Journal of the Grodno State Medical University最新文献

{"title":"ANALYSIS OF PLATELET AGGREGATION IN PATIENTS WITH DIABETIC FOOT SYNDROME","authors":"E. L. Stavchikov, I. V. Zinovkin, A. V. Marochkov","doi":"10.25298/2221-8785-2024-22-2-161-166","DOIUrl":"https://doi.org/10.25298/2221-8785-2024-22-2-161-166","url":null,"abstract":"Purpose. To analyze the aggregation function of platelets in patients with diabetic foot syndrome (DFS). Material and methods. Prospective clinical trial in which 31 patients participated have been conducted by us. To achieve this purpose, 2 groups have been formed: group 1 – patients with no history of diabetes (n=17); group 2 – patients with diabetes mellitus type 2 complicated by DFS (n=14). The studying of platelet aggregation was carried out once for first days after the admission of patients to the general somatic health care units, turbidimetric count method with an inductor: adenosine diphosphate (ADP) (concentrations of 0.3 mcg/ml, 0.6 mcg/ml, 1.25 mcg/ml and 2.5 mcg/ml were used), adrenaline (concentrations of 2.5 microns and 5.0 microns were used), collagen – 2 mg/ml. Results. In group 2 patients, the average platelet aggregation time, as well as in group 1, was lower than the reference values with an ADP inducer at a dose of 0.6 mcg/ml, 1.25 and 2.5 mcg/ml, and higher with adrenaline at a dose of 2.5 microns and with adrenaline at a dose of 5.0 microns. The degree of aggregation was lower than normal when used with all inducers except ADP 0.3 mcg/ml (normal), and the average platelet aggregation rate was lower with adrenaline. With the other inducers, platelet aggregation parameters were within the reference values. When adding inducers with all platelet aggregation parameters, significant differences were obtained between the two groups (p<0.05), and only when using ADP at doses of 0.6 mcg/ml, 1.25 mcg/ml and 2.5 mcg/ml, no significant differences were obtained for the aggregation rate parameter (p>0.05). Conclusion. In patients with DFS, compared with the people without diabetes mellitus type 2, the lowest degree of aggregation is noted with the use of ADP and adrenaline, the aggregation time is less with ADP, the aggregation rate is less with adrenaline and collagen 2 mg /ml. The degree of aggregation has increased with the use of collagen, and the aggregation time with adrenaline and collagen. The studying of platelet function is an important link in the laboratory control of spontaneous aggregation, which will limit the appearance of new vascular occlusions in patients with DFS.","PeriodicalId":177418,"journal":{"name":"Journal of the Grodno State Medical University","volume":"4 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141053719","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":"VLADIMIR MIKHAILOVICH PYROCHKIN: A LIFE DEDICATED TO MEDICINE AND EDUCATION (ON THE OCCASION OF THE 70TH BIRTHDAY)","authors":"E. S. Ausianik, M. S. Dzeshka","doi":"10.25298/2221-8785-2024-22-2-193-196","DOIUrl":"https://doi.org/10.25298/2221-8785-2024-22-2-193-196","url":null,"abstract":"The article is dedicated to the anniversary of a competent and highly qualified specialist, an outstanding scholar, teacher, professor of the Department of Internal Medicine No1 of the Grodno State Medical University, Doctor of Medical Sciences, Professor V.M. Pyrochkin.","PeriodicalId":177418,"journal":{"name":"Journal of the Grodno State Medical University","volume":"24 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141046761","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":"CONGENITAL ABNORMALITY OF THE APPENDIX COMPLICATED BY APPENDICITIS","authors":"N. Prokopchik, P. G. Rassoshko, E. L. Cherevan, A. I. Shoka","doi":"10.25298/2221-8785-2024-22-2-173-176","DOIUrl":"https://doi.org/10.25298/2221-8785-2024-22-2-173-176","url":null,"abstract":"Congenital malformations of the appendix are an extremely rare pathology, do not have a specific clinical picture and are usually detected at the time of surgery or pathohistological examination of the removed appendix. The purpose of the study. To present a description of a rare pathology – a case of incomplete doubling of the appendix and its atypical location, which contributed to the development of chronic recurrent appendicitis and periappendicitis. Results. The patient, aged 19, was operated on with a diagnosis of acute appendicitis. Laparoscopy has revealed that the appendix is partially retracted into the inguinal hernia and purulent fibrinous periappendicitis occurs. The vermiform appendix was removed. During its examination by both the surgeon and the pathologist, no developmental abnormality was detected. Pathohistological examination revealed incomplete doubling of the appendix. The additional process was located in the thickened mesentery of the main appendix. The complete absence of the outer layer in the muscle membrane and the serous membrane of the accessory process was revealed. This abnormality has provoked the development of chronic recurrent appendicitis and periappendicitis with the formation of an appendicular infiltrate. Conclusion. This article describes a rare clinical case of not only abnormal development of the appendix with the formation of chronic recurrent appendicitis, the formation of periappendicular infiltrate, but also its atypical location – it was partially involved in an inguinal hernia.","PeriodicalId":177418,"journal":{"name":"Journal of the Grodno State Medical University","volume":"39 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141047306","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 EXPERIENCE OF THE PILOT PROJECT “GRODNO UNIVERSITY CLINIC” IMPLEMENTATION REGARDING THE EFFICIENCY OF PRACTICE-ORIENTED TRAINING OF MEDICAL STAFF","authors":"I. G. Zhuk, S. N. Lazarevich, E. V. Mahiliavets, E. A. Moiseenok","doi":"10.25298/2221-8785-2024-22-2-185-189","DOIUrl":"https://doi.org/10.25298/2221-8785-2024-22-2-185-189","url":null,"abstract":"The training of highly professional medical staff with minimal need in their further workplace adjustment is an important current problem facing health care and medical higher education institutions authorities. To a large extent, existing clinical healthcare organizations, which are an example of cooperative relationships are serving this purpose. At the same time, the existing practice of their functioning indicates an insufficient degree of integration of the academic environment and practical healthcare. The purpose of this publication is to summarize the experience of the pilot project “Grodno University Clinic” implementation regarding the efficiency of practice-oriented training of medical staff. The integration of academic medicine and practical healthcare in a university clinic allows solving a number of important problems. Maximum involvement of teaching staff in medical activities allows maintaining and improvement of their professional competencies. The logical consequence of this process is the improvement of the quality of practice-oriented undergraduate and postgraduate training of medical specialists. Participation of the students in the diagnostic and treatment process as both active observers and direct participants to an even greater extent contributes to a quality learning experience and a conscious approach to choosing their future specialization.","PeriodicalId":177418,"journal":{"name":"Journal of the Grodno State Medical University","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141025905","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":"CURRENT TRENDS IN ANTIBIOTIC RESISTANCE OF PATHOGENIC MICROORGANISMS IN SURGICAL PATIENTS","authors":"R. Dovnar","doi":"10.25298/2221-8785-2024-22-2-137-146","DOIUrl":"https://doi.org/10.25298/2221-8785-2024-22-2-137-146","url":null,"abstract":"Background. To carry out adequate antibacterial therapy directed against pathogenic microflora in patients with surgical infection it is necessary to take into account indicators of antibiotic resistance of leading etiological agents. The aim of the work is to study the spectrum and current dynamics of changes in antibiotic resistance of purulent pathogens in soft tissues of surgical patients. Material and methods. An analysis of the results of antibiotic resistance of the seeded leading microflora in patients with purulent processes of soft tissues was made. Results. Isolates of Staphylococcus aureus from surgical patients are characterized by high resistance to all β-lactam antibiotics, the combination drug trimethoprim-sulfamethoxazole, and macrolides. The resistance of Klebsiella pneumoniae and Proteus mirabilis to all studied β-lactam antibiotics, as well as fluoroquinolones, aminoglycosides, tetracyclines, nitrofurans, and chloramphenicol ranges from 37 to 100%. Escherichia coli resistance to β-lactams, fluoroquinolones, carbapenems, and aminoglycosides reaches 50-73%. A high level of antibacterial resistance is also characteristic of other bacteria most often cultured in surgical patients. Conclusions. The most frequently cultured strains of both gram-positive and gram-negative groups of microorganisms from surgical patients are characterized by a high level of antibacterial resistance, reaching 100%. Currently, cases of polyantibiotic resistance and resistance even to reserve antibiotics are not uncommon. All this dictates the need to search for new classes of substances that have an antimicrobial effect, and metal nanoparticles may be one of them.","PeriodicalId":177418,"journal":{"name":"Journal of the Grodno State Medical University","volume":"41 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141024740","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":"UNRESOLVED ISSUES IN THE TREATMENT OF CEREBRAL ISCHEMIA IN OCCLUSIVE-STENOTIC LESION OF THE VERTEBRAL ARTERIES","authors":"N. N. Iaskevich, V. M. Rukhovets, A. V. Aleinikov, P. A. Harachau","doi":"10.25298/2221-8785-2024-22-1-5-12","DOIUrl":"https://doi.org/10.25298/2221-8785-2024-22-1-5-12","url":null,"abstract":"Background. The relevance of the review is determined by the fairly high incidence of strokes in the vertebrobasilar region. Aim. To analyze the literature on occlusive-stenotic lesions of the vertebral arteries as the causes of ischemic strokes and methods of their treatment. Results. It has been established that the problem of ischemic strokes due to occlusive-stenotic lesions of the vertebral arteries is a poorly covered topic. Existing options for eliminating stenosis of the vertebral artery mouth have advantages and disadvantages, and vary depending on many factors. Conclusions. The most effective method of treating occlusive-stenotic lesions of the vertebral arteries, which cause the development of vertebrobasilar insufficiency, has not yet been finally determined. This emphasizes the need for further research to develop a pathogenetically based treatment algorithm for such patients.","PeriodicalId":177418,"journal":{"name":"Journal of the Grodno State Medical University","volume":"122 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140090584","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":"POLYMORPHISM OF COL1A1, VDR GENES IN PATIENTS WITH BONE CYSTS","authors":"O. A. Kvyatkovskaya, V. Anosov, O. V. Gorchakova","doi":"10.25298/2221-8785-2024-22-1-61-64","DOIUrl":"https://doi.org/10.25298/2221-8785-2024-22-1-61-64","url":null,"abstract":"Background. The relationship between the decrease in bone mineral density, a violation of bone metabolism and functionally defective alleles of the VDR and SOL1A1 genes was proved. Taking into account the peculiarities of bone biodynamics and the fact that in the period from 5 to 16 years, the bone mineral density increases by 3 times, which coincides with the age period for the detection of bone cysts in children, the study of polymorphism of the VDR and COL1A1 genes (which mainly regulate bone formation) in patients with bone cysts is relevant today. Aim. To investigate the polymorphism of collagen type 1 (COL1A1), vitamin D receptor (VDR) genes in children with bone cysts, to establish the influence of the gene factor on the development of this pathology. Material and methods. During the period from June to December 2021, the polymorphism COL1A1, VDR was studied in 27 patients diagnosed with bone cysts. 41 patients with other orthopedic and traumatological pathology were examined as comparison groups. Genotyping of polymorphic alleles of the VDR and COL1A1 gene was performed by \"real time\" polymerase chain reaction. Results. In patients with bone cysts, the frequency of heterozygous genotype AG and homozygous GG was the same – 37% for each, the AA genotype accounted for 26%. In children from the comparison group, heterozygous genotype AG and homozygous AA were found with the same frequency – 39% each, genotype GG – 22% each. In patients with bone cysts, the frequency of homozygous genotype AA and heterozygous CA was the same – 15% for each, the CC genotype accounted for 70%. In children from the comparison group, homozygous genotype CC was found in 70.5% of cases, heterozygous genotype CA – 27%, homozygous genotype AA – 2.5%. Conclusions. It was found that the percentage of mutant homozygous type for the VDR and COL1A1 genes is higher in patients with bone cysts. There is a certain genetically determined relationship between bone cysts and a violation of bone formation and bone resorption.","PeriodicalId":177418,"journal":{"name":"Journal of the Grodno State Medical University","volume":"29 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140271846","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":"EXPERIENCE OF IMPLEMENTING THE PILOT PROJECT «GRODNO UNIVERSITY CLINIC» IN THE ASPECT OF THE EFFECTIVENESS OF TREATMENT ACTIVITIES","authors":"I. G. Zhuk, S. N. Lazarevich, E. V. Mahiliavets, E. A. Moiseenok","doi":"10.25298/2221-8785-2024-22-1-78-83","DOIUrl":"https://doi.org/10.25298/2221-8785-2024-22-1-78-83","url":null,"abstract":"In accordance with the Resolution of the Council of Ministers of the Republic of Belarus dated December 11, 2018 No. 886 “On the implementation of a pilot project to create a university clinic”, the Ministry of Health, together with the Grodno Regional Executive Committee, has been implementing a pilot project to create a university clinic in the Grodno region since 2019. The participants in the pilot project were the health care institution “Grodno Regional Clinical Hospital” and the educational institution “Grodno State Medical University”. The purpose of this publication is to summarize the experience of implementing the pilot project at the Grodno University Clinic in terms of the effectiveness of medical activities. In frames of pilot project implementation a regional “diabetic foot” center has been organized; a center for “Medical Image Visualization” was organized (regional PACS archive of DICOM images of CT and MRI); a system of multi-level provision of medical care to the population of the Grodno region was developed and approved; a telemedicine consultation center was organized and equipped; a scientific and practical conference “Innovative achievements in the work of the University Clinic” is held annually; Regional professional skills master classes are held on a regular basis; modern diagnostic and treatment methods are being introduced into the clinical process, according to the work plans of scientific and clinical departments; the surgical building of the university clinic is at the stage of completion of reconstruction. The experience of implementing the pilot project gives the possibility to make next conclusions: 1. The results of functioning within the framework of the Grodno University Clinic project indicate that the comfortable conditions created contributed to a significant intensification of the process of generating ideas and introducing the most promising innovations into clinical practice. 2. The effectiveness of interaction between representatives of academic medical science, education and practical healthcare has increased significantly, which has contributed to an increase in the volume and quality of medical care provided. 3. It is necessary to continue to accumulate experience in the functioning of university clinics, followed by periodic assessment of the results of their activities in order to widely implement the best practices developed in them.","PeriodicalId":177418,"journal":{"name":"Journal of the Grodno State Medical University","volume":"270 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280457","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":"APPLICATION OF THE METHOD OF EXTRACORPOREAL AUTOHEMOMAGNETIC THERAPY FOR THE PURPOSE OF CORRECTION OF HEMODYNAMIC DISORDERS IN THE INTRAOPERATIVE PERIOD WHEN PERFORMING CORONARY BYPASS UNDER ARTIFICIAL CIRCULATION","authors":"K. .. Kratkou, V. N. Valentyukevich","doi":"10.25298/2221-8785-2024-22-1-51-55","DOIUrl":"https://doi.org/10.25298/2221-8785-2024-22-1-51-55","url":null,"abstract":"Purpose of the study. To evaluate the effect of extracorporeal autohemomagnetic therapy on the parameters of central hemodynamics during surgical intervention for myocardial revascularization (aortocoronary and mammary coronary bypass surgery) under conditions of artificial circulation. Material and methods. The parameters of invasive hemodynamics of 100 patients who were treated in anesthesiology and intensive care units were studied. All patients were divided into 2 groups. Group 1 (50 people) received standard anesthesia (multicomponent balanced anesthesia) for coronary artery bypass grafting and mammary coronary artery bypass grafting under artificial circulation without the use of extracorporeal autohemomagnetic therapy. In group 2 (50 people), in addition to standard anesthesia autohemomagnetic therapy was used. Аfter catheterization of a. radialis dextra (sinistra) and v. jagularis interna dextra (sinistra), the invasive hemodynamics parameters were assessed using the Draeger Infinity Delta monitoring system (Germany): systolic blood pressure, diastolic blood pressure, mean arterial pressure, central venous pressure, heart rate. The parameters were studied at 2 stages of the surgical intervention: 10 minutes after induction of anesthesia, 10 minutes after administration of the calculated dose of protamine. Results. The use of autohemomagnetic therapy made it possible to increase the parameters of invasive central hemodynamics: systolic blood pressure, diastolic blood pressure, mean arterial pressure. The study of the parameters of heart rate and central venous pressure revealed no statistical differences. Conclusions. The use of extracorporeal autohemomagnetic therapy in the intraoperative period during myocardial revascularization can help correct hemodynamic disorders.","PeriodicalId":177418,"journal":{"name":"Journal of the Grodno State Medical University","volume":"1 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270452","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":"MONITORING THE LEVEL OF ANTIBODIES AGAINST THE MEASLES VIRUS AMONG STAFF OF HEALTH INSTITUTIONS OF THE REGIONAL CENTER IN 2023","authors":"V. M. Tsyrkunov, N. G. Malyshko, A. A. Grik, I. A. Kuzmich","doi":"10.25298/2221-8785-2024-22-1-27-32","DOIUrl":"https://doi.org/10.25298/2221-8785-2024-22-1-27-32","url":null,"abstract":"Background. In 2023, measles incidence has worsened in the world and the European region. The purpose of the study is to assess the strength of immunity against the measles virus based on the level of antibodies among students and staff of healthcare institutions of the regional center in 2023. Material and methods. The object of the study was different categories of medical workers (students, doctors, nurses, orderlies, paramedical personnel) of city/regional healthcare institutions in Grodno, who were examined for the content of measles antibodies. Determination of the level of IgG to the measles virus in blood serum was carried out by ELISA using Vector-Best test systems (Russia). The level was considered protective with an IgG titer of more than 0.18 IU/ml, uncertain (gray zone ELISA) with an IgG titer of 0.11-0.18 IU/ml, the absence of a protective antibody level was observed with an IgG titer of less than 0.11 IU/ml. Results. In 2023, the non-immune proportion of personnel working in the city's healthcare system, who did not have a protective level of specific antibodies, amounted to 15.3%, which creates additional risks of the spread of measles in the region and in healthcare institutions when providing medical care. The most vulnerable age group is medical workers aged 19 to 50 years. Сonclusions. The significant difference in the strength of immunity against measles among personnel of various healthcare institutions necessitates an additional assessment of the strength of immunity in all healthcare workers as well as individual preventive vaccination for persons with no protective level of antibodies.","PeriodicalId":177418,"journal":{"name":"Journal of the Grodno State Medical University","volume":"113 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273922","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}