Saratov JOURNAL of Medical and Scientific Research

Clinical hospital n.a. S. R. Mirotvortsev SSMU

Radiation methods for evaluating renal function in children

Year: 2018, volume 14 Issue: №3 Pages: 385-388
Heading: Radiology Article type: Review
Authors: Chekhonatskaya M.L., Averianov А.Р., Uts I.A., Velikanova M.G., Bobylev D.A., Chekhonatsky I.A.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Russian Medical Academy of Postgraduate Education, Moscow, Saratov State Medical University
Summary:

 An accurate assessment of renal function is critical for adequate dosing of medications. The most informative marker reflecting the functional state of the kidneys is glomerular filtration rate (GFR). Determination of inulin clearance is the most accurate way to assess GFR in children and adults. In this case, the method is invasive, cumbersome, younger children require the installation of a urinary catheter. Techniques for radioisotope estimation of GFR can solve this problem, but all widely used radioisotopes have the ability to bind slightly to plasma proteins, which leads to an underestimation of real values.

AttachmentSize
2018_3_385-388_1.pdf278.2 KB

Ultrasound Diagnostics of Premature Birth

Year: 2014, volume 10 Issue: №1 Pages: 74-79
Heading: Obstetrics and Gynecology Article type: Review
Authors: Chekhonatskaya M.L., Vasilevich L.K., Petrosyan N.O., Kolesnikova E.A.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Saratov Clinical Hospital № 8, Saratov State Medical University
Summary:

The purpose of the article is to analyze the data of native and foreign literature and to consider the modern aspects of ultrasound diagnostics of premature birth, and new additional criteria for early diagnostics and prediction of preterm delivery. Hemodynamic characteristics in the second and third trimesters of the pregnancy have been covered.

AttachmentSize
2014_01_74-79.pdf268.63 KB

Ultrasound diagnostics of miscarriage in the first trimester of pregnancy

Year: 2013, volume 9 Issue: №4 Pages: 652-656
Heading: Obstetrics and Gynecology Article type: Review
Authors: Chekhonatskaya M.L., Vasilevich L.K., Kolesnikova Е.А., Petrosyan N.O.
Organization: Saratov State Medical University, Saratov Clinical Hospital № 8, Clinical hospital n.a. S. R. Mirotvortsev SSMU
Summary:

On the basis of the analysis of Russian and foreign literature the modern aspects of ultrasonic diagnostics of miscarriage in the first trimester of pregnancy have been examined. The attention is focused on the assessment of the extraembryonic structures and provisional organs. The features of Doppler imaging in the assessment of the course of pregnancy in the first trimester have been highlighted.

AttachmentSize
2013-04_652-656.pdf285.03 KB

Change of microbiological composition of deminer-alized dentin from the bottom of carious cavity during the course of treatment of acute deep caries in children

Year: 2013, volume 9 Issue: №3 Pages: 412-415
Heading: Stomatology Article type: Original article
Authors: Kazakova L.N., Vlasova S.P., Lebedeva S.N., Babadjanyan. S.G.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Saratov State Medical University
Summary:

Purpose: to compare the antimicrobial efficacy of chlorhexidine bigluconate used in different forms for the treatment of acute deep caries, to define the percentage of complications in the treatment of acute deep caries in children on the stage of its development in 6 and 12 months. Material and methods: Bacteriological study of demineralized dentin taken from the bottom of «the work space» by the sterile instrument, clinical monitoring of children after 6 and 12 months. Results. A significant reduction of colonies forming odontopathogenic and opportunistic microorganisms during the application of the film «Diplen» and a high percentage of favorable outcomes over the period of follow-up in the second study group. Conclusion. Qualitative etiological treatment conducted in a timely manner taking into account the structural features of hard and soft tissues of the tooth, creates the conditions for full formation of all tooth tissues.

AttachmentSize
2013-03_412-415.pdf275.43 KB

Anaesthesiological maintenance in total endo-prosthesis of large joints

Year: 2013, volume 9 Issue: №2 Pages: 241-246
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Prigorodov М.V., Pominova I.V., Noskova I.L, Tashkaev I.V., Virsta A.M.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Saratov State Medical University
Summary:

Purpose: To improve the quality of anesthetic protection in prosthetics of large joints based on a steady state energy balance. Materials and methods: Prospective, randomized study on the basis of a controlled hemodilution (CM) double mask has been performed. In the first group of patients (32-19 women) hemodilution (HS) has not been done. The second group of patients (31-17) consisted of patients with HS. Three phases of the survey have been selected — before surgery, traumatic phase of the operation, after the operation. Analyzed the parameters of central hemodynamics (Cl (I/ min/m2) and total peripheral vascular resistance TPVR (dyn * sec1 * cm5), gas exchange (DO (ml / min) and V02 (ml / min), energy metabolism (kcal / min; kcal / day). For data processing statistical package STATISTICA6,0 was used. Results: Central hemodynamic parameters in both groups did not significantly change, and did not differ between the groups. A significant reduction in D02. DO differences between groups of patients at all stages of the studies found has been determined in both groups of patients. Oxygen consumption in the first group of patients decreased significantly to traumatic phase of the operation, and the next stage rose to baseline. Oxygen consumption in the group with CM increased by traumatic phase of the operation, but then returned to baseline. In patients with CM oxygen consumption was significantly higher than in patients without CM at all time points. It is found that there is a significant drop in energy metabolism in the first group of patients in traumatic phase of the operation, followed by reduction of the energy poten-
tial. It is noted that insignificant increase of energy on stage traumatic operation in the second group of patients, with a subsequent decrease to the original level. Energy exchange at all stages of the study was significantly higher in the second group of patients. Logistic regression analysis found that controlled hemodilution is associated with increased energy metabolism at the stage prior to surgery for traumatic stage and after the intervention. Conclusion: It has been established a connection with the growth of energy controlled hemodilution with radical intervention on the hip joint. Substantial energy deficit in patients without HS on traumatic phase of the operation reveals that the high probability of occurrence of cardiovascular complications.

AttachmentSize
2013-02_241-246.pdf399.46 KB

Influence of anaesthesia on energy metabolism in surgery

Year: 2013, volume 9 Issue: №1 Pages: 47-49
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Prigorodov М.V., Tashkaev I.V., Pominova I.V., Noskova I.L, virsta A.M.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Saratov State Medical University
Summary:

The purpose of the article is to establish adequacy of protection of energy metabolism in a patient under anaes-thesiology in cholecystectomy from mini-access. Material et methods: 122 patients subjected to cholecystectomy from mini access have been surveyed. Among them 92 patients have got intravenous general anaesthesia with AVL, 30 patients have got prolonged epidural anaesthesia on spontaneous breath with insufflations of oxygen through an obverse mask with sedatations. Monitoring of energy-plastic metabolism has been carried out in all patients. Results: Groups of patients have been compared by anthropometrical data, traumatic interventions. In both groups of patients loss of energy to traumatic to an operation stage has insignificantly increased, but after the anaesthesia termination in the group of patients with intravenous anaesthesia loss of energy continued to rise, and in the group of patients with prolonged epidural blockade it has returned to the initial level. After the anaesthesia termination the energy metabolism became essential higher in the first group of patients in comparison with the second one (p

AttachmentSize
2013-01_047-049.pdf274.71 KB

The diagnostic value of biomarkers of inflammation, angiogenesis and fibrogenesis to assess the severity of urodynamic obstruction in children with congenital megaureter

Year: 2012, volume 8 Issue: №4 Pages: 996-1001
Heading: Urology Article type: Original article
Authors: Morozov D.A., Krasnova E.I., Deryugina LA., Zakharova N.B., H'icheva Yu.A.
Organization: Saratov State Medical University, Clinical hospital n.a. S. R. Mirotvortsev SSMU, Moscow Research Institute of Pediatrics and Pediatric Surgery
Summary:

The aim of the study is to determine the diagnostic value of urine biomarkers of inflammation (interleukin-1p, tumor necrosis factor-a), angiogenesis (vascular endothelial growth factor) and fibrogenesis (monocyte chemoattractant protein-1, matrix metalloproteinase-9) to assess the severity of urodynamic obstruction of the ureter. Materials and Methods — Complex investigation of 47 children with congenital nonrefluxing megaureter at the age from 1 month till 11 years is carried. Results. The correlation between the urine level of IL-1p and main laboratory criteria of inflammation occurred, so IL-1p as an integrative indicator of pyelonephritis activity was appeared. The relation between levels of VEGF and MCP-1 and indicators of renal hemodynamics allowed to consider increased levels of these factors as markers of irreversible nephrosclerosis. The urine level of MMP-9 was strongly correlated with parameters of peristalyic activity of the ureter. The group of children with lower peristalyic activity of the megaureter was significantly different from group with normal ureteral peristalsis by the high urine level of MMP-9. We do not have reliable data about the diagnostic value of determination of the urine level of TNF-a in children with congenital megaureter. Conclusion: The urine level of biological markers investigations are very important for clinical practice for determination of pyelonephritis activity (IL-1p), severity of ischemic deterioration of renal parenchyma (VEGF, MCP-1). Further studies are needed to clarify the pathogenic role of MMP-9 in the regulation of peristalyic activity of the ureter during embryonic and postnatal development in patients with congenital nonrefluxing megaureter.

AttachmentSize
201204-996-1001.pdf462.21 KB

Effciency of HIV-infected patients detection in neurological hospitals of large industrial center

Year: 2012, volume 8 Issue: №2 Pages: 563-567
Heading: Neurology Article type: Short message
Authors: Shuldyakov A.A., Kolokolov O.V., Potemina L.P., Abramova T.P., Kolokolova A.M., Lukina E.V., Sholomov I.I., Be-lousov M.I., Gryaznеv R.А., Salina E.A., Ornatskaya N.А., Mysovskaya O.V., Shmelev V.V., Eystrakh V.A., Shumilova A.V., Sotskova V.A.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, Clinical Hospital № 12, Saratov, Clinical Hospital № 9, Saratov, Saratov State Medical University
Summary:

Aim of the study: to evaluate the effciency of detection for HIV-infection in patients of neurological departments of Saratov. Materials and methods. We retrospectively analyzed 25 250 medical histories of patients hospitalized into neurological departments of Saratov hospitals between January 2007 and April 2012. Results. Blood samples of 2010 patients (7,96 %) were tested for the presence of HIV-antibodies. 37 patients were HIV-positive (1,84 % of examined patients and 0,15 % of the total number of patients). Conclusion. Increasing popularity and variety of clinical manifestations of HIV-infection requires the expansion of neurological patients whom serum test for antibodies against HIV is needed.

AttachmentSize
201202_563-567.pdf467.25 KB

Clinical aspects and characteristics of the course of Parkinson’s disease with chronic cerebral ischemia

Year: 2012, volume 8 Issue: №2 Pages: 491-494
Heading: Neurology Article type: Original article
Authors: Makarov N.S., Spiridonova S.V., Voskresenskaya O.N.
Organization: Clinical hospital n.a. S. R. Mirotvortsev SSMU, First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

The article is devoted characteristics current of Parkinson’s disease with chronic cerebral ischemia. Objective: to study the clinical presentation and features of PD against cerebral ischemia. Methods. A total of 44 patients with a diagnosis of “Parkinson’s disease”, 20 of which were determined by accurate clinical and instrumental signs of chronic cerebral ischemia. Comparative characteristics of the neurological status, cognitive functions, some laboratory and instrumental data in the two groups of patients: Parkinson’s disease with a background of chronic ischemia of the brain and without it. Results. Statistically signifcant differences between groups are observed on the following variables: duration of illness, severity of depression, the concentration of glucose in the blood. Formed groups of signifcant difference in the severity of atherosclerosis of cerebral vessels. Conclusion. The data of the acceleration of the progression of Parkinson’s disease with chronic cerebral ischemia, as well as the more frequent occurrence of depression in this patient group.

AttachmentSize
201202_491-494.pdf294.78 KB