Saratov JOURNAL of Medical and Scientific Research

Tsarev О.А.

Saratov State Medical University, Chair of Hospital Surgery, Professor, Doctor of Medical Science

Professor Zakharova Galina Nikolaevna (to the 100th teacher's birth anniversary)

Year: 2018, volume 14 Issue: №3 Pages: 470-472
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Tsarev О.А.
Organization: Saratov State Medical University
Summary:

The article states the biographical information about Professor G. N. Zakharova, describing her academic contribution into the development of surgery, health care organization and training of academic staff of Saratov Medical Institute.

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Acute varicothrombophlebitis: modern approach to the problem

Year: 2018, volume 14 Issue: №1 Pages: 87-94
Heading: Surgery Article type: Review
Authors: Tsarev О.А., Anisimov A.Yu., Prokin F.G., Zakharov A.A., Lobanov A.V., Senin A.A.
Organization: Saratov State Medical University
Summary:

Acute varicothrombophlebitis, or thrombosis of superficial veins (TSV), is a dangerous complication of lower extremity varicose vein disease, as it is a frequent cause for pulmonary artery thromboembolism. The survey states the modern approach to pathogenesis, diagnostics, clinical findings and therapeutic approach to patients with TSV.

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Surgical approach to patients with varicothrombophlebitis with undifferentiated dysplasia of connective tissue

Year: 2016, volume 12 Issue: №1 Pages: 66-70
Heading: Surgery Article type: Original article
Authors: Tsarev О.А., Anisimov A.Yu., Zakharov N.N., Korobov A.V.
Organization: Saratov State Medical University
Summary:

Aim: to study the peculiar features of clinical course of acute varicothrombophlebitis and surgical approach to patients with undifferentiated dysplasia of connective tissue. Material and Methods. The features of undifferentiated dysplasia of connective tissue, character of clinical course of acute varicothrombophlebitis, remote results for 94 patients, who had had Troyanov — Trendelenburg's operation, were studied. Results. 70 patients (74,5%) with acute varicothrombophlebitis demonstrated more than four phenotypic characters which showed the presence of undifferentiated dysplasia of connective tissue. 22 patients (31,4%) with acute varicothrombophlebitis with undifferentiated dysplasia of connective tissue were proved to have the discrepancy between localization of acute varicothrombophlebitis clinical evidences and level of proximal part of thrombus in the lumen of great saphenous vein. During the remote observation period, 66 patients (94,3%) with acute varicothrombophlebitis with undifferentiated dysplasia of connective tissue had pheblectomy, as there was vertical and horizontal pathological venous reflux. Out of 24 patients (25,5%) with acute varicothrombophlebitis without undifferentiated dysplasia of connective tissue, only four patients (16,7%) needed thesecond stage of surgical treatment, because 20 patients (83,3%), in 6 months after Troyanov — Trendelenburg's operation, demonstrated the restoration of functional consistency of valves of great saphenous and perforating veins. Conclusion. When determining the indications for urgent disconnection of saphenofemoral junction for patients with acute varicothrombophlebitis and also when choosing surgical treatment approach during remote observation period, it is reasonable to examine the phenotypic characters of undifferentiated dysplasia of connective tissue.

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Prognosis of complicated clinical course of varicose veins of lower extremities on the basis of analysis of phenotypic characteristics of connective tissue dysplasia

Year: 2015, volume 11 Issue: №4 Pages: 587-591
Heading: Surgery Article type: Original article
Authors: Tsarev О.А., Anisimov A.Yu., Zakharov N.N.
Organization: Saratov State Medical University
Summary:

Aim: to identify the phenotypic characteristics of indeterminate connective tissue dysplasia, which help to predict the progression of varicose veins of lower extremities and disease recurrence after surgery. Material and Methods. The long-term results of surgical treatment of 60 patients with varicose veins of lower extremities in a 5-year period after phlebectomy were analyzed. The phenotypic characteristics of indeterminate connective tissue dysplasia were researched. 24 patients had recurrence of varicose veins of lower extremities associated with disease progression; 36 patients did not have recurrence of varicose veins of lower extremities. Results. All the patients demonstrated the signs of indeterminate connective tissue dysplasia, whereas their frequency was different. There were specified nine phenotypic characteristics of indeterminate connective tissue dysplasia, which were significantly more frequent for patients with recurrence of varicose vein disease of lower extremities: 1) postural abnormality, 2) flat foot, 3) skin pallor, 4) hyperextension of skin, 5) positive "wrist test", 6) positive "pollex test", 7) diastasis recti abdominis, 8) myopia, 9) hematomas which form quickly. Conclusion. The determined sum of phenotypic characters of indeterminate connective tissue dysplasia allows to predict progression of varicose vein disease of lower extremities, and offers new opportunities for improving the results of surgical treatment via developing special therapeutic measures aimed at improving lifestyle and dysplasia treatment.

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Amputation of extremity in patients with atherosclerotic gangrene

Year: 2011, volume 7 Issue: №4 Pages: 947-953
Heading: Surgery Article type: Original article
Authors: Tsarev О.A., Prokin F.G., Zaharov N.N., Voloshuk I.N., Shinde S., Tsareva Yu.O., Imangulov A.M., Mingan T.
Organization: Saratov State Medical University
Summary:

Aim of investigation — to analyze the results of treatment of patients with atherosclerotic gangrene of a limb, to identify the causes of adverse outcomes amputation. Materials and methods: We analyzed the results of examination and treatment of 218 patients with atherosclerotic gangrene of the limb. Good outcome of amputation was considered the primary surgical wound healing of the stump. Suppuration, secondary healing, re-amputation and death we attributed to the adverse results of amputation. Results: The adverse outcomes of amputation due to technical errors in surgery, properly chosen level, inadequate drainage of the wound stump, an unsuccessful operation on the arteries of a limb, inadequate empirical antibiotic therapy, patient's age, functional capabilities of myocardium, the duration of critical ischemia, as well as the lack of psychological adaptation of patients before amputation. Conclusion: To decide the need for amputation in patients with atherosclerotic gangrene follows the assessment of possible vascular reconstructive surgery. In determining the level of amputation is necessary to objectively assess the degree of disruption of regional blood flow using multilevel manometry and laser Dopplerflowmetry. In preparation for amputation should be paid special attention to the correction of rheological and coagulation properties of blood, normalization of the functional state of the myocardium, as well as specialized psychotherapeutic training for timely and adequate psychological adaptation of the patient

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Noninvasive method of blood viscosity and hematocrit monitoring

Year: 2010, volume 6 Issue: №1 Pages: 194-198
Heading: Surgery Article type: Original article
Authors: O.A. Tsarev, F.G. Prokin, Ju.V. Mashchenko, A.I. Nabegaev, V.V. Dubanosov, A.M. Imangulov, S.A. Zyazyanov
Organization: Saratov State Medical University
Summary:

Research objective is to study substantiation of noninvasive method of blood viscosity and hematocrit monitoring. it contains the results of theoretical, experimental and clinical studies held to examine the mechanism of pulse wave distribution. The interrelation between pulse wave parameters, pulse wave velocity, systolic and diastolic blood pressure, blood viscosity and hematocrit has been revealed. Noninvasive method of blood viscosity and hematocrit determination has been worked out. it is distinguished by the following factors: pulse wave of the main artery registered at two limb levels, the amplitude of pulse wave, the duration of its trailing edge and the time of pulse wave distribution. Systolic and diastolic blood pressure are recorded. Blood viscosity and hematocrit calculations are made by means of mathematical treatment with the help of original program. the device for noninvasive blood viscosity and hematocrit monitoring has been created on the basis of elaborated method. Data precision obtained by noninvasive measurement of hematocrit and blood viscosity does not exceed 3%.
the clinical use of noninvasive method enables to approach the problem of atherosclerosis prevention, to improve the results of atherosclerosis treatment and to look at it from critically new noninvasive positions

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A Clinical Course of The Varicose Disease of Patients With Different Grades of Connective Tissue Dysplasia Intensity

Year: 2009, volume 5 Issue: №2 Pages: 261-266
Heading: Surgery Article type: Original article
Authors: А.А. Svistunov, О.А. Tsarev, G.N. Maslyakova, Yu.V. Mashchenko
Organization: Saratov State Medical University
Summary:

To study the variants of the clinical course of varicose disease of patients with different grades of connective tissue dysplasia intensity. The results of the examination and treatment of 280 patients with various forms of varicose disease have been studied. The degree (grade) of connective tissue dysplasia intensity has been estimated. The values characterizing flow and coagulation properties of blood, functional activity of thrombocytes have been studied. Morphological, histological, histochemical check studies of extirpated varicose modified veins of patients with various grades of connective tissue dysplasia intensity have been held. The conducted check studies have shown that lower limbs varicose disease of patients with evident connective tissue dysplasia is characterized by early evidence of clinical signs, rapid advance of the disease, widely spread damage of veins and complicated course caused by the weakness of the connective-tissular carcass of a vein wall as well as by evident disorders of flow and coagulation properties of blood. Patients with varicose disease secondary to the evident (expressed) connective tissue dysplasia are in the risk group of palindromia, thrombus complications and trophesies development, need dispensary observation for proper treatment in good time.

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