.S.
Organization: S. Fedorov Eye Microsurgery Federal State Institution

Purpose: to assess the efficacy of transpupillary thermotherapy (TTT) in treatment of the progressive choroidal nevus. Material and Methods. Diagnosis and treatment of 29 patients (29 eyes) with progressive choroidal nevus were analyzed. The follow-up was from 4 months to 3 years. In the diagnosis of the neoplasm we paid a special attention to the ultrasound B-scanning, optical coherence tomography (ОСТ), OCT-angiography. According to the ultrasound scanning (B-scanning) data the neoplasm height varied from 0.78 to 3.64 mm (1.60 (1.40; 1.84) before treatment, the length varied from 1.30 to 14.05 mm (6.41 (5.12; 7.54). For treatment we used laser device IRIS MEDICAL IQ 810 "IRIDEX" in the LONGPULSE mode. Results. After treatment the prominence in the nevus zone was not defined in 14 cases (48.3%) according to B-scanning data. In 15 (51.7%) patients the neoplasm height and length decreased: prominence height was 1.40 (1.20; 1.50), varying from 0.7 to 3.1 mm, the length was from 1.3 to 7.5 mm (6.10 (4.69; 7.30). In 28 (96.5%) patients visual acuity has not changed. Conclusion. The treatment of progressive choroidal nevus by TTT showed its efficacy, safety and good tolerance.

Keywords: transpupillary thermotherapy, ophthalmooncology, choroidal nevus

Influence of valsartan on clinical and instrumental parameters in patients suffering from chronic heart failure with mid-range ejection fraction

Year: 2021, volume 17 Issue: №1 Pages: 19-22
Heading: Cardiology Article type: Original article
Authors: Glebova Т.А., Galin P.Yu.
Organization: City Clinical Hospital n. a. N.I. Pirogov, Orenburg State Medical University

Purpose: to establish the effectiveness of valsartan in patients with chronic heart failure with mid-range ejection fraction from the standpoint of influencing the clinic, the parameters of central hemodynamics and the level of natriuretic peptide. Material and Methods. Our study included 45 patients with CHF with mid-range ejection fraction, with NYHA (New York Heart Association) functional class II (FC). All patients underwent a comprehensive clinical and standard echocardiographic examination. Valsartan was administered in titrated dosages up to the maximum tolerated ortarget daily dose in accordance with the recommendations. The observation period was one year. Results. During the observation period, 89% of patients switched from FC II to FC I of CHF (p<0.001), the left ventricular (LV) ejection fraction increased from 46 (44-47) % to 55 (53-60) % (p<0,05), the level of natriuretic peptide decreased from 455 (397-513) pg/ml to 210 (146-343) pg/ml (p<0.05). Conclusion. The use of valsartan in patients with CHF with mid-range ejection fraction improves the clinical condition and parameters of central hemodynamic during a year of observation.

Keywords: chronic heart failure with mid-range ejection fraction, natriuretic peptide, valsartan

Laboratory and instrumental diagnostics of viral pneumonia (review)

Year: 2021, volume 17 Issue: №1 Pages: 13-18
Heading: Internal Diseases Article type: Review
Authors: Tyapkina D.A., Boroday А.А., Tyapayeva A.R., Semenova O.N., Naumova E.A.
Organization: Saratov State Medical University

The review analyzes the published data on laboratory and instrumental diagnostics of viral pneumonia. To search for articles, we used the PubMed database and eLIBRARY RU, as well as archives of the journals "Clinical Microbiology and antimicrobial chemotherapy", "Pulmonology", "Medical education today", "Complex problems of cardiovascular diseases", "Archives of internal medicine", "Kremlin medicine. Clinical Bulletin" and others. The literature review uses 44 sources of literature, articles published in the period from 2004 to 2020. Recently, in connection with the coronavirus infection (SARS-CoV-2) pandemic, differential diagnosis and treatment of viral pneumonia has become a rather urgent problem in medicine. Currently, new diagnostic methods are being developed and existing ones are being improved. Despite the variety of methods developed, the leading one is the polymerase chain reaction (PCR) which has been researched to have disadvantages. They include high cost of equipment, technical training of personnel, obtaining false negative results, and the complexity of research.

Keywords: viral pneumonia, SARS-CoV-2, new coronavirus infection, diagnostics, COVID-19

Multiple fibroadeno-ma of the breast in combination with abnormal development of internal genitalia in a teenage girl (clinical case)

Year: 2021, volume 17 Issue: №1 Pages: 7-12
Heading: Obstetrics and Gynecology Article type: Case report
Authors: Fedyushina А.О., Trushina O.V., Khvorostukhina N.F., Novichkov D.A., Pokalitsina Yu.A., Sukhanov S.A.
Organization: Saratov State Medical University, Children's Hospital of the Saratovsk Region, Saratov

Fibroadenoma is the most common benign neoplasm of the mammary glands. In most cases, the tumor occurs in the form of single nodes, the diameter of which does not exceed 3 cm. A clinical case of multiple large breast fibroadenoma in a teenage girl, combined with an abnormality in the development of internal genitalia, is presented. The presented observation focuses on an important aspect of juvenile mammology and shows the feasibility of dynamic monitoring of the growth and development of mammary glands in childhood and adolescence adolescence, which will prevent cases of late diagnosis of such obvious diseases.

Keywords: fibroadenoma, children, adolescents, abnormal development of genitalia