Vol 9, No 4 (2017)

Reviews

THE CORRELATION BETWEEN INFLAMMATION MEdIATORS ANd MYOCARdIAL CONTRACTILITY IN PATIENTS WITH ACuTE CORONARY SYNdROME.THE IMPACT OF EARLY INTENSIVE STATIN THERAPY

Shalnev V.I., Mazurov V.I.

Abstract

The article highlights the impact of early intensive statin therapy on myocardial contractility in patients with acute coronary syndrome. 303 patients with ACS were enrolled in the study. All patients were randomized into two groups. 156 of them received early statin therapy by atorvastastin (80 mg/ day) or simvastatin (40 mg/day) starting from the first day of hospitalization. 147 patients received standard therapy (the control group). The left ventricle ejection fraction was assessed by echocardiography on 12-14 day of disease and after 6 months. The first assessment reveаled no significant difference between groups, while the second examination found better EF results in patients treated with high doses of statins. The statistical analysis was performed to estimate the correlation between inflammation markers and myocardial function. The negative relationship between several inflammation markers and myocardial contractility was revealed. The most significant relationship was found between LV EF and CRP and IL-6 levels. The role of inflammation markers in pathogenesis of ACS and possible mechanisms of early intensive statin therapy effect on myocardial function are being discussed.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):5-11
pages 5-11 views

MOLECULAR GENETIC CHARACTERISTICS CHILDREN WITH GROWTHHORMONE DEFICIENCY

Berseneva O.S., Glotov A.S., Glotov O.S., Serebryakova E.A., Ivashenko T.E., Bashnina E.B., Baranov V.S.

Abstract

Clinical manifestations of heterogeneity of growth hormone deficiency when definitive results of hormonal stimulus test determines the need to search for molecular genetic markers of the disease to form personalized therapeutic algorithms. Molecular genetic analysis in patients with congenital hypopituitarism was carried out by new-generation sequencing (NGS) with "Amplisek" technology. All patients with congenital hypopituitarism, who are in a special registry of Saint Petersburg, were included in this study. differences in the frequency of detection of mutations in patients with multiple anterior pituitary hormone deficiency and in patients with isolated growth hormone deficiency were found. The mutation frequency of diagnosis in genes responsible for congenital hypopituitarism in patients of St. Petersburg were studied.Mutations in genes associated with congenital hypopituitarism were identified in 16.3% of patients with pituitary dwarfism (16 of 98). The most commonly diagnosed mutations are changes in gene PROP1. In carrying out the molecular genetic studies of patients with congenital hypopituitarism is necessary to consider the likelihood of the presence of these rare pathologies such as loss of genes GHSR, ARNT2, BTK. Currently conducting molecular genetic studies in patients with congenital hypopituitarism further predicts development of the disease and, if necessary, adjust the ongoing replacement therapy.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):12-16
pages 12-16 views

ULTRASOUND INVESTIGATION POSSIBILITIES IN PARATHYROID GLANDSESTIMATION IN SECONDARY HYPERPARATHYROIDISM

Zotova I.S., Kholin A.V.

Abstract

It was assessed the efficacy of the parathyroid gland (PTG) ultrasonography in secondary hyperparathyroidism (SHRT). The data of 120 patients with the diagnosis of SHPT were analyzed. The majority of patients (44,2%) had chronic glomerulonephritis, 59,2% of patients were on hemodialysis,40,8% - on peritoneal dialysis. In 62,3% of cases, an increase in the size of the glands was found, combined with a change in the echostructure. The amount of PTG in one patient was from 1 to 5, ectopic glands were found in 5,4% of cases. In the majority of patients with hyperplastic PTG (68,3%) the increase in the level of parathyroid hormone was more than 300 pg / ml.diffuse hyperplasia was detected in 37,7% of cases, nodal hyperplasia - in 62,3% of cases. The characteristics of ultrasonography with regard to the detection of nodular hyperplasia in case of inhomogeneity of PTG echostructure are: accuracy - 85,7%; sensitivity - 82,4%, specificity - 86,9%, in terms of determining the size of the PTG, the characteristics of the method are: accuracy - 75,8%; sensitivity- 79,3%; specificity - 68,2%.The conclusion is made that ultrasonography is a highly informative method for diagnosing hyperplasia of the prostate gland in patients with SHPT, which allows timely detection of changes in the glands, determining the severity of hyperplasia, suggesting a morphological variant of the observed changes, and increasing the effectiveness of the operative intervention in the PTG.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):17-22
pages 17-22 views

VIDEO-ASSISTED GASTROENTEROSTOMY PILORODUDODENAL STENOSISIN PATIENTS WITH SENIOR AND SENIOR AGE

Glushkov N.I., Gorshenin T.L., Dulaeva S.K.

Abstract

Introduction. The immediate results of surgical treatment of 80 patients with pyloroduodenal stenosis of older age groups, operated in the traditional way and with the use of endovideosurgical techniques, were analyzed. An optimal variant of preoperative preparation with inclusion of early enteral therapy and nutritional support was offered, which allowed to reduce the degree of hypovolemia and tissue dehydration, to correct the water-electrolyte balance and acid-base state. The incidence of postoperative complications and mortality in both groups were studied. Individualized surgical tactics that allowed to reduce the number of postoperative complications and lethality were proposed.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):23-28
pages 23-28 views

THE FEATURES OF MAGNETIC RESONANCE IMAGING IN THE DIAGNOSISOF RECURRENT RECTAL CANCER

Otochkin V.V., Rozengauz E.V.

Abstract

The article presents the MRI studies results of 138 patients after surgery for colorectal cancer. The recurrence was diagnosed in 48 patients (n=48; 35%) in terms of three to 82 months after surgery. The effectiveness of various pulse sequences and planes, bolus contrast enhancement and dWI was evaluated. The semiotics of recurrence of colorectal cancer were described on various pulse sequences, planes and postcontrast images. The combination of the optimal plane and pulse sequence allowed us to identify the tumor and assess its prevalence, structure and form. diagnostic difficulties were associated with small sizes of recurrence - up to 15 mm; in the event of recurrence in the structure of scarring, the presence of areas of hemorrhage in the tumor structure. The use of dynamic bolus contrast enhancement and additional pulse sequence and planes to the standard protocol in difficult cases didn’t increase the sensitivity and specificity of the study. The sensitivity of the MRI was 89.5%, specificity - 98,9%.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):29-34
pages 29-34 views

THE POSSIBILITIES OF COMPuTEd TOMOGRAPHY IN ASSESSING THE RISK OF STROKE

Kotov M.A., Sebelev K.I., Terent’ev R.O.

Abstract

Stroke occurs when the blood flow in the brain tissues decreases, causing morphological changes - microcirculation disturbances leading to a change in the density of the substance, which can be visualized using radiation diagnostic methods and based on the data obtained, to identify patients at high risk of stroke. The purpose of this study is to study density of brain stem structures in patients with different stroke outcomes compared to the control group. When analyzing these indicators, a correlation was found between changes in brain stem density and the likelihood of a stroke.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):35-38
pages 35-38 views

COMPARISON OF DIFFERENT METHOD OF ANALGESIA IN AGED PATIENTSWITH CHRONIC LOW BACK PAIN

Vasilieva G.N., Linkov A.L., Kukushkina N.O., Dimitrienko F.I., Karelov A.E.

Abstract

Effectiveness of different methods of analgesia was studied in 34 aged patients suffering chronic low back pain. All patients were at age 60 to 86 and were randomized into N-group in which nefopam (60 mg rectally) was administrated and K-group that included patients who received ketoprofen (100 mg rectally). The end-points of this prospective study were decrease of pain intensity after analgesics administration, contentment of therapy, and characteristics of side effects of medications taking (twice daily for three days). We found that pain intensity decreases by 6,3±1,6 in N-group and 6,1±1,3 in K- group (p<0.05 in the both cases) and achieves 0,9±1,4 and 0,9±1,6 in N- and in K-group, respectively (p>0.05 in comparison between groups). No significant differences between groups were in estimation of therapy contentment. No side effects were registered. Thus, our data proved the equal effectiveness of central nonopioid analgesic nefopam and nonselective cyclooxygenise inhibitor ketoprofen for achievement of good analgesia in aged patients with chronic low back pain.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):39-45
pages 39-45 views

IRON METABOLISM, IRON DEFICIENCY ANEMIA AND CARDIORENALANEMIA SYNDROME IN IN ELDERLY AND OLD PATIENTS

Bogdanov A.N., Shcherbak S.G., Pavlovich D., Lomonosova E.V.

Abstract

Modern information about iron metabolism, features of iron deficiency anemias and cardiorenal anemia syndrome in elderly and old patients are revelealed in this lecture.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):46-52
pages 46-52 views

INFLUENCE OF BRAIN BASAL CHOLINERGIC SYSTEM DYSFUNCTIONON THE CONDITION OF COGNITIVE FUNCTIONS (LITERATURE REVIEW)

Lobzin S.V., Sokolova M.G., Nalkin S.A.

Abstract

This article is dedicated to the impact of dysfunction of the basal cholinergic system on the state of cognitive functions in various diseases of the brain. domestic and foreign literature is completely reviewed. The pathogenetic mechanisms of dysfunction cholinergic system of the brain are described in myasthenia gravis. Modern approaches in the treatment of cognitive impairment with using central cholinomimetics are described.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):53-58
pages 53-58 views

A REVIEW OF FOREIGN LITERATURE ON INSTABILITY OF THE LUMBAR SPINE

Mooraby Z., Ptashnikov D.A., Masevnin S.V., Michaylov D.A., Zaborovskii N.S., Volkov I.V., Yang L.

Abstract

Spinal instability is a pathological condition, which is based on the mechanical displacement of the vertebrae relative to each other, accompanied by pain in the corresponding region of the spine. This pathology is often the determining factor in establishing the indications for surgical stabilization of the vertebral-motor segments. Although instability of the lumbar spine, has been discussed in literature it still hasn’t been sufficiently studied.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):59-65
pages 59-65 views

MODERN SURGERY OF NON-TRAUMATIC INTRACEREBRAL HEMORRHAGE

Yarikov A.V., Morev A.V., Lavrenuk A.N.

Abstract

In this publication, the authors provide an overview of the literature devoted to modern methods of surgical treatment of non-traumatic intracerebral hemorrhage. Currently under hemorrhagic stroke is meant a wide range of non-traumatic origin of diseases which are accompanied by bleeding in the brain tissue under its shell and / or into the ventricular system. Relevance of the work associated with high mortality (74%) and disability (75-80%) among surviving patients with this pathology. The paper details the etiology and pathogenesis of this type of disorders of cerebral circulation. We describe the surgical technique used in modern neurosurgery. Highlighting their positive and negative sides, given the outcome of treatment of various authors. On the basis of these studies the indications, contraindications, and patient selection criteria for surgical treatment of non-traumatic intracerebral hemorrhage.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):66-75
pages 66-75 views

VISUALIZATION OF THE DISTRIBUTION OF AUTOLOGOUS MESENCHYMAL CELLS INTRODUCED INTO THE BODY OF A PATIENT SUFFERING FROM CIRRHOSISOF THE LIVER NUTRITIONAL ETIOLOGY

Kotkas I.E., Enukashvily N.A., Asadulaev S.M., Marchenko N.V.

Abstract

The article presents own observation about the ability to visualize, entered through its own hepatic artery autologous mesenchymal cells in the human body.
HERALD of North-Western State Medical University named after I.I. Mechnikov. 2017;9(4):76-78
pages 76-78 views


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