Vol 23, No 4 (2023)

CARDIOLOGY

Comparative evaluation of permanent cardiac pacing modes in patients with arrhythmic variant of coronary artery disease (bradyarrhythmia)

Romanov M.D., Kireeva E.M., Levina T.M., Bikmurzin A.K.

Abstract

Aim – to analyze and compare the results of permanent cardiac pacing therapy in patients with arrhythmic variant of coronary artery disease (CAD) (grade II – III AV block and sinus node weakness syndrome).

Material and methods. We studied the results of examination of 63 patients with arrhythmic variant of coronary artery disease (sinus node weakness syndrome and AV block), who received pacing therapy in VVI and DDD modes in the Department of Rhythm and Conduction Disorders of the Republican Clinical Hospital No. 4. All patients underwent clinical, laboratory and instrumental tests in accordance with federal clinical guidelines for CAD, rhythm and conduction disorders.

Results. The left ventricular ejection fraction (LVEF) in patients with pacemakers in VVI mode was 9% lower when compared to LVEF in DDD mode. Mitral regurgitation was 47.6% more common in patients having VVI mode than DDD mode. In patients with the VVI regimen, the interventricular septal asynchrony was 25.1% more common and was accompanied by more pronounced left ventricle hypertrophy and dysfunction. Pacemaker syndrome was observed in 3 (7.5%) patients with VVI stimulation mode, stopped by reimplantation of a two-chamber frequency–adaptive pacemaker, and in 1 (4.35%) patient with DDD mode, eliminated by reprogramming.

Conclusion. In patients with coronary artery disease, the effectiveness of pacing in correction of the cardiac rhythm and conduction depends on the treatment mode. Disorders of myocardial contractility are more pronounced in patients with VVI mode, if compared to DDD mode.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):4-9
pages 4-9 views

OPHTHALMOLOGY

Computer accomodography data for assessing tolerability of optical correction for myopia in near work

Abida M., Zhukova O.V., Sineok A.E., Malov V.M., Eroshevskaya E.B.

Abstract

Aim – to study the results of computer accomodography in children with myopia optical correction in order to assess the optical correction tolerability during visual work at close distance.

Material and methods. The study of myopia optical correction tolerance in near work included 45 children of school age. Subjective and objective research methods were used: a relative accommodation reserve study and computer accomodography.

Results. The computer accomodography performed with glasses allowed to determine the nature of the ciliary muscle work in near vision. Computer accomodography data correlated with the value of relative accommodation reserve.

Conclusion. We recommend to study the relative accommodation reserve and to use computer accomodography when choosing the optical correction for myopic children.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):10-14
pages 10-14 views

Reposition of dislocated piggyback intraocular lens in a patient with induced keratectasia after radial keratotomy

Artemov M.A., Kazakov I.S., Malov V.M., Zolotarev A.V., Eroshevskaya E.B., Karlova E.V.

Abstract

Aim – to substantiate low-traumatic sutureless surgery for piggyback intraocular lens (IOL) reposition as a method of choice in a patient after previous keratorefractive surgery and cataract phacoemulsification.

The article provides the examination and surgical treatment data of one patient with piggyback intraocular lens dislocation after previous radial keratotomy and keratectasia.

The presented clinical case shows that proper consideration of eye anatomical features allows for effective low-traumatic sutureless piggyback IOL reposition in patients who have previously undergone radial keratotomy, and may lead to sustainable high visual and functional results.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):15-19
pages 15-19 views

Methods of intraocular lens fixation in complicated cases of lens surgery

Ben Amor F., Sineok A.E., Zhukova O.V., Malov V.M., Eroshevskaya E.B.

Abstract

There is a growing attention to the lens surgery in complicated cases that require to obtain a good functional result and to minimize the surgical volume. The intraocular lens fixation remains a major problem in complicated cases in lens surgery due to the inadequate capsular support. It is essential to achieve the refractive goal and correct positioning of the intraocular lens both immediately after operation and in the long-term period.

The article reviews current available scientific literature of domestic and international authors devoted to the problem of intraocular lens fixation in complicated cases of lens surgery.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):20-26
pages 20-26 views

Micropulse cyclophoto-coagulation in patients with primary open-angle glaucoma: early results

Germanova V.N., Sorokin A.V., Zolotarev A.V., Karlova E.V., Malov V.M., Radaykina M.V., Zhukova O.V.

Abstract

Aim – to evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) procedure in patients with primary open-angle glaucoma (POAG).

Material and methods. The study was conducted in 21 patients with POAG and uncompensated intraocular pressure (IOP) using pharmacotherapy. All patients underwent MP-TSCPC procedure with IRIDEX Cyclo G6 device. The follow-up period lasted for 1 month. During this time, the visual acuity, IOP dynamics, complications, as well as the number of hypotensive drugs used were evaluated. Statistical analysis was performed using STATISTICA 12.0 software.

Results. Among patients with moderate and advanced glaucoma, the IOP reduced by 46.7 (3.3; 64.3) % from baseline values by the end of the follow-up period. The target IOP was achieved in 30.7% of patients. In 75% of patients who achieved target IOP, the number of hypotensive drops used was reduced by 1 component. In all patients with terminal stage glaucoma, pain was relieved, and IOP was reduced by 35.5 (8.4; 41.1) %. No intra- or postoperative complications were reported in any case.

Conclusion. MP-TSCPC can be considered as a relatively safe adjunctive method to achieve target IOP in addition to medical treatment in patients with moderate and advanced glaucoma, as well as appropriate method to control pain in patients with the terminal stage of the disease.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):27-31
pages 27-31 views

Long-term outcomes of surgical treatment for cataract and asteroid hyalosis

Danilov A.M., Grinev A.G., Eroshevskaya E.B.

Abstract

Aim – to assess long-term surgical treatment outcomes and subjective level of satisfaction in patients with cataract and asteroid hyalosis.

Material and methods. The study involved 120 patients (120 eyes) diagnosed with cataract and asteroid hyalosis. During the study, the patients were randomly assigned into 3 equivalent groups of 40 people each, depending on the surgical treatment method. Group I was formed of patients after phacovitrectomy through posterior capsulorhexis, group II included patients after total three-port phacovitrectomy, group III - patients after cataract phacoemulsification. Before the surgery, on the day of discharge, 1, 3 and 6 months after the operation, all patients received standard ophthalmological check-up and answered validated visual function questionnaire "The Visual Function test" (VF-14) assessing their subjective perception of life quality.

Results. Visual acuity was comparable in all groups up to 1-3 months after surgery. The subjective level of satisfaction was significantly higher in patients after phacovitrectomy (groups I and II), regardless of the time passed after the operation. Some patients of group III applied for surgical treatment again due to unsatisfactory results of the previous operation.

Conclusion. In patients with cataract with underlying vitreous destruction in the form of asteroid hyalosis, it is recommended to perform phacovitrectomy in order to achieve high functional result, as well as to improve the patient's subjective feeling of the life quality.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):32-37
pages 32-37 views

Origin of stage I-II retinopathy

Lazutkina A.Y.

Abstract

Aim – to study the causes of retinopathy (RP) formation and progression at the initial stages.

Material and methods. The data of a 6-year prospective follow-up of a natural group of initially healthy male workers aged 18-66 years (n = 7,959) were used to determine the predictors of stage I-II RP. For this purpose, a 2×2 confusion matrix and a multivariate regression model were used, and the relative risk factors were assessed.

Results. Stage I-II retinopathy was caused by such factors as age from 26 to 66 years, arterial hypertension, smoking, dyslipidemia, hyperglycemia, family history of early cardiovascular diseases, degree I-III obesity, left ventricular myocardial hypertrophy, microalbuminuria, type 2 diabetes mellitus, creatininemia, atherosclerotic plaque / thickening of the intima-media complex, aortic atherosclerosis. All predictors except for smoking, degree I-III obesity and aortic atherosclerosis had a statistically significant result in the applied mathematical models.

Conclusion. Statistical heterogeneity of the stage I-II RP predictors is likely to be related to the qualitative specific characteristics of RP predictors and their unique damage effect in the development of stage I-II RP.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):38-43
pages 38-43 views

Suprachoroidal administration of triamcinolone acetonide in patients with macular edema after vitrectomy: Technique and results

Pershakova A.E., Kazakov I.S., Artemov M.A., Zolotarev A.V., Zhukova O.V., Karlova E.V., Eroshevskaya E.B., Malov V.M.

Abstract

Aim – to study the effectiveness of triamcinolone acetonide (TA) injection into the suprachoroidal space using a microneedle for the treatment of macular edema after vitrectomy.

Material and methods. During the study, the results of suprachoroidal administration of triamcinolone acetonide were analyzed in 8 patients (8 eyes) who were observed with macular edema as a complication of vitrectomy. Ophthalmological examination included visometry, non-contact tonometry, indirect ophthalmoscopy with lens 78 D, and optical coherence tomography (OCT) of the macular area. Best corrected visual acuity (BCVA) before the operation ranged from 0.1 to 0.8 (0.25 (0.10; 0.50), retinal thickness in the foveolar area varied from 342 to 728 µm (513.0 (443.0; 585.5) according to OCT data. During the operation, all patients underwent the injection of 0.1 ml of triamcinolone acetonide using a microneedle into the suprachoroidal space 3.5-4.0 mm posterior to the limbus.

Results. One month after suprachoroidal injection of TA, the thickness of macular edema statistically significantly decreased to 327.5 (309.0; 380.5) μm (p = 0.011719) and BCVA increased to 0.45 (0.25; 0.80) (p = 0.027709). Three months after surgery, the retinal thickness in the macular area was 333.5 (311.5; 503.0) (p = 0.068704). The lack of statistical significance in the reduction of macular edema 3 months after suprachoroidal TA injection is explained by the fact that 3 out of 8 patients (37.5%) experienced a recurrence of macular edema after 3 months. However, BCVA has significantly increased to 0.6 (0.25; 0.90) (p = 0.043115). In 5 out of 8 patients (62.5%) a stable positive result was achieved within 3 months in the form of relief of macular edema. In the postoperative period, an increase in intraocular pressure was noted only in 2 cases of measurements, in patients observed for secondary glaucoma as a concomitant diagnosis. Intraocular pressure was compensated in both cases after correction of the treatment regimen.

Conclusion. The presented technique is effective in treatment of macular edema associated with vitrectomy, as well as safe, which may be the reason for its further study.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):44-50
pages 44-50 views

Pharmacological modulation of wound healing in glaucoma surgery

Radaykina M.V., Zolotarev A.V., Karlova E.V., Malov V.M., Eroshevskaya E.B.

Abstract

Excessive scarring in the area of hypotensive glaucoma surgery is still a challenge in ophthalmology as it is the main cause of postoperative IOP elevation. The antiproliferative pharmacologic agents currently used for wound healing modulation are either not effective enough or have poor safety profile.

The review provides a brief description of wound healing physiology including cytokines involved in it. It also represents the mechanisms of action and effects of drugs that influence wound healing and are used as antiproliferative agents for prevention of excessive scarring in glaucoma surgery.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):51-58
pages 51-58 views

DENTISTRY

Pre-treatment of granular osteoplastic material for improving the reparative regeneration of jaw bone defects

Malchikova D.V.

Abstract

Aim – to develop a method for preliminary preparation of a granular osteoplastic material (GOM) for improving the quality of reparative osteogenesis of jaw bone defects that can be used in clinical setting.

Material and methods. The in vitro study was performed using 9 samples (3 samples in each study group). Group 1 included intact samples of grafting material Cerabone (Botiss biomaterials GmbH, Germany). In group 2, the samples of Cerabone (Botiss biomaterials GmbH, Germany) were subject to degassing and dust extraction in two stages using the original method developed by the author. In group 3, a culture of mesenchymal-stromal cells (MSC) obtained from the human umbilical cord was used as a control. The developed method was assessed for cytotoxicity using human MSC. The proliferative index and cell doubling time were registered. A topographic analysis of the sample surface was performed using scanning electron microscopy. To assess the rate of degassing, the experiment included three replicates. The fluid volume was recorded every 2.5 minute. For statistical data processing, we used SPSS 25.0 software (IBM Corporation, Armonk, New York, USA).

Results. In Group 2, that included the samples of GOM fractions with the preliminary degassing and dust extraction, we revealed a decreased content of coarse and fine fraction dust on the outer and inner surfaces of the pores and mouths of interpore channels and voids in all samples. The granular osteoplastic material prepared for the use by the method of degassing and dust extraction proved to have no toxic effect on the growth and viability of human mesenchymal-stromal cells.

Conclusion. A preliminary preparation of GOM by the method of degassing and dust extraction developed by the author in clinical conditions ex tempore significantly optimizes the adsorption and drainage properties of the GOM fraction.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):59-65
pages 59-65 views

PHARMACEUTICAL CHEMISTRY, PHARMACOGNOSY

Comparative phytochemical study of white poplar (Populus alba L.) and black poplar (Populus nigra L.)

Kosenko A.A., Kurkina A.V.

Abstract

Aim – to conduct a comparative phytochemical study of leaves, wood buds, shoots, bark of two representatives of the genus poplar – white poplar and black poplar.

Material and methods. For the experiment, we have chosen leaves, wood shoots, buds, bark of black poplar (Populus nigra L.), white poplar (Populus alba L.) and also reference standards (RS). The thin-layer chromatography was carried out on the plates Sorbfil-PTSH-AF-A-UV in the systems n-butanol-acetic acid-water (4:1:2) and chloroform-ethyl alcohol-water (25:18:2). The spectrophotometry was carried out on a Specord 40 spectrophotometer (Analytik Jena) in cuvettes with a layer thickness of 10 mm in the wavelength range from 190 to 500 nm. The comparison solution was ethyl alcohol of 96% concentration.

Results. In the water-alcohol extracts of the leaves of poplar species the presence of rutin and other phenolic compounds was detected. Pinostrobin and pinocembrin were observed in wood shoots, buds and bark of the plants. The bathochromic shift of the long-wavelength line in the ultraviolet spectra of the studied extracts solutions indicated the presence of flavonoids.

Conclusion. In all cases, flavonoids made the greatest contribution to the absorption curves of the spectra, in particular: flavanones (pinocembrine, pinostrobin, and others), and phenylpropanoids (caffeic acid and other cinnamic acids). The leaves, wood shoots and buds of the plants contained substances of a phenolic nature, including flavonoids. The composition of the bark of the white poplar was mainly represented by phenolic compounds – phenylpropanoids and simple phenols.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):66-71
pages 66-71 views

Polysaccharide content and composition analysis in the herb Astragalus albicaulis DC

Pozdnуakova T.A., Bubenchikov R.A.

Abstract

Aim – to isolate and analyze the polysaccharides content in the herb Astragalus albicaulis.

Material and methods. The object of the study was the herb Astragalus albicaulis harvested in the Kursk region in 2022 during the period of mass flowering. To isolate the polysaccharide complex, polyphenolic compounds were previously removed from the raw material. After drying, a water-soluble polysaccharide complex, pectin substances, hemicellulose A and hemicellulose B were sequentially isolated from the extraction cake. As extractants, purified water was used to isolate the water-soluble polysaccharide complex, a mixture of 0.5% solutions of oxalic acid and ammonium oxalate (1:1) was used for pectin substances extraction, to obtain hemicelluloses – a 10% aqueous solution of alkali followed by neutralization with acetic acid. The composition of the obtained substances was analyzed after acid hydrolysis using paper chromatography.

Results. It was found that the yield of water-soluble polysaccharides from the herb Astragalus albicaulis was 9.41% ± 0.46%, pectin substances – 17.49% ± 0.62%, hemicellulose A – 0.86% ± 0.04%, hemicellulose B – 5.36% ± 0.25%. After acid hydrolysis, 5 monosaccharides were found in the complex of water-soluble polysaccharides: rhamnose, xylose, arabinose, galactose, and glucuronic acid, of which arabinose and galactose were predominant. The monosaccharide composition of pectin substances was represented by xylose, arabinose, glucose, galactose and galacturonic acid, galacturonic acid predominated. As a result of the identification of hydrolysis products of hemicellulose A and B, rhamnose, xylose and glucose were found, the predominant monosaccharide was xylose.

Conclusion. For the first time, complexes of polysaccharides – water-soluble polysaccharides, pectin substances, hemicellulose A and B – were isolated and studied by fractions from the herb Astragalus albicaulis, their qualitative composition was registered. The data obtained indicates that the herb Astragalus albicaulis can be used as a source of natural polysaccharides.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):72-76
pages 72-76 views

ENDOCRINOLOGY

Topical issues of toxic goiter diagnosis and treatment

Makarov I.V., Galkin R.A., Shpigel A.S., Lebedeva E.A., Bulgakova S.V., Romanov R.M., Kudashkin V.N.

Abstract

Among the causes of thyrotoxicosis, the diffuse toxic goiter is found in 75-80% of cases, the toxic multinodular goiter is observed in 20-25% of cases. The article presents the data on various aspects of surgical treatment of thyroid diseases found in international databases.

Aspirantskiy Vestnik Povolzhiya. 2023;23(4):77-86
pages 77-86 views

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