Saratov JOURNAL of Medical and Scientific Research

2022, volume 18

Chronic granulomatous disease in a two-year-old child: the trajectory to diagnosis (clinical case)

Year: 2022, volume 18 Issue: №3 Pages: 364-369
Heading: Pediatrics Article type: Case report
Authors: Spivakovsky Yu.M., Shcherbina A.Yu., Spivakovskaya A.Yu., Yukhacheva D.V., Pershin D.E.
Organization: Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology, Saratov State Medical University

The article presents a clinical case of diagnosis of chronic granulomatous disease in a two-year-old child. The difficulties of diagnosing a primary immunodeficiency condition in routine pediatric practice are described. The problems of diagnosis of primary immunodeficiency are discussed, nonspecific warning signs are identified when a pediatrician should include primary immunodeficiency in the differential diagnosis plan.

Keywords: chronic granulomatous disease, primary immunodeficiency

Cardiometabolic risk factors and target-organ damage in women with hypertensive disorders during pregnancy 10 years and more after delivery

Year: 2022, volume 18 Issue: №3 Pages: 359-363
Heading: Cardiology Article type: Original article
Authors: Tarasova О.А., Chulkov V.S., Starodubtseva I.A.
Organization: South Ural State Medical University, Voronezh State Medical University n.a. N.N. Burdenko

Objective: to assess cardiometabolic risk factors and target-organ damage in women with hypertensive disorders during pregnancy 10 years and more after delivery. Material and methods. A cross-sectional study based on a prospective cohort study. The study included 66 women divided into two groups: group 1 — with a history of hypertensive pregnancy disorders (n=33), group 2 (control) —with a history of normotensive pregnancies (n=33). Results. The frequency of cardiometabolic risk factors in group 1, including arterial hypertension (87.9 vs6.1%, p=0.019), abdominal obesity (36.4 vs 12.1%, p=0.042), increased uric acid levels (18.2 and no cases in group 2, p =0.012) and impaired fasting glycemia (15.2 vs 3.0%, p=0,197) and a higher laboratory markers of insulin resistance (HOMA-IR index 1.47 [0.55-1.62] vs 0.40 [0.27-0.67], p<0.001) were higher compared with group 2. Metabolic syndrome was detected in every third case (36.4%), and stage II hypertension was found in every second woman with hypertension (44.8%) in group 1 (44.8%) and absence rate in the control group. Conclusion. Women who had hypertensive disorders during pregnancy are at high risk of developing metabolic syndrome with target-organ damage compared to normotensive women during pregnancy.

Keywords: arterial hypertension, cardiometabolic risk factors, hypertensive disorders during pregnancy, target-organ damage

Comorbid pathology and mechanisms of development of atherosclerosis with in-stent restenosis in ischemic heart disease after percutaneous transluminal coronary angioplasty (review)

Year: 2022, volume 18 Issue: №3 Pages: 354-359
Heading: Cardiology Article type: Review
Authors: Meshkova M.A., Starodubtseva I.A.
Organization: Voronezh State Medical University n.a. N.N. Burdenko

In-stent restenosis (ISR) is the most unfavorable complication of interventional treatment of coronary heart disease. The main pathogenetic mechanisms of this complication are neointimal hyperplasia and neoatherosclerosis. Concomitant pathology can provoke the mentioned processes increasing the probability of restenosis formation. Objective: comprehensive coverage of the main issues of comorbidity influence on the risk of coronary artery restenosis after percutaneous transluminal coronary angioplasty. Literature search was performed in PubMed, Google Scholar, Scopus, Web of Science, eLibrary, including original studies in the period from 2006 to 2021. A total of 37849 articles were initially found in the above databases by the fact of keyword mention; 32 most significant papers were included in the review as a result of using the exclusion criteria. The influence of obesity, diabetes mellitus on the risk of ISR was demonstrated.

Keywords: percutaneous transluminal coronary angioplasty, in-stent restenosis, comorbid pathology

Quality of life for women after transposition of urethra

Year: 2022, volume 18 Issue: №3 Pages: 350-353
Heading: Urology and andrology Article type: Original article
Authors: Komyakov В.К., Shevnin M.V., Ochelenko V.A., Tarasov V.A.
Organization: City Multidisciplinary Hospital №2, Mariinsky Hospital, North-West State Medical University n.a. I.I. Mechnikov, Department of Neuropathology Assistant Professor, Candidate of Medical Science, Urology Center with Robot-assisted Surgery

Objective: to evaluate the quality of life, sexual function in women with recurrent postcoital cystitis before and after urethral transposition. Material and methods. The study included women suffering from recurrent postcoital cystitis, who underwent transposition of urethra by Komyakov in the period from 2019-2021. Quality of life was assessed using the SF-12v2 questionnaire. Sexual function was assessed using the Female Sexual Function Index (FSFI). Atotal of 60 patients were included in the study, who filled out questionnaires before and after surgery. The average age was 28.8 ±5.2 years. Results. Quality of life indicators for all domains were statistically significantly different in the pre- and postoperative period. Changes in the indicator of the physical component of the quality of life according to the questionnaire before the operation were 50.6±8.4 points, after the operation 57±3.7 (p<0.001). More pronounced differences were noted in the mental component of the quality of life, the total score before surgery was 35.4± 10.4, and after surgery the total score was 47.5±5.6 (p<0.001). An analysis of the sexual function showed a pronounced difference both between each domain of the FSFI questionnaire and the total score before (21.49±3.67) and after the intervention (29.9±2.7), p<0.001. Conclusion. In patients with recurrent postcoital cystitis, there is a decrease in the quality of life and sexual function. After transposition of urethra, there is an improvement the quality of life and the sexual life of patients.

Keywords: postcoital cystitis, quality of life, recurrent lower urinary tract infection, sexual function

Risk analysis of carotid endarterectomy complications in the early period after stroke

Year: 2022, volume 18 Issue: №3 Pages: 341-349
Heading: neurosurgery Article type: Original article
Authors: Yakubov R.A., Khairutdinov A.I., Tarasov Yu.V., Valiullin D.Kh., Yakubova V.T., Komarov R.N., Shchanitsyn I.N., Bazhanov S.P.
Organization: N. V. Sklifosovsky Research Institute for Emergency Medicine, Saratov State Medical University, State Autonomous Health Institution of the Republic of Tatarstan "Emergency Hospital"

Objective: analysis of the predictors of carotid endarterectomy complications in early poststroke recovery. Material and methods. A retrospective analysis of the results of early carotid endarterectomy in 88 patients with symptomatic stenosis of the internal carotid artery stenosis (according to NASCET) up to 30 days after stroke was performed. The analysis of stroke, myocardial infarction, and 30-day mortality predictors was univariate and regressive. Results. Ipsi-lateral stroke was observed in 3 patients (3.4%) and was fatal in one case. The univariate analysis revealed female sex (p=0.009; OR=5.31; CI95%: 3.42-8.26), stenosis of the operated artery <70% (p=0.037; OR=3.15; CI95% 2.31-4.29) and multiple lesions on computed tomography/magnetic resonance imaging (p=0.04; OR=16.80; CI95%: 1.39-205.3) to be significant risk factors, while the multivariate analysis did not reveal any significant risk factors for 30-day stroke and death after surgery. Conclusion. The univariate analysis revealed the female sex, <70% ipsilateral carotid artery stenosis, and multiple brain lesions as significant risk factors of 30-day stroke and death after surgery. Further large-scale studies are needed to improve these findings.

Keywords: acute stroke, carotid stenosis, early carotid endarterectomy

Comparison of surgical techniques for managing patients with rigid posttraumatic thoracic and lumbar deformities

Year: 2022, volume 18 Issue: №3 Pages: 334-340
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shulga А.Е., Zaretskov V.V., Ostrovskiy V.V., Bazhanov S.P., Likhachev S.V., Smolkin A.A.
Organization: Saratov State Medical University

Objective: to analyze of surgical outcomes in patients with rigid post-traumatic deformities of thoracic and lumbar spine. Material and methods. The analyzed cohort (80 patients) was divided into 2 groups: Group 1 — patients with the consequences of stable vertebral injuries (type A; 40 patients — 50.0 percent); Group 2 — patients who suffered unstable spinal injuries (types В and C; 40 patients — 50.0 percent). Surgical management was either isolated performed from the ventral approach or combined staged interventions. Results. In Group 1, staged interventions took longer, featured larger blood loss (p<0.001) and more severe postoperative pain syndrome (p<0.001) as compared to anterior surgeries. Nevertheless, regardless of the type of their surgical treatment all patients presented stable positive long-term outcomes. In Group 2 patients the comparison of the outcomes of anterior and staged interventions, revealed a significant difference in the degree of residual kyphosis (p<0.001), severity of pain syndrome (p=0.002), and quality of life (p<0.001). Conclusion. The determination of surgical treatment tactics in patients with rigid post-traumatic deformities of thoracic and lumbar spine should be differentiated considering the type of primary injury and deformity.

Keywords: injuries of thoracic and lumbar vertebrae, rigid posttraumatic spine deformities, transpedicular fixation, ventral screw stabilization

Application of orthobiological products in the treatment of osteoarthritis of knee joints

Year: 2022, volume 18 Issue: №3 Pages: 327-334
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Gorbatenko A.I., Kostyanaya N.O., Malanin D.A., Sikilinda V.D., Demeshchenko M.V., Suchilin I.A., Kondrashenko V.V.
Organization: Volgograd State Medical University, Southern Federal University

Objective: to compare the effectiveness of treatment of patients with osteoarthritis stages II-III using orthobiological products, in particular autologous bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP), by intraosseous injection in the area of overload bone marrow edema. Material and methods. The prospective study conducted on the basis of two medical clinics from 2016 to 2019, involved 40 patients with knee OA of II-III using. The patients of the main (BMAC) group underwent a single intraosseous injection of BMAC, whereas the comparison (PRP) group undergoing a single intraosseous PRP injection. The results were assessed after 1, 3, 6, 12 months with VAS, Leken, WOMAC, and verbal rating scale (VRS). Results. After 12 months there was a decrease in the VAS index in the main group to 3.9±0.3 points, in the control group to 4.2±0.1 points, Leken in the main group 5.8±0.7 points, in the con- trol group to 6.1±0,8 points, WOMAC in the main group upto40.6±0.3 points, in the control group upto42.5±0.6 points. The assessment according to the VRS showed that in the control periods of 3 and 6 months. Patients' preferences were given in favor of treatment with autologous BMAC, while after 12 months the differences were not significant. Conclusion. Using orthobiological products for osteoarthritis treatment proved to be effective, with intraosseous BMAC injection proving more efficient compared to PRP injection in terms of pain, knee functionality, physical activity, and patients satisfaction during the entire observation period. Both methods of treatment proved to be safe.

Keywords: platelet-rich plasma (PRP), knee osteoarthritis, bone marrow aspirate concentrate (BMAC)

Dynamics of atrophy of the alveolar part of the mandible when using a full removable plate prosthesis

Year: 2022, volume 18 Issue: №3 Pages: 322-326
Heading: Stomatology Article type: Original article
Authors: Pospelov A.N., Konnov V.V., Krechetov S.A., Bizyaev A.A., Pospelova E.A.
Organization: Saratov State Medical University

Objective: improving the effectiveness of the diagnosis of loss of bone tissue of the mandible in patients with complete absence of teeth, by applying a method for calculating the level of atrophy of the alveolar part according to diagnostic plaster models of the jaws. Material and methods. The examination of patients was carried out according to the generally accepted scheme: anamnesis collection, examination, examination of the oral cavity, analysis of diagnostic plaster models of the mandible according to our proposed methodology for assessing the level of bone atrophy. In accordance with Keller's classification, groups were formed: group 1 — type 1 according to Keller (n=27); group 2 — Keller type 2 (n=21); group 3 — Keller type 3 (n=21); group 4 — Keller type 4 (n=18). Results. Atrophy of various sections of the alveolar part of the toothless mandible reaches values in the sagittal plane B1 — B2: 4.62±0.32 mm (group 1), 5.31±0.26 mm (group 2), 4.63±0.29 mm (group 3), 4.09±0.41 mm (group 4); in the transversal — G1 — G2: 4.15 ±0.37 mm (group 1), 5.48±0.39 mm (group 2), 4.40±0.72 mm (group 3), 4.50±0.42 mm (group 4); in vertical — B1 — E: 0.74±0.31 mm (group 1), 0.29± 0.19 mm (group 2), 0.67±0.22 mm (group 3), 0.14± 0.07 mm (group 4) and proceeds more intensively in the first year of using the prosthesis. Conclusion. An uneven level of alveolar part atrophy has been established in various departments of mandible, which must be taken into account when planning the stages of orthopedic dental treatment.

Keywords: atrophy, complete removable plate prosthesis, pars alveolaris mandibulae

Characterization of changes in cellular renewal and apoptosis of gingival epithelium in patients with chronic generalized periodontitis in the postmenopausal period

Year: 2022, volume 18 Issue: №3 Pages: 319-322
Heading: Stomatology Article type: Original article
Authors: Ismailova O.A., Eremina N.V., Strukov V.I., Vichrev D.V.
Organization: Penza Institute for Further Training of Physicians — Branch Campus of the Russian Medical Academy of Continuous Professional Education

Objective: determination of the nature of violation processes of proliferation and apoptosis in gum epithelium women have in the postmenopausal period with different degree of bone mineralization for early diagnostics and optimization of complex therapy. Material and methods. There has been examination of 80 women aged 55-60 у о. with chronic generalized periodontitis (CGP) and decreased bone mineral density (BMD). All patients got standard dental examination, including index evaluation of periodontal tissues. Quantitative evaluation of BMD was held with use of densitometric analysis of state of bone tissue. Studying the indicators of cell renewal was held with help of immunohistochemical examination. Results. As a result of the conducted research, it was found that patients with CGP and BMD violations had a reduce of proliferation of gum epithelial cells with their apoptosis activation апоптоза (lapt=0.73±0.03%, Iki-67=11.77±0.27%) compared with patients with intact periodontium (lapt 0.29±0.04%, lki-67=9.88±0.09%) at p=0.04. Conclusion. As a result of the conducted research, it was found that patients in the postmenopausal period have CGP with increasing activity of gum epithelial cells apoptosis amid falling their cell proliferation indicators. The patients' inflammatory and destructive processes activity in periodontal tissues is higher amid osteopenia comparing with patients without violation of BMD.

Keywords: chronic generalized periodontitis, lapt, lki-67, postmenopausal osteopenia, proliferation and apoptosis of gingival epithelial cells

Methods for collecting the contents of the gingival groove (review)

Year: 2022, volume 18 Issue: №3 Pages: 315-319
Heading: Stomatology Article type: Review
Authors: Vinnik A.V.
Organization: Samara State Medical University

Objective: to analyze the methods and characteristics of instruments for sampling the contents of the gingival groove and/or periodontal pocket forthe subsequent improvement of the instruments used. The literature analysis was carried out with a depth of 36 years (from 1985 to 2021) using the following scientometric databases: PubMed, Scopus, Google Academy, Rospatent, RSCI. This article describes the instruments and methods for taking the contents of the gingival groove and/or periodontal pocket and provides links to 30 scientific publications. An analysis of the literature has shown that many devices and techniques have been proposed to study the contents of the periodontal trough or periodontal pocket, but all of them have certain disadvantages, such as the presence of special equipment, which makes its use limited, high cost of equipment, as well as the difficulty of isolating biological material from the instrument, this worsens the quality of the obtained sample and distorts the results of the study.

Keywords: periodontal diseases