Saratov JOURNAL of Medical and Scientific Research

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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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A comprehensive approach to the diagnosis and treatment of straghorn nephrolithiasis

Year: 2018, volume 14 Issue: №1 Pages: 81-86
Heading: Urology Article type: Review
Authors: Chekhonatskaya M.L., Rossolovsky A.N., Kryuchkov I.A., Bobylev D.A.
Organization: Saratov State Medical University
Summary:

A review of the literature is devoted to the most topical diagnostic questions and treatment of patients with urolithia-sis. The role and the latest advances and benefits of minimally invasive surgery were described. Particular attention was paid to the problems of residual calculi and the condition of the renal parenchyma in the perioperative period. The theme of choice of conducting such patients tactics was considered. The actual diagnostic methods and a differentiated approach to the algorithm choice of the examination and treatment of patients with staghorn nephrolithiasis were considered. The review provided a scientometric analysis of research information (documents reference), contained the analytical array of scientific publications. Electronic information resources of scientific electronic library bibliographic databases: eLibrary, PubMed, Clinical Key, Science Direct — were used.

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Clinical review of allergic rhinitis in children with parasitic infestation

Year: 2018, volume 14 Issue: №1 Pages: 76-80
Heading: Otolaryngology Article type: Original article
Authors: Nurmukhamedova F.B.
Organization: Tashkent Medical Academy
Summary:

The research goal. Clinical and laboratory data in children with allergic rhinitis (AR) with parasitic infestation (PI) and without it were studied. Material and Methods. The study of AR patients was performed in the children's city diagnostic center. There were 100 children aged 3 to 14 years under our observation. Children were divided on to 2 groups: the main group (67 sick children with permanent allergic rhinitis with concomitant parasitic invasion), and a comparison group (33 patients with permanent allergic rhinitis without parasitic invasion). Results. We found that the clinical picture of AR with concomitant parasitosis in children is characterized by dyspeptic, asthenic vegetative, allergic dermatologi-cal syndromes, in addition to manifestations typical for AR. Conclusion. Analysis of the main clinical and laboratory parameters in children with AR revealed that PI in this case usually occur with subclinical symptoms. In many cases, patients AR required specific parasitological diagnosis allows you to assign a specific therapy is adequate in the detection of concomitant PI.

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Peculiarities of remodeling of hyalin cartilage at early stages of development of degenerative-distrophic processes of knee joints

Year: 2018, volume 14 Issue: №1 Pages: 70-75
Heading: pathological anatomy Article type: Original article
Authors: Gladkova E.V., Romakina N.A., Ananyeva O.E., Belova S.V., Babushkina I.V., Persova E.A., Karyakina E.M.
Organization: Saratov State Medical University
Summary:

The aim is to develop methods for detection of hyaline cartilage metabolic imbalance in patients with initial degenerative dystrophic changes in the substantiated pathogenetically knee. Material and Methods. Subject of inquiry: 50 women aged from 35 up to 57 (49.1 ±2.4), among them 36 patients with an early stage of knee osteoarthrosis made up an experimental group, 14 women without any musculoskeletal disease clinical presentations made up a control group. We carried out a complex examination including physical assessment, study of orthopaedic status, interview with the use of KOOS (Knee Injury and Osteoarthritis Outcome Score) scale, roentgenography and MRI of the knee and also a number of laboratory tests: enzyme-linked immunosorbent assay determination of the content of cytokine profile indices (IL-1, TNF-a, IL-6), cartilage oligomeric matrix protein (COMP) and bone (SerumCrossLaps and bone isozyme of alkaline phosphatase (BAP)) tissue metabolism markers in blood serum in all the groups of patients. Results. In all the patients of the experimental group the roentgenologic stage of osteoarthrosis was defined as 0-1 according to J. Lawrence and J. Kellgren, but at the same time knee degenerative changes were objectivized on the series of MR images in the form of MR signal changes of the articular cartilage, erosions and cysts, degenerative meniscus. We observed increased serum cartilage oligomeric matrix protein (COMP) in the same group and that is characteristic of hyaline cartilage destruction activation. We also detect disorders in bone tissue remodeling in the form of bone resorption intensification (Serum CrossLaps), osteogenesis increase (BAP) and activation of proinflammatory cytokine system link (IL-1, TNF-a). Conclusion. The leading pathogenetic links of the early degenerative changes of the knee are hyperproduction of proinflammatory cytokines (IL-1, TNF-a), destruction of the hyaline cartilage and disorder in bone tissue remodeling. Assessment of biochemical predictors of cartilage and bone tissue degradation along with the instrumental methods of diagnosis is of great theoretical and practical importance in the system of early detection of incipient osteoarthrosis.

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Research on the level of thyroid-stimulating hormone and thyroid hormones in children with neuroinfections to evaluate the process of adaptation

Year: 2018, volume 14 Issue: №1 Pages: 65-69
Heading: Infectious Diseases Article type: Original article
Authors: Zakharova I.S., Malyugina T.N.
Organization: Saratov State Medical University
Summary:

The aim is to study the features of the adaptation process in children of different ages with acute neuroinfections depending on the etiology, severity of the disease and the period of the disease using indicators of the pituitary-thyroid system. Material and Methods. A comprehensive clinical and laboratorial checkup of 237 children with different noso-logical forms of neuroinfections was carried out: meningitis: viral, enteroviral, purulent and cerebromeningitis. Control board group was composed of 15 healthy children of the identical age. All the patients underwent the thyroid-stimulating hormone and thyroid hormones blood serum level, IFA technique being used, during acuity and reconvalesence. Re-sults. The neuroinfections status of the pituitary-thyroid system depends on the period and severity of the disease and does not depend on the etiology, age and sex of the child. Conclusion. According to the indices of the pituitary-thyroid system revealed that different adaptive responses develop in neuroinfections depending on the reactivity of child's organism and severity of the disease.

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The cytokine status and the levels of thyroid hormones in children with acute respiratory viral infections

Year: 2018, volume 14 Issue: №1 Pages: 61-65
Heading: Infectious Diseases Article type: Original article
Authors: Malinina N.V., Malyugina T.N.
Organization: Saratov State Medical University
Summary:

The research goal is to study the performance of INF-а, INF-y and IL-1(3 in children with acute respiratory viral infection (ARVI) depending on etiology, the presence of mixed infection, disease severity, presence of complications, the concentration of thyroid hormones. Material and Methods. Examined 147 patients aged from 1 to 10 years at the outbreak of the ARVI and 15 healthy children. Patients in the midst of acute respiratory infections was conducted to determine levels of IL-1(3, INF-а, INF-y, triiodothyronine (T3) and free thyroxine free (T4) by ELISA using standard test kits JSC "Vector-best" (Koltsovo, Novosibirsk region). Results. It was showed elevated level of INF-y in patients with PC-infection in comparison with the same indicator in healthy children. Set the increased level of INF-а in severe ARVI and the level of INF-y at medium severe form. It was showed increased levels of INF-y in patients with mixed infection. In children with complications, the level of IL-1 (3 was lower almost in 2.4 times, than in children without complications. Among patients with complications, the highest numbers of INF-а were detected in children with pneumonia and INF-y increased in patients with bronchitis. When conducting correlation analysis, the highest rates of INF-а were observed in children with the syndrome of "low T3", and INF-y in children as low T3 and low T4. Conclusion. An increase in the level of INF-y in patients with RS infection was found. Revealed that in children in acute period of SARS levels IL-1 IS, INF-а do not depend on the etiological factor of SARS. These indicators are influenced by the severity of the disease, which in our study was due to the development of mixed infection, the presence and nature of complications. High rates of INF-а and INF-y have significant inverse correlation with the level of T3, which reflects the degree of intoxication in the acute period of infectious diseases.

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Irritable bowel syndrome: epidemiological and pathogenetic aspects

Year: 2018, volume 14 Issue: №1 Pages: 53-60
Heading: Internal Diseases Article type: Review
Authors: Tikhonova Т.А., Kozlova I.V.
Organization: Saratov State Medical University
Summary:

The literature review focuses on some epidemiological aspects, molecular-genetic predictors of irritable bowel syndrome formation, the role of psychosocial and infectious factors, low-grade inflammation, imbalance between neu-rotransmitters and cytokines, as well as changes in the intestinal microbiome in the development of irritable bowel syndrome.

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Prediction of heart remodeling in patients with bronchial asthma

Year: 2018, volume 14 Issue: №1 Pages: 49-52
Heading: Internal Diseases Article type: Original article
Authors: Ryabova A.Yu., Shapovalova T.G., Shashina M.M., Lekareva L.I., Kudishina M.M.
Organization: Saratov State Medical University
Summary:

The aim of the study was to identify cardiac remodeling in bronchial asthma (BA), to construct a mathematical model for its prediction to optimize diagnosis. Material and Methods. Atotal of 283 patients with asthma who underwent a comprehensive examination including general clinical, immuno-enzymatic (determination of the N-terminal fraction of the brain natriuretic propeptide, activity of the angiotensin-converting enzyme) and instrumental methods: ECG, ECHO, daily Holter monitoring of ECG, FVD. Results. The analysis of the obtained results showed that in patients with asthma, structural, geometric changes of the myocardium of the right and left ventricles were noted, increasing as the disease became more severe. The activation of local neurohormonal systems, primarily myocardial is no less important. An analysis of the relationship between the concentration of natriuretic peptide and the end-diastolic size of the right ventricle in BA patients revealed a moderate correlation relationship. There was a weak correlation between the right ventricular end-diastolic size, the right ventricular frontal wall thickness and the ACE level. The analysis of the relationship between the above dimensions of the right ventricle and the index of the balance of the autonomic nervous system was reliable. Conclusion. Thus, the development of cardiac remodeling in AD patients occurs against the background of the hyperactivation of neurohumoral systems, including sympathoadrenal, renin-angiotensin-aldosterone and the system of natriuretic peptides.

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Comparative evaluation of autonomic regulation of circulation in patients undergone coronary artery bypass grafting or correction of acquired valvular heart disease

Year: 2018, volume 14 Issue: №1 Pages: 45-49
Heading: Internal Diseases Article type: Short message
Authors: Kiselev A.R., Vulf K.A., Shvartz V.A., Karavaev A.S., Borovkova E.l., Bockeria O.L.
Organization: Bakulev Center of Cardiovascular Surgery, Saratov State Medical University n.a. V.I. Razumovsky Research Institute of Cardiology, Saratov state university
Summary:

The aim of the research was to study the peculiarities of vegetative regulation of blood circulation in cardiac surgery patients who underwent coronary artery bypass grafting (CABG) or correction of acquired valvular heart disease (CAVHD). Material and Methods. In this study we included 42 patients (12 women; 63 (57; 67) years), who underwent CABG, and 36 patients (16 women; 58 (47; 65) years) who underwent CAVHD. The synchronous 15 minutes records of electrocardiogram and photoplethysmogram (PPG) were performed in all patients before and after surgery. Time domain and frequency domain measures of heart rate variability (HRV) and index of synchronization between low-frequency (LF) oscillations in HRV and PPG (index S) were analyzed. Results. Most studied autonomic indices did not have statistically significant differences between patients with CABG and CAVHD in the study stages, except for heart rate, which was higher in patients before CAVHD (p=0,013). Conclusion. The values of HRV and index S do not depend on the difference in the clinical status and the features of performed cardiac surgical interventions between patients with CABG and CAVHD.

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Features of the clinical course of gastroesophageal reflux disease associated with obesity

Year: 2018, volume 14 Issue: №1 Pages: 42-45
Heading: Internal Diseases Article type: Original article
Authors: Andreeva E.l.
Organization: Stavropol State Medical University
Summary:

The research goal is to reveal the features of clinical manifestations of gastroesophageal reflux disease (GERD) in obesity. Material and Methods. A survey and anthropometric study of 51 patients suffering from GERD and obesity aged 30 to 60 years were conducted. The average age of the patients was 42.3±2.11 years. Patients were divided into groups according to the BMI score. The control group consisted of patients suffering from GERD without obesity. Results. The main complaint of the patients of the control group was heartburn, while the patients of the main group had complaints of dyspeptic nature. With an increase in BMI, there was an increase in the incidence of complaints, in addition, complaints of an extra-esophageal nature associated with the direct effect of acidic gastric contents on the pharyngeal mucosa were detected. This regularity is explained in the article by pathogenetic mechanisms of GERD development. In patients suffering from GERD without obesity, the development of the disease is caused by a change in the motor activity of the esophagus due to a decrease in the tone of the lower esophageal sphincter, and in patients with co-pathology the main role is given to increased intragastric pressure, which leads to disruption of the sphincter. Conclusion. Thus, the clinical picture of combination of GERD and obesity differs atypical for GERD current, the main features of which are the predominance of dyspeptic complaints, motor-evacuation disorders, and the presence of extraesophageal complaints.

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