Saratov JOURNAL of Medical and Scientific Research

Saratov State Medical University

www.sgmu.ru

Pulmonary lymphangioleiomyomatosis (case report)

Year: 2017, volume 13 Issue: №4 Pages: 828-833
Heading: Internal Diseases Article type: Case report
Authors: Shashina M.M., Shapovalova T.G., Kazimirova N.E., Ryabova A.Y., Arkhangelskaya Е.Е., Lifanova D.V., Chernyshkova M.A.
Organization: Saratov Clinical Hospital № 8, Saratov State Medical University
Summary:

This article presents a clinical observation of a patient with a proven diffuse-nodular form of lymphangioleiomyomatosis of the lungs. Features of the course of the process against the background of pathogenetic therapy which included sirolimus and progesterone have been considered. It is necessary to raise awareness of doctors about the disease that facilitates timely diagnosis and treatment.

A rare case of Loeffler endocarditis associated with eosinophilic granuloma-tosis with polyangiitis

Year: 2017, volume 13 Issue: №4 Pages: 823-828
Heading: Internal Diseases Article type: Case report
Authors: Skryabina E.N., Safonova V.N., Agareva Т.А.
Organization: Saratov State Medical University
Summary:

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare disease that affects small and medium-sized blood vessels of different organs, characterized by asthma, prominent peripheral blood eosinophilia. Cardiac involvement was reported in 20-50% and it is the major cause of mortality. A case of EGPA in a 43-year-old female, who had endocarditis, associated with thrombus formation in left ventricle, thromboembolic syndrome and recurrent stroke has been reported. The described case has showed that it is of crucial importance to perform the full cardiac imaging even in asymptomatic patients with suspected EGPA. The early identification of cardiac involvement may lead to better prognosis.

A clinical case of fast progression of amyloidosis of kidneys in rheumatoid arthritis

Year: 2017, volume 13 Issue: №4 Pages: 821-823
Heading: Internal Diseases Article type: Case report
Authors: Romanova I.A., Magdeeva N.A., Nikitina N.M.
Organization: Saratov State Medical University
Summary:

The article presents clinical case of unfavorable outcome of amyloidosis of kidneys in a patient with rheumatoid arthritis. The absence of basic treatment and persistent activity of disease leads to fast progression of nephrotic stage of secondary amyloidosis in a young woman.

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Interdisciplinary aspects of rehabilitation of patients with oncological diseases in non-terminal situation of the disease

Year: 2017, volume 13 Issue: №4 Pages: 806-808
Heading: Health Service Organization Article type: Review
Authors: Shmerkevich А.В., Vodolagin A.V., Balakina D.D.
Organization: Saratov State Medical University
Summary:

Medical social rehabilitation of patients with oncological diseases in the non-terminal stage of the disease is based on the principle of an interdisciplinary approach, which involves complex special treatment, providing patients and their families with various types of social and psychological support at all stages of specialized care. The authors of the review consider the solution of medical and social problems in the rehabilitation of patients with oncological diseases in the context of the synergistic effect. Weak social and psychological protection of patients with oncological pathology adversely affects the prognosis of the disease and worsens patients quality of life. The review provides evidence that patients who receive social support are best adapted to the cancer situation, while a lack of social support is a significant risk factor for increased mortality in cancer patients.

Keywords: quality of life
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The role of health centers in preventive care provision

Year: 2017, volume 13 Issue: №4 Pages: 803-805
Heading: Health Service Organization Article type: Original article
Authors: Shemetova G.N., Sidorova N.V., Gubanova G.V.
Organization: Saratov State Medical University
Summary:

Aim: to assess the importance of the Centers of Health in the organization and provision of preventive care to the population, in the early detection of risk factors for the development of chronic non-communicable diseases and the development of a healthy lifestyle. Material and Methods. On the basis of the Health Center of Engels Center for Medical Prevention in the Saratov Region, the detection of risk factors for 2011-2015 was analyzed according to statistical reporting (form No. 68) and health cards (form025-CZ/y) of 207 patients. To assess the satisfaction of visitors with the work of the Center, a specially developed questionnaire was conducted, which included 22 questions that characterize the patient profile, his attitude to the organization and the results of the survey, and the motivation to modify the way of life. Results. The study confirmed the important role of the Centers of Health in the organization and provision of preventive care to the population, the formation of a healthy lifestyle and the early detection of diseases and risk factors for their development. Conclusion. Only joint efforts of medical institutions, authorities, educational organizations, mass media can lead to the formation of the population's responsibility for their health and readiness to modify the way of life.

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Rehabilitation after hip and knee joints replacement: several results of medical and sociological monitoring

Year: 2017, volume 13 Issue: №4 Pages: 796-799
Heading: Health Service Organization Article type: Original article
Authors: Fedonnikov A.S., Andriyanova Е.А., Erugina M.V, Norkin I.A.
Organization: Saratov State Medical University
Summary:

Aim: research of rehabilitation process problem areas after hip and knee joints replacement. Material and Methods. Program of monitoring and evaluation of medical, organizational, social and psychological components of rehabilitation was developed. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. It was revealed an absence of real interaction between key parties of rehabilitation processes based on significant disproportion between high level (more than 80%) of patients' satisfaction of rehabilitation organizing and low activity of health managers (9.4%). Despite of declared patients' high rehabilitation quality permanent pain noted by 45% of respondents, move freely without additional support is available only for about 50% of patients. Conclusion. Rehabilitation management and its' quality are the key values for locomotor system functional recovery. Provided study has designated main problems of rehabilitation quality evaluation after hip and knee joints replacement.

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Computer modeling of biomechanical systems «femoral bone — endoprosthesis / transplant — tibia» in different methods of anterior cruciate ligament plastics in knee joint

Year: 2017, volume 13 Issue: №3 Pages: 764-768
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shormanov A.M., Ivanov D.V., Norkin A.l., Ulyanov V.Yu., Bakhteeva N.Kh., Klimov S.S., Chibrikova Yu.A.
Organization: Saratov State Medical University
Summary:

The aim: to specify the indices of dislocation (displacement) and effective stress in biomechanical systems «femoral bone — endoprosthesis / transplant — tibia» in different methods of anterior cruciate ligament by computer modeling of a knee joint geometrically, physically and mechanically similar to human. Material and Methods. Steady-state tasks of the stress given on a knee joint after anterior cruciate ligament plastics fulfilled by different methods were resolved numerically by the method of finite elements implemented in the system of finite element analysis. Results. Maximum dislocations comprised 3.45 mm. for the method of single-beam plastics of ACL, 0.35 mm. for two-beam plastics and 0.93 mm. for plastics with semi-tendinous and gracilis tendons. Maximum stress were 1190 MPa for single-beam plastics of ACL, 141 MPa for two-beam plastics and 150 MPa for plastics with semi-tendinous and gracilis tendons. Conclusion. Finite element modeling of different ways of ACL plastics indicates higher stability of synthetic endoprosthesis under rising stress in case of two-beam plastics and transplant of semi tendinous and gracilis tendons compared to the single-beam plastics.

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Medical and sociological issues of rehabilitation of patients after hip and knee joints replacement

Year: 2017, volume 13 Issue: №3 Pages: 761-764
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Fedonnikov A.S., Erugina M.V., Andriyanova E.A., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The aim: research of medical and social issues of rehabilitation after hip and knee joints replacement. Material and Methods. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. Within the scope of medical surveillance after the surgery 69.8% of patients made regular visits to orthopedic specialists after joint replacement, but only 9.4% of surveyed patients confirm the practice of active monitoring of rehabilitation on the part of health services. There had been determined a high level of declared patients satisfaction (more than 80%) with weak health managers activities argue considerable informational gap between the key parties of rehabilitation. Conclusion. Provided study has designated problem areas of patient and health system communication in rehabilitation after hip and knee joints replacement.

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Role of humoral immunity markers and bone tissue metabolism in paraimplant inflammation pathogenesis after primary knee arthroplasty

Year: 2017, volume 13 Issue: №3 Pages: 756-761
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ulyanov V.Ju., Bondarenko A.S., Galashina E.A., Chibrikova Ju.A,. Avilov R.G., Kupina E.S.
Organization: Saratov State Medical University
Summary:

The aim: is to study the peculiarities of paraimplant inflammation pathogenesis after primary knee arthroplasty on the basis of dynamic changes of humoral immunity markers and bone tissue metabolism. Material and Methods. Research object includes 140 cases: 50 patients with paraimplant inflammation make up the main group; 30 patients with early aseptic instability make up the first experimental group; 30 patients undergoing primary arthroplasty make up the second experimental group; 30 conditionally healthy blood serum donors make up the control group. We determined the content of humoral immunity markers (circulating immune complexes binding C3d and containing IgG, triggering receptor expressed on myeloid cells) and bone tissue metabolism (tumor necrosis factor a, interleukin 1 (3, bone isoen-zyme of alkaline phosphatase) by the method of hardphase immune-enzyme analysis in all the groups. Results. We noticed elevated activity of circulating immune complexes binding C3d and containing IgG, triggering receptor expressed on myeloid cells, proinflammatory cytokines and alkaline phosphatase in blood serum of patients with paraimplant inflammation; proinflammatory cytokines and alkaline phosphatase — in patients with early aseptic instability; there were no changes in the studied indicators- in patients undergoing primary arthroplasty. Conclusion. Increased expression of triggering receptor expressed on myeloid cells causing release of proinflammatory cytokines and also elevated activity of circulating immune complexes binding C3d and containing IgG and bone isoenzyme of alkaline phosphatase play a significant role in paraimplant inflammation pathogenesis after primary knee arthroplasty.

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Decompressive stabilizing operations in the treatment of complicated aggressive hemangiomas of transitional spine.

Year: 2017, volume 13 Issue: №3 Pages: 746-751
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Likhachev S.V., Arsenievich V.B., Salina E.A., Stepukhovich S.V., Norkin A.l., Mizyurov S.A., Zaretskov V.V.
Organization: Saratov State Medical University
Summary:

The aim: to study the efficiency of surgical treatment of complicated aggressive hemangiomas in transitional spine. Material and Methods. Decompressive stabilizing operations were made to 26 patients aged 35-52 years with hemangiomas of vertebral bodies. Individual surgical features varied due to the character and level of the injury. Results. In the experimental patients' group in admission there was neurological deficit of compressional origin associated with the critical values of luminal narrowing due to the epidural component of the neoformation. Stable antalgic effect and decrease in neurological deficit were seen postsurgically. Conclusion. While choosing the surgical option of decompressive stabilizing treatment a surgeon should take into account roentgenomorphometric features of the injured vertebrae. Adequately planned intervention fulfilled with the account of the injury character allows obtaining favorable outcomes as well as LQ improvement, neurological deficit decrease and the elimination of pain syndrome.

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