Saratov JOURNAL of Medical and Scientific Research

Saratov Regional Clinical Hospital

Comprehensive comparative evaluation of results of surgical management of unstable distal tibia fractures

Year: 2019, volume 15 Issue: №1 Pages: 48-52
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Barabash Yu.A., Mandrov D.V., Balayan V.D.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University, Tuchkovskaya District Hospital

Objective: to evaluate the outcomes of various methods of surgical interventions and functional properties of lower extremities in patients with complicated ankle fractures. Material and Methods. Clinical outcomes of 140 surgically managed patients with unstable bimalleolar and trimalleolar fractures were studied. 80 patients were managed with external fixation devices applied by original method (main group) and 60 patients were managed with submersible structures (comparison group). Results. Compared to submersible structures, the use of transosseous metalosteosynthesis has led to 100% ankle fracture unions. In early postsurgery period the index of average anatomic and functional result reached values of 93.4% corresponding to "good" and 6.6% corresponding to "satisfactory". Conclusion. It has been established with rheovasography data that transosseous osteosynthesis contributed to restoration of blood microcir-culation in the damaged segment of lower extremity in 8 weeks period after surgery and submersible structures in 6 months period.

2019_1_048-052.pdf560.94 KB

Rituximab treatment efficacy in a patient with systemic lupus erythematosus with severe thrombocytopenia

Year: 2018, volume 14 Issue: №3 Pages: 417-419
Heading: rheumatology Article type: Case report
Authors: Alexandrova O.L., Nikitina N.M., Magdeeva N.A., Shmelkova M.Yu., Grigoryeva S.N.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University

The article presents a clinical case of systemic lupus erythematosus with severe thrombocytopenia in a 55 year old patient. The standard therapy of usage of high doses of glucocorticoids, cyclophosphamide and intravenous im-munoglobulin was not effective. Application of Rituximab improved the course of disease, decreased the severity of thrombocytopenia, led to disappearance of leucopenia and anemia.

2018_3_417-419.pdf268.86 KB

Sclerosurgical and surgical treatment of patients with lower extremity varicose vein disease: analysis of results in a long-term period of observation

Year: 2017, volume 13 Issue: №4 Pages: 839-845
Heading: Surgery Article type: Original article
Authors: Gafurova D.R., Kulikova A.N., Chabbarov R.G., Pyatnitsky A.G.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University, Saratov «Omega-clinic»

Aim: to analyze and evaluate the long-term results of sclerosurgical and surgical treatment of patients with lower extremity varicose vein disease (VVD). Material and Methods. Diagnostics and treatment findings of 228 patients are presented. The main group consists of 153 patients (189 extremities) after intraoperative trunk catheter sclerotherapy of the great saphenous vein (GSV) with a crossectomy. The comparison group consists of 75 patients (96 extremities) after the GSV phlebectomy by Babcock — Narat. Long-term results (5-9 years) of treatment were evaluated by comparing the quality of life (QL) parameters of patients, the ultrasonic characteristics of venous bed for operated extremities, and the progression of VVD. Results. There was not found any considerable differences in respondents' QL during the comparison. Duplex ultrasound scanning of the lower extremities in most cases revealed a wide spectrum of pathological ultrasound signs (6 of 13 signs, the differences in which are statistically significant, but not specific for stem sclerotherapy and phlebectomy). Investigation of VVD dynamics after correction of the varicose syndrome revealed three variants of the disease course: regression, lack of dynamics, progression. Conclusion. The effectiveness of sclerosurgical interference in the long-term observation period is comparable with the surgical one, which is confirmed by the total number of positive (good and satisfactory) treatment results after using both methods (93.7 and 81.3% respectively), ultrasound diagnosis results, absence of significant differences in QL of patients.

2017_04_839-845.pdf1.31 MB

Parkinsonism accompanying the left frontal lobe tumor

Year: 2016, volume 12 Issue: №2 Pages: 285-287
Heading: Neurology Article type: Case report
Authors: Razdorskaya V.V., Kolokolov O.V., Lomakin A.l., Yudina G.K.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University

Objective: to draw the attention of experts on rare cause of secondary parkinsonism — a brain tumor. Material and methods. The clinical observation of the patient 52 years with Parkinson's syndrome. Brain MRI. Results. In parallel the patient had classical progressing clinic bilateral parkinsonism in combination with progressive cognitive decline. MRI research revealed the left frontal lobe tumor. Conclusions. Secondary parkinsonism as a result of intracerebral neoplasms are caused mostly by compression of basal ganglia or mesencephalon increasing tumors. Hemiparkinsonism in these cases usually precedes the other focal neurological symptoms.

2016_02-1_285-287.pdf425.68 KB

Neuron specific enolase as a marker of the nervous system damage in primary hypothyroidism

Year: 2016, volume 12 Issue: №2 Pages: 264-267
Heading: Neurology Article type: Original article
Authors: Kuznetsova Е.В., Gerasimov S.V., Sholomov I.I.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University

In order to predict and detect neurological complications at somatic diseases earlier, there have recently been started to use some of the markers determined in the patient's blood serum. Aim of the study. The aim of the work was to evaluate the activity of neuron specific enolase (NSE) in patients with primary hypothyroidism (PHT). Materials and methods. In 110 patients with PHT detailed study of neurological and neuropsychological status, determined NSE level in serum. Results. The results of this study showed that the NSE activity depended on the gender, age of the patient, the duration of existence of the endocrinopathy and the presence / absence of neurological symptoms. Conclusion. Produced a comprehensive assessment of the state of the nervous system in patients with PHT, NSE defined value as a non-specific marker NA lesions in these patients. The goal set at the beginning of the study, achieved.

Aristarchus Lewkowski — the founder of Saratov's Neurology (the 150th anniversary of his birth)

Year: 2016, volume 12 Issue: №2 Pages: 245-250
Heading: Neurology Article type: Short message
Authors: Kolokolov O.V., Sitkali I.V., Kolokolova Т.О., Pavlova E.V., Razdorskaya V.V.
Organization: Saratov State Medical University, Saratov Regional Clinical Hospital, Lyceum of Mathematics and Computer Science

The article presents the information about the life, career and scientific work of Aristarchus Lewkowski — the founder of Saratov'sNeurological science school and the creator of outpatient neurological services.

2016_02-1_245-250.pdf2.26 MB

Morphometric characteristics of the forearm bones in subjects of childhood, adolescence and early adulthood

Year: 2015, volume 11 Issue: №3 Pages: 249-254
Heading: Macro- and Micromorphology Article type: Original article
Authors: Popov A.N., Anisimova Е.А., Anisimov D.l., Popryga D.V., Kesov L.A., Kesov A.L.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University

Objective: to identify patterns of typology, age and variability of bilateral forearm bones in children, adolescents and young adults. Material and methods. The method of direct linear osteometry determined length (maximum length) and circumference (maximum circumference of the diaphysis) size of the bones of the forearm. Calculated thickness-length index as a percentage of the maximum circumference of the diaphysis to the greatest length of the bone. Results. The age characteristics of greatest length, the greatest circumference of the diaphysis and thickness-length index, as well as communication with the studied parameters of body length. Conclusion. The largest relative increase in the parameters identified in the second childhood and adolescence. Thickness-length index with age decreases slightly from 16,82 to 15.28% in the ulna (9%) and from 20,26 to 19,24% at the radius (5%). A direct close and substantial connection between the length and circumference of the bone and medium-reverse thickness-length index of forearm bones with age and body length.

2015_03_249-254.pdf1.95 MB

Fundamental Basis of Medical Aid Organization and Management in the Region

Year: 2012, volume 8 Issue: №2 Pages: 255-258
Heading: Internal Diseases Article type: Author's opinion
Authors: Denisova Т.Р., Danilov A.N., Malinova L.I., Shuldyakov V.A., Malinov I.A., Shuvalov S.S., Gorjainov V.V.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University, Saratov Regional Clinical Hospital

The article presents computations on informational and analytical basis of public health database, that help to perform accurate monitoring, and detection of public health system state, as well as prognosis of further dynamics of public health system parameters for scientifically proved health care organization and decisions in management.

201202_255-258.pdf291.25 KB

Features of endothelial dysfunction changes at patients with systemic lupus erythematosus on a background of various therapy// Saratov Journal of Medical Scientific Research

Year: 2011, volume 7 Issue: №4 Pages: 822-827
Heading: Internal Diseases Article type: Original article
Authors: Nam I.F., Rebrov А.Р.
Organization: Saratov State Medical University, Saratov Regional Clinical Hospital

Aim. To investigated endothelial dysfunction in patients with systemic lupus erythematosus (SLE), depending on different activity, duration of disease and different type of therapy. Methods. We examined 77 patients with SLE during 1 year. We administered puls therapy with high dose glucocorticoids and cyclophosphamide in the 33 patients. 44 patients were given low dose steroids orally or hydroxychloroquine. We investigated the number of circulating endothelial cells in peripheral blood. Vasoactive function was assessed in reactive hyperemia test, antitrombogenic function with short-lived ischemia was examined. Results. Patients with SLE demonstrated endothelial damage, its antitrombogenic and vasodilatation function was reduced especially in high activity of disease. Pulse therapy improved endothelial function after 12-month treatment periods. The activity of the SLE decreased what was associated with reduced endothelial damage. Also vasodilatation function improved, but anticoagulant activity was without changes. Conclusion. It is necessary to administer pulse therapy according to the right indication despite potential danger of steroids and cyclophosphamide on endothelial function. Probably pulse therapy should be used with vasoprotective drugs in order to improve anticoagulant function

201104_822-827.pdf278.04 KB

Peculiarities of dyslipidemia in patients with psoriatic arthritis: connection with atherosclerosis, cardiovascular risk factors and inflammation activity

Year: 2010, volume 6 Issue: №3 Pages: 592-596
Heading: Internal Diseases Article type: Original article
Authors: Rebrov A.P., Gaydukova I.Z.
Organization: Saratov State Medical University, Saratov Regional Clinical Hospital

Objective: to found the dyslipidemia in patients with psoriatic arthritis and to study the connection between dyslipidemia and cardiovascular risk factors, atherosclerosis and inflammation activity. 40 persons with PsA without cardiovascular diseases were involved in the study, 25 healthy people were examined like controls. Activity of PsA was learned by DAS, Likert index, Ritchie Arthicular Index, Number of swelling joints (NSJ), ESR, C-reactive protein (CRP) and fibrinogen. Total cholesterol, triglycerides, low and high density lipoprotein cholesterol, hypertension, body mass index, individual cardiac history were performed like cardiovascular risk markers. The ultrasound measuring the thickness of intima-media layer (IML) in carotid arteries was performed to subclinical atherosclerosis study. Increase of total cholesterol, triglycerides and low density lipoprotein cholesterol level was found in patients with PsA comparative with controls. There was prevalence of high and moderate increase of total cholesterol in patients with PsA, and in controls only low increase was measured. Correlation between total cholesterol and NSJ, fibrinogen, hypertension and IML was found. Low density lipoproteins were tingly interrelated with ESR, hypertension and IML. Very low density lipoproteins were connected with age of disease beginning, hypertension and IML, and triglycerides-with hypertension, enthesitis and dactilitis. Dyslipidemia in patients with PsA characterizes by total cholesterol, triglycerides, low density lipoprotein cholesterol increase, but not high density lipoprotein decrease. There is the connection between dyslipidemia in PsA and inflammation activity, arterial hypertension and IML

201003_592_596.pdf275.92 KB