HERALD of North-Western State Medical University named after I.I. Mechnikov最新文献

{"title":"Clinical case of fulminant course of atypical hemolytic-uremic syndrome","authors":"Georgy A. Rysev, Alexander V. Rysev, Elena V. Karyagina, Nadezhda V. Medvedeva, V. I. Mazurov","doi":"10.17816/mechnikov114815","DOIUrl":"https://doi.org/10.17816/mechnikov114815","url":null,"abstract":"This clinical observation describes a case of a fulminant course of an atypical hemolytic-uremic syndrome. The initial stage of the course of the disease is of particular interest, which was not accompanied by typical manifestations of atypical hemolytic-uremic syndrome according to the type of acquired autoimmune hemolytic anemia. Thus, revealing this clinical observation may help in the diagnosis of atypical hemolytic-uremic syndrome with atypical initial manifestations and avoid errors, delays and adverse outcomes of this disease.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"27 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139002737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamics of the prevalence of Helicobacter pylori infection from 2015 to 2023","authors":"N. V. Bakulina, S. Tikhonov, I. V. Savilova, A. V. Zharkov, Viktoriia A. Ponomarenko","doi":"10.17816/mechnikov623259","DOIUrl":"https://doi.org/10.17816/mechnikov623259","url":null,"abstract":"BACKGROUND: The global prevalence of Helicobacter pylori infection has decreased from 58.2% (1980–1990) to 43.1% (2011–2022). To develop clinical recommendations for prevention diseases associated with Helicobacter pylori, it is important to assess changes in Helicobacter pylori infection in the world and in the Russian Federation, in particular. \u0000AIM: To assess the dynamics of Helicobacter pylori infection among patients in St. Petersburg, who undergone 13С-urease breath test in the period from 2015 to 2023. \u0000MATERIALS AND METHODS: All the patients have been included in the descriptive study to conduct 13C-urease breath test. If the Delta Over Baseline was less than 2.5‰, the test was considered negative. The value of this indicator of more than 2.5‰ indicated infection with Helicobacter pylori. The database for subsequent statistical analysis included age, gender, the facts of prior eradicative therapy, test results, including degree of infection. \u0000RESULTS: Helicobacter pylori was detected in 32.7% (16,642; 95% confidence interval 32.3–33.1%) of the patients. Of the 50,884 study participants, 83.6% (42,543; 95% confidence interval 83.3–83.9%) of the patients had not received eradication therapy in the past (primary “naive” patients), 16.4% (8341; 95% confidence interval 16.1–16.7%) had undergone eradication therapy in the past therapy (treated “recurrent” patients). The average infection rate among primary patients was 36.1% (15,358; 95% confidence interval 35.6–36.6%), among recurrent patients — 15.4% (1284; 95% confidence interval 14.6–16.2%). From 2015 to 2017, a decrease in Helicobacter pylori infection was detected in “naive” and “recurrent” patients in all the groups by 14.8 and 21.1%, respectively, and from 2020 to 2023 — by 3.6 and 6.2%, respectively. The majority of both primary and recurrent patients showed a very high (IV) degree of infection — 73.0 and 66.5%, respectively. \u0000CONCLUSIONS: The study demonstrated significant reduction of Helicobacter pylori infection from 2015 to 2017 indicating that information from doctors about the importance of diagnosing and treating Helicobacter pylori infection is a priority task. The new coronavirus infection also had an impact on the incidence of the infection; however, it is still unclear what the negative consequences of the active use of antibacterial agents in patients with COVID-19 are, first of all, potential impact on Helicobacter pylori resistance to key antibacterial drugs.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"34 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139002717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic atrophic gastritis: focus on diagnosis","authors":"I. Bakulin, A. G. Sushilova, A. V. Zharkov","doi":"10.17816/mechnikov623654","DOIUrl":"https://doi.org/10.17816/mechnikov623654","url":null,"abstract":"Currently, chronic atrophic gastritis is a risk factor for the development of gastric cancer. Data on the prevalence of chronic atrophic gastritis in Russia and the world are limited. Among the adult population of St. Petersburg aged 21 to 81 years, the prevalence of histologically verified chronic atrophic gastritis is 5.3%. Moreover, the chances of developing chronic atrophic gastritis in people over the age of 60 years compared to the group of 45–59 years are 2.5 times higher (95% confidence interval 1.5–4.1). \u0000Morphological verification of the Operative Link for Gastritis Assessment diagnosis is not carried out in clinical practice in most cases. However, this method remains the most reliable method for timely verification of chronic atrophic gastritis, including chronic atrophic gastritis of mixed origin (autoimmune gastritis and Helicobacter pylori-associated gastritis), especially in the case of a seronegative variant of autoimmune gastritis. \u0000Also, in addition to the heterogeneity of epidemiological data on chronic atrophic gastritis, there is disagreement about how to confirm its etiology as well as about the correlation of serological markers of atrophy and histological stage.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"28 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138975027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary artery thrombosis. Clinical aspects and the possibility of prognosis","authors":"O. Porembskaya, K. Lobastov, S. Tsaplin, L. Laberko, Victoria A. Ilina, M. Galchenko, V. Kravchuk, Sergey A. Sayganov","doi":"10.17816/mechnikov611007","DOIUrl":"https://doi.org/10.17816/mechnikov611007","url":null,"abstract":"BACKGROUND: Recently, there has been a growing interest to the pulmonary artery thrombosis due to the collected data on pathogenesis of this complication and the awareness about developing diagnostic and therapeutic strategy distinctive from those in pulmonary embolism. \u0000AIM: To estimate the pulmonary artery thrombosis clinical presentation, its electrocardiographic and echocardiographic signs and the possibility of applying venous thromboembolism risk assessment scores and diagnostic scoring systems in the cohort of deceased patients with verified pulmonary artery thrombosis. \u0000MATERIALS AND METHODS: A retrospective study based on the medical records analysis of two groups of deceased patients has been carried out. The first group included 80 patients with pulmonary artery thrombosis and the second one included 42 patients with pulmonary embolism. All the patients’ diagnoses were confirmed by the results of sectional and histological studies. 61 patient with COVID-19 and 19 non-COVID urgent patients with different pathologies were included in pulmonary artery thrombosis group. All 42 patients in pulmonary embolism group had verified venous thrombosis or heart chambers thrombi. Clinical presentation peculiarities, the electrocardiographic and echocardiographic reports as well as the possibility of application of Caprini, IMPROVE VTE, Padua, Wells and Geneva scoring systems were analyzed. \u0000RESULTS: None of the 80 pulmonary artery thrombosis patients had hemoptysis, unexpected dyspnoea, sudden strong cough, chest pain, or syncopea. Electrocardiographic changes indicative of right ventricular strain were found in 52.5% in the pulmonary artery thrombosis group and in 57.1% in the pulmonary embolism group. Inversion of T waves, complete and incomplete right bundle branch block were recorded in 14.6% and in 12.5%, in 36.3% and in 47.5% in the pulmonary artery thrombosis group and in the pulmonary embolism group, respectively, without statistical significance between two groups. Echocardiographic findings of right ventricular overload and/or dysfunction were present in 5 out of 10 patients with pulmonary artery thrombosis and in 5 out of 9 patients with pulmonary embolism. The correlation between Caprini, IMPROVE VTE and Padua scores and the incidence of pulmonary artery thrombosis was as strong as with the incidence of pulmonary embolism. On the contrary, Wells and Geneva clinical prediction scores failed to determine the probability of pulmonary artery thrombosis. \u0000CONCLUSIONS: Pulmonary artery thrombosis occurs without obvious clinical manifestations typical for pulmonary embolism. Electrocardiography and echocardiography reveal right ventricular overload in pulmonary artery thrombosis and in pulmonary embolism with equal frequency. Patients with high risk of pulmonary artery thrombosis can be identified by using the Caprini, IMPROVE VTE, Padua Prediction scores.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"3 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138971785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New method for determining volume of intraoperative blood loss during burn treatment surgery","authors":"E. V. Zinovev, D. O. Vagner, A. E. Chukharev","doi":"10.17816/mechnikov321450","DOIUrl":"https://doi.org/10.17816/mechnikov321450","url":null,"abstract":"BACKGROUND: Nowadays, there are numerous ways to assess the volume and minimize intraoperative blood loss; however, their effectiveness is subjective. To compare the effectiveness of blood-saving techniques, it is necessary to create new more reliable methods for determining intraoperative blood loss. \u0000AIM: To develop a new technique for determining intraoperative blood loss in the surgical treatment of burn victims. \u0000MATERIALS AND METHODS: In the course of the study, we have developed and proposed our own, original method for determining the volume of intraoperative blood loss, taking into account the indicators of hemoglobin and hematocrit as well as a differentiated calculation of the volume of circulating blood. This technique has been tested on 82 victims with deep burns of the II–III degree (International Classification of Diseases 10th Revision), who were admitted to the department of thermal lesions in the period from April 2021 to December 2021. The data obtained have been processed in the Microsoft Excel 2007 program as well as by generally accepted methods of nonparametric statistics. \u0000RESULTS: The methods currently available have a large variability of results when performing the same intervention. The developed technique shows a stable relationship between the volume of blood loss and the area of the excised scab. \u0000CONCLUSIONS: The data obtained allow to conclude that the new method for determining blood loss in burn victims appears to be a simple and effective method. The new technique will allow to find the most effective methods of minimizing blood loss during surgical necrectomies, which will reduce the need for additional hemotransfusions and promote earlier rehabilitation of burn treatment.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"5 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138972502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of the course of COVID-19 and post-COVID syndrome in patients with inflammatory bowel disease and COVID-19 caused by the Omicron strain and earlier strains","authors":"L. Kupkenova, A. Odintsova, D. G. Iskhakova, N. Cheremina, D. Abdulganieva","doi":"10.17816/mechnikov120007","DOIUrl":"https://doi.org/10.17816/mechnikov120007","url":null,"abstract":"BACKGROUND: Patients with inflammatory bowel disease have specific features of the course of COVID-19 and post-COVID syndrome. The available literature is limited in data comparing the course of COVID-19 of different strains in patients with inflammatory bowel disease as well as assessing the course of post-COVID syndrome. \u0000AIM: To conduct a comparative analysis of the course of COVID-19 and post-covid syndrome in patients with inflammatory bowel disease and COVID-19 caused by the Omicron strain and earlier strains. \u0000MATERIALS AND METHODS: The study included 159 patients diagnosed with ulcerative colitis and Crohns disease and COVID-19, who were observed in two temporary infectious diseases hospitals in Kazan (Republican Clinical Hospital and City Clinical Hospital No. 7) and on outpatient basis since April 2020 to May 2022. For a comparative analysis of the course of COVID-19 and post-COVID syndrome in patients who had come through COVID-19, 2 periods were defined: the 1st period from March 2020 to December 2021, the 2nd period from January 2022. \u0000RESULTS: None of the patients with Omicron developed lung damage (0 (0%) vs 36 (44.4%), p 0.05). It has been also found that among patients with Omicron there were more patients with comorbidity (62 (79.5%) versus 50 (61.7%), (p 0.05). \u0000Dynamic observation of the patients has revealed that post-covid syndrome was significantly less common in the patients with Omicron for 3 months after COVID-19 (25.6% vs. 47.1%). \u0000When analyzing the complaints associated with asthenia, it was found that they were significantly more common in the patients with Omicron 3 months after COVID-19 (58 (74.3%) in comparison with 17 (50%), p 0.05). The complaints associated with cognitive impairment (0 (0%) vs. 3 (8.8%), p 0.05) and depression (Hospital Anxiety and Depression Scale (31 (39.7%) vs. 22 (64.7%), p 0.05), Hamilton scale (22 (28.2%) vs. 22 (64.7%), p 0.05)) were significantly less common in the patients with Omicron for 3 months after COVID-19. \u0000After analyzing the activity in the patients with inflammatory bowel disease before COVID-19 and 3, 6, 9 months after COVID-19, we have found that the maximum number of patients with the exacerbation of inflammatory bowel disease was noted after 3 months in the patients with Omicron and after 6 months in the patients with earlier strains. \u0000CONCLUSIONS: Thus, the results of the study have shown that in the patients with inflammatory bowel disease, both in ulcerative colitis and Crohns disease, the course of COVID-19 caused by the Omicron strain proceeded in a milder form compared with the patients who had earlier strains. In the patients with Omicron, complaints characteristic of post-COVID syndrome were less common. After a previous infection with COVID-19, the frequency of inflammatory bowel disease relapses increased: in the patients with Omicron due to mild exacerbation 3 months after COVID-19; in the patients with earlier strains due to moderate and severe relapse.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79968026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of clinical and social aspects of the course of coronary heart disease after coronary bypass graphing according to the International Classification of Functioning, Disabilities and Health","authors":"S. V. Stolov, Irina I. Polonskaya, A. Rodionova, O. Makarova, T. V. Evdokimova","doi":"10.17816/mechnikov232866","DOIUrl":"https://doi.org/10.17816/mechnikov232866","url":null,"abstract":"BACKGROUND: It has been established that the prognosis of ischemic heart disease patients after myocardial revascularization depends on the presence of comorbid pathology, which includes, in addition to cardiovascular and non-cardiac, low physical activity as well as the patients social status and environmental barriers. The use of the international classification of functioning in this category of patients makes it possible to assess the severity of the impairment of the structures and functions of the organs and systems involved in the process as well as the role of social, personal and contextual environmental factors necessary for the implementation of a comprehensive rehabilitation program. \u0000AIM: To study structural and functional changes in the cardiovascular system and other organs and systems of the body based on clinical and expert parameters and the International Classification of Functioning, Disabilities and Health, the need for social protection measures, the main directions of complex rehabilitation of patients with coronary heart disease after coronary artery bypass grafting. \u0000MATERIALS AND METHODS: The study included 221 patients with severe coronary artery disease requiring myocardial revascularization. All the patients have been examined after coronary bypass surgery in the Bureau of Medical and Social Expertise in Saint Petersburg and recognized as disabled by the third group. The amount of surgical intervention in the patients was different; in most cases (55%) 3 coronary bypass grafts have been inserted. Comorbidity has been assessed according to the Charltson and Kaplan Feinstein indices. \u0000RESULTS: High frequency of comorbid pathology has been revealed; the most common are cardiovascular diseases, less common lung diseases, the diseases of the musculoskeletal system, diabetes mellitus. The value of the Kaplan Feinstein index was 10.08 0.25; Charlson index 6.50 0.16. In addition to structural disorders of the cardiovascular system, moderate dysfunctions of the respiratory and digestive systems, and metabolism have been determined. Violations of the functions and structures of the body led to restrictions on the categories of life activity: the ability to self-service in 85.07%, independent movement in 81.90%, labor activity in 100%. Among the domains of the international classification of functioning that characterize activity and participation, problems with paid labor activity (100%), movement, housework, and recreation have been identified. \u0000CONCLUSIONS: The study expands the understanding of the frequency of comorbid pathology of disabled people due to coronary artery disease, its impact on prognosis and the development and implementation of an individual rehabilitation program. The international classification of functioning allows to assess the severity of functional and structural changes, disability as well as to determine the need for social protection measures in patients with coronary artery disease.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82557231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of changes in coronary blood flow in patients with preserved ejection fraction","authors":"E. S. Kalinina, A. Zagatina, S. Sayganov","doi":"10.17816/mechnikov321811","DOIUrl":"https://doi.org/10.17816/mechnikov321811","url":null,"abstract":"BACKGROUND: The measurement of the left ventricular ejection fraction during at echocardiographic study evaluates global contractility. A decrease in this parameter indicates a poor prognosis. However, in the range of normal values, the left ventricular ejection fraction loses prognostic significance. This category of patients requires the development of other prognostic methods. \u0000AIM: To explore the effect of changes in coronary blood flow parameters measured using dopplerography in patients with preserved left ventricular ejection fraction in predicting adverse outcomes over the next year. \u0000MATERIALS AND METHODS: The prospective study included patients referred for echocardiography in 20192020 followed up at the Saint Petersburg Research Center of Cardiology Medika. The inclusion criterion was age over 18 years. A decrease in left ventricular ejection fraction of less than 53% was an exclusion critrion. In addition to standard echocardiography, dopplerography has been used to study the velocity parameters of blood flow in the coronary arteries. The observation period was 1 year. \u0000RESULTS: The control group included 453 patients. During the year of observation, 89 cases of spontaneous adverse events (death / myocardial infarction / progressive heart failure) occurred, including 19 deaths. The patients who died were older (76.6 8.6 vs. 59.3 15.5 years; р 0.000001), with lower global longitudinal function (13.8 4.3% vs. 18.3 3.6%, р 0.000001), with a large volume index of the left atrium (54.6 15.5 vs. 36.5 13.1 ml/m2; р 0.000000), high pressure in the pulmonary artery (39 14.7 vs. 29.5 8.1 mmHg; р 0.000000), high left ventricular myocardial mass index (108.7 37.2 vs. 88,1 24.1 g/m2, р 0.000000) and impaired diastolic function [the ratio of blood flow velocity through the mitral valve in the first (early) phase of left ventricular filling and the average velocity of the mitral valve fibrous ring 13.6 7.1 vs. 9.4 4.4; р 0.000000]. The blood flow velocity in the anterior interventricular artery was significantly higher (78.0 39.0 vs. 50.0 25.4 cm/s, р 0.000007). Only age and flow velocity in anterior interventricular artery were independent predictors of death / myocardial infarction (р 0.004). \u0000CONCLUSIONS: Velocity parameters in the anterior interventricular artery are a significant predictor of short-term spontaneous events, including death, in patients with preserved ejection fraction.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83885371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of surgical treatment of patients of fertile age planning pregnancy with hernias of the anterior abdominal wall","authors":"Badri V. Sigua, Dmitrii S. Semin, D. V. Gurzhiy, A. A. Kozobin, V. Zemlyanoy","doi":"10.17816/mechnikov133634","DOIUrl":"https://doi.org/10.17816/mechnikov133634","url":null,"abstract":"BACKGROUND: Currently, there is no consensus and approved tactics for choosing the method of hernioplasty in the surgical treatment of patients of fertile age planning pregnancy with hernias of the anterior abdominal wall. The study is devoted to the comparative analysis of surgical treatment of these patients. \u0000AIM: To determine the algorithm of surgical treatment of hernias of the anterior abdominal wall in the patients of fertile age planning pregnancy. \u0000MATERIALS AND METHODS: The analysis of the treatment results of fertile age patients with hernias of the anterior abdominal wall in the period from 2010 to 2019 has been carried out. The inclusion criteria were as follows: patients of fertile age who underwent surgical treatment of hernias of the anterior abdominal wall, who did not have a relapse before pregnancy. Thus, 252 patients have been included in the study. \u0000RESULTS: The surgical tactics and optimal timing of the operation in patients of fertile age with hernias of the anterior abdominal wall have been determined. \u0000CONCLUSIONS: When planning surgical treatment of hernias of the anterior abdominal wall in patients of fertile age, it is necessary to clarify information about pregnancy planning. The most favorable period for planning pregnancy and childbirth is 3 years or more after hernioplasty. When planning a pregnancy in the next 12 years after surgical treatment of a ventral hernia, it is necessary to give preference to hernioplasty with local tissues, which has fewer complications in the long-term postoperative period as well as fewer relapses after childbirth compared with open prosthetic surgery. When planning a pregnancy 3 or more years after surgical treatment, preference should be given to prosthetic hernioplasty. When analyzing the results of treatment of the patients of fertile age with inguinal and femoral hernias, planning pregnancy, clinical experience has shown that there are no contraindications to performing laparoscopic transabdominal preperitoneal prosthetic hernioplasty.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73354678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic markers of recurrence in adrenocortical carcinoma patients after surgery","authors":"V. Kalugina, N. Vorokhobina, L. Velikanova, Zulfiya R. Shafigullina, E. Malevanaya, E. Strelnikova, V. Bokhyan, T. Britvin, N. Kushlinskii","doi":"10.17816/mechnikov233493","DOIUrl":"https://doi.org/10.17816/mechnikov233493","url":null,"abstract":"BACKGROUND: Adrenocortical carcinoma is a rare and aggressive disease. Tumor recurrence prevention is vital for increasing patients survival rate. Therefore, the identification of prognostic markers is of particular importance. \u0000AIM: To evaluate clinical, laboratory and chromatographic criteria for adrenocortical carcinoma recurrence using gas chromatography-mass spectrometry to optimize patients follow-up. \u0000MATERIALS AND METHODS: 40 patients [10 (25%) men and 30 (75%) women] with histologically confirmed adrenocortical carcinoma (according to the European Network for the Study of Adrenal Tumors stage I 3, II 29, III 8 patients at presentation) have been recruited. Measurement of 24-hour urinary steroid metabolite excretion has been carried out by gas chromatography-mass spectrometry (GCMS-ТQ8050, Shimadzu) in preoperative period. The survival distribution has been assessed according to the KaplanMeier method. Cox proportional hazards regression methods have been used to determine predictive factors on recurrence-free survival. \u0000RESULTS: The patients with early stages of disease (III versus III) had a significantly longer recurrence-free survival, overt hypercortisolism was associated with significantly shorter recurrence-free survival. A significant correlation between pregnenediol urinary excretion and tumor diameter, stage has been found. Increased urinary excretion of tetrahydro-11-deoxycortisol, pregnenediol was associated with a decreased recurrence-free survival in the patients with overt hypercortisolism. Increased urinary excretion of 16-OH-dehydroepiandrosterone was a marker of a shorter recurrence-free survival in the patients without Cushing syndrome. Increased urinary excretion of pregnenediol, pregnenetriol, 16-oxo-androstenediol in all the adrenocortical carcinoma patients was associated with a recurrence risk. In the multivariate analysis pregnenediol urinary excretion, stage and overt cortisol excess were significantly and independently associated with a shorter recurrence-free survival. \u0000CONCLUSIONS: Adrenocortical carcinoma recurrence prognostic markers have been found by gas chromatography-mass spectrometry. The application of these findings may improve patient-centered outcomes.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74051938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}