Vol 11, No 2 (2019)

Original researches
Electroencephalographic arousal pattern in severe alcohol poisoning
Aleksandrov M.V., Povalyukhina E.S., Alexandrova T.V., Ivanov L.B., Chernyi V.S.

Parameters dynamics of brain bioelectric activity of 50 patients in alcoholic coma are  considered. Patients underwent continuous EEG monitoring from the end of the basic resuscitation to the apparent recovery of consciousness (awakening). The average registration time was 4.5 hours. EEG was recorded in standard derivations using the 10–20 system. The amplitude-frequency indices of spontaneous activity and reactivity are analyzed. Electroencephalographic correlates of cerebral insufficiency in comatose states are distinguished by pronounced polymorphism and high individual variability. Considering these features, “dynamic” parameters should be used as prognostic criteria: spontaneity and variability of the pattern, reactivity during stimulation. The increase in the frequency of bioelectric activity, desynchronization with external stimuli may indicate the beginning of the process of recovery of consciousness. Electrophysiological criteria for awakening, developed in this work on the example of alcoholic coma, can be mostly applicable to unconscious states caused by other etiological factors: trauma, hypoxia, vascular failure.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):5-12
The performance of the specialists working in a big clinical facility of Saint Petersburg in the field of «urgent abdominal surgery» from the standpoints of medical quality assessment and its administrative monitoring
Scryabin O.N., Movchan K.N., Vovk A.V., Tatarkin V.V., Chernyshev D.A.

In this topic the role and place of experts work in the area of health care quality control for patients with an acute surgical disease of abdominal cavity in the big multi-profile medical clinic in St. Petersburg were reviewed. There was an analysis of some data of 2155 patients who were urgently taken to the hospital in 2017. As a result surgical care analysis of diseases included in "acute abdomen syndrome" we found the correlation between negative outcomes caused by defects in diagnostics and treatment and insufficiency of activity in experts work in surgery. In these study groups increasing cases of post-operative mortality, delaying of surgical intervention without strong argumentation in all diseases included in "acute abdomen syndrome" were found. Nowadays there is no opportunity to change the balance between acute and planning hospitalization of patients who have abdominal cavity diseases in positive way. Some paths of improving the quality of medical assessment to patients who has abdominal surgery diseases were discussed. In average, the example of positive improvement the abdominal surgery could be given speaking about the importance of systematically estimation of results some of the surgery teams activity and managerial decisions which could be made in time.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):13-26
Acute traumatic spinal cord injury in saint petersburg. Epidemiological data: incidence rate, gender and age characteristics
Lobzin S.V., Mirzaeva L.M., Tcinzerling N.V., Dulaev A.К., Tamaev T.I., Tyulikov K.V.

This paper presents the results of retrospective analysis of 361 cases with acute traumatic spinal cord injury (TSCI) admitted to neurosurgical departments of specialized city hospitals and  Saint Petersburg Dzhanelidze Research Institute of Emergency Care from January 1, 2012, to December 31, 2016. Retrospective cohort epidemiological study allowed us to estimate the incidence rate of TSCI, age and gender characteristics and to compare data with some foreign and domestic publications. Comprehension of the incidence and structure of TSCI will improve the medical care of these patients.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):27-34
Results of surgical treatment of patients of elderly and senile age with complicated forms of locally advanced colon cancer
Glushkov N.I., Gorshenin T.L., Belikova M.Y., Dulaeva S.K., Borovik I.K.

The paper analyzes the results of treatment of 74 elderly and senile patients with complicated forms of locally advanced colon cancer. The article demonstrates the prevalence of symptomatic operations due to the severity of the condition advanced oncological process. The use of endovideosurgical technologies in treating patients with complications of locally advanced colon cancer reduces the number of postoperative complications.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):35-42
The effect of β-endorphin on the functional parameters of the isolated heart and lymphatic vessels of the white rat
Nechaykina O.V., Laptev D.S., Petunov S.G., Radilov A.S.

Objective. The work is devoted to the comparison of the mechanisms of β-endorphin action in isolated rat heart and lymphatic vessels.

Materials and methods. The experiments were performed using the Langendorff System perfusion device (Panlab, Spain) and the multichannel wire myograph 620M (DMT). During the study, selective opioid receptor blockers, K + channel blockers were used.

Conclusion. In the course of experimental studies it was found that the most likely target for β-endorphin in an isolated rat heart are δ-opioid receptors, in isolated lymphatic vessels of a rat - μ- and δ-opioid receptors. The inhibitory effect of β-endorphin in the heart muscle is associated with stimulation of ATP-sensitive K + channels. In isolated lymphatic vessels, the effect of β-endorphin is realized through the activation of both potential-dependent and ATP-sensitive K+ channels.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):43-48
The importance of obstructive sleep apnea in the development of metabolic syndrome and obesity
Chizhova O.Y.

The aim of this study was to assess the role of obstructive sleep apnea (OSA) in the development of metabolic syndrome. 360 OSA patients were studied. Interactions with glucose intolerance, effects of treatment with continuous positive airway pressure (CPAP) were revealed.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):49-52
Case report
Clinical case of an acute toxic-allergic reaction due to single intake of methotrexate
Mazurov V.I., Shostak M.S., Kalinina E.Y., Ripachev V.V., Bashkinov R.A.

This is the case report of an acute allergic reaction in a patient with psoriatic arthritis due to a single intake of low-dose methotrexate. We review the presentation, laboratory tests and results of autopsy. The management of the disease and its outcome were analyzed according to current treatment recommendations for psoriatic arthritis.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):53-58
Kabuki Syndrome. Neurological disorders, case report
Sсhugareva L.M., Poteshkina O.V., Galaktionova S.M.

Kabuki syndrome [Kabuki syndrome, Kabuki make-up syndrome, Niikawa-s: Kuroki syndrome] (КS) – refers to rare genetic disorders, in which are involved multiple systems of the body. Of the neurological manifestations in КS are characteristic microcephaly, floppy baby syndrome, sizures, abducens nerve palsy, delayed maturation of the sucking-swallowing refleх, hearing loss, mental retardation.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):59-70
Bronhoadenitis simplex in mycoplasma pneumonia in the child (differential diagnostics and treatment)
Orlov A.V., Pashkevich A.A., Gonchar N.V., Borisenko T.S., Babachenko I.V., Romanyuk F.P.

Background. Mycoplasma pneumoniae is included in the group of atypical pathogens of acute respiratory diseases. Mycoplasma pneumoniae is characterized by a tendency to prolonged course with progressive changes in the lungs. Main value in the confirmation of mycoplasma infection has microbiome in biosubstrates selection and serological diagnostics: the determination of specific immunoglobulins IgM or IgG in the dynamics to M. pneumoniae. Antibacterial therapy of mycoplasma pneumonia is prescribed based on the sensitivity of the pathogen to them. The duration of antibiotic treatment of mycoplasma pneumonia is determined by the dynamics of clinical and radiological data.
Materials and methods. The article describes the features of the clinical course of mycoplasma pneumonia in a patient with tubinfection proceeding with bronchoadenitis and obstruction of the bronchus, which necessitated a differential diagnosis with tuberculosis of the intrathoracic lymph nodes and the appointment of repeated courses of antibiotic treatment.
Results. In the described clinical case, the duration of Mycoplasma infection exceeded 3.5 months, during which time the patient received several courses of antibiotics. Mycoplasma pneumonia had a prolonged course, accompanied by bronchoadenitis.
Conclusion. Our observations show the need to study the effectiveness of extended courses of antibiotics from the azalid group in the treatment of prolonged and complicated forms of Mycoplasma pneumonia.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):71-78
Proteomic analysis in the diagnostics of chronic heart failure with normal ejection fraction
Sveklina T.S., Shustov S.B., Kozlov V.A., Kolyubayeva S.N., Denisov D.G.

This review is devoted to the analysis of information on protein-markers of chronic heart failure (CHF). The review contains current information about protein predictors of cardiovascular disease and concomitant CHF. The methodology of proteomic analysis is considered. The following conclusions were made: 1. The method of controlling the expression of individual genome sections proteomic analysis is a method of early, preclinical diagnosis of diseases, because it allows to identify the initial stages of the pathological genome in the phenotype. 2. The study of CHF protein markers is at the primary stage of accumulation of factual material, making this research direction promising. 3. In many ways, in addition to the prognostic effect of pathological protein-markers, the detection allows to understand the pathogenesis of the disease, its implementation at the molecular level. 4. In turn, determining exact molecular mechanisms of the pathological process development helps finding new treatment modalities. 5. Changes in the number of pathological protein-markers dynamics allows to predict the severity and outcome of the disease.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):79-90
Long non-coding RNAs and their role in metastasis
Beylerli O., Gareev I.F., Beilerli A.

Cancer metastasis is a multistep process in which cancer cells leave the primary focus, survive in the bloodstream, and colonize in a distant organ. This is the main cause of cancer morbidity and mortality. It is mediated by a multistep process called the metastatic cascade. Initial steps include local invasion and migration, angiogenesis, epithelial-mesenchymal transition (EMF) and intravasation. Non-coding RNAs represent a large part of the transcriptome, with long non-coding RNAs (lncRNAs) constituting a large proportion. The perception of long non-coding RNAs as fragments of RNA and transcriptional noise has been constantly replaced by their role as confirmed targets for various physiological processes in the past few years. A large amount of evidence has revealed their role at all stages of carcinogenesis and in modulating metastasis through regulatory networks. In this review, we focus on the role of long non-coding RNAs as promoters or inhibitors in the main stages of the metastatic cascade, and in particular consider their role in the metastasis of malignant tumors to the brain.

HERALD of North-Western State Medical University named after I.I. Mechnikov. 2019;11(2):91-97

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