Saratov JOURNAL of Medical and Scientific Research

№3

ROHHAD syndrome

Year: 2019, volume 15 Issue: №3 Pages: 601-606
Heading: Pediatrics Article type: Review
Authors: Pushko L.V., Gutyrchik Т.А., Ovsyannikov D.Yu., Petrova N.A., Teterkina А.О., Gutyrchik N.A., Menshikov D.D.
Organization: Morozov Children's City Clinical Hospital, Peoples' Friendship University of Russia, The Almazov National Medical Research Centre, Head of Second Cerebral and Spinal Cord Tumors Department, Doctor of Medical Sciences
Summary:

The literature review is devoted to a rare variant of hypoventilation, sleep-dependent, in children — central hypoventilation with a late onset and hypothalamic dysfunction, ROHHAD syndrome (Rapid-onset Obesity, Hypothalamic dysregulation, Hypoventilation, Autonomic Dysregulation). Diagnosis and management of patients with this syndrome requires a multidisciplinary approach of a team of specialists. On the basis of modern data, the issues of clinical and laboratory-instrumental diagnosis of the disease, possible etiological factors, diagnostic criteria and frequency of symptoms, approaches to therapy and prognosis are presented.

Keywords: ROHHAD syndrome
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Progression of chronic heart failure in atrial fibrillation in patients with arterial hypertension in combination with extracardial pathology

Summary:

Purpose: to study the features of the course of atrial fibrillation (AF) in patients with arterial hypertension (AH) and chronic heart failure (CHF) in combination with concomitant extracardial pathology and to assess the effect of AF on the progression of chronic heart failure. Material and Methods. In an observational cohort study was observed in 308 patients 45-60 years with AF in hypertension and CHF in combination with noncardiac pathology: diabetes mel-litus (DM) (n=40); diffuse toxic goiter (DTG) (n=42); hypothyroidism (GT) (n=59); abdominal obesity (АО) (n=64); and chronic obstructive pulmonary disease (COPD) (n=47). The comparison group consisted of 56 patients with AF and CHF hypertension, without concomitant noncardiac disease. When comparing groups, the unpaired Mann — Whitney U- test for numerical variables and the exact two-way Fisher test for categorical variables were used. Differences were considered significant at a level of p <0.05. The calculations were carried out in the program Rstudio. Results. In all the presented clinical groups there were no differences in the frequency of the permanent form of AF, paroxysmal form was more often recorded in thyroid and АО pathology, and persistent form in COPD, DTZ and DM. Transformation of paroxysmal AF into chronic AF occurred in groups of patients with DTZ (p<0.001), DM (p=0.041) and АО (p=0.004). Progression of CHF was revealed in groups of patients with DTZ (p<0.004), DM (p<0.008), АО (p<0.001) and COPD (p=0.05). Conclusion. Significant progression of AF and CHF is observed in patients with SSD, COPD, АО and DTZ. The most pronounced indicators of left ventricular diastolic dysfunction were found in patients with DM, GT and АО.

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Prognostic value of percutaneous coronary intervention for heart failure with mid-range ejection fraction

Year: 2019, volume 15 Issue: №3 Pages: 591-595
Heading: Cardiology Article type: Review
Authors: Galin PYu, Kulbaisova SA, Erov NK
Organization: Orenburg State Medical University
Summary:

The updated classification of heart failure ESC 2016 highlights new problems of understanding epidemiology and treatment of the syndrome. In particular, today there is a lack of prognostically advantageous management of patients with heart failure with preserved or midrange left ventricular ejection fraction (HFpEF/HFmrEF). Even less information exists regarding long-term outcomes after the application of percutaneous coronary intervention (PCI) in these patients. There is only a small amount of studies about the long-term prognosis after PCI with stratification on values of LVEF Their results are analyzed in this article and make it possible to indirectly judge the effectiveness of this method in the group of patients with HFmrEF

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Dorsal correction of rigid posttraumatic deformities of thoracic spine in spinal cord injury

Year: 2018, volume 14 Issue: №3 Pages: 611-617
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shul'ga А.Е., Zaretskov V.V., Likhachev S.V., Smolkin A.A.
Organization:
Summary:

Aim: the analysis of the outcomes of dorsal remedial operation in patients with rigid posttraumatic deformities in thoracic spine accompanied by spinal cord injury. Material and Methods. We analyzed surgical outcomes of transpe-dicular anchorage of 28 patients aged 34.5±19.5 with rigid posttraumatic deformities of thoracic spine: 12 patients with acute injury (1st group), 16 patients with long-term deformities (2nd group). The results were estimated by the severity of neurological deficit, pain intensity,the grade of deformity correction as well as by the LQ indexes. All interventions were performed from lateral medial approach with transpedicular anchorage. Results. There were no changes of neurological deficit in both patient groups, however we managed to obtain sufficient spine deformity correction. Pain intensity in patients of 1st group was 6 (5.3-7.8), function — 46.5 (42.5-49.8); 12 months postsurgically pain intensity corresponded to the score of 0 (0.0-0.1); function — 82 (79.0-86.0). The intensity of pain syndrome was significantly reduced in 2nd group patients (VAS reduced from 6 (4.0-7.0) to 1 (0.0-2.0), which in turn allowed for earliest rehabilitation of patients in sedentary position, thus increasing their mobility and functional independence (FIM increased from 70 (65.0-76.0) to 92 (89.0-95.0). Conclusion. Single-step dorsal surgical interventions in patients with rigid deformities of thoracic spine allow restoring normal spinal column axis, performing reconstruction of spinal cord column and safely stabilize injured locomotor segments both in acute and in late periods of spinal cord injury.

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The methods of deep periprosthetic infection diagnostics in the area of knee joint

Year: 2018, volume 14 Issue: №3 Pages: 607-610
Heading: Traumatology and Orthopedics Article type: Review
Authors: Shpinyak S.P., Babushkina I.V., Maksyushina T.D., Galashina E.A., Chibrikova Yu.A., Bondarenko A.S., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The data on the methods and promising areas of investigations potent to improve diagnostic tactics in patients with infectious complications after total knee replacement is presented.

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The capacity of the thrombin generation test in the diagnostics of hemostasis system disorders in patients with osteoarthritis

Year: 2018, volume 14 Issue: №3 Pages: 602-606
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shakhmartova S.G., Vorobyova I.S., Puchinyan D.M.
Organization:
Summary:

Aim: to determine the diagnostic significance of thrombin generation test parameters in the diagnostics of hemostatic disorders in patients with osteoarthritis of large joints in preoperative period. Material and Methods. 137 subjects have been investigated, among whom there were 115 hip and knee osteoarthritis patients, submitted for primary arthroplasty (68) and re-prosthetics (47); control group — 22 conventionally healthy blood donors. All subjects underwent plasma hemostasis study and thrombin generation test with two activators — RB (TF 2 pmol/ml) and RC-low (TF 5 pmol/ ml). Osteoarthritis patients were divided into two groups according to the results of thrombin generation test. The 1st group included patients with an adequate response to the stronger activator (t-lagR >t-lag ow, tt-peak^tt-peak^^), the 2nd —with an inversion response (t-lagRBlow). Results. In trie control group and group 1 patients, the thrombin formation process is more pronounced when using an activator with a high TF(RC-low) content than when using an activator with a lowTF (RB) content, which is regarded as an adequate reaction of thrombin formation to the action of a stronger agonist. Patients of the 2nd group inresponse to the action of the activator with a high content of TF was observed inhibition of the reaction of formation of thrombin, which was reflected in the slowdown in the speed of the generation of this enzyme and reduce its quantity. Conclusion. The use of two activators with different concentrations of tissue factor in the test of thrombin generation allows the nature of the response of the hemocoagulation system to initiate the process of thrombin formation to identify patients with adequate and inadequate response.

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The history of the development of national traumatology on the example of medical and scientific activities of Saratov Research Institute of Traumatology and Orthopedics (SarNIITO) (1950-1980)

Year: 2018, volume 14 Issue: №3 Pages: 596-602
Heading: Traumatology and Orthopedics Article type: Short message
Authors: Ulyanov V.Yu., Grishin S.E., Puchinyan D.M., Fedonnikov A.S., Chibrikov G.l., Norkin I.A., Ilyina E.S., Skobelkina A.V.
Organization: Saratov Socio-Economic Institute of G. V. Plekhanov Russian University of Economics
Summary:

We outlined and described basic directions of national traumatology development at the period of 1950-1980 illustrated by the example of Saratov traumatological school, estimated the contribution of SarNIITO traumatologists into this development at the abovementioned period, depicted syna — one of the founders of acute trauma clinics.

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The epidemiology of spine and spinal cord injuries

Year: 2018, volume 14 Issue: №3 Pages: 592-595
Heading: Traumatology and Orthopedics Article type: Review
Authors: Tolkachev V.S., Bazhanov S.P., Ulyanov V.Yu., Fedonnikov A.S., Ninel V.G., Salikhu Kh., Norkin I.A.
Organization: Saratov State Medical University
Summary:

The article contains domestic and foreign data reflecting epidemiological peculiarities of traumatic injuries of spine and spinal cord, their character and incidence among various population groups with respect to gender and age parameters. The study outlines spine and spinal cord injury structure with regard to modern classification schemes, introduces injury incidence data, specifies indexes of lethality in spine and spinal cord injuries.

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Circular anchorage of the spine in the correction of scoliotic deformity.

Year: 2018, volume 14 Issue: №3 Pages: 586-591
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Stepukhovich S.V., Zaretskov V.V., Arsenievich V.B., Likhachev S.V., Shul'ga A.E., Zaretskov V.V.
Organization:
Summary:

Aim: to demonstrate clinical case of surgical treatment of scoliotic deformity of the spine in a 17-year-old child. It is shown that the correction of sagittal profile achieved by 2-stage intervention and normalized global balance parameters in combination with circular spine anchorage allows providing earliest and fullest rehabilitation of a child.

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Growth factors of fibroblasts and vascular en-dothelium in the early stages of knee osteoarthritis

Year: 2018, volume 14 Issue: №3 Pages: 583-586
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Puchinyan D.M., Gladkova E.V., Karyakina E.V., Romakina N.A., Belova S.V.
Organization:
Summary:

Aim: to compare and study the relationship between the maintenance of vascular endothelial growth factor and acidic fibroblast growth factor in individuals with the initial clinical and radiological manifestations of the degeneration of the hyaline cartilage of the knee joints and healthy people. Material and Methods. 27 women with initial symptoms of knee osteoarthritis (main group, average age

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