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Vol 6, No 4 (2014)

Reviews
VIDEO ASSISTED OPERATIONS IN THE TREATMENTOF COMPLICATED FORMS OF COLON CANCER IN ELDERLYAND SENILE PATIENTS
Glushkov N.I., Gorshenin T.L.
Abstract
Article presents the results of the treatment of complicated forms of colon cancer in patients with elderly using laparoscopic technology. The authors analyzed the data and showed the effectiveness of minimally invasive technologies in treatment of colon cancer.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):7-11
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SURGICAL TREATMENT OF PATIENTS WITH FOLLICULARTUMOR OF THYROID GLAND
Simbirtsev S.A., Tatarkin V.V., Trunin E.M., Smirnov A.A., Davidov D.V., Sultanova F.M.
Abstract
In this work, based on the research of treatment results of 646 patients that were operated for nodular and multinodular nontoxic goiter in Hospital St. Elizabeth endocrinology center, in the period from 1997 to 2013, an analysis of the malignant tumor frequency in patients with follicular thyroid tumors who underwent surgical treatment for the nodular goiter was performed. In this group gender and age characteristics of patients with follicular thyroid tumors were identified, and also an evaluation of surgical treatment safety in patients operated for follicular thyroid tumors was performed.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):12-15
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FEATURES OF SURGICAL TACTICS IN WOUNDS OF THE ANTERIORABDOMINAL WALL AND LUMBAR REGION WITH LIVER DAMAGE
Sigua B.V., Zemlyanoy V.P., Badalova Z.E., Yalda K.D., Gorbunov G.N.
Abstract
We analyzed the results of treatment of 339 patients with wounds of abdominal and lumbar regions, that were treated during the period from 1991 to 2010. For the purpose of continuity in providing of the specialized surgical care we used the scales, evaluating the severity of multiple and combined injuries, developed by military surgery department (VPH-P ((R) and (OR))) and the classification of liver damages by E. Moore. Abandonment of liver injury packing in favor of suturing allowed to achieve a significant reduction of post-operative complications in patients with injuries of the abdomen and lumbar region with liver damage from 24.1% (40) to 9.2% (16) (p <0,001), and the level of mortality from 6.1% (10) to 1.2% (p <0.05).
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):16-20
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THE VALUE OF HIGH EFFECTIVE LIQUID CHROMATOGRAPHYIN THE DIAGNOSIS OF PRIMARY HYPERALDOSTERONISM
Rebrova D.V., Vorokhobina N.V., Velikanova L.I.
Abstract
Primary hyperaldosteronism is considered to be the most common cause of secondary hypertension. Therefore a relevance of early diagnosis of primary aldosteronism is obvious. The article discusses the possibility of using the determination of precursors of aldosterone in blood and urine samples by high effective liquid chromatography as an additional diagnostic criterion. The method is safe for the patients who have contraindications to recommended confirmatory tests. It can be used in patients with uncontrolled hypertension and high risk of cardiovascular complications. Our data showed that increased levels of blood corticosterone, 18-hydroxycorticosterone in blood and urine samples are laboratory signs of primary aldosteronism. We consider measurement of 18-hydroxycorticosterone blood level for early differential diagnosis of various types of primary aldosteronism.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):21-25
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INSULIN AND CERTAIN STEROIDS SECRETION IN PATIENTSWITH VARYING SEVERITY OF BURN DISEASE
Pugachev M.I., Dobrovolskaya L.M., Ivanov V.V., Shustov S.B.
Abstract
The results levels of insulin, testosterone and cortisol in patients with burn disease are presented. The analysis of the secretion hormones in groups with varying severity of the injury are provided. It was shown that in male burned patients was accompanied with prolonged decrease in testosterone secretion. Degree of inhibition testosterone secretion depends on the severity of burn injuries. Also there were revealed that burn disease was accompanied with prolonged increase in cortisol secretion. It was shown that increase IRI-activity on the 6 th and 14 th day of hospitalization, which may indicate emerging insulin resistance in this period disease. Severe burn injury were observed to hormonal failure, which may reduce the chances of survival of the injured.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):26-31
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INFLUENCE OF THE DEGREE OF OBESITY AND HIGH-VOLUME LIPOSUCTIONON BODY COMPOSITION, HEMODYNAMIC CHANGES, BLOOD OXYGEN
Nikolaeva I.P., Kapranova A.S., Popova V.B., Lodyagin A.N., Frolova T.A.
Abstract
To evaluate the influence of the degree of obesity and high-volume liposuction on body composition, hemodynamic, blood oxygen. The actual values of the cardiac index and stroke index, as well as the calculation of these indicators on a body surface area of the "ideal subject" showed a significant correlation with body mass index, which confirms the impact of obesity on hemodynamic changes, myocardial dysfunction and the development of severe arterial hypoxemia. Analysis of the parameters of liquid sectors body showed insufficient increase in total, extracellular fluid and blood volume by a significant rise of fat and muscle mass. It is believed that the increase in blood volume in obesity is adaptive in nature and occurs in response to expansion of the vascular bed with increasing body weight. After liposuction large volume of significant hemodynamic changes were not obtained. In the late period against reduction in fat mass oxygenizing improved lung function. Carrying a large volume liposuction are not adversely impact on the reserve possibilities myocardial hemodynamics in the long term. Timely diagnosis of adaptive changes in hemodynamics and fluid sectors organism, which can be considered as prognostic risk factors must be considered when choosing the volume lipoaspiration.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):32-38
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DINAMICS OF HAEMODIYNAMIC INDExES IN PATIENS WITH AN AORTIC STENOSIS IN A PERIOPERATING PERIOD DEPENDING ON ANATOMIC FEATURES OF VALVULARVEHICLE
Slepenok E.V., Stolov S.V.
Abstract
The aortal stenosis is the most widespread diseases among valvate damages of heart. The hypertrophy of the left ventricle which degree correlates with weight of the defect in many respects defines outcomes of an aortal stenosis. Thus in the literature there is no precise communication between in thickness myocardium left ventriculum and initial valve the device (the size of a ring aortic the valve), as well as speeds of regress of a hypertrophy in the postoperative period and the size of an implanted artificial limb. In work the analysis of dynamics of haemodynamic parameters of heart in a perioperating period depending on anatomic features of the valvate device is carried out (the diameter of a ring aortic the valve). In surgical practice at implantation of an aortal artificial limb estimate body surface area, thus try to provide as much as possible physiological needs for warm emission. Therefore most often to them plan artificial limbs the sizes more than №23. However owing to expressiveness of a kaltsinoz of an aortal ring and deformation it owing to fibrosis it is not always possible to establish artificial limbs of the corresponding diameter. Our research is directed on detection of features of haemodynamic indicators in postoperative the period, as forecast predictors depending on diameter of an aortal artificial limb. It is established, that patients with implantation of prosthetic appliance sizes №19-23 in early operational period had a higher gradient of pressure on an aortic valve, more slow reduction of degree of hypertrophy of myocardium as compared to the group of patients with prosthetic appliances more than № 23. At comparison hemodynamic parameters of both groups in the remote timeframes the increase of a gradient of pressure of an artificial limb aortic the valve in group with artificial limbs less than №23 in comparison with preoperative periods is revealed. At patients with artificial limbs more than № 23 intracardial characteristics in the remote period especially did not change. The given features, probably, are connected with shaped dysfunction of an artificial limb (pannus) or with more expressed load on left ventriculum (at slower regress of a hypertrophy left ventricuulum), that the trancevalve a gradient of pressure tends to increase.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):39-44
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STUDY OF REINNERVATION PROCESS IN PATIENTS WITH 2 TYPEOF SPINAL MUSCULAR ATROPHY: CLINICAL EXPERIMENTAL STUDY
Sokolova M.G., Penniyaynen V.A., Rezvantsev M.V., Lobzin S.V., Aleksandrov N.Y.
Abstract
Spinal muscle atrophy (SMA) of type 2 is an autosomal-recessive disease defined by a degenerative change in alpha-motor neurons of anterior horns. The disease is manifested in weakness of proximal muscles, pareses, respiratory disturbance and early death. Study of reinnervation process in patients with 2nd type of SMA can provide valuable information on a condition of adaptive mechanisms within the limits of neuron plasticity. According to electroneuromyography study in patients with 2nd type SMA reinnervation process is low intense. It was found out that concentration NGF (nerve growth factor) in serum of patients with 2nd type SMA is considerably higher than in control group. We studied the influence of blood serum of patients with 2 type SMA on growth neurites of sensory ganglia of 10-12 days old chicken embryos in organotypic culture. For the first time it was shown that blood serum of patients with 2nd type SMA dose-dependent inhibits of growth neurites of sensory ganglia. Apparently, neurite-inhibitory effect is caused by high concentration of neurotrophins in patient serum, due to that the reinnervation mechanisms in 2 type SMA patients are not so efficient.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):45-51
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APPLICATION OF CELLULAR TECHNOLOGIES FOR RESTORATIONOF PROCESS OF REGENERATION AT PEOPLE OF THE SENIOR AGE GROUPS
Pechersky A.V., Pechersky V.I., Smolyaninov A.B., Velyaninov V.N., Adylov S.F., Semiglazov V.F.
Abstract
This manuscript is devoted to the vital topic - restoration of process of the regeneration at people of the senior age groups. Cells-predecessors and differentiated cells can divide a limited number of times and are not capable of providing regeneration of tissues during all of ontogenesis. The updating of tissues during such a long period is impossible without the participation of a specialized system responsible for regeneration. The given system is submitted by stem cells which are capable of being differentiated in all types of somatic cells and in a line of genital cells, and also have ability to self-update during the whole life of an organism. Results of research allow to consider, that the number of a pool of pluripotent stem cells at people of the senior age groups can be restored by a transfusion of mononuclear fraction of peripheral blood from young donors of 18-23 years of one blood types and a floor with the recipient (The patent of the Russian Federation № 2350340).
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):52-62
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EMPATHIC ABILITIES AND EMOTIONAL BURNOUT SYNDROMEAT SPECIALISTS OF PSYCHIATRIC PROFILE: RISK FACTORS AND CORRECTIION
Gorodnova M.Y.
Abstract
The study of communication burnout and empathic abilities of 270 specialists of child and adult psychiatry were examined during postgraduate study, selected corrective factors of the educational process. Emotional exhaustion and professional success at the output of the educational process are determined by their initial values. Level of output is determined by the depersonalization emotional exhaustion at the entrance. The risk factors for the development of burnout in men are a high level of empathy, intuition, identification, and the women high emotional involvement. Developments of empathic attitudes, ability to create an atmosphere of trust, to see the world through another’s eyes, spontaneous interest reduce the risk of the syndrome. The personal experience of supervision and participation in personal growth groups reduce symptoms of emotional burnout syndrome
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):63-70
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PATIENT-ORIENTEDMODEL OF DELIVERY OF HEALTH CARE AS INSTRUMENT OF IMPROVEMENT OF QUALITY OF MEDICALAND DIAGNOSTIC PROCESS
Gilvanov V.A., Minaycheva N.E., Lebedev I.A., Filatov V.N.
Abstract
On the basis of the employees given questioning and patients of versatile hospital, influence of patient-oriented model of delivery of health care on its quality is shown. The most important results of introduction of this model are high commitment of health workers to clinic and increase of a self-assessment of employees, and also improvement of quality of medical and diagnostic process, according to repeatedly hospitalized patients. One of the most significant components of the work of medical institution focused on the patient is observance of the principles of corporate culture.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):71-74
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PERSONAL SPACE: PATIENT, DISEASE, PHYSICIAN
Khurtsilava O.G., Khubulava G.G.
Abstract
This article represents a brief review of the development of the doctor’s and the patient’s attitudes towards each other. Where does the estrangement stage start, when a patient turns from an individual into an interesting medical case? What unites and distinguishes these images? How does the image of the doctor change from healer shaman into a specialist wearing the medical uniform? What unites and distinguishes these two images?
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):75-78
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ADRENAL MYELOLIPOMA
Fedorov E.A., Sablin I.V.
Abstract
Myelolipoma is a rare benign tumor that is usually asymptomatic, one-sided as a rule and hormonally inactive. It consists of mature adipose tissue with inclusion of hematopoietic cells. Most often it occurs in the adrenal gland. Patients with incidentally identified myelolipoma require careful examination in order to plan optimal management tactics. Using highly informative methods of radiodiagnostics (ultrasound, CT, MRI) allows to establish the correct diagnosis in most cases. Currently, the choice of the optimal survey algorithm, which allows not only to diagnose myelolipoma, but also to differentiate it from malignant tumors of adrenal glands, has not lost its relevance. The issues of follow-up of these patients, indications for surgery and methods of surgical interventions are also relevant.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):79-85
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CRANIOVERTEBRAL ABNORMALITIES: THE SYSTEMATIZATION PRINCIPLES,THEORIES, CLINICAL MANIFESTATIONS (LITERATURE REVIEW)
Lobzin S.V., Yurkina E.A.
Abstract
The authors analysis of the scientific literature on the problem of craniovertebral abnormalities has been conducted. In this article the history of research on craniovertebral abnormalities, the classification, theories of pathogenesis have been described.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):86-93
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SUBTOTAL ESOPHAGECTOMY WITH SIMULTANEOUS GASTRIC TRANSPLANT PLASTICSIN A PATIENT WITH PREVIOUSLY FORMED GASTROSTOMY
Zemlyanoy V.P., Sigua B.V., Oblapenko P.G., Kotkov P.A.
Abstract
Currently, the best operative method of esophageal resection in cases of its scar stenosis is performing one-stage resection with gastric transplantat plastics. However, in some cases, gaster is compromised by various pathological processes, and the use of such stomach as plastic material is questionable. Often, the presence of "defective" stomach promotes the selection of colon as a plastic material. The article presents a case report of successful one-stage esophageal resection with gastric transplant plastics in a patient, which was formed earlier gastrostomy.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):94-96
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MODERN IMAGING TECHNIGUES IN THE DIAGNOSIS OF BRAIN ALVEOCOCCOSIS(OWN OBSERVATION )
Kholin A.V., Amanbaeva G.T.
Abstract
The Brain Alveococcosis is a rare parasitic disease of the central nervous system, caused by the larval stage of the Echinococcus multilocularis. Alveococcus characterized by prolonged chronic course, severe organ and systemic disorders, extensive damage, leading to disability and often to the death of a patient, by the difficulty of diagnosis and surgical treatment. There is brain alveococcosis of the young man living in rural areas of Kyrgyzstan. The radiologic diagnosis methods significantly improve the quality of brain alveococcosis’ diagnosis, thus is a highly MRI study.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):97-102
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PRAVILA DLYa AVTOROV
- -.
Abstract
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2014;6(4):103-104
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