Zaporozhye Medical Journal最新文献

{"title":"Post-COVID syndrome in children: whether a change in lymphocyte count is a risk factor for its development?","authors":"O. Lychkovska, D. I. Kvit, I. Kulachkovska, О. M. Sadova, L. Y. Zhyvko, М. I. Dats-Opoka, N. S. Kosmynina","doi":"10.14739/2310-1210.2022.6.258928","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.6.258928","url":null,"abstract":"The aim of the study: to find risk factors for post-COVID syndrome formation based on the analysis of the dynamic leukocyte count, the relative and absolute blood lymphocyte contents.\u0000Materials and methods. A retrospective analysis of medical records of children, aged 10–17 years, who were hospitalized during the second wave of the pandemic (January – July 2021) to the CNE “Lviv Regional Children’s Clinical Hospital “Ohmatdyt” with a diagnosis of moderate COVID-19. A total of 46 children were selected, among them 26 children (post-COVID(-) group), who had no symptoms after COVID-19 and 20 children (post-COVID(+) group) who described various complaints related to disfunction of different organ systems, which affected a normal child’s life.\u0000Results. All children from the post-COVID(+) group complained of fatigue, about a third of children – headache (30 %), which were not observed before the disease, quarter of children (25 %) had problems with concentrating, one fifth (20 %) – periodically felt unmotivated anxiety. Analysis of the leukocytosis dynamics, absolute and relative lymphocytosis in the control after one week ±2 days revealed no significant changes in these indicators in the post-COVID(-) group of children. While in the post-COVID(+) group, a slight increase in leukocytosis (from 3.9 × 109/L to 4.05 × 109/L, P = 0.13) was accompanied by a significant decrease in the number of lymphocytes, both relative (from 27 % to 16 %, P = 0.002) and absolute (from 1.51 × 109/L to 0.51 × 109/L, P = 0.001).\u0000Conclusions. Patients with persistent lymphopenia or hyperlymphocytosis (one week ±2 days) during acute period of COVID-19 represent a “vulnerable cohort” concerning long-term persistence of symptoms, including severe asthenia. The tendency towards normalization of lymphocyte number can be considered as a protective factor for the formation of post-COVID syndrome, while the negative dynamics or its absence – as a risk factor for prolonged persistence of symptoms.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81545292","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":"Platelet and coagulation hemostasis status in patients with atrial fibrillation depending on warfarin dosing method","authors":"M. Kolesnyk, Yа. М. Mykhailovskyi","doi":"10.14739/2310-1210.2022.6.263895","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.6.263895","url":null,"abstract":"The aim. To evaluate indicators of induced platelet aggregation and D-dimer level in patients with atrial fibrillation (AF) depending on the method of warfarin (WF) dosing.\u0000Materials and methods. The study involved 110 patients with AF (mean age 68.72 ± 0.79; men – 57, women – 53). Patients with AF were divided into two groups: the main group – 50 patients with AF and genotype-guided dosing method, the control group – 60 patients with AF and traditional dosing method. CYP2C9, CYP4F2, VKORC1 genetic polymorphisms were determined using multiplex real time polymerase chain reaction, D-dimer concentration – by the method of solid-phase enzyme immunoassay; ADP- and epinephrine-induced aggregation indicators – by the method of G. Born.\u0000Results. The percentage (by 24 %), time (by 3 min 6 s) and rate in 30 s (by 19.5 %/min) of ADP-induced platelet aggregation were significantly lower in patients with AF and genotype-guided WF dosing method. D-dimer concentration in patients of the main and control groups did not differ significantly. However, significantly fewer patients with elevated D-dimer values were registered in the group with genotype-guided WF dosing method compared to the group with traditional dosing method: 0 (0.00 %) vs. 7 (11.67 %) at 500 ng FEU/ml cut-off (χ2 = 4.43, P < 0.05), 1 (2.00 %) vs. 9 (15.00 %) at 390 ng FEU/ml cut-off (χ2 = 4.16, P < 0.05), 0 (0.00 %) vs. 7 (11.67 %) at age-adjusted cut-off (χ2 = 4.43, P < 0.05).\u0000Conclusions. The obtained results may indicate a potentially lower risk of thrombotic events in patients with AF and genotype-guided WF dosing method compared to the group with traditional dosing method, which confirms the benefit of the widespread use of the pharmacogenetic testing in clinical practice.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78320700","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":"Modern aspects of treatment for patients with atrial fibrillation (a literature review)","authors":"O. Shershnyova, I. Stetsiuk, O. O. Lisova, T. О. Hawker","doi":"10.14739/2310-1210.2022.6.260847","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.6.260847","url":null,"abstract":"The aim of the work is to analyze and summarize the data of the scientific literature which highlight modern approaches to the management of patients with atrial fibrillation (AF).\u0000In the article, on the basis of the modern literature analysis, the basic therapeutic directions and methods of surgical correction of AF are analyzed. Emphasis is placed on the need to treat AF patients in accordance with the ABC strategy, which includes the prevention of thromboembolic complications (A), control of symptoms (B), as well as treatment of comorbidities and elimination of risk factors (C). The main risk factors for AF, its relationship with other cardiovascular events (including mortality, stroke rate and acute coronary syndrome) are analyzed, the main scales used to objectively assess the risks of AF are determined, and detailed analysis of different strategies for anticoagulant therapy is conducted. The main approaches to the control of symptoms by regulating the frequency of ventricular rhythm, restoration and maintenance of sinus rhythm with the use of cardioversion, the administration of antiarrhythmic peptide and catheter ablation are considered. In addition, attention is paid to the need to identify and treat comorbidities, cardiometabolic risk factors and lifestyle, which complement stroke prevention and reduce the severity of AF and symptoms.\u0000Conclusions. A large number of clinical studies is focused on AF, the main idea of which is the integrated management of AF to improve the prognosis and quality of patients’ life. According to current recommendations, treatment of a patient with AF should be consistent and in accordance with the ABC strategy. Taking into account etiological factors, cardiometabolic risk factors, lifestyle, comorbid conditions will allow physicians to timely individualize complex treatment of patients with AF.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82473388","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":"Association between morphological manifestations of inflammatory bowel disease and biochemical markers of inflammation","authors":"M. Stoikevych, Y. Haidar, D. Mylostуva, I. Klenina, O. Tatarchuk, V. A. Karachynova V. A.,","doi":"10.14739/2310-1210.2022.6.260285","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.6.260285","url":null,"abstract":"Aim. To determine morphological and morphometric changes in the structure of the mucous membrane of the large intestine and their relationship with the content of short-chain volatile fatty acids and fecal calprotectin in patients with inflammatory bowel disease.\u0000Materials and methods. We examined 68 patients with inflammatory bowel disease, including 30 women and 38 men aged 20–66 years, 55 patients were with ulcerative colitis and 13 patients – with Crohn’s disease. Histological examination focused on changes in the mucous membrane of the large intestine. Determination of short-chain volatile fatty acids in feces was performed using gas chromatography. Calprotectin content was measured in fecal samples by enzyme-linked immunosorbent assay.\u0000Results. Significant correlations were found between epithelial disruption and changes in crypt architecture, infiltration density, and histological activity. The higher degree of inflammation in patients with severe course was combined with a lower level of tissue nonspecific protection, which was detected by the number of goblet cells, eosinophilic and neutrophilic leukocytes. There was a decrease in the fecal concentration of butyric acid in patients with nonspecific ulcerative colitis and Crohn’s disease compared with controls, but a more significant decrease was observed in patients with severe nonspecific ulcerative colitis.\u0000The data have confirmed the association between inflammatory bowel disease and the content of short-chain volatile fatty acids, fecal calprotectin in coprofiltrate, which was evidenced by the presence of correlations between low content of short-chain volatile fatty acids and eosinophilic infiltration (r = -0.412; fecal calprotectin levels and disease severity (r = 0.589; P = 0.001), atrophy (r = 0.458; Р < 0.05), infiltration density (r = 0.434; Р < 0.05).\u0000Conclusions. All patients with inflammatory bowel disease are characterized by a specific histological picture, which reflected the different degrees of inflammation. Morphometric parameters more accurately show significant atrophic changes in the mucous membrane of the large intestine. The data have confirmed the association between inflammatory bowel disease and the content of short-chain volatile fatty acids and calprotectin in coprofiltrate.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90171223","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":"Lymphoproliferative disorder – Castleman’s disease with early childhood-onset in a child (a clinical case)","authors":"O. Mukvich, N. Vdovina, H. Klymniuk, L. Omelchenko, T. A. Hridina, N. B. Matsiuk","doi":"10.14739/2310-1210.2022.6.257594","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.6.257594","url":null,"abstract":"Castleman’s disease (angiofollicular lymphoma, giant lymph node hyperplasia, Castleman’s pseudotumor) is an understudied orphan lymphoproliferative disease with a long period of asymptomatic course and a high risk of malignancy, and variability of its clinical features can cause difficulties in diagnosis.\u0000The aim of the study. To acquaint clinicians and increase the effectiveness of early diagnosis and treatment of Castleman’s disease (CD) in children to prevent malignancy and improve prognosis.\u0000Results. The article presents a clinical case of CD in a 3.5-year-old boy with a long history of fever, stunted growth, sweating, arthralgia, anemia, high laboratory inflammatory factors, elevated IL-6. There was a complex diagnostic search except for infectious, immunodeficiency, autoimmune conditions. The diagnosis of hyaline-vascular type of CD was confirmed by immunohistochemical examination after lymph node excisional biopsy. Rapid positive dynamics was noted after radical removal of the lymph node conglomerate. At follow-up after 8 months, the patient met criteria for clinical and laboratory remission.\u0000Conclusions. Castleman’s disease should be included in the search algorithm for lymphoproliferative diseases. Determining the role of genetic mutations in interferon regulatory factor (IRF8) is of scientific interest to clarify the etiology of this disease.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77813032","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 of night eating syndrome and melatonin levels in the urine of adolescents","authors":"T. Sorokman, L. Khlunovska","doi":"10.14739/2310-1210.2022.6.259870","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.6.259870","url":null,"abstract":"Aim. The aim is to study the frequency of night eating syndrome (NES) and its correlation with melatonin levels in the daily urine of adolescents.\u0000Materials and methods. Primary screening of 486 adolescents (15–18 years) with complaints of eating disorders, overweight, obesity, which included a survey (test “Depressive Disorders in Adolescents”, Night Eating Questionnaire (NEQ), Dutch Eating Behaviour Questionnaire (DEBQ) and anthropometry (BMI) was conducted. In the second stage, a sample of 56 adolescents (11.5 %) who met the NES criteria of DSM-5 (main group) and 50 adolescents who did not have NES (comparison group) was formed. The urine concentration of 6-sulfatoxymelatonin (6-COMT) was determined by enzyme immunoassay (Buhlmann 6-Sulfatoxymelatonin ELISA Kit, Switzerland).\u0000Results. Deficit of body weight had 3 (8.8 %) of adolescent boys, 20 (58.8 %) were overweight, 1 (2.9 %) – obese and only 10 (29.4 %) had the average normative values of body weight; among female adolescents, 1 (4.5 %) – body weight deficit and obesity, 10 (45.5 %) – overweight and average normative indicators. According to the DEBQ, restrictive eating behaviors were identified in 15 (26.8 %) adolescents; in 30 (53.6 %) adolescents – emotional and in 11 (19.6 %) adolescents – external. The mean score of the NEQ was 28.4 ± 2.2 and positively correlated with BMI (r = +0.62, P < 0.05). Participants who exceeded the screening threshold for NES (n = 56, 11.5 %) had increased BMI (P < 0.01), likelihood of overweight/obesity (P = 0.001), consumption of sugary drinks (P < 0.001), daytime sleep less than twice a week (P < 0.01), shorter sleep duration (P < 0.01), high and moderate levels of depression, lower levels of melatonin, which were inversely correlated with the results of the NEQ (r = -0.68, P < 0.05).\u0000Conclusions. The prevalence of NES among teenagers was 11.5 %. Among the types of eating behavior, the most common was the emotional type (53.6 %). Adolescents with NES had a significantly higher total depression score (96.7 ± 8.06, P < 0.001) and a lower level of 6-COMT (22.89 ± 3.44, P < 0.001), which was inversely correlated with the degree of NES (r = -0.68, P < 0.05), BMI (r = -0.74; P < 0.01) and depression level (r = -0.65; P < 0.01).","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86434083","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":"Modern aspects of comorbidity of urological disease and metabolic syndrome","authors":"A. O. Hubar, A. I. Bilai, I. Bilai","doi":"10.14739/2310-1210.2022.6.266232","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.6.266232","url":null,"abstract":"Urinary stone disease (USD) is one of the most common urological diseases occurring mainly in people of working age. USD is associated with metabolic disorders, the causes of which include endogenous and exogenous factors. Metabolic syndrome (MS) is a “non-infectious epidemic” that manifests itself in diabetes, hypertension, atherosclerosis, and obesity. The bidirectionality of metabolic processes is an important factor of USD and MS.\u0000Aim. The paper aims at reviewing modern literary sources regarding the determination of pathogenetic links between the comorbidity of USD and MS.\u0000Results. Nephrolithiasis spreads and recurs simultaneously with obesity. A decrease in urine pH, which is the basis for the formation of urate stones, is associated with the presence of obesity, insulin resistance, and MS. Under such conditions, urine alkalinization is the main treatment for urolithiasis. The risk of stone formation increases when the body mass index is more than 30 kg/m2.\u0000Among patients with insulin resistance, nephrolithiasis is more severe, and kidney stones occur more often. The relationship between the hypertensive component of MS and USD has been established. Disorders of lipid metabolism have a negative prognosis, causing physicochemical aberrations in urine and the development of nephrolithiasis. Hyperuricemia is related to both the ability of insulin to reduce uric acid clearance in the proximal renal tubules and insulin resistance.\u0000The link between USD and chronic inflammation is based on an increase in the endogenous synthesis of oxalates from endogenous glycogenic amino acids, which leads to the development of hyperoxaluria in patients with MS. Clinical studies show the formation of kidney stones in conditions of oxidative stress, an association between stone formation and the development of MS, coronary heart disease, arterial hypertension, which is the result of common pathogenetic characteristics.\u0000Conclusions. The comorbidity of USD and MS is a systemic disorder. Kidney stone formation is associated with a decrease in urine pH against the background of MS. Hyperuricemia is comorbid with insulin resistance, dyslipoproteinemia, arterial hypertension, and abdominal obesity. Systemic chronic inflammation, comorbid with obesity and USD, based on an increase in the endogenous synthesis of oxalates from endogenous glycogenic amino acids. Oxidative stress has a common pathogenetic link between stone formation and insulin resistance, atherosclerosis, hypertension, and obesity.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80429630","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":"A method for the biological age of the heart determination","authors":"L. Bodretska, I. Shapovalenko, A. Pisaruk, I. A. Antoniuk-Shchehlova, O. Bondarenko, S. Naskalova, V. Shatylo","doi":"10.14739/2310-1210.2022.6.261227","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.6.261227","url":null,"abstract":"Determination of the human heart biological age (BA) is relevant for timely stratification of the risk of developing diseases, prevention, control of individual aging rate and geroprotective therapy.\u0000Aim. To study age-related changes in echocardiographic examination of the heart and to develop a formula for estimating the BA of the human heart.\u0000Materials and methods. Echocardiographic examinations of the heart were performed in 188 practically healthy people aged 30 to 79 years (73 men and 115 women), who signed an informed consent and had no clinically significant diseases in the anamnesis or at the moment. The examined were divided into age groups: I (n = 25) – 30–39 years, II (n = 40) – 40–49 years, III (n = 38) – 50–59 years, IV (n = 46) – 60–69 years, V (n = 39) – 70–79 years old. Echocardiography with Doppler in continuous-wave, pulse modes and colour mapping of flow and tissue was performed on a device Xario SSA-660A (Toshiba, Japan), sensor – PST-30BT 3.0 MHz. The state of systolic and diastolic function of the ventricles of the heart was assessed, myocardial stiffness indicators were calculated. To obtain BA formula, the calculation of the multiple linear regression equation was used based on significant features.\u0000Results. Significant increase in atrial size with age, development of diastolic dysfunction, increase in left and right ventricular myocardial infarction were found. Based on the data of the study by the method of step-by-step multiple linear regression, a formula for estimating the biological age of the human heart was obtained. The multiple correlation coefficient was a fairly high value of R = 0.847, the adjusted coefficient of determination R2 = 0.701 (F = 43.496, P ˂ 0.00001). The mean absolute error of age calculation (M ± σ) was 5.55 ± 4.24 years. The proposed formula for determining the biological age of the heart can be used for early diagnosis of accelerated aging.\u0000Conclusions. An increase in the size of the atria, the development of concentric hypertrophy of the left atrium and diastolic dysfunction, and an increase in the myocardial stiffness of the left and right ventricles of the heart, which occur with age in practically healthy people, were revealed. A formula for determining the BA of the heart with good model quality was developed using the multiple linear regression method taking into account age-related changes in the echocardiographic parameters.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78710010","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 laparoscopic modified antireflux monoanastomotic gastric bypass in the treatment of morbid obesity","authors":"A. Klymenko, M. Nikolaiev","doi":"10.14739/2310-1210.2022.6.263405","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.6.263405","url":null,"abstract":"Aim. Improving the results of surgical treatment for patients with morbid obesity by evaluating the effectiveness and comparing the results of bariatric operations, namely laparoscopic modified monoanastomotic gastric bypass (LMMGB) and laparoscopic standard Roux-en-Y.Materials and methods. The work analyzed the results of treatment of 41 patients with morbid obesity. All patients were divided into two groups. LMMGB surgery was performed for 30 patients (the main group). The control group consisted of 11 patients after the standard technique of laparoscopic standard Roux-en-Y. Inclusion criteria were: persons of both sexes aged 18–60 years with morbid obesity and body mass index of 40 kg/m2 or more, as well as 35 kg/m2 or more in the presence of comorbid diseases (type 2 diabetes, hypertension, dyslipidemia, sleep apnea syndrome). Body weight of the patients ranged from 83 kg to 173 kg. The average body mass index was 42.5 kg/m2 in the main group before the operation. Violation of carbohydrate metabolism, which is included in the criteria of metabolic syndrome, was detected in 28 (93.33 %) of 30 studied patients of the main group and in 10 (90.90 %) of 11 studied patients of the control group. Comorbid pathology was found in 76.67 % of the main group and 72.72 % of the control group.Statistical processing was carried out via the Statistica 13.0 software package using parametric and non-parametric statistical methods.Results. There were no deaths, anastomosis failures, conversions, and intraoperative complications. The duration of LMMGB operation ranged from 120 to 290 minutes. The postoperative period was 5 days in the main group and 7 days in the control group, that is, a statistically significant reduction in the postoperative period duration was observed. In both groups, a decrease in body weight ranged from 12 kg to 81 kg within 6 months. In the main group, the median weight loss was 26.0 kg after 6 months and 38.5 kg after 12 months. BMI was 31.25 kg/m2 after 6 months, 26.88 kg/m2 after 12 months. In the control group, this indicator was 28.0 kg after 6 months and 42.0 kg after 12 months. Median BMI after 6 months – 31.64 kg/m2, after 12 months – 26.03 kg/m2, respectively. After the operation, there was a tendency towards an increase in all indicators of quality of life, both in the group of patients who underwent gastric bypass according to the classic Roux technique and in the group of patients after LMMGB. Clinical manifestations of the enterogastric biliary reflex were detected in both groups, in addition, clinical manifestations of the corresponding symptoms were noted by patients of both groups. No statistically significant difference was found in these parameters.Conclusions. Monoanastomotic gastric bypass in the modification of the clinic has the same positive properties as the standard Roux-en-Y technique, allowing to avoid the risks associated with possible pathological reflux of bile into the esophagus. Patients who have undergone","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90574459","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":"A clinical case of gunshot shrapnel penetrating wound of the chest with injury to the inferior vena cava with migration of a foreign body along the blood stream","authors":"V. I. Tsumbaliuk, I. Lurin, V. Makarov, V. Nehoduiko, O. Buchnieva, S. Tertyshnyi, Y. Bunin","doi":"10.14739/2310-1210.2022.6.266619","DOIUrl":"https://doi.org/10.14739/2310-1210.2022.6.266619","url":null,"abstract":"Damage to the major vessels in a retroperitoneal trauma belongs to the category of the most difficult, including damage to the inferior vena cava.\u0000The aim of the work is to demonstrate the features of clinical manifestations and tactical solutions of a gunshot fragment blind wound of the inferior vena cava with the migration of a foreign body along the blood stream.\u0000Materials and methods. A case of a gunshot fragment wound of the inferior vena cava with migration of the foreign body along the blood stream was studied. An injured person underwent sCT with and without contrast, FAST protocol, general blood test, biochemical blood test, CBV was determined using the formula of Moore, hourly diuresis was measured.\u0000Results. The patient was operated on for vital signs, the condition of the injured person was stabilized. During the revision of the abdominal cavity and paranephric tissue, no foreign body was identified. In the immediate postoperative period, the injured person underwent chest and abdominal CT, according to the data of that, a metal fragment was identified, which migrated along the inferior vena cava to the point of connection with the right atrium.\u0000The injured man was operated on at another specialized facility, where the foreign body was removed using a surgical magnetic tool.\u0000Conclusions. Fire damage to the inferior vena cava is classically accompanied by a severe general condition, massive blood loss, which requires urgent surgical interventions. Multi-component preoperative preparation, a clearly established diagnostic plan, a multidisciplinary approach based on the example of our clinical case allow saving life even in the most complex cases.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91119392","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}