Bulletin of RSMU

ISSN Print 2500–1094 ISSN Online 2542–1204

Bulletin of RSMU

BIOMEDICAL JOURNAL OF PIROGOV UNIVERSITY (MOSCOW, RUSSIA)

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Alexandrov AV, Rybchenok VV, Lvov NV, Aleksandrova NE, Palinkash AM

Two-stage repair is a well-developed method that is commonly used to repair chronic ruptures of flexor digitorum profundus tendons. However, its use in pediatric hand surgery is limited due to the absence of tendon implants adapted for children. The article describes a modified Paneva-Holevich/Hunter technique for two-stage tendon reconstruction using original, oval, Lavsan-reinforced silicone prosthetic implants of four sizes (depending on patients’ age). The surgery was performed in 34 children aged 1.5–17 years. Long-term outcomes were assessed in 12 patients (8 boys and 4 girls) using the Total Active Motion scale. The follow-up period was 30 months. The average active range of motion accounted for 178.8° in boys and 218.8° in girls. The results of treatment (TAM %) were considered good in all the girls (average score of 84.3 %), and in those boys who received surgery for fingers IV and V (average score of 80.0 %). The boys who received tendon repair for fingers II and III had “good” and “poor” results (average score of 67.0 %). The proposed method of two-stage tendon repair of chronic tendon ruptures in fibro-synovial channels in children was shown to provide good results with minimal complication rates and acceptable donor site deficiency.

Received: 2016-09-28

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-05-04

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VIEWS 6081

Khagurov RA, Alexandrov AV, Rybchenok VV, Glukhovskij EM, Velskaya YuI, Lvov NV, Koval SYu

The article describes the treatment of children with vast scar deformities and extensive benign soft tissue neoplasms. The method is presented in a clinical case of successful skin restoration using balloon skin expansion. The opinion and recommendations of the authors on optimal treatment of these defects and decrease of possible complications using laser Doppler flowmetry for evaluation of the state of microcirculation in the skin flap are based on the results of the long-term use of this method in the Department of Reconstructive and Plastic Microsurgery of Filatov Children’s Municipal Clinical Hospital No. 13.

Received: 2016-09-26

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-05-05

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VIEWS 4933

Bobrysheva IV

The immunomodulatory agent Imunofan (Bionox, Russia) is widely used in clinical practice. It affects the immune and endocrine systems and enhances cell-mediated and humoral immunity. The aim of this study was to investigate the cell profile (lymphoblasts, small, medium and large lymphocytes, macrophages, mitotic cells and damaged cells) in the subcapsular and inner zones of the thymic cortex and thymic medulla of random-bred male albino rats with conspicuous age-related changes after stimulating their immune system with Imunofan. The animals in the experimental group (n = 30) were administered to intramuscular injections of the drug (0.7 mg/kg) on the 1st, 3rd, 5th, 7th and 9th days of the experiment; the controls (n = 30) were administered to the equivalent amount of normal saline on the same days. Rats were decapitated on the 1st, 7th, 15th, 30th and 60th days after the final injection. Thymic sections were studied using Olympus CХ-41 microscope, Olympus SP 500UZ camera (Olympus, Japan) and Morpholog software (Ukraine). Thymic morphology was similar in the experimental and control groups; however, cell profiles were different. On the 7th, 15th and 30th days, lymphoid cells and macrophages prevailed over damaged cells, the number of which decreased (p <0.05). Similar statistically significant trends were found in the inner zone of the thymic cortex. The number of medium lymphocytes was statistically higher on the 7th, 15th and 30th days of the observation, while the number of small lymphocytes was also higher on the 60th day of the observation. The number of damaged cells was significantly lower on the 15th and 30th days (p <0.05). The obtained results indicate conspicuous thymic response in rats with conspicous age-related changes to Imunofan administration, and partial temporary delay of age-related thymic involution.

Received: 2016-05-31

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-05

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VIEWS 6746

Zaitseva MA, Bragvadze BG, Svitich OA, Namazova-Baranova LS, Gankovskaya LV

Bronchial asthma (BA) is one of the most common respiratory system diseases. The role of innate immunity components in the pathogenesis of bronchial asthma is studied widely, with particular focus on the antimicrobial peptides. Those include beta defensins that prevent pathogen intrusion into the respiratory tract mucosa, the most active of such pathogens being β-defensin-1 (human beta defensin-1, HBD-1) encoded by the DEFB1 gene. We studied the association of three single nucleotide polymorphisms in the 5’- untranslated region of the gene, namely, rs11362, rs1799946 and rs1200972, with bronchial asthma in children. We also evaluated gene expression of toll-like receptors TLR2, TLR4 and TLR9. The experimental group included 48 patients of 3 to 7 years of age with BA and 70 healthy children. The АА genotype of the rs11362 polymorphism and the СС genotype of the rs1799946 polymorphism were reliably associated with the disease, while the GG genotype of the rs1799946 polymorphism and the АА genotype of the rs120097 polymorphism were found protective. Also, the АА genotype of the rs11362 polymorphism was associated with the reduced expression of DEFB1, the human beta defensin-1 encoding gene, while the AG genotype was associated with its increased expression. In children with BA, TLR2 expression increased 19.5 times in comparison with the controls; TLR9 expression increased 9.5 times, while TLR4 expression increased 8.3 times.

Received: 2016-06-14

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-06

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VIEWS 5636

Korolev MA, Yarmak DO, Miroschnikova EA, Moldakulov JM, Skoroglyadov AV, Korobushkin GV

Delayed or missed diagnosis of foot fractures in patients with multiple or concomitant injuries often leads to the inadequate choice of treatment and causes serious long-term effects. This article reports the most common mistakes accompanying diagnostic procedures and therapy of this injury type. The study conducted in 2007–2015 enrolled 67 patients. Patients were divided into two groups: a prospective experimental group (n = 31) and a retrospective control group (n = 36). For both groups, diagnostic procedures and the range of therapeutic interventions applied were the same, but with the experimental group we used a stepped care approach, followed a specific sequence of activities and adjusted therapy considering the limb condition and the patient’s overall state. In total, we identified 40 and 69 foot fractures in the prospective and retrospective groups, respectively. In the prospective group there were 5 delayed and 3 missed fracture diagnoses; in the second group those numbers were 7 and 9, respectively. The most common factors contributing to diagnostic errors were: excluding radiographic evaluation, severity of patient’s overall condition, poor medical history. Missed fractures were often due to a combination of various factors. A one-step approach was prevalent in the controls (41 fractures); the experimental group underwent a multistep treatment (30 fractures). Therapy outcomes were assessed by Visual Analogue Scale. The results were statistically higher in the prospective group (Mann–Whitney U was 347), which indicates a better treatment applied in this group. The study also showed that using minimally invasive fixation for foot fractures improves treatment outcome.

Received: 2016-03-30

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-07

Comments 0

VIEWS 5793

Baboshina NV

Gas diffusion and transcapillary exchange take place in the microvasculature. Therefore, the evaluation of skin blood flow regulation and functional capacities of the microcirculatory system at various ontogenesis stages is of great importance. Using laser Doppler flowmetry in the group of boys (n = 15) and girls (n = 13) of 8 and 10 years of age, skin microcirculation and its regulatory mechanisms were evaluated. The study found an increase in the perfusion index in children between the age of 8 and 10 induced by the shifting roles of mechanisms of the microcirculatory regulation. The comparison of basal microcirculatory parameters did not display statistically significant differences related to sex in 8- and 10-year old participants. However, almost equal perfusion in boys and girls was maintained by different contributions of regulatory mechanisms. The breath holding test showed an increase in the initial microcirculation index and capillary blood flow reserve in the group of 10-year-old boys and girls. Our study revealed differences in various microcirculation parameters, in the intensity of active and passive rhythms of blood flow oscillations and response to inspiratory breath hold, which indicates age-related transformations of microcirculation system.

Received: 2016-06-01

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-08

Comments 0

VIEWS 6280

Bokareva NA, Milushkina OYu, Ovchinnikova ZA, Pivovarov YuP, Sheina NI

Physical development and health of today’s schoolchildren are influenced by various factors, including the way the learning process is organized. This article presents data on some aspects of physical development of 1585 teenagers (15 to 17 years old) from 35 Moscow schools, including general education schools, specialized schools, schools with optional advanced courses in biomedical sciences, and health promoting schools. We studied basic anthropometric characteristics of the participants (body height and weight), assessed their psychoemotional status using the Children’s Form of Manifest Anxiety Scale and their lifestyle using questionnaire surveys. The control group included teenagers from general education schools. The study showed that the number of teenagers with no abnormalities in their physical development was significantly higher in health promoting school while the number of overweight students there was significantly lower, compared to the controls (p <0.05). For other groups of participants, the results were statistically insignificant. We established statistically significant correlations between well-proportioned physical development and the impacts of night sleep deficit (r= – 0.44, p <0.05), time spent working on the computer (r = –0.44, p <0.05), psychological climate in the family (r = –0.20, p <0.05), and meal frequency (Pearson's contingency coefficient was 0.41, with p <0.01, Cramer's contingency coefficient was 0.32, with p <0.03).

Received: 2016-05-23

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-09

Comments 0

VIEWS 5495

Trushina EV, Minkina OV, Dvornikov AS, Skripkina PA, fon Zimfer EI, Konyshev YaI

This article presents the results of an anonymous online survey on skin tattooing conducted in the community of medical students and professors. The article covers issues of tattoing from medical and sociocultural perspectives. The survey was carried out in Pirogov Russian National Research University and included 210 participants of different ages. The results demonstrate the insufficient knowledge of medical indications, contraindications and potential complications associated with tattooing. The obtained data can be a good starting point for developing programs aimed at raising awareness among young people, especially in higher medical institutions. The opinion expressed in this article is not necessarily shared by students and professors from other institutions for higher medical education and does not necessarily reflect the level of expertise in other medical communities. This work is an example of how socially oriented practical training can be organized for the 3rd- and 4th-year students of the Faculty of General Medicine at Pirogov Russian National Research University.

Received: 2016-05-23

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-10

Comments 0

VIEWS 5057