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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Aronov LS, Lukanin DV, Tonoyan AA

The article presents the results of studying the possibilities of using of a catheter microenterostomy for the early enteral feeding of patients undergone resection of the stomach in emergency or urgency. The study was conducted on the main group of 32 patients to whom there was used the percutaneous catheter microenterostomy for the introduction of nutrients. In the control group of 30 patients enteral nutrition was carried out through the gastrointestinal duel channel combined probe transnasally installed. These results indicate that the using of catheter microenterostomy provides adequate nutritional support and metabolic care in the postoperative period, reduces postoperative complications and improves the results of treatment in patients undergone resection of the stomach.

Received: 2012-02-06

Published online: 2017-01-05

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Makarov OV, Bogatyrev YuA, Osipova NA

The aim of the study was to determine the clinical significance of studying a number of autoantibodies in blood serum to detect preeclampsia as well as to carry out differential preeclampsia and arterial hypertension diagnosis. Among 76 examined women there were 28 patients with detected preeclampsia, 26 with arterial hypertension and 22 healthy pregnant women. In all patients there was determined the content of IgG autoantibodies against doublestranded DNA, two platelet membrane antigens (TrM-001-15, TrM-015-12), two kidney antigens (KiM-05-300, KiS-07-120) and antigen liver mitochondria (HMMR) by enzyme-multiplied immunoassay. The algorithm to interpret enzyme-multiplied immunoassay results for preeclampsia diagnosis was put forward. There was proved the high diagnostic value of the method.

Received: 2012-03-05

Published online: 2017-01-05

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Fedin AI, Starykh EP, Parfenov AS, Mironova OP, Abrakhmanova EK, Starykh EV

This article is devoted to the studying of blood flow in cerebral arteries and endothelial function at various stages of chronic cerebral ischemia in cerebral atherosclerosis. While reducing the linear velocity of blood flow, ultrasound scans showed a reduction of visco-elastic properties of the aorta and endothelial dysfunction in large muscular arteries, which correlated with the thickness of the intima-media of the carotid arteries. The data obtained show the reduction of linear blood flow velocity in ultrasonic scanning and the reduction of visco-elastic properties of the aorta, as well as endothelial dysfunction in large muscular arteries. It was found that the most sensitive among the parameters studied in atherosclerosis of the arteries of the brain is a phase shift in occlusive sample. It is determined by the influence of nitric oxide on the smooth muscle cells of the arterial wall of large muscular arteries. It is possible a pharmacological correction of endothelial dysfunction in the large vessels of muscular type of atherosclerosis in patients with chronic cerebral ischemia.

Received: 2012-04-02

Published online: 2017-01-05

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Rubtsov VV, Tsap NA, Shtukaturov AK

Electrothermal lesions are most often seen in pediatric injuries. This type of injury is uncommon, but is one of the leading causes of death and disability in children. Using medical records, we analyzed the outcomes of the treatment and rehabilitation of children with electrothermal lesions (n = 51) admitted to Pediatric Burn Center, Children’s City Clinical Hospital No. 9 (Yekaterinburg, Russia) over the period from 2010 to 2015. The patients were divided into two groups: group 1 (39 children) had injuries from electrical household appliances and group 2 (12 children) sustained high-voltage injuries. Primary surgical debridement was performed on all children; the extent and depth of the burns were established. The next step of surgical treatment for Group 1 included necrectomy and single-stage dermatoplasty; in group 2 necrectomy and the first stage of skin grafting (formation of a skin flap) were performed. Subsequently, all patients in group 2 received skin grafts for final closure of the skin defect. The duration of treatment in group 2 was 2 times longer than in group 1, due to larger burn areas (an average of 12 % vs. >5 %), longer burn shock (>24 h vs. 10 h), higher complication rate, and multiple stages of surgical treatment. Six patients from group 2 received surgical amputation. However, the division into groups according to the physical properties of the electric current can be beneficial for the development of more effective treatment algorithms.

Received: 2016-06-10

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-05-08

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VIEWS 3115

Krasenkova EA, Ovechkin AYu, Pyregov AV

Postoperative cognitive dysfunction (POCD) is a disorder that develops in the early postoperative period, persisting for several days or weeks and leading to decrease in higher cortical functions (speech, memory, attention, etc.). POCD is often associated with anesthetic techniques and drugs. This paper studied the effect of general, neuraxial and combined anesthesia on POCD development in elderly women undergoing gynecological surgery. The study featured 43 patients (mean age 65,0 ± 2.2 years). There were 12 women in the general anesthesia group, 23 in the neuraxial anesthesia group, and 8 women in the combined anesthesia group. Intraoperative monitoring included electrocardiography, non-invasive blood pressure measurement, determination of blood oxygen saturation level (rSO2) and determination of bispectral index (BIS monitoring). A day before surgery and on the 5th day after the surgery, neuropsychological tests were carried out through tracking test, Mini-Mental State Examination and frontal assessment battery. All intraoperative indicators were normal in all the patients. POCD was diagnosed in 3 women who were under general anesthesia, in 7 women under neuraxial anesthesia and 2 under the combined group (25, 30 and 25 % relative to the total number of patients in the groups, respectively). The average rSO2 value was below the initial level in all groups: below by 6 % in the general anesthesia group, by 15 % in the neuraxial group, and by 10 % in the combined group. However, the differences were statistically insignificant (p >0.05). The study found no relationship between anesthetic techniques and POCD.

Received: 2016-06-09

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-08

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Tumanova UN, Lyapin VM, Bychenko VG, Schegolev AI, Sukhikh GT

Congenital pneumonia is one of the leading causes of neonatal deaths. In this work we assess the possibility of using post- mortem magnetic resonance imaging for the diagnosis of congenital pneumonia. The study was conducted on 21 neonate bodies. Before the autopsy, MRI scanning was performed on the Magnetom Verio 3T system (Siemens, Germany) in T1 and T2 standard modes. The resulting images were used to analyze signal intensities of lung tissue, pleural fluid and air. Airiness index was computed as the ratio of pleural fluid signal intensity to lung tissue signal intensity. Then, the autopsy was performed. Based on the histological analysis results, the main and the control groups were formed. The bodies of 9 neonates who had died from congenital pneumonia were included into the main group; the control group consisted of 12 dead neonates with no signs of pneumonia. On T1-weighted images, the signal intensity from the lungs of the infants with congenital pneumonia was higher by 26.5 % in the left lung and 12.9 % in the right lung, compared to the controls (p >0.05). On T2-weighted images, the corresponding figures were 23.7 and 31.2 % (p >0.05). The sensitivity of the method is 77.8 %, specificity is 75.0 % and diagnostic efficacy is 76.2 %.

Received: 2016-08-17

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-07

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VIEWS 3545

Kondakov AK, Znamensky IA, Mosin DYu, Grechko AV

In this work the authors share their opinion on the role of nuclear medicine imaging in the diagnosis and differential diagnosis of dementias. Perfusion single–photon emission computed tomography using 99mTc-exametazim and 18F-fluorodeoxyglucose positron emission tomography are highly sensitive and specific; they are recommended for a wide range of clinical applications. The efficacy of amyloid imaging in Alzheimer’s is still a matter of discussion, because amyloid accumulation is also typical in patients with other dementias. Dopamine transporter imaging using 123I-ioflupane is a very reliable diagnostic tool for Parkinson’s disease and Lewy body dementia, and can help to adjust treatment strategies. Further evolution of nuclear medicine methods will most likely include the development of new radionuclide tracers for such targets as microglial cells' activation and neurofibrillary tangles.

Received: 2016-08-16

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-06

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VIEWS 3518

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 4183