Medical alphabet最新文献

{"title":"B vitamins and homocysteine in cancer patients with solid malignancies before chemotherapy administration","authors":"O. A. Tikhonova, D. Druzhinin, L. Litvinova, S. Doktorova, N. Todosenko, N. D. Gazatova, M. Bograya, E. L. Naumova, M. I. Dolgaleva","doi":"10.33667/2078-5631-2024-7-55-59","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-7-55-59","url":null,"abstract":"Recently, the role of vitamin imbalance in carcinogenesis has been actively discussed. Studies aimed at assessing their role in the processes of cancer development are various, and the evaluation of the initial level of vitamins is relevant when planning antitumor therapy.Objective. To determine the state of the initial level of B vitamins and homocysteine before chemotherapy in patients of different oncologic profile.Material sand Methods. The level of vitamins B1, B6, B9, active form of B12* and homocysteine in fresh frozen plasma was determined by enzyme[1]linked immunosorbent assay (ELISA) using test systems in 66 patients with verified malignant neoplasms before chemotherapy. The study included 66 patients: women n=40 and men n=26, with cancer: gastric n=12, colorectal cancer n=21, cancer lung n=11, cancer pelvic organs n=22.Results. According to the results of the study the increase in the level of holotranscobalamin (Holo-TC) and decrease in homocysteine in comparison with reference values was observed in 100% of cases. Significant difference was found only for B1: reliable differences between patients with colorectal cancer and with pelvic cancer (in the latter the mean value of B1 levels was 2.4 times higher at p = 0.0425). According to the results of correlation analysis, a weak correlation between B12 and B9 was determined. When comparing the levels of vitamin B12 and homocysteine in patients after surgical treatment and without it, no significant differences were found.Conclusion. Increased Holo-TC levels and decreased homocysteine levels by ELISA are characteristic of all varieties of solid cancer, independent of sex, age, stage and previous surgical intervention. A relative decrease in vitamin B1 is characteristic of colorectal cancer","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140991430","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 prevalence of vaginal dysbiosis in women of reproductive age","authors":"A. B. Khuraseva, T. V. Reminnaya","doi":"10.33667/2078-5631-2024-8-22-24","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-8-22-24","url":null,"abstract":"","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140993863","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":"Study of gas exchange under different modes of ventilation in yoga breathing exercises","authors":"A. Frolov, I. Manichev, S. Ermolaeva","doi":"10.33667/2078-5631-2024-6-39-46","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-6-39-46","url":null,"abstract":"Yoga breathing exercises that develop the ability to voluntarily regulate the minute volume of respiration (MV) and maintain the state of hypoventilation, hypoxia and hypercapnia, can be considered as a way of hypoxic-hypercapnic training, potentially capable of influencing cerebral circulation and neuroprotective factors. However, at the moment, individual anthropometric features that affect the ability to develop a hypoventilation mode of breathing have not been studied, and methodological criteria for training have not been developed.Methods: The study involved 44 people (32 men and 12 women) who regularly practice yoga breathing techniques with a voluntary decrease in respiratory rate using maximum tidal volume (TV). Free breathing was recorded for 2 minutes, then each subject performed the respiratory hypoventilation pattern available to him or her (minimum RR values with maximum TV, inhalation and exhalation were of equal duration). The following parameters of external respiration were determined: respiratory rate (RR), minute ventilation (MV), tidal volume (TV), partial pressure of CO2 in the exhaled air at the end of exhalation (PetCO2 ), percentage of O2 in the exhaled air (FeO2) and hemoglobin saturation (SpO2 ).Results: Compared to breathing at rest (MV = M±SD 8.51 ± 2.57 (95% CI 7.72–9.29) l/min; PetCO2 = M±SD 36.98 ± 3.71 (95% CI 35.85–38.11) mm Hg), the mode with RR = 3 times/min (inspiration and expiration for 10 s), n = 44, leads to an increase in MV up to M±SD 12.02 ± 3.42 (95% CI 10.98–13.06) l/min (p < 0.001) and a decrease of CO2 : PetCO2 = M±SD 33.99 ± 3.59 (95% CI 32.90–35.08) mm Hg (p < 0.001) — that is, to development of alveolar hypocapnia. The mode with RR = 1.5 times/min (inhalation and exhalation for 20 s), n = 44, demonstrates a decrease in MV to M±SD 5.95 ± 1.59 (95% CI 5.46–6.43) l/min (p < 0.001) and growth of PetCO2 up to M±SD 41.19 ± 3.71 (95% CI 40.06–42.32) mm Hg (p < 0.001). The mode with RR = 1 time/min (inspiration and exhalation for 30 s), n = 24: with a decrease in RR to 1 time/min, a decrease in MV was observed to M±SD 4.22 ± 0.92 (95% CI 3.83–4.61) l / min (p < 0.001) and an increase in PetCO2 up to M±SD 44.05 ± 3.05 (95% CI 42.76–45.33) mm Hg (p < 0.001). The breathing pattern with RR = 1 r/min is accompanied by a statistically significant decrease in MV compared to rest, as well as an increase in PetCO2 and a decrease in FeO2 , that is, it is hypoventilation. We have proposed a ventilation coefficient (Qvent), which is the ratio MV/VC, which allows us to judge at what values of MV an individual reaches a state of hypoventilation. It was previously shown in this sample that the breathing exercise becomes hypoventilation when Qvent values are equal to or less than 1. With Qvent in the range from 1 to 2, the ventilation mode is within normal values, and when Qvent is more than 2, hyperventilation occurs.Conclusion: when performing yoga breathing exercises, variations in MV are observed both in the directi","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995006","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":"Ultrasound vector mapping of common femoral artery blood flow in normal and early-stage stenosis","authors":"T. Kulagina, E. Dutikova, V. A. Sandrikov, A. V. Gavrilenko, Al-Samsei Naim Nas","doi":"10.33667/2078-5631-2024-6-47-50","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-6-47-50","url":null,"abstract":"It is assumed that the wall shear stress (WSS), which determines the function of the endothelium, is constant along the arterial bed. The assessment of turbulence, blood flow velocity in the arterial system in healthy (13 patients) and in patients with the initial form of atherosclerosis in the femoral artery (42 patients) was discussed. The study quantified blood flow in the common femoral artery using V Flow with visualization of blood flow with a high frame rate. The results obtained in the femoral arteries were evaluated by the wall shear rate, velocity profile and oscillation index (OSI). It was shown that the average value of WSSmean in the femoral artery in healthy and in patients with stenosis <30–35% is 0.9± 0.4 – 0.91±0.4 Pa and does not significantly differ. The wall thickness in the common femoral artery in patients with the initial form of atherosclerosis was 0.9–1.1 mm, and in healthy patients 0.8–0.9 mm. The correlation between the parameters was evaluated by nonparametric analysis of Kendall’s Taub. It was revealed that there is no correlation between WSSmean and blood flow velocity (Vs) in both healthy and patients with the initial form of atherosclerosis.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994978","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":"Optimization of the method of introducing anti-adhesion gel “Аntiadhesin” during laparoscopic access in gynecology","authors":"A. A. Grigoryants","doi":"10.33667/2078-5631-2024-8-8-12","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-8-8-12","url":null,"abstract":"","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997456","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":"Choice of adjuvant therapy for HER2-positive breast cancer in real clinical practice: analysis of physician preferences in the Russian Federation","authors":"E. Lubennikova, E. Artamonova","doi":"10.33667/2078-5631-2024-7-7-12","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-7-7-12","url":null,"abstract":"Adjuvant therapy with trastuzumab made a significant contribution to improving disease-free and overall survival rates in patients with HER2-positive breast cancer. However, in a number of clinical situations the risk of disease recurrence remains increased. Carrying out neoadjuvant treatment followed by post-neoadjuvant therapy, depending on the degree of pathomorphological response, is the modern standard, allowing to cure a significantly larger number of patients. This became possible thanks to the expansion of the arsenal of terget anti-Her drugs and the introduction into real clinical practice of double anti-HER2 blockade (trastuzumab + pertuzumab) and an antibody conjugate with a cytostatic drug – trastuzumab emtansine. To assess actual clinical practice in the Russian Federation, a survey study “Therapy of HER2-positive breast cancer” was conducted. The survey involved 50 specialists from different regions of the country who are directly involved in developing a treatment plan for patients, which allows them to reflect the preferences of leading chemotherapists regarding tactics for HER2-positive breast cancer. This publication reflects the results of part of the survey, devoted to the choice of adjuvant and post-neoadjuvant therapy for HER2-positive breast cancer. Identified a clear positive trend in favor of neoadjuvant treatment followed by post-neoadjuvant therapy using modern targeted drugs such as pertuzumab and trastuzumab emtansine. The survey results show that 68% of patients with RCB-II–III residual tumor receive post-neoadjuvant trastuzumab emtanzine, in 2021 this figure was only 24%. The absolute majority of patients who have not received neoadjuvant therapy, but have N2–3 stage, receive double anti-HER2 therapy with trastuzumab + pertuzumab in the adjuvant setting. High adherence to the therapy was noted, as 97% of patients complete the planned course of T-DM1, and 91.2% of patients complete a year of adjuvant anti-HER2 therapy. These figures are noticeably higher than the indicators of registration studies. Issues of effectiveness come to the fore in choosing therapy. Issues of drug availability remain relevant, but are not decisive. The survey also revealed factors that were not obvious at first glance and influenced treatment results.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996153","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 in the prevention of undeveloped pregnanc","authors":"L. Tkachenko, T. A. Verovskaya, N. I. Sviridova, T. I. Kostenko, E. A. Homich","doi":"10.33667/2078-5631-2024-8-13-15","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-8-13-15","url":null,"abstract":"The problem of non-developing pregnancy (NB) remains relevant due to the rather wide spread of this complication and is due to the search for prognostically significant causes of this pathology, the development of adequate prevention of the detected disorders [1–4]. Polymorphic variants of folate genes lead to excessive accumulation of HC in the blood and hypomethylation of DNA, which contributes to an increase in early miscarriage (the frequency of this pathology is 20–25% of all pregnancies). Carrying out periconceptional prophylaxis with high doses of folic acidreduces the level of free HC in the blood, but this technique is effective only when it begins 3 months before conception and in the early stages of embryo and fetus development (up to 12 weeks). The evaluation of laboratory and clinical data in the course of the study confirmed the effectiveness of the use of folic acid at a dose of 800 mcg in a high risk group for the development of NB (pregnant women with hyperhomocysteinemia (GHZ)) 16 weeks before conception and 12 weeks after conception.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997460","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 effectiveness of the combination of lenvatinib and everolimus in metastatic renal cell carcinoma in patients with resistance to targeted treatment in real clinical practice","authors":"R. Rakhimov, A. V. Sultanbaev, K. Menshikov, A. Nasretdinov, S. Musin, O. Lipatov, V. A. Suravatkin","doi":"10.33667/2078-5631-2024-7-18-25","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-7-18-25","url":null,"abstract":"Every year, 400,000 new cases of renal cell carcinoma (RCC) and 175,000 deaths are registered worldwide. Currently available advanced treatments for RCC have less toxicity than previously used therapeutic agents, but drug resistance remains a clinically significant problem. Drug resistance occurs as a result of angiogenic transition through activation of pathways that do not depend on VEGF targets of most first-line treatments. Lenvatinib with everolimus can fight resistance to increase both progression-free survival and overall survival in patients with metastatic RCC according to clinical studies.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995189","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":"Vacuum fine-needle aspiration biopsy as a method of early detection of thyroid cancer","authors":"A. O. Tagil, A. V. Borsukov","doi":"10.33667/2078-5631-2024-7-34-40","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-7-34-40","url":null,"abstract":"Relevance. Malignant neoplasms of the thyroid gland account for 1–3% in the structure of oncological pathology in the territory of the Russian Federation. Fine needle aspiration biopsy of thyroid foci is an integral part of the examination and is included in both foreign and domestic recommendations. However, there is a problem of obtaining uninformative cytological conclusions, and the risk of obtaining false positive and false negative results remains.Objective. To determine the possibilities of using vacuum aspiration fine needle biopsy under ultrasound control in patients with focal thyroid pathology in a multidisciplinary hospital.Materials and methods. From 2021 to 2023, 331 patients with focal thyroid pathology were examined at the clinical base of the Department of Diagnostic and Minimally Invasive Technologies of the Clinical Hospital № 1 in Smolensk. All patients were divided into two clinical groups. Patients of both groups underwent a comprehensive examination, including palpation of the thyroid gland and lymph nodes of the neck, multiparametric ultrasound examination of the thyroid gland, including B – mode, color Doppler mapping, compression elastography, shear wave elastography, laboratory examination (calcitonin level, TSH, T3, T4, antibodies of TPO, AtTTP, thyroglobulin). In patients who had previously undergone surgical treatment, ultrasound was performed to determine areas of thyroid tissue, and additionally the level of thyroglobulin was determined as a marker of the recurrent process.Results. The median size of the thyroid formation was 15.2 (13.9–19.1) mm. Mainly multiple foci of thyroid gland were detected in both the control group – 106 (79.1%) and the main 107 (54.3%) patients, the share of single foci accounted for 28 (20.9%) of the control and 90 (45.7%) of the main groups. Fine – needle aspiration biopsy was performed using the «Free hand» method using type syringe with a volume of 10 ml. During the vacuum fine – needle aspiration biopsy, depending on the data of the multiparametric ultrasound examination, the level of negative pressure in the range from –0.3 bar to –0.8 bar was determined. At a pressure of –0.3 bar, 54 (27.4%) were performed,–0.5 bar – 126 (64.0%),–0.8 bar – 17 (8.6%) vacuum fine – needle aspiration biopsy.Conclusions. A device has been developed for the implementation of vacuum fine – needle aspiration biopsy with the creation of an improved technique for conducting vacuum fine – needle aspiration biopsy in focal thyroid pathology. The informative value of the method of routine fine – needle aspiration biopsy and vacuum fine – needle aspiration biopsy under ultrasound control in patients with focal thyroid pathology was evaluated. The sensitivity and specificity of fine – needle aspiration biopsy was 75.0% and 52.9%, respectively. The sensitivity and specificity of vacuum fine – needle aspiration biopsy during the study were 95.6% and 92.5%, respectively. The data obtained indicate the effectiveness ","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994265","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 use of medical thermal imaging in assessing the dynamics of healing of pressure ulcers in patients with severe brain damage","authors":"A. Yakovleva, A. Shestopalov, I. Dolgov","doi":"10.33667/2078-5631-2024-6-58-62","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-6-58-62","url":null,"abstract":"Patients with severe brain damage often develop pressure ulcers (PU). The phases of the wound process significantly extend in time due to the underlying disease, severity of the condition and metabolic changes. Medical thermal imaging can be used to assess the level of PU microcirculation.Aims: to study the possibility of using medical thermal imaging to predict the course of PU in patients after severe brain damage.Methods: 38 ICU patients after brain injury and stage III–IV PU (25 men, 13 women, mean age 59±17 years). The series of thermograms (native image, after the “cold test” and 3 minutes after) were recorded before treatment and after 21 days. We used an NEC ThermoTracer TH 9100 thermal imager.Results. We assessed the minimum/maximum overall temperatures and in the 1st–4th quartiles. With a positive outcome, the temperatures Q3-Q4 were higher (35.1 C–37.6 C versus 34.8 C–36.7 C for a negative outcome) and the lower thresholds of all quartiles. We hypothesized that a sign of PU healing is a narrowing of the range of temperature points on the surface of the wound. We used a point system for assessing the dynamics of temperature parameters, then checked the model using ROC analysis: the AUC was 0.932 (0.81–1.0), which indicates the high quality. The best ratio of sensitivity and specificity (0.81; 0.83) corresponds to a cut-off point of 9.5.Conclusion. The use of medical thermal imaging makes it possible to objectively assess the level of blood supply to the PU in patients after severe brain damage, as well as the prognosis of further wound healing.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996946","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}