Saratov JOURNAL of Medical and Scientific Research

Gulyaev D.A.

Almazov National Medical Research Center, N. P. Bekhtereva Institute of Human Brain, Chief Research Assistant of Scientifc Research Laboratory for Integrative Neurosurgical Technologies, Professor of Department of Neurosurgery of the Institute of Post-graduate Education, DSc

The study of surgical activity dynamics at patients with hypertensive intracerebral haematoma using simulation analysis in the Chuvash Republic

Summary:

Objective: improving the efciency of treatment for patients with hypertensive intracranial hematomas by means of planning optimization, epidemiological evidences simulation analysis and dynamics of surgical treatment indices. Material and Methods. 225 patient charts with hypertensive intracerebral hematomas have been analyzed. All patients were examined and treated in Cheboksary Republican Clinical Hospital January 2008 to December 2017 Results. The retrospective analysis revealed decrease in the number of surgeries for hypertensive intracerebral hematomas from 35 to 19 From 2011 to 2017 mortality in the group of patients with 30 to 60 ml hematomas decreased as well. Surgeries in the group of patients aged 50–70 who had strokes most frequently in 2010–2017 got fewer. Conclusion. Introduction of decision-making system at diagnosis stage enables applying diferentiated approach for choosing surgical treatment approach.

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The tactics of surgical treatment in metastatic lesions of upper cervical spine.

Year: 2018, volume 14 Issue: №3 Pages: 498-501
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Bazhanov S.P., Gulyaev D.A., Ulyanov V.Yu., Ostrovskiy V.V., Tolkachev V.S.
Organization: The Almazov National Medical Research Centre, Head of Second Cerebral and Spinal Cord Tumors Department, Doctor of Medical Sciences
Summary:

We demonstrated a successful case of surgical treatment of the patient with metastatic lesion of upper cervical spine with respect to multidisciplinary approach. We performed simultaneous two-stage surgical intervention, the first stage being occipitospondylodesis by multi-segment construction; and second —tumor resection from expanded combined access. It has been stated that the proposed surgical tactics allows performing curative resection in one surgical session without neurological deficit buildup in the postoperative period.

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Comparative retro- and prospective analysis of treatment outcomes in patients with SCI and cervical spine injuries in acute and early periods of traumatic disease

Year: 2017, volume 13 Issue: №3 Pages: 710-715
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Bazhanov S.P., Ulyanov V.Yu., Chibrikova Yu.A., Biryukova A.V., Norkin I.A., Gulyaev D.A., Salihu H.
Organization: Almazov National Medical Research Centre, Saratov State Medical University
Summary:

The aim: to conduct comparative retro- and prospective study of treatment outcomes in patients with cervical spine and SC injuries on the basis of assessment scale analysis. Material and Methods. 217 patients with closed cervical spine and SC injuries commeasurable by age, degree of neurological deficit, acute physiological and chronic state disorders were enrolled into the study. 177 patients comprised the main group (prospective study) and 40 — comparison group (retrospective study). To compare treatment outcomes we used Karnofsky score (Karnofsky, 1949), a quantitative assessment score for general patient status scales, APACHE II, Acute Physiology and Chronic State Evaluations (Knaus — Draper, 1985) and SCIM II, Spinal Cord Independence Measure Scale. Results. Comparative analysis based on the quantitative values of assessment scales, indicates an improvement of short-term treatment outcomes in patients with SC and cervical spine injuries in the main group. Conclusion. Complex approach to differentiated surgical treatment management and unique neuroprotection methods significantly improves short-term treatment outcomes having positive effect on general patient status, severity of acute physiological and chronic state disorders and patients' independence in the post-surgical period.

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Correction of immune disorders in patients with malignant tumors at level of craniovertebral junction and upper cervical spine

Year: 2013, volume 9 Issue: №2 Pages: 295-301
Heading: Oncology Article type: Original article
Authors: Bazhanov S.P., Uljanov V.Yu., Norkin I.A., Gulyaev D.A.
Organization: Russian Scientific Research Institute of Neurosurgery n.a. Professor A. L. Polenov
Summary:

Objective: To study the cellular and humoral immunity in patients with malignant tumors of the upper cervical spine. Material and methods: The study included 22 patients with malignant tumors of the craniovertebral junction and upper cervical spine. To assess the function of the immune system the methods of population and subpopulation immuno-phenotyping of peripheral blood lymphocytes have been applied. Cytokine parameters and functional status (cytotoxic) activity of NK-cells have been studied using immunofermental methods. The indices have been presented in absolute and relative terms. All the patients have been subjected to the adjuvant therapy. Results: Correction of cellular immunity has led to significant increase in CD3 + (T-lymphocytes) and CD3 + CD8 + (T-killers). Cytokine levels in the groups studied in the dynamics have not been significantly altered. The changes of cytotoxic (functional) activity of NK-cells in the first group after the combined treatment have been considered to be higher than before the treatment. Cytotoxic index of (functional) activity of NK-cells in the second group under the study after the combined treatment has been determined to be lower than before the treatment. Conclusion: It has been found out that the application of complex treatment accompanied by immunotropic therapy may positively influence the immune status.

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