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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Takhchidi KhP, Takhchidi NKh, Kasmynina TA, Mahno NA

Drusenoid pigment epithelial detachment is a condition characterized by separation of the retinal pigment epithelium from the underlying Bruch’s membrane due to formation of drusenoid deposits. The disorder represents the intermediate stage of the age-related macular degeneration, and is a risk factor for the age-related macular degeneration progression to late stage characterized by geographic atrophy, which results in the irreversible central vision loss. Management of patients with this disorder is in most cases limited to follow-up. The feasibility of using the multimodality low power mode laser therapy for treatment of drusenoid pigment epithelial detachment is reported. The results of laser photocoagulation of the retina demonstrate the morphological and functional recovery: retinal pigment epithelial detachment sealing, improvement of visual function, and restored retinal architecture.

Received: 2021-11-24

Published online: 2021-12-29

DOI: 10.24075/brsmu.2021.067

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VIEWS 2850

Mozheyko EYu, Pavlov AO, Chistov MA, Khramchenko MA, Gurevich VA

An anterior cruciate ligament tear is one of the most common injuries to the capsular ligament apparatus of the knee necessitating operative treatment. Postoperatively, patients with anterior cruciate ligament injuries develop a pathologic gait pattern. Today, innovative diagnostic and rehabilitation methods for patients with gait disturbances associated with such injuries are in high demand. Below, we present a case of using 3D motion capture analysis for the personalized assessment of gait function in a patient with the reconstructed anterior cruciate ligament two months after surgery. The analysis revealed that the patient had a slower, shorter, wider step with longer step intervals than the healthy subject; the flexion and extension amplitude in the large joints of the operated leg was smaller than in the healthy contralateral leg. Motion capture analysis can be used to assess the postoperative dynamics in patients with anterior cruciate ligament tears.

Received: 2021-11-20

Published online: 2021-12-28

DOI: 10.24075/brsmu.2021.063

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VIEWS 3104

Gavryushin MYu, Sazonova OV, Gorbachev DO, Borodina LM, Frolova OV, Tupikova DS, Berezhnova OV, Trubetskaya SR

Traditionally, anthropometric method is used in clinical practice for the diagnosis of excess body weight. Obesity is the excess development of primarily visceral and subcutaneous adipose tissue, which can be diagnosed by bioimpedance analysis (BIA). The study was aimed to assess the role of BIA of body composition in the diagnosis of the physical development disorders in children and adolescents. Anthropometric assessment and BIA were performed in 431 Samara school students aged 12–16 of the health status groups I and II (230 boys and 201 girls). The results were analyzed with the use of the regional regression scores, BAZ indices, and the body fat percentage values. The results of estimation using the regression scores showed that 22.61% of boys and 23.43% of girls were overweight, while more than 2/3 of the sample had a normal pattern of physical development. The BAZ indices revealed a significantly higher proportion of overweight children among boys (25.7%), than among girls (11.5%, p < 0.01). The body fat percentage fluctuations based on the BIA data were found not only in children with disharmonious physical development, but also in 60% of children with normal body weight. Moreover, the data of BIA confirmed the body weight fluctuations, revealed with the use of the regression scores, in the significantly larger number of cases compared to the low body weight and excess body weight, diagnosed based on the BAZ indices. Accordingly, anthropometric analysis with the use of the regional regression scores may be used at the baseline for the early diagnosis of the nutritional status disorders in children. To confirm overweight and obesity in children, as well as to provide further treatment, the reliable method for estimation of the body fat content is required, which may be the method of BIA.

Received: 2021-12-01

Published online: 2021-12-27

DOI: 10.24075/brsmu.2021.062

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VIEWS 2859

Takhchidi KhP, Takhchidi EKh, Kasmynina TA, Tebina EP

Macular retinal folds are a rare yet grave complication of surgical rhegmatogenous retinal detachment repair. Clinical symptoms vary depending on the location and severity of folding. Fold located in the periphery of the ocular fundus can be asymptomatic, but macular retinal folds cause diminished visual acuity and metamorphopsia. Currently, the most effective treatment for retinal folds is repeat surgery. Its serious disadvantage is the risk of complications in the early postoperative period, including hemophthalmia, inflammation, secondary glaucoma, cataracts, RRD recurrence, macular tears, retinal vascular occlusion, etc. The clinical case described below demonstrates the potential of combination laser therapy for the treatment of macular retinal folds based on the use of modern diagnostic and therapeutic methods.

Received: 2021-11-19

Published online: 2021-12-21

DOI: 10.24075/brsmu.2021.060

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VIEWS 2510

Novikova AV, Pravdyuk NG, Saklakova VS, Lolomadze EA, Feniksov VM, Nikolaev DA, Davygora KS, Timofeev VT, Shostak NA

Back pain (BP), associated with the degenerative disc disease (DDD), poses a heavy social and economic burden due to early disability and indications to surgery, emerging in young adults. Pathophysiological basis of premature intervertebral disc (IVD) degeneration is being actively studied. The study was aimed to define the profiles of inflammatory cytokines in DDD, as well as their relationship to the structural spine diseases. The molecular genetic analysis of the mRNA gene abundance in patients with BP and herniated IVD after discectomy and healthy individuals was performed by the quantitative polymerase chain reaction method. High expression of TNFα, IL17 was revealed in the IVD tissues of the affected patients (p < 0.01); the levels of TNFα and IL1β correlated with the DDD severity (r = 0.301 and 0.37; p < 0.05). Elevated expression of IL1β, IL6 was found in peripheral white blood cells (p < 0.01); the levels of IL6 negatively correlated with Modic type 1 and 2 changes (r = –0.31; p < 0.05), and the levels of IL17 positively correlated with the IVD herniation in combination with erosions of the adjacent vertebral body endplates and Modic changes (r = 0.401; p < 0.05). The expression of VEGF-А in the IVD tissues and white blood cells negatively correlated with the DDD grades (r = –0.85; p < 0.001), indicating reduced vascularization in the terminal phase of the disease. The findings on DDD demonstrate the contribution of the local low-immune inflammation, coupled with the intense disc vascularization at the earlier stages, and associated with the reactive inflammation in vertebral bodies. The results are prerequisites for developing the anti-inflammatory and reparative therapy based on the DDD grade and the presence of Modic changes in young adults with BP.

Received: 2021-11-22

Published online: 2021-12-20

DOI: 10.24075/brsmu.2021.061

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VIEWS 2747

Gerasimova AA, Asyrafyan LA, Manuchin IB, Shamarakova MV, Miryasova MS, Klimenko PA

Currently, surgical treatment aimed to exclude the malignant ovarian tumors is performed in almost 90% of patients with decidualized endometrial cysts (DEC). However, unnecessary surgical interventions increase the risk to maternal and fetal health. The study was aimed to perform a differential diagnosis of DEC in pregnant women in order to define the rational treatment. A total of 82 female patients were included in the study: 63 had endometrial cysts (EC), 16 had DEC, 3 had rare forms of endometriosis, and 10 had ovarian serous papillary borderline tumors. When performing the diagnostic ultrasound, our proposed model was used. The ultrasound imaging data obtained were juxtaposed with the concentration of the protein tumor markers (СА-125), the risk of malignancy index (RMI) was calculated, and the morphological assessment of the masses was performed. The ultrasound imaging parameters, being the most valuable for differential diagnosis of EC, DEC, and serous borderline tumors, were as follows: the altered mass wall thickness, the existence and shape of papillary masses, avascular echogenic inclusions with blurry contour, blood circulation and arrangement of blood vessels, ascites. The frequency analysis revealed the differences between groups based on the ultrasound imaging data (in 60–100% of observations). Histological examination revealed the differences between groups in 100% of observations. Our findings have made it impossible to prolong pregnancy in patients with DEC without performing surgery. The results of treatment provided to patients with DEC during pregnancy were worse compared to those in patients with no prominent decidualization in ovarian EC. Today, the diagnosis of DEC and the treatment of patients during pregnancy remain unsophisticated. Further clinical observation and the search for more reliable methods of the diagnosis and rational treatment of pregnant women with DEC are required.

Received: 2021-11-23

Published online: 2021-12-12

DOI: 10.24075/brsmu.2021.059

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VIEWS 2629

Khizhnikova AE, Klochkov AS, Fuks AA, Kotov-Smolenskiy AM, Suponeva NA, Piradov MA

Balance impairment at advanced age is a serious medical problem that often has significant implications and affects the quality of the patient’s life. Among the underlying causes are overall slowness of motor response and vestibular syndrome. Virtual reality exergames, including reaction and balance training, hold promise for managing balance dysfunction. The aim of this study was to investigate the effects of a combination rehabilitation program containing elements of virtual reality exergame on the postural and psychophysiological parameters of elderly patients with small vascular disease The study was conducted in 24 patients with small vascular disease (median age: 66 years). All patients underwent a virtual reality rehabilitation program. Psychophysiological, postural and clinical evaluations were performed at baseline and after the program was completed. Balance function measured on the Berg scale improved significantly and was 53 [52; 55] after the training program vs 50 [45; 54] at baseline (p < 0.05). The strategy of balance control also changed: the Romberg ratio was 266 [199.5; 478.5] before rehabilitation and 221 [149.25; 404] after the program was completed (p < 0.05). The most pronounced changes in the measured psychophysiological parameters occurred in the simple audiomotor reaction, which improved from 210 [174.25; 245.5] at baseline to 180.5 [170.5; 208] after rehabilitation (p < 0.05). Thus, the combination balance and reaction virtual reality training is an effective rehabilitation method for advanced-age patients with balance impairment.

Received: 2021-10-26

Published online: 2021-12-09

DOI: 10.24075/brsmu.2021.058

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VIEWS 2912

Maksimova MYu, Ivanov AV, Nikiforova KA, Virus ED, Suanova ET, Ochtova FR, Piradov MA, Kubatiev AA

It was found that ischemic stroke (IS) results in decreased levels of a number of reduced forms of low molecular weight aminothiols (LMWTs). The study was aimed to assess the impact of type 2 diabetes mellitus (Т2D) on the total content, reduced forms and redox status of LMWTs in patients with IS. A total of 175 patients with IS in the internal carotid artery basin (the average age was 62 (55–69)) years) were assessed, who were admitted to the Center within the first 10–24 h since the onset of neurological disorder. The index group included 68 patients with IS and T2D (males made up 41.2%). The comparison group consisted of 107 patients with IS and stress hyperglycemia (males made up 57%), and the control group included 31 non-diabetic patients with chronic cerebrovascular disease (CCVD) (males made up 54.8%). The admission plasma levels of LMWTs were assessed by liquid chromatography in all patients. It was found, that IS in patients with T2D was associated with the rapid decrease in total cysteine (tCys), total glutathione (tGSH), total homocysteine (tHcy), reduced glutathione (rGSH), and glutathione redox status (GSH RS), along with the increase in cysteine redox status (Cys RS) and homocysteine redox status (Hcy RS). In contrast to patients with stress hyperglycemia developing during the acute period of IS, patients with T2D had lower tCys, tGSH, and tHcy levels. Thus, GSH RS of 4.06% or lower in the first 24 hours after the IS in patients with T2D was a predictor of poor functional outcome (mRS score was 3 or more 3 weeks after IS).

Received: 2021-10-25

Published online: 2021-12-09

DOI: 10.24075/brsmu.2021.057

Comments 0

VIEWS 2641