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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Shapovaliants SG, Larichev SE, Zhitareva IV, Babkova IV, Safarov AN

To improve the results of treatment of acute adhesive small bowel obstruction there was formulated and developed a new method for the diagnosis of a strangulation form of obstruction, based on the prognostic evaluation of routine clinical, laboratory and instrumental data. Retrospective analysis and estimation of the results of treatment of 274 patients with acute adhesive small bowel obstruction were performed. As a result of the comparative analysis of the two groups of patients — with obstructive (group 1 — 208 patients (75.9 %)) and strangulation (group 2 — 66 patients (24.1 %)) forms of obstruction there were identified 10 criteria and developed a predictive system which allowed to differentiate the form of the disease. With heterogeneous sequential analysis for each of the resulting diagnostic criteria there were calculated ratios and assigned points according to its differential diagnostic significance. As a result, there were identified three prognostic groups of patients — with high, medium and low risk of strangulation. System efficiency was 89.8 %.

Received: 2012-11-26

Published online: 2017-01-05

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VIEWS 4629

Skoroglyadov AV, But-Gusaim AB, Sirotin IV, Pimenov AA, Krapivin AA, Stepanov NV, Rozaev VYu, Makushin YaE

The paper presents the experience of providing high-tech medical care — the hip replacement — in the Municipal clinical hospital of Moscow. The organizational measures directed on improving the efficiency of the hospital were described. Effectiveness of the measures was confirmed by the analysis of the results of treatment of 50 patients. There were described the directions of further improvement of the system.

Received: 2012-06-01

Published online: 2017-01-05

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VIEWS 4579

Skoroglyadov AV, Ataev EA

There were treated 51 patients with the delayed union and nonunions of gunshot genesis extremities. In the main group of 31 patients there was carried out bone autoplasty with the technology application, developed by the authors. Using minimally invasive techniques under the supervision of an electron-optical converter in the zone of the delayed union and nonunion, by the spoke there was introduced a flexible cannulated drill and rotary movements made cylindrical resection of scar tissue at the junction of the line break. The resulting cavity was filled with dense spongy tissue taken from the iliac crest. It is possible to reduce the period of hospital treatment by 2.6 times, and the terms of seam 1.5 times, compared with the control group.

Received: 2012-10-02

Published online: 2017-01-05

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VIEWS 4539

Gerasimova AA, Shvyrev SL, Shevchenko YuV, Gus AI, Klimenko PA

The sizes, compartments, wall thickness, contents quality, internal lining, presence of ovarian tissue, course of vessels and features of blood flow were studied in ovarian cysts/tumors in 197 pregnant women (12–39 weeks). Based on the clinical and ultrasound features with the help of statistical methods there were developed the most important criteria for the diagnosis of tumors and tumor-like formations of the ovaries during pregnancy.

Received: 2012-07-06

Published online: 2017-01-05

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VIEWS 4848

Butorina NV, Zaprudnov AM, Vakhrusev YaM

The features of the motor function of the stomach and vegetative status in 62 children with gastroesophageal reflux disease at the age of 9–12 (39 %) and 13–17 (61 %) years old were studied. In children aged 9–12 years there were identified tachygastria and hyperkinetic type of elektrogastrogrammy. At the same time there was observed high activity of the sympathetic nervous system. In adolescents of 13–17 years old bradigastriya and hypokinetic type of elektrogastrogrammy prevailed with a significant role of parasympathetic nervous system.

Received: 2012-07-11

Published online: 2017-01-05

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VIEWS 4532

Belova EV, Stakhanov VA

There was assessed efficiency of Diaskintest and computed tomography (CT) scan of the chest in comprehensive diagnostics of tuberculosis process for 440 children and adolescents in the ТВ dispensary. It was found that the reactions to Diaskintest were positive, including hyperergic, with an active tuberculous process. Negative responses to Diaskintest were recorded in healthy children and those with inactive tuberculous process. The reaction to tuberculin in those children was positive and hyperergic. In patients with an active tuberculous process and in children infected by Mycobacterium tuberculosis through contacts with ТВ patients the response to Diaskintest was more pronounced (hyperergic reactions, including those with lymfangoitis, vesicles, necrotic responses) compared with the reaction to tuberculin. The use of CT of the chest has a greater diagnostic value than conventional methods in identifying X-ray tomography “minor” forms of tuberculosis in children and adolescents.

Received: 2012-10-31

Published online: 2017-01-05

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VIEWS 4278

Tlostanova MS, Yablonsky PK, Pischik VG, Levhenko EV, Avetisyan AO, Petrov AS

The aim of the investigation was to study the efficiency of positron emission tomography with [<sup>18</sup>F]-fluorodeoxyglucose in diagnosis of various bronchopulmonary diseases taking into account the mass size of a pathological formation and the level of metabolic activity. A retrospective analysis of 615 patients with focal or infiltrative changes in the lungs was performed. The maximum level of Standardized Uptake Value (SUV) was measured in 443 of 615 patients with focal glucose hypermetabolism uptake. There was proposed the new method of calculating the SUV threshold depending on the size of the pathological formation. On the basis of the size of the pathological formation the new method of SUV threshold calculating was proposed depending on the mass size. Sensitivity, specificity, positive and negative predictive values of the method were calculated taking into account the mass size. The greatest number of false-positive and false-negative results was obtained in the SUV range from 1.9 to 4.3. The optimal SUV threshold for lung cancer revelation was defined by trees classification method.

Received: 2012-09-05

Published online: 2017-01-05

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VIEWS 4017

Mescheryakova NN, Belevsky AS, Niovikov YuK, Avdeev AN, Chernyak YuV

The aim of our study was to assess the dyspnea changes in chronic obstructive pulmonary disease patients during physical rehabilitation. 39 patients with obstructive pulmonary disease participated in this study: 21 patients were treated with standard medications and physical rehabilitation with the use of respiratory muscles training devices, 18 patients were treated with medications only. The intensity and changes of dyspnea were measured by baseline dyspnea index and transition dyspnea index. The exercise tolerance increased significantly (distance during 6-min walking test increased by 103 m) in the first group as well as lung function (forced expiratory volume increased in the 1st second by 9.6 %pred., functional residual capacity and residual volume decreased by 10.4 and 17.5 %pred., respectively). Significant decrease of dyspnea severity (transition dyspnea index changed by 3.3 points) was noted. There were no significant reliable changes in the control group.

Received: 2012-06-30

Published online: 2017-01-05

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VIEWS 4021