Saratov JOURNAL of Medical and Scientific Research

2021, volume 17

The effectiveness analysis of modern vitreo-retinal technologies for the treatment of different diameters macular holes

Year: 2021, volume 17 Issue: №3 Pages: 611-615
Heading: Тhematic supplement Article type: Original article
Authors: Andreychenko О.А., Plotnikova Е.Е., Gazdieva D.I., Gadzhimagomedova M.A.
Organization: Saratov State Medical University, University Clinical Hospital №2 (Clinic of Eye Diseases)
Summary:

Objective: to compare anatomical and functional outcomes of operations in patients with through macular holes of different diameters. Material and Methods. 33 patients with different diameters macular holes were examined. The optical coherence tomograph Spectralis HRA-OCT (Heidelberg Engineering, Germany) was used in the study. The patients were divided into two groups: group 1 included 9 patients with holes of average diameter from 250 to 399 urn; group 2 contained patients with large-diameter holes. Group 2 was divided into subgroups A and B, depending on the size of the macular hole and the use of different techniques for closing the holes: group 2A consisted of 17 patients with a holes diameter from 400 to 600 urn; group 2B included 7 patients with holes from 670 to 1100 urn. All patients underwent vitrectomy using the STELLARIS and Eva systems. In group 1, peeling of the internal limiting membrane (ILM) was performed, using PRP (platelet-rich plasma); in group 2A, ILM peeling of a larger diameter was performed, air tamponade and PRP were used. During vitrectomy in group 2B, ILM peeling with the formation of a flap to close the macular hole and air-gas tamponade were performed. Results. Closure of the macular hole was achieved in all patients; only one patient required reoperation with additional ILM peeling and gas tamponade to close the hole. In group 1, the maximum corrected visual acuity (MCVA) increased from 0.1±0.04 to 0.5±0.1; in group 2Afrom 0.08±0.03 to 0.3±0.1. In group 2B, the MCVA increased from 0.06±0.02 to 0.08±0.03. Conclusion. There is a significant dependence of the functional results of vitrectomy on the macular hole diameter. The use of the inverted flap technique and the use of platelets increase the likelihood of closing the macular hole.

Keywords: macular hole, PRP, vitrectomy

Analysis of various toric intraocular lenses in terms of their effectiveness in correcting astigmatism during phacoemulsification surgery

Year: 2021, volume 17 Issue: №3 Pages: 605-610
Heading: Тhematic supplement Article type: Original article
Authors: Alnoelaty Almasri M.A., Stebnev V.S.
Organization: Samara State Medical University
Summary:

Purpose: to evaluate the effectiveness of AT TORBI plate tactile toric intraocular lens (IOL) (Carl Zeiss Meditec AG, Jena, Germany) and AcrySof loop tactile toric IOL (Alcon Laboratories, Inc., Fort Worth, Texas, USA) forthe correction of astigmatism >0.75 D in patients after phacoemulsification surgery in terms of visual and functional results and rotation stability. Material and Methods. A prospective randomized controlled trial was conducted. This study involved 100 patients (200 eyes) with cataracts and pre-existing astigmatism of 0.75 D or more for implantation of plate tactile-toric (AT TORBI) or loop tactile-toric (AcrySof) lOLs. Depending on the type of implanted lens, the patients were randomly divided into two groups, each of which included 50 people (100 eyes). Postoperative examination was performed on the 3rd day after surgery, after 1 week, 1 month and 3 months. The effectiveness of each IOL in both groups was evaluated by measuring uncorrected visual acuity at a distance (UDVA), the best corrected visual acuity (VA) and the position of the IOL. Results. Three months after surgery, the average logarithmic UDVA index was 0.21 and 0.18 in groups I and II, respectively (p=0.7), the average residual cylindrical refractive error in the group I was 035 D, and in the group II was 0.4 D (p=0.64). It was found that the average rotation of the IOL in 3 months after surgery in group I was 3.42°, and in group II was 2.03° (p=0.25). Conclusion. The effectiveness of both lOLs is recognized as equally high when eliminating uncorrected VA, as well as when correcting pre-existing astigmatism in the range of 0.75-5 D. Both lenses also demonstrated resistance to rotation.

Keywords: astigmatism, cataract, intraocular lens, phacoemulsification, rotation

Features of clinical and laboratory manifestations of COVID-19 in outpatients one month after their recovery

Year: 2021, volume 17 Issue: №3 Pages: 587-593
Heading: Тhematic supplement Article type: Original article
Authors: Tyapkina D.A., Boroday А.А., Tyapayeva A.R., Semenova O.N., Naumova E.A.
Organization: Saratov State Medical University
Summary:

Objective: to identify in patients with cardiovascular diseases (CVD), who underwent COVID-19, dynamic changes in clinical, laboratory and psychological manifestations of the disease one month after their recovery. Material and Methods. A survey was conducted among 54 CVD outpatients with confirmed COVID-19. One month after their recovery, the following was carried out: a survey about the persisting clinical manifestations; physical examination; laboratory and instrumental diagnostics; testing according to the HADS scale and the Beck scale. 34 patients agreed. Results. People aged 45-82 years were most often ill. A month after treatment, there is a decrease in the number of patients with symptoms of respiratory system damage, but symptoms of damage to other systems persist: 41.2% — destabilization of blood pressure, 52.9% — sleep disorders, 58.8% — memory loss, 94.1 % — decreased exercise tolerance. When assessing the mental properties of a person, it was found that 29.4% of respondents have subclinical and clinically severe depression. Conclusion. Within one month after treatment, there are fewer patients with cough, shortness of breath, congestion and chest pain, but they still have manifestations from the nervous and cardiovascular systems. Some individuals, after recovery, developed new symptoms: shortness of breath on exertion or at rest, swelling of the lower extremities, tachycardia, hair loss, unsteadiness or "unsteadiness" when walking.

Keywords: coronavirus infection, COVID-19, SARS-CoV-2

Difficulties in diagnosing late cardiovascular syphilis

Year: 2021, volume 17 Issue: №3 Pages: 582-586
Heading: Тhematic supplement Article type: Case report
Authors: Tolstov S.N., Agapov V.V., Lipatova Т.Е., Tolkachev A.D., Sladkov A.V., Malinova L.I.
Organization: Regional Cardiology Clinic (Saratov), Saratov State Medical University
Summary:

Purpose: on the presented clinical case, to show the difficulties of diagnosing late cardiovascular syphilis. The difficulties of diagnosing late cardiovascular syphilis are largely determined by the extreme variability of the clinical manifestations of the disease and the lack of awareness of dermatovenereologists and other doctors (primarily therapists, cardiologists and cardiac surgeons). A feature of this case is the "cardiac" mask of the disease debut.

Keywords: cardiac infarction, late cardiovascular syphilis, syphilitic mesoaortitis

Space weather and human health: current state of the issue (review)

Year: 2021, volume 17 Issue: №3 Pages: 578-581
Heading: Тhematic supplement Article type: Review
Authors: Strekalovskaya А.А., Parshina S.S.
Organization: North-Eastern Federal University n. a. M.K. Ammosov, Saratov State Medical University
Summary:

The review work is devoted to the analysis of current research results and new original approaches to studying space weather influence on human health. For information retrieval, materials of the indicated topic for 2005-2020 were used, published in the electronic databases PubMed and eLibrary. The review presents an analysis of 15 works. Analysis of the literature showed the connection between geophysical disturbance and the state of human health. There is a tendency towards an increase in the number of persons sensitive to geophysical manifestations of solar activity, which is especially pronounced among elderly and senile people, as well as people with diseases of the cardiovascular system.

Keywords: cardiovascular system, geomagnetic disturbance, space weather

COVID-19 associated myocarditis: mechanisms of pathogenesis, problems of diagnostics (review)

Year: 2021, volume 17 Issue: №3 Pages: 571-577
Heading: Тhematic supplement Article type: Review
Authors: Sergeeva V.A., Lipatova Т.Е.
Organization: Saratov State Medical University
Summary:

The review summarizes actual information on inflammatory myocardial injury in COVID-19. The most update works from 2020-2021 were used as the literature sources, as well as earlier research containing fundamental information on the relevant topic. The substantial information is reflected in the review. Used queries: myocarditis, myocardial injury, COVID-19 — in the search engines PubMed/MedLine, eLibrary. The analysis of current international literature has demonstrated convincing evidence of the possible development of myocarditis in case of new coronavirus infection. The histological verification of myocardial injury associated with COVID-19 presents significant difficulties, since in conditions of a severe course of infection; it is not always possible to perform endomyocardial biopsy. In this regard, the statistics do not reflect complete information on the prevalence of COVID-19 associated myocarditis. All mechanisms of the pathogenesis of inflammatory myocardial injury have not been completely clarified. Due to the ambiguity of the prognosis of patients with COVID-19 associated myocarditis, further study of the problem is required.

Keywords: cardiovascular system, COVID-19, myocardial injury, myocarditis, SARS-CoV-2

Infectious endocarditis with congenital heart disease and complicated by asymptomatic spleen abscess (clinical case)

Year: 2021, volume 17 Issue: №3 Pages: 568-571
Heading: Тhematic supplement Article type: Case report
Authors: Romanova N.A., Povarova T.V., Khaybekova T.V., Parshina S.S.
Organization: Clinical Hospital "RZD-Medicine", Saratov, Saratov State Medical University
Summary:

Purpose: to present a clinical case demonstrating the features during infectious endocarditis in a patient with congenital heart disease due to the development of an asymptomatic complication — the spleen abscess. In addition, to draw the attention of doctors to the need to be alert in connection with the possibility of developing infectious endocarditis in congenital heart disease patients with an increase in body temperature and the onset of "signs of acute respiratory disease".

Keywords: congenital heart disease, infectious endocarditis, spleen abscess

Chronic lymphocytic leukemia induced by repeated coronavirus infection (clinical case)

Year: 2021, volume 17 Issue: №3 Pages: 566-568
Heading: Тhematic supplement Article type: Case report
Authors: Romanova N.A., Lipatova Т.Е., Kutina M.A., Khaybekova T.V., Parshina S.S.
Organization: Clinical Hospital "RZD-Medicine", Saratov, Saratov State Medical University
Summary:

The article presents a clinical case (with examination and treatment data) of chronic B-lymphocytic leukemia, detected in arterial hypertension patient, and induced by multiple new coronavirus infection. It is concluded that it is necessary to conduct more careful monitoring of the general blood test and the state of the lymph nodes in persons with coronavirus infection.

Keywords: arterial hypertension, chronic B-lymphocytic leukemia, lymph nodes, new coronavirus infection

Acute coronary syndrome and anemia: features of choosing the optimal medical tactics (review)

Year: 2021, volume 17 Issue: №3 Pages: 560-565
Heading: Тhematic supplement Article type: Review
Authors: Puchinyan N.F., Furman N.V., Malinova L.I., Dovgalevskiy Ya.P.
Organization: Regional Cardiology Clinic (Saratov), Saratov State Medical University
Summary:

The review evaluates, according to the literature, the clinical and pathogenetic significance of anemia in patients with acute coronary syndrome (ACS). In this clinical situation, the problems of choosing the optimal therapy associated with the smallest evidence base are highlighted. For this, the results of clinical studies published in bibliographic databases: PubMed, Publons and eLibrary were analyzed (the review included 40 publications for 1989-2020). The epidemiological features of the anemia syndrome in patients with ACS are most well studied. Anemia is often circulated in ACS and is associated with an unfavorable prognosis. The question remains whether anemia plays a direct causal role in the deterioration of short- and long-term morbidity and mortality, or is it rather an indicator of a poor clinical condition. A separate study for ACS in patients with anemia, due to the minimal evidence base, requires the choice of optimal antithrombotic therapy: specific drugs and the duration of their administration.

Keywords: acute coronary syndrome, antithrombotic therapy, clinical recommendations

Chronic obstructive pulmonary disease and cardiovascular risk in terms of nutritional status (review)

Year: 2021, volume 17 Issue: №3 Pages: 553-559
Heading: Тhematic supplement Article type: Review
Authors: Potapova M.V., Lukyanov V.F., Raikova S.V., Broyaka N.A.
Organization: Saratov Hygiene Medical Research Center of Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Saratov State Medical University
Summary:

Comorbidity risk factors in chronic obstructive pulmonary disease (COPD) is largely determined by the systemic effects of chronic inflammation. Individual phenotypes of the disease have different prognostic significance. The review presents an analysis of literature data about cardiovascular risk in COPD, depending on the nutritional status of a patient. Literature sources were searched using PubMed, CyberLeninka, MedLine, Global Health, eLibrary, Google Scholar databases on queries: comorbidity with COPD, systemic inflammation and COPD, cardiovascular pathology and COPD, obesity and weight deficiency with COPD. The work includes 40 literature sources over the past 10 years on the risk factors of comorbidity in view of systemic inflammation. Four works from an earlier period were also used, demonstrating fundamental and historical information from the point of view of the authors. As a result of the search, the factors of the worst prognosis in COPD patients with weight deficiency and the protective sense of obesity are clarified. This effect allows you to personalize dietary recommendations. Nevertheless, there are not enough data about mechanisms of chronic inflammation with weight deficiency.

Keywords: cardiovascular risk, COPD, nutritional status, systemic inflammation, weight deficiency