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

{"title":"Systematic review of the clinical efficacy of various methods of surgical treatment of patients with ventral hernias","authors":"Dmitry S. Syomin, B. Sigua, P. Kotkov, E. G. Timofeeva, A. A. Kozobin, K. V. Fetisov, V. Zemlyanoy","doi":"10.17816/mechnikov109236","DOIUrl":"https://doi.org/10.17816/mechnikov109236","url":null,"abstract":"BACKGROUND: To date, the problem of relapse-free treatment in herniology has not been solved. In recent years, the development and wider application of modern technologies in herniology, including endovideosurgical, has been noted. The principles of preparation for surgical interventions, postoperative management and the choice of surgical treatment have also changed significantly, which has affected the improvement of the quality of surgical care for patients with ventral hernias. \u0000AIM: To determine the clinical effectiveness of various methods of surgical treatment of patients with ventral hernias by conducting a systematic review and identifying differences associated with statistical heterogeneity in the study findings. \u0000MATERIALS AND METHODS: More than 1400 domestic publications devoted to surgical treatment of ventral hernias have been preliminarily studied. Taking into account the inclusion and exclusion criteria, the review included 35 domestic scientific publications dated from 2007 to 2020. 8906 cases of surgical treatment of patients with ventral hernias have been analyzed to assess the results of treatment and the clinical effectiveness of various methods. \u0000RESULTS: The wider introduction of endovideosurgical operations into practice has demonstrated the best result in assessing the risk of relapses and postoperative complications. However, the total share of endovideosurgical operations remains small compared to other types of surgical treatment. \u0000CONCLUSIONS: Standardized approaches to the management of surgical patients and the prevention of possible complications due to the principles of evidence-based medicine can improve the overall effectiveness of the treatment of patients with ventral hernias.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83956360","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":"The role of redox status in platelet dysfunction in severe COVID-19-associated pneumonia","authors":"Mikhail V. Osikov, V. Antonov, S. Zotov, G. Ignatova","doi":"10.17816/mechnikov109076","DOIUrl":"https://doi.org/10.17816/mechnikov109076","url":null,"abstract":"BACKGROUND: Platelet dysfunction in patients with COVID-19 is a well-known fact; however, its formation mechanisms remain unclear. \u0000AIM: To evaluate the role of oxidative stress in dysfunction of platelets in the patients with severe COVID-19-associated pneumonia. \u0000MATERIALS AND METHODS: The study has involved patients with COVID-19 (n = 27) aged 47 to 75 with more than 50% lung damage according to the chest multi-slice computed tomography. The control group has included healthy people comparable in sex and age (n = 24). All the patients have undergone evaluation of the number of platelets in blood, measurement of platelet aggregation induced by adenosine diphosphate, collagen, adrenaline and ristocetin and the level of lipid peroxidation and protein oxidative modifications products in platelet-rich plasma. The calculation and analysis of the obtained data has been carried out using the IBM SPSS Statistics v. 23. \u0000RESULTS: For the patients with severe COVID-19, a decrease in the number of platelets in the blood is characteristic. Acceleration of platelet aggregation induced by collagen and ristocetin has been observed on the 1st day, with the induction of adenosine diphosphate, collagen, adrenaline and ristocetin on the 8th day of the admission. Oxidative stress in COVID-19 leads to a significant increase in the level of primary markers of protein oxidative modifications in the platelets and an increase in the level of products of primary and secondary lipid peroxidation markers in the platelets. A direct correlation between the products of lipid peroxidation and protein oxidative modifications in the platelets and their aggregation has been found. \u0000CONCLUSIONS: The following study deepens the knowledge of the status of oxidative stress in SARS-CoV-2 infection, confirming its important role in the pathogenesis of COVID-19. The growth of protein oxidative modifications and lipid peroxidation products in patients with severe COVID-19-associated pneumonia in the course of the disease may be one of the causes of platelet dysfunction and, as a result, lead to lethal thrombotic complications.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82790236","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":"Clinical and metabolic features of diabetic encephalopathy","authors":"V. Golovkin, Maria A. Privalova, Tatyana A. Garan, D. A. Gulak","doi":"10.17816/mechnikov108788","DOIUrl":"https://doi.org/10.17816/mechnikov108788","url":null,"abstract":"BACKGROUND: Actual mindset, concerning the pathogenesis of type 2 diabetes mellitus and its complications, is described in the glucocentric, lipocentric and lipokine theories. At the same time, it is known, that acute cerebrovascular disorder in type 2 diabetes mellitus can also develop with normoglycemia. The mechanism of association between obesity and type 2 diabetes mellitus in metabolic syndrome has not yet been studied, and 40% of diabetic patients are not obese. In the physiological state hyperglycemia is prevented by pancreatic regulatory oligopeptides rather than insulin, and protein glycation occurs before the development of diabetes symptoms. That facts indicate the need to continue investigation of the pathogenesis in general and diabetic encephalopathy in particular from the standpoint of metabology in order to substantiate the peptidergic theory of the diabetes mellitus and dyscirculatory encephalopathy pathogenesis. \u0000AIM: To consider little-known clinical, morphological and metabolic manifestations of diabetic encephalopathy from the standpoint of improving the disease diagnosis. \u0000MATHERIALS AND METHODS: Among 162 elderly and senile patients in the pre-stroke and stroke stages of diabetic encephalopathy, modern methods of radiological, laboratory, histological, psychometric and clinical analysis have been used: the relationship between low total cholesterol and disease progression has been determined according to Schulte and MMSE psychometric tests with the same hyperglycemia in different age groups sick; cases of amyloid angioencephalopathy on magnetic resonance imaging in the ultrasensitive weighted imaging mode and amyloidosis have been identified. \u0000Staining post-mortem ultrathin tissue biopsy sections with Congo red allowed to find amyloid deposition in 12% of autopsy cases in the absence of diagnosing amyloidosis during life; preparations, in which Congo red staining was positive for the presence of amyloid, were taken for inspection in polarizing light and typing of amyloid. Staining of histological preparations with hematoxylin-eosin and Van Gieson revealed a morphological characteristic of diabetic encephalopathy different from that of atherogenic and hypertensive dyscirculatory encephalopathy; using immunological studies, a statistically significant increased content of induced interleukin-1 production, a trigger for the serum amyloid analogue in the liver synthesis, was determined, and an experimental method for beta-amyloid peptide adhesion by monocytes and the density of amyloid expression on the surface of monocytes in patients with diabetic encephalopathy at senile age at 23 times higher than the density of the peptide in the elderly and in the patients with dyscirculatory encephalopathy of the same old age. \u0000RESULTS: It has been established that a fairly frequent and early manifestation of metabolic disorders in diabetic encephalopathy is a violation of protein metabolism with its final conformation into toxic amyloi","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78489622","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":"Systematic review and meta-analysis: Main points","authors":"B. Sigua, P. Kotkov, Aleksey A. Kurkov, V. Zemlyanoy","doi":"10.17816/mechnikov108171","DOIUrl":"https://doi.org/10.17816/mechnikov108171","url":null,"abstract":"The growth of the scientific medical community publication activity has led to the emergence of large volumes of disparate, often contradictory information of varying degrees of methodological quality. In such circumstances, a single tool for processing the results of numerous clinical trials was only a matter of time, reflecting the needs of practitioners. Such a tool within the framework of the principles of evidence-based medicine was the conduct of systematic reviews, in some cases supplemented by meta-analyses. The Cochrane is now the leading scientific organization that sets the tone for all research of this kind, providing most of the research of this design every year. Without taking into account the possible negative consequences of such a monopoly, it should be noted that this organization offers a detailed algorithm for writing systematic reviews, which is in the public domain along with the necessary software. This highly transparent methodology makes writing systematic reviews a task within the reach of any professional, regardless of supervision by the Cochrane, whose guiding resource is limited. This work is based on the methodological recommendations of the Cochrane and focuses on the main stages of writing systematic reviews.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75496475","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":"Arterial hypertension and diabetes developed in pregnancy","authors":"E. Zagarskikh, S. A. Partsernyak, S. V. Rishchuk, G. A. Proshchai","doi":"10.17816/mechnikov108134","DOIUrl":"https://doi.org/10.17816/mechnikov108134","url":null,"abstract":"BACKGROUND: Gestational diabetes mellitus is a significant medical and social problem in most countries. Despite the relatively high level of development of modern medicine, following the growth of obesity and type 2 diabetes, the prevalence of gestational diabetes mellitus is also increasing worldwide. \u0000AIM: To identify the frequency and structure of carbohydrate metabolism disorders and to compare the level of blood pressure in a random sample of pregnant women registered in the Perinatal center. \u0000MATHERIALS AND METHODS: The analysis of the data of examination of carbohydrate metabolism of pregnant women who are registered in the Perinatal Center (Leningrad region, Gatchina), has been carried out. The analysis of medical documentation, survey, endocrinological and gynecological examination, calculation of the body mass index and the study of carbohydrate metabolism have been carried out. \u0000RESULTS: There is an increase in the number of pregnant women with impaired carbohydrate metabolism over the years of observation. Gestational diabetes on diet therapy was 64.4% in 2019, 31.0% in 2020, 65.1% in 2021, on insulin therapy 32.2, 62.3, 28.9% respectively. There was an increase in the number of women with type 1 and type 2 diabetes diagnosed before pregnancy and newly diagnosed diabetes during pregnancy. Body mass index and blood pressure levels are higher and glycated hemoglobin levels are lower in diet-treated pregnant women with gestational diabetes compared with insulin therapy. An increase in glycated hemoglobin was found annually in a group of women with gestational diabetes mellitus on insulin therapy. \u0000CONCLUSIONS: The high prevalence of carbohydrate metabolism disorders and the associated increase in blood pressure in pregnant women in Saint Petersburg and the Leningrad Region justifies a targeted search for carbohydrate metabolism disorders in pregnant women.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90762297","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":"Clinical case of Whipple’s disease","authors":"M. Osipenko, Aleksandr P. Nadeev, Yuliya Yu. Venzhina, Elena A. Zhuk","doi":"10.17816/mechnikov105632","DOIUrl":"https://doi.org/10.17816/mechnikov105632","url":null,"abstract":"The article presents a clinical case of 68-years old patient with a Whipples disease. The diagnosis was made after 10 years of following-up in presence of gastroenterological symptoms. On examination flattened rounded villi with the content of PAS-positive (PAS periodic acid Schiff) foamy macrophages, highly specific for Whipples disease, have been described in the biopsy specimen of the distal duodenum. The therapy led to a distinct positive dynamics persisting for 1 year.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90232142","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":"Medical tactics for bleeding after oncological interventions on the pancreas","authors":"N. I. Glushkov, M. Kabanov, K. Sementsov, A. Skorodumov, T. E. Koshelev, D. K. Savchenkov, V. V. Alekseev, Maksim V. Vasilchenko, Vladimir A. Loginov, D. O. Vagner, Anastasia V. Andrusenko, Arina A. Romanova","doi":"10.17816/mechnikov108471","DOIUrl":"https://doi.org/10.17816/mechnikov108471","url":null,"abstract":"About 60% of malignant tumors of the hepatopancreatoduodenal region are represented by neoplasms of the pancreas, accounting for 10% of the total number of malignant tumors of the gastrointestinal tract. Simultaneously with the accumulation of experience, the improvement of the instruments used and the improvement of the supply of medical institutions, the number of cases of surgical treatment of pancreatic neoplasms is growing. The geography of these interventions is expanding. Accordingly, the issues of prevention and treatment of postoperative complications during these interventions, including such a dangerous complication as bleeding, are becoming increasingly important. Postoperative bleeding is diagnosed in 22% of operated patients with a given localization of a malignant neoplasm. The review analyzes modern views on the etiology, diagnosis and treatment of bleeding after resection interventions for pancreatic tumors.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79656315","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 applying author’s manual method for repositioning shoulder dislocation","authors":"M. A. Slabospitskii, Dmitrii Ye. Mokhov, A. N. Tkachenko","doi":"10.17816/mechnikov108430","DOIUrl":"https://doi.org/10.17816/mechnikov108430","url":null,"abstract":"BACKGROUND: Shoulder joint dislocation is the most frequent among all types of dislocations. There are many ways to correct a dislocation of the shoulder. There are many ways to reduce a dislocated shoulder in both outpatient and inpatient settings. The results of conservative treatment of patients with shoulder dislocation are not always positive. \u0000AIM: To analyze the results of the authors manual technique for repositioning shoulder dislocation. \u0000MATERIALS AND METHODS: The study was conducted from 2013 to 2020 inclusive with unselected sampling; the study base is the trauma center of the City Hospital No. 1 by N.I. Pirogov. Criteria for including the patients in the study primary dislocation of the shoulder. Diagnosis: Closed traumatic dislocation of the shoulder in total 1968 people. Non-inclusion criteria secondary dislocation. In the outpatient setting, successful reduction of the shoulder was carried out in 1159 (58.9%) patients; after unsuccessful reduction, 809 (41.1%) patients were hospitalized with shoulder dislocation. The outpatient patients were randomly divided into two groups: in group 1 (n = 1552) the shoulders were adjusted using traditional methods with local anesthesia, the patients in group 2 (n = 416) received treatment according to the authors manual technique without local anesthesia. There were no statistically significant differences in gender, age, and type of dislocation in both groups. \u0000RESULTS: The use of manual techniques was effective in 85% of the cases (352 people), 64 people were hospitalized (15%). The effectiveness of using traditional methods with the use of local anesthesia was 52% (dislocation was repositioned in 807 patients), the rest of the patients were treated in the inpatient setting. \u0000CONCLUSIONS: The use of the authors manual technique in patients with shoulder dislocation in the outpatient setting has higher efficiency compared to traditional methods due to the fact that more patients receive assistance in the outpatient setting. In addition, this type of treatment is carried out without anesthesia, which also reduces the cost of treatment.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84116466","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":"Frequency and structure of arthroscopy complications in patients with knee joint osteoarthritis","authors":"Aleksandr G. Balglei, A. N. Tkachenko, Valerii M. Khaydarov, D. Mansurov, I. Urazovskaya","doi":"10.17816/mechnikov108370","DOIUrl":"https://doi.org/10.17816/mechnikov108370","url":null,"abstract":"BACKGROUND: Arthroscopy is one of the most popular techniques in traumatology and orthopedic practice. The development of the criteria for selection of patients and indications for knee arthroscopy should be carried out for the improvement of arthroscopic technology. It is important to develop safe and informative surgical access to intra-articular structures, optimize stages and techniques, minimize the complications of arthroscopic surgery. \u0000AIM: The publications describing results of knee arthroscopy in patients with knee osteoarthritis have been analyzed in the study. \u0000MATERIALS AND METHODS: A systematic literature review has been conducted by searching in the Pub-Med/MEDLINE database and eLibrary. The search depth was 20 years; a keyword searching has been performed (including the keywords complications, indications/contraindications for arthroscopy). Possible relevant peri-, intra- and postoperative complications of knee arthroscopy are discussed. \u0000RESULTS: Knee joint arthroscopy is the treatment of choice for trauma, injury and orthopedic disease. However, arthroscopy of the knee joint does not always bring a positive effect. The number of negative consequences of this surgical intervention, according to the statistics, range from 0.1 to 2.6% of all cases of knee joint arthroscopy. Complications can be local and systemic and develop both in the early postoperative and in the long-term period after the operation. The review is devoted to the analysis of the data concerning the frequency and structure of knee arthroscopy complications in patients with osteoarthritis of knee joints. \u0000CONCLUSIONS: Intra- and postoperative complications of arthroscopic surgery of the knee joint include nerve and vascular lesions, port disposition, thrombosis, pulmonary embolism, instrument breakage, and compartment syndrome associated with a defect in the joint capsule and leakage of irrigation fluid. In the postoperative period, complications such as hemarthrosis, thrombosis, pulmonary embolism, infection and synovial fistulas are possible. Complications of the late postoperative period of arthroscopic interventions are arthrofibrosis, Ahlbacks disease or aseptic osteonecrosis of the femur or tibia, as well as complex regional pain syndrome.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88396957","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":"Evolution of surgical treatment for breast cancer","authors":"A. V. Kcheuso, S. G. Shapovalov, D. K. Savchenkov, T. E. Koshelev, A. O. Votinova","doi":"10.17816/mechnikov81010","DOIUrl":"https://doi.org/10.17816/mechnikov81010","url":null,"abstract":"Breast cancer holds the leading position among womens cancer. Nowadays extensive experience has been acquired in surgical treatment of this disease. However, a significant proportion of young and middle-aged patients, the expansion of adjuvant therapy capabilities and the effectiveness of integrated treatment dictate a need to pay more attention to the aestheticity of surgical interventions. The review analyzes the results of the modern studies on the effectiveness and aestheticity of the most common types of surgical treatment of breast cancer; the evolutionary trends in oncosurgery are presented.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80753248","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}