Saratov JOURNAL of Medical and Scientific Research

treatment

Personalized approach to diagnostics and treatment of patients with posttraumatic and degenerative diseases of cervical spine

Year: 2018, volume 14 Issue: №2 Pages: 244-250
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ostrovsky V.V., Shchanitsyn I.N.
Organization:
Summary:

Aim: to develop a personalized approach to diagnostics and treatment of patients outcomes with degenerative and post-injury deformities of cervical spine. Material and Methods. Between January 2009 and January 2016, 520 patients at the age of 15-80 years with degenerative (227) and traumatic (293) lesions of cervical spine were treated in neuro-surgical department. We conducted a comparative analysis of two groups of patients: treated in the period from 2009 to 2012 (group 1: 235 patients) and in the period from 2013 to 2016 (group 2: 285 patients). The developed diagnostic algorithm was used in patients of group 2 when the operation was planned. Results. The frequency of all complications was significantly lower in group 2. In the analysis of complications it was revealed that more often in group 1 there were: dysphagia, dysphonia, severe postoperative pain in the neck and upper limbs; breakdown or malposition of the screw, graft or plate. Conclusion. The comprehensive algorithms for diagnosis and treatment of patients with degenerative and post-injury deformities of cervical spine that take into account their individual morphometric and functional data allow to form an effective personalized program of surgical rehabilitation and reduce the number of perioperative complications from 35 to 9%.

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Norm and disease. Monomorbidity, comorbidity and methodology for their diagnostics

Year: 2018, volume 14 Issue: №2 Pages: 209-216
Heading: Internal Diseases Article type: Review
Authors: Kats Y.A., Parkhoniuk E.V., Skriptsova S.A.
Organization: Saratov State Medical University
Summary:

The absence of a single classification and generally accepted terminology of comorbidity leads to a different understanding of the issues of diagnosis of comorbidity. Comorbidity is a complex system in which the patient is both an integral object and part of this system, which includes diseases complexes. As it is known, the success of solving diagnostic problems, especially in the presence of comorbidity ultimately determines the consistency and validity of the findings, and, consequently, the effectiveness of the diagnosis as a whole. Previously, we proposed an integrative method which, preserving the system approach and the method of comparison, suggests using the sum of data from genetic, constitutional, immunological, anthropological and other types of examination to obtain the most complete representation not only of the nature of the disease, but, first of all, the patient himself. Proceeding from the foregoing, the present review focuses not only on the features of compiling a "patient diagnosis" in the presence of comorbidity but also on the sequence in which the pathological conditions should be considered and reflected in the main diagnosis in the presence of several active processes.

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Effectiveness evaluation of application of niosomal gel "Regenerin" in the treatment of chemical burns of cornea

Year: 2017, volume 13 Issue: №2 Pages: 216-220
Heading: Microbiology Article type: Original article
Authors: Bazikov I.A., Botasheva V.S., Kalinkina N.I., Maltsev A.N., Kostyukova N.Yu., Domenyuk D. A.
Organization: Stavropol State Medical University
Summary:

The aim of the work was to study the effectiveness of using the ophthalmic gel "Regenerin" in the treatment of a simulated chemical burn of the cornea in an experiment. Material and Methods. The chemical composition of the drug "Regenerin" was studied by mass spectrometry The regenerative action of the niosomal gel, including low molecular weight peptides extracted from placental cells and encapsulated, was then studied in 40 organisms of 20 rabbits of the chinchilla breed with a 10% solution of caustic soda. The subjects of the study are divided equally into two groups: in the experimental group, the treatment was carried out by applying a gel to the burn surface, the therapy was not performed in the control group. Results. The result of treatment with the "Regenerin" Ophthalmic Gel is a significant reduction in the timing of reparative regeneration in the animals of the experimental group due to increased metabolism and corneal neovascularization processes. Conclusion. The combined effect of these mechanisms, manifested in the arrest of edema, resorption of inflammatory infiltrates, normalization of the integrity of the endothelium, epithelial layer and basal membrane leads to completely restoring the histological structure of the cornea on the seventh day.

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Effectiveness evaluation of application of niosomal gel "Regenerin" in the treatment of chemical burns of cornea

Year: 2017, volume 13 Issue: №2 Pages: 216-220
Heading: Microbiology Article type: Original article
Authors: Bazikov I.A., Botasheva V.S., Kalinkina N.I., Maltsev A.N., Kostyukova N.Yu., Domenyuk D. A.
Organization: Stavropol State Medical University
Summary:

The aim of the work was to study the effectiveness of using the ophthalmic gel "Regenerin" in the treatment of a simulated chemical burn of the cornea in an experiment. Material and Methods. The chemical composition of the drug "Regenerin" was studied by mass spectrometry The regenerative action of the niosomal gel, including low molecular weight peptides extracted from placental cells and encapsulated, was then studied in 40 organisms of 20 rabbits of the chinchilla breed with a 10% solution of caustic soda. The subjects of the study are divided equally into two groups: in the experimental group, the treatment was carried out by applying a gel to the burn surface, the therapy was not performed in the control group. Results. The result of treatment with the "Regenerin" Ophthalmic Gel is a significant reduction in the timing of reparative regeneration in the animals of the experimental group due to increased metabolism and corneal neovascularization processes. Conclusion. The combined effect of these mechanisms, manifested in the arrest of edema, resorption of inflammatory infiltrates, normalization of the integrity of the endothelium, epithelial layer and basal membrane leads to completely restoring the histological structure of the cornea on the seventh day.

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The modern view of the examination and treatment of patients with intracranial cystic formations

Year: 2017, volume 13 Issue: №1 Pages: 147-149
Heading: Neurology Article type: Author's opinion
Authors: Kolesov V.N., Lukina Е.М., Chekhonatsky А.А.
Organization: Saratov State Medical University
Summary:

Objective: to determine the diagnostic and treatment policy (conservative and operative) in patients with intracranial cysts of various origins. We observed 116 patients with different brain cystic formations. Diagnostic tactics and principles of treatment were refined. The evaluation of treatment results was made.

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Innovation in diagnostics and treatment of epilepsy

Year: 2017, volume 13 Issue: №1 Pages: 143-147
Heading: Neurology Article type: Review
Authors: Kalinin V.A., Poverennova I.E., Yakunina A.V., Beketova E.M.
Organization: Samara State Medical University, Municipal Hospital No. 1 n.a. N. I. Pirogov, Samara
Summary:

The aim of the review is try to systematize the innovative achievements of modern epileptology and indicate the levels of diagnosis and treatment of epilepsy that are not sufficiently developed, from our point of view. Applied to epileptology, the innovation process is realized at all levels. In principle, you can divide the entire process into a diagnostic and treatment level. Promising in the diagnosis of epilepsy should be considered the analysis of age characteristics, new methods of EEG analysis and evoked potentials, innovative methods of functional neuroimaging, genetic testing. New anticonvulsants with the original mechanism of action allow to overcome pharmaco-resistance of epilepsy in a number of observations. In rare cases it is necessary to use minimally invasive surgical methods of treatment.

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Evaluation of treatment of patients with essential hypertension at primary care units using structured questionnaires (a polyclinic of the Saratov region as an example)

Year: 2016, volume 12 Issue: №4 Pages: 560-565
Heading: Internal Diseases Article type: Original article
Authors: Gerasimov S.N., Korotin A.S., Alexandrova I.N., Popova Yu.V.
Organization: Saratov Institute of Cardiology, Russia, Krasnoarmeysk Regional Hospital, Engels City Polyclinic №4
Summary:

The aim of the article is to assess patients' view on the treatment of hypertension in polyclinic located in the Saratov region using structured questionnaires. Material and Methods. 83 patients (aged 64.6±9.6 years, males 30%) with the diagnosis of essential hypertension who referred to the polyclinic of workers settlement of the Saratov region during the period from July 1, 2015 to July 7, 2015 were interviewed. The questionnaire for patients with elevated blood pressure (BP) developed by S. N. Gerasimov et al. (2015) was used. The questionnaire included 16 questions organized in the following panels: awareness of hypertension and risk factors, BP self-monitoring, conducted treatment, compliance to therapy, referrals to medical care. Results. 90% of the interviewed patients have known previously about BP elevation; 90% of respondents have had a tonometer; 84% of hypertensives measured BP no rare then once a week, and 54% did it daily; 88% of enrollers regularly take antihypertensive drugs. Only 36% of patients could be classified as compliant to therapy according the Morisky — Green scale (had 4 points). 92% of respondents have received one or more advice on lifestyle modification: 82% — advice on eating, 66% — advice on weight reduction, 55% — advice on physical activity, 28% — advice on smoking cessation, 26% — advice on alcohol consumption. 62.7% of patients were interested in organization of special follow-up program. Conclusion. High frequency of BP self-measurement was identified together with low compliance of patients to antihypertensive therapy, good knowledge on non-pharmacologic treatment interventions.

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Retrocervical endometriosis: etiology, pathogenesis, classification, diagnosis and treatment

Year: 2016, volume 12 Issue: №2 Pages: 138-144
Heading: Obstetrics and Gynecology Article type: Review
Authors: Tarlamazian A.V., Stolyarova U.V.
Organization: Saratov State Medical University
Summary:

The review deals with contemporary issues of etiology, pathogenesis, classification, diagnosis and treatment of retrocervical endometriosis on the basis of existing data in the literature on this disease. Among the various forms of endometrial disease incidence retrocervical endometriosis, according to various authors, is 30-34%. The process is characterized by the formation of deep infiltrative lesions, originating from the recto-vaginal septum, without capsules and clear boundaries, extensively localizing, affecting the adjacent organs with the formation of scar-adhesions and characterizing this pathology as a multi-disciplinary (gynecological, surgical, urological). There are many options etio-pathogenesis of retrocervical endometriosis, but none of them fully explains the diversity of forms of expression and localization of this pathology. Particular attention is paid to the influence of immune and hormonal factors on the development of the disease. It is noted that currently there is no single universally accepted by clinicians and morphology full classification of retrocervical endometriosis, and there are no generally accepted standards of its diagnosis. The variants of the treatment of this disease have been considered including hormonal and immunomodulatory therapies.

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Prognosis of development of unfavorable phenomena of chemotherapy in patients with for the first time revealed tuberculosis of lungs

Year: 2015, volume 11 Issue: №4 Pages: 576-582
Heading: Phthisiology Article type: Original article
Authors: Danilov A.N., Morozova T.l., Doktorova N.P.
Organization: Saratov State Medical University, Saratov Research Institute of Rural Hygiene
Summary:

Aim: development of criteria and a method of prognosing of emergence of adverse side effects to the first mode of chemotherapy at patients with for the first time revealed tuberculosis. Materials and Methods: The analysis of the collateral reactions (CR) on tubercular preparations has been carried out at 214 patients receiving treatment at the first mode of chemotherapy. During the treatment an indicator of quality of life by a technique the DIGNITY (health, activity, mood), a condition of intersystem interaction of respiratory and cardiovascular systems of an organism (Hildebrant's coefficient), a vegetative index of Kerdo were estimated at patients. Results. Ufavorable effects on PTP develop at every third patient (33,6%). The CR different types depends on the age and availability of the accompanying pathology. Allergic reactions develop at patients with existence of endocrine pathology (27,8%) authentically more often, toxic — at patients with defeats of nervous system (56,3%). Extent of change of an index of Kerdo of 59,4±2,4%, Hildebrant's coefficient 48,9± 1,6% in the first 4 weeks of treatment of the patient corresponds to emergence of CR in the first 3 months of chemotherapy. Conclusion. Dynamics of coefficient of Hildebrant, Kerdo's index and an indicator of treatment, SAN at the initial stages, are considerably associated with the risk of development of side effects of chemotherapy and were a basis of the developed computer system expert for prognosing the development of these complications. The predictive value of system is 76,3% of sensitivity at 84,7% of specificity.

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Modern approaches to surgical treatment of juvenile hemangiomas

Year: 2015, volume 11 Issue: №3 Pages: 471-476
Heading: Dermatovenerology Article type: Short message
Authors: Dubensky V.V.
Organization: Tver State Medical University of the Ministry of Russia
Summary:

Aim: studying of clinical and functional features of juvenile hemangioma to identify indications to their removal. Analysis of the nature of side effects at the different methods of treatment and determination of efficiency of the ra-diowave moving away of juvenile hemangioma. Materials and methods. The study involved 216 children with juvenile hemangioma and 14 adult patients with persistent hemangioma. Radiowave treatment was conducted to 32 children with superficial juvenile hemangioma. Results. Superficial juvenile hemangioma are diagnosed in 76.1%, thus the highest prevalence of superficial juvenile hemangioma of small diameter and thickness. At the inspection of children with complications of different methods of treatment of hemangioma found the prevalence of formation of pathological scars, during removing of hemangioma by carbon-dioxide laser and at a scelerotherapy — 58,3%. Swelling and soreness at the radio wave moving away at most patients (84,3%) passed through 3 days, recovery after a 1 session came at 65,6% of patients, after 2 sessions — at 28,2%, after 3 sessions — at 6,2%. At watching the patients of this group during one to three years their proof recovery is set. Conclusion. High postoperative cosmetic effect under strict indications for surgical removal, the absence of relapses and the low percentage of continued growth (6.2% after the second session deletion) allow to recommend high-frequency radio wave removing for the treatment of superficial juvenile hemangioma of the skin.

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