Saratov JOURNAL of Medical and Scientific Research

№3

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.
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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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Sexual dimorphism of dynamics of concentration of endothelium alteration factors in blood in surgical treatment of chronic generalized periodontitis.

Summary:

Aim: to study the sexual dimorphism of the concentration in the blood of endothelial alteration factors in the dynamics of the surgical treatment of moderate chronic generalized periodontitis (CGP) in comparison with clinically healthy volunteers. Material and Methods. A total of 20 clinically healthy volunteers (average age is 30 (24; 37), 50% are men) and 31 patients with moderate chronic generalized periodontitis (average age is 31 (27; 38), 40% are men) were examined. Serum concentrations of homocysteine and C-reactive protein were determined. Patients with chronic generalized periodontitis were treated following the surgical scheme. Results. In patients with chronic generalized periodontitis, prior to treatment, an increased level of homocysteine and C-reactive protein (CRP) was detected in the serum. Conservative treatment in the preoperative period caused a decrease in the level of homocysteine in patients, while there was no significant change in the rate of C-reactive protein. 10 days after the surgery, an increase in the concentration of homocysteine and C-reactive protein in serum was observed in patients of both sexes, indicating a reactive change. At the same time, reactive changes were more pronounced in women. Long-term results of surgical treatment of chronic generalized periodontitis indicate a decrease in C-reactive protein and homocysteine levels in patients of both sexes. Sexual dimorphism was manifested by the fact that women had lower homocysteine content than men: 9.4 (8.9; 9.7) versus 13.3 (10.8; 14.1) umol/l (p=0,004). Conclusion. Patients of both sexes with moderate chronic generalized periodontitis have elevated C-reactive protein and homocysteine levels. Sexual dimorphism is manifested by higher levels of homocysteine, but not C- reactive protein in men. The acute period of surgical treatment of chronic generalized periodontitis is characterized by an increase in the concentration of factors affecting the endothelium in the blood, which are more pronounced in women. Long-term surgical treatment results of chronic generalized periodontitis demonstrate a decrease of homocysteine and C-reactive protein levels in blood with homocysteine levels being lower in women than in men.

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The state of the hemocoagulation system and endothelial dysfunction in benign and malignant skeleton neoplasms

Year: 2018, volume 14 Issue: №3 Pages: 574-578
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ponamarev I.R., Puchinyan D.M., Gladkova E.V., Korshunov G.V.
Organization:
Summary:

Aim: to study the functional status of the vascular endothelium and the activity of the hemocoagulation system, as well as the relationship between some indicators characterizing their state in patients with benign and malignant skeleton neoplasms. Material and Methods. 62 patients with benign (45) and malignant (17) bone neoplasms and 10 healthy individuals of the control group were examined. The coagulation properties of blood plasma and the content of vascular endothelial growth factor (VEGF), intercellular adhesion molecules of sICAM and adhesion molecules of vascular endothelium (sVCAM) in blood serum were investigated. Results. In patients with benign bone tumors, prothrombinase formation mechanisms were activated, the concentration of soluble fibrin-monomer complexes (FSC) was

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Chronic non-specific back pain: patho-genetic substantiation of manual therapy

Year: 2018, volume 14 Issue: №3 Pages: 570-574
Heading: Traumatology and Orthopedics Article type: Review
Authors: Medentsov V.A., Komleva N.E., Goncharenko I.M., Danilov A.N., Chekhonatskiy A.A.
Organization: Saratov Scientific Research Institute of Agricultural Hygiene
Summary:

We presented the review of data from MEDLINE, EMBASE, CINAHL on the mechanisms of therapeutic activity of manual therapy, as well as on studied tissue and systemic responses, and the elaborations on the issue of manual treatment choice in chronic non-specific back pain.

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