Ural Medical Journal最新文献

{"title":"Disruption of the dopaminergic system in the pathophysiology of diabetes mellitus","authors":"Y. Bykov, V. Baturin","doi":"10.52420/2071-5943-2023-22-4-119-127","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-119-127","url":null,"abstract":"Introduction. Diabetes mellitus (DM) is the most common endocrinopathy with a high incidence and a high number of complications.The aim of this work was to conduct an analytical literature review assessing the state of the problem of dopaminergic dysfunction in diabetes from a pathophysiological perspective.Materials and methods. Searching Cochrane Library, PubMed, eLibrary, Medscape databases and digital libraries using the search words: diabetes mellitus, dopamine, insulin, dopaminergic system, diabetic encephalopathy. A total of 66 sources were selected for the review.Results and discussion. Dopaminergic system dysfunction can be considered an important component of the pathophysiology of diabetes. Hyperactivation of dopamine (DA) production in the setting of diabetes inhibits insulin synthesis, resulting in hyperglycemia. On the other hand, hypoinsulinemia triggers activation of the dopaminergic system, forming a vicious circle. Increased DA production in diabetes plays an important role in the development of secondary central nervous system dysfunction, primarily through the development of cerebral insufficiency. Numerous preclinical studies confirm the dysfunction of the dopaminergic system (its activation) in diabetes. Clinical studies on this issue are scarce and require further investigation.Conclusion. Dysfunction of the dopaminergic system in diabetes is an important area of research into the pathophysiology of symptomatic neurological disorders in this disease. Type 1 and type 2 diabetes are pathogenetically different diseases, and therefore impaired DA production may be due to insulin deficiency in patients with type 1 diabetes, different timing of manifestation, with hyperinsulinemia and insulin resistance in type 2 diabetes. Finding reliable methods to diagnose dysfunction of the dopaminergic system may improve understanding of the ongoing pathological processes in the neuroendocrine system in diabetes, which is important in addressing their correction in addition to pathogenetic therapy.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122852181","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":"Stroke telemedicine: yesterday, today and tomorrow","authors":"Елена Васильевна Праздничкова","doi":"10.52420/2071-5943-2023-22-4-113-118","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-113-118","url":null,"abstract":"Introduction. Telemedicine, by fitting into the long chain of events of the patient’s fate, plays an integrative role, allowing all stages of stroke care to be monitored.The aim of the study was to analyse and systematise the scientific literature in the context of the development of telemedicine for stroke.Materials and methods. Narrative review is compiled from literature sources found in the scientific electronic library eLIBRARY.RU and the National Library of Medicine database (PubMed.gov) using the keywords “telemedicine”, “stroke”, “telestroke” for the years 1999 to 2022.Results and discussion. The emergence of thrombolytic therapy perceived as a risk treatment, the lack of specialists to provide round-the-clock care, the requirement of regulatory authorities to improve the quality of care and technological improvements in data transmission capacity served to develop stroke telemedicine in the first decade of the 21st century. In the second decade of the 21st century telestroke, which initially originated in North America and Western Europe, began to spread widely around the world. The pandemic of a new coronavirus infection at the turn of the third decade of the 21st century provided the greatest impetus for the development of telemedicine in general and was the third impetus for the development of stroke telemedicine. Stroke telemedicine is pushing the boundaries of clinical practice, making specialised care more accessible and less dependent on local manpower.Conclusion. Further evolution of telemedicine for stroke will proceed in three directions: (1) telemedicine for stroke will become routine clinical practice; (2) telemedicine for stroke will become more personalized; and (3) regional telestroke networks will be connected to national and international telestroke networks, and stroke telemedicine networks will develop.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131685993","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":"Combination of known methods of bone autoplasty in Hartofilakidis grade 2 dysplastic hip arthroplasty in a patient with severe associated pathology","authors":"В.Е. Назаров, Константин Владимирович Закревский, Левон Вагифович Согомонян, Россия Санкт-Петербург","doi":"10.52420/2071-5943-2023-22-4-85-91","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-85-91","url":null,"abstract":"Introduction. Hip dysplasia is a current problem that requires a special approach for surgical treatment. The Crowe and Hartofilakidis classifications, which include grade 3 and 4 dysplasia respectively, are widely used. There are various methods for increasing the surface of the acetabulum: osteoclase of the medial wall, grafting with volumetric bone grafts and impaction grafting with bone chips. There are no definite recommendations that prescribe the surgical technique in any given clinical and radiological case. Therefore, the choice of acetabular grafting is individual and variable for each patient with hip dysplasia.The aim of the work was to evaluate the treatment of patients with stage 3 coxarthrosis combined with Hartofilakidis dysplasia degree I−II after total hip replacement using bone autoplasty with crumb and/or bone graft volume from the resected femoral head, using the patient with haemophilia and concomitant pathology of the musculoskeletal system as an example.Materials and Methods. Patient with Hartofilakidis hip dysplasia grade II with a history of right hip arthroplasty, haemophilia, multiple soft tissue mobilisations associated with joint contractures of the upper and lower extremities. Harris Scale score − 19.Results. Endoprosthesis of the left hip joint with combined acetabular roof plasty with a femoral head graft and bone shavings was performed. Six months later, the patient had increased range of motion, improved the biological axis of the limb, and residual shortening − 1.4 cm (due to deforming knee arthrosis). The prosthesis is stable. The method of plastic grafting with a bone graft showed a 100 % survival rate of the endoprosthesis, a decrease in pain and an increase in the function of the joint.Discussion. In this study, patients were followed up for five years. In similar studies, the time range was 10 years, at which point the survival rate of the arthroplasty decreased. The present case showed a good result because of its complexity due to concomitant pathology. In order to draw accurate conclusions, more such surgeries and follow-ups over a period of 10 years should be performed.Conclusion. Bone grafting makes it possible to effectively replace acetabular defects without excessive medialisation and to improve the degree of prosthetic coverage while preserving the native bone mass.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125474184","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 non-invasive diagnosis of endometriosis","authors":"В. Кудрявцева, В. Геец, Я. А. Мангилева, А. В. Чижова, О. В. Пацюк, Россия Екатеринбург, Городская Клиническая Больница","doi":"10.52420/2071-5943-2023-22-4-140-147","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-140-147","url":null,"abstract":"Introduction. Endometriosis is a disease characterized by an overgrowth of morphologically and functionally endometrium-like tissue outside the uterine cavity. Early diagnosis of endometriosis is very difficult. The gold standard for diagnosis is the surgical method − laparoscopy, performed for infertility, pelvic pain or the presence of pelvic masses. However, this approach is currently being reconsidered, and the search for endometriosis markers for earlier diagnosis of this disease is relevant.The purpose of the literature review was to summarize the current data on promising noninvasive markers of endometriosis determined in various biological media.Materials and methods. Scientific literature was searched in PubMed, ResearchGate, and Elibrary databases for 2017−2022 using a combination of Russian and English keywords: endometriosis, endometrioma, endometriosis pathogenesis, peritoneal fluid, biomarkers, serum markers.Results. We evaluated more than 30 putative biomarkers in peritoneal fluid, serum, urine, and saliva, as well as their combinations in publications that met the selection criteria. Studies have evaluated the diagnostic value and efficacy of endometriosis biomarkers, but the results of these studies have sometimes been inconsistent. We were unable to identify a single biomarker or combination of biomarkers that was unequivocally clinically useful. The most significant changes in biochemical composition were observed in peritoneal fluid, but it requires invasive intervention to obtain it.Discussion. Saliva and urine studies have shown promising results in terms of diagnostic accuracy, but the evidence was of low quality for introduction into clinical guidelines. A number of serum biomarkers may be useful either for detecting endometriosis at early stages or for differentiating ovarian endometrioma from other benign ovarian masses, but the evidence for meaningful conclusions is insufficient. Conclusion None of the biomarkers have shown sufficient accuracy for clinical use outside of the research environment, yet research in this area remains promising.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129963915","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":"Methods for modellind and forecasting dynamics of infectious diseases","authors":"A. Kosova, V. Chalapa, O. Kovtun","doi":"10.52420/2071-5943-2023-22-4-102-112","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-102-112","url":null,"abstract":"Introduction. Despite dramatic progress in public health, infectious diseases are common issue leading to significant burden in terms of morbidity and mortality, and emergence and re-emergence of infections and its dynamic are often unpredictable. Infectious diseases modelling and forecasting is effective instrument for policy making in epidemiology.The aim of the review is to systematize current literature on modelling and forecasting in infectious disease epidemiology.Materials and methods Literature review in field of modelling and forecasting of infectious diseases without restrictions by publication date was conducted. Publication activity was estimated using text mining software.Results and discussion. The following most common classes of modelling methods were marked: regression models, time-series models, compartmental models, agent-based models and artificial neural networks. It was noted that a number of methods (regression analysis, time-series models and artificial neural networks) are relatively simple to implement, but a considerable volume of history data is required for teaching these models. Compartmental models are partially free from this restriction, and they can be rapidly developed for assessment of emerging and reemerging infections, but their implementation presents issues caused by host population heterogeneity. Agent-based models that present most complete descriptions of host population heterogeneity and social interactions within it are extremely complex from the technical point of view.Conclusion. Despite the presence of various mathematical algorithms for disease modelling, the demand for user-friendly statistical software for disease forecasting in field practice is persist.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123090903","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":"Glutathione peroxidase and superoxide dismutase as markers of brain dysfunction in adolescents with diabetic ketoacidosis","authors":"Yu. V. Bykov","doi":"10.52420/2071-5943-2023-22-4-77-84","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-77-84","url":null,"abstract":"Introduction. Diabetic ketoacidosis (DKA) is the most prevalent and severe acute complication of type 1 diabetes mellitus (DM) in children and adolescents. Oxidative stress (OS) is viewed on the one hand as a possible pathophysiological element in the development of this complication, and on the other, as an important factor that triggers the development of cerebral insufficiency in patients with type 1 DM.Aim: to study the content of antioxidant enzymes in adolescents with type 1 DM in the setting of DKA and determine the correlation between the concentration of glutathione peroxidase (GP) and superoxide dismutase (SOD) and brain dysfunction after the manifestation of DKA.Materials and methods. The study involved 52 adolescents (mean age − (16.7±1.25) years), of whom 26 were patients with type 1 DM complicated by DKA (study group; duration of disease − (6.5±0.46) years) and 26 were apparently healthy adolescents (control group). Cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA) test. Concentration of GP and SOD was assessed in serum samples by ELISA. Mann-Whitney test was used to assess differences between means, and Spearman’s coefficient was used to calculate correlations.Results. Assessment using the MoCA tool showed a statistically significant cognitive decline in adolescents who had an episode of DKA (p = 0.0001). Another statistically significant finding in DKA was the lower mean levels of both GP (p = 0.0031) and SOD (p = 0.0173). Negative correlation was discovered between values obtained in the MoCA test and duration of disease and number of hospital admissions with DKA, and between GP levels and number of admissions with DKA, as reflected in patient history. Positive correlation was discovered between GP and SOD levels and values obtained in the MoCA test.Discussion. Patients were found to have decreased antioxidant defense, along with brain dysfunction, after the manifestation of DKA. DKAassociated impairment of antioxidant defense is one of the pathophysiological mechanisms underpinning the development of cognitive dysfunction in adolescents with type 1 DM. Conclusion GP and SOD can be viewed as markers of DKA-associated brain dysfunction in patients with type 1 DM.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"17 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123647279","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":"Peculiarities of paravulvar microcirculation in skin and muscle in blast wound in variants of early local injection of reparative active agent","authors":"I. A. Sperling, A. S. Kourov, A. V. Shulepov, N. V. Sperling, E. Zinoviev, M. V. Bazhenov, S. O. Rostovtsev, O. Y. Kuzmina","doi":"10.52420/2071-5943-2023-22-4-44-60","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-44-60","url":null,"abstract":"Introduction. A promising method of correcting microcirculatory disorders in the area of soft tissue injury is the use of agents with antihypoxant action, which include deproteinized calf-blood hemoderivate.The aim of the work was to reveal the peculiarities of subcutaneous and intramuscular local injection of deproteinized calfblood hemoderivate on the changes of microcirculation in the skin and muscles in the experimental blast wound area.Materials and methods. The experiments were performed on 90 male Wistar rats weighing (320±20) g in compliance with international rules of work with laboratory animals. Modeling of an explosive wound of the soft tissues of the femur with mild degree of blood loss was carried out according to the original author’s method (Patent RU No. 2741238 dated 22.01.2021). After primary surgical treatment was performed paravulnarly, deproteinized calf-blood hemoderivate was injected intramuscularly, intramuscularly and subcutaneously (Actovegin drug) once in six points with an insulin syringe. Microcirculation in the skin and muscles of the injured area was assessed by laser Doppler flowmetry using the device LAKK-M (Russia). To determine the normal values of microcirculation, data obtained from healthy animals were used.Results. Local intramuscular injection into the paravular area resulted in an increase of the constant perfusion component (M) by 24.1−35.9 % (p < 0.05) and by 18.0−56.4 % (p < 0.05) in the skin and muscles during all periods of observation, an increase of the variable perfusion component (σ) in the skin by 31.4−38.0 % (p < 0.05) during 28 days and in muscles by 8.8−58.7 % (p < 0.05) during the first 14 days only, increase of Kv ratio in skin by 12.4 % (p = 0.01) early after injury (7 days) and decrease in muscles by 18.3−20.8% (p < 0.05) at 14−28 days. Local combined administration (intramuscularly and subcutaneously) of the drug around the wound promoted the increase of the constant perfusion component (M) in the skin by 23.8 % (p = 0.005) and 6.9 % (p = 0.01) at the 7th and 28th days of observation, increase of σ index in skin by 14.2−45.1 % (p < 0.007) on the 7−14 days and its decrease in muscles by 15.7 % (p = 0.009) by the end of the 7th day of observation in comparison with animals after only intramuscular injection only. Also, the coefficient of variation (Kv) with the combined route of injection was increased in the skin by 8.8−23.8 % (p < 0.009) in the first 14 days and decreased in the muscles by 15.7 % (p = 0.008) in the early period after injury (7 days) relative to its values in animals with intramuscular injection.Discussion. The results of the study allow noting the stimulating effect of deproteinized calf-blood hemoderivate on neovasculogenesis in the damaged tissues, which can be judged by the increase in the constant perfusion component (M). In addition, we can conclude that the direct endothelium-protective effect of the drug consists in the modulation of microcirculatory flow, which c","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130716321","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":"Epidemiological analysis of the incidence of urolithiasis among the adult population of the Republic of Tatarstan in 2012−2021","authors":"Алексей Шулаев, Камиль Ильмирович Гайнетдинов","doi":"10.52420/2071-5943-2023-22-4-27-35","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-27-35","url":null,"abstract":"Introduction. Urolithiasis is one of the leading urological diseases in terms of prevalence and is among the top three in terms of the frequency of emergency hospital admissions to the urological hospital. The Republic of Tatarstan is endemic for the prevalence of urolithiasis. In this connection, it is important to study the trends of urolithiasis morbidity, which will allow further development of special preventive measures that will help to reduce the cases of recurrence of this pathology.The aim of this work was to evaluate the dynamics of urolithiasis morbidity in the Republic of Tatarstan and to identify the territories endemic for this pathology.Materials and methods. The material for the study was statistical data on the number of detected cases of urolithiasis in 2012−2021, provided by the Republican Medical Information Analytical Center of the Republic of Tatarstan.Results. A decrease in the prevalence and primary incidence of urolithiasis in the Republic of Tatarstan has been revealed; a significant variability of these indicators in individual municipalities has been noted. Discussion Over the past decade, the Russian Federation has seen a steady increase in the prevalence of urolithiasis. To reduce the prevalence and primary morbidity in municipalities with the highest rates, a comprehensive approach is required, including correction of territorial features of environmental exposure, alimentary, metabolic factors, adequate prophylaxis and metaphylaxis of urolithiasis.Conclusion. Analysis of urolithiasis morbidity over a ten-year period in the Republic of Tatarstan revealed a decrease in primary morbidity and prevalence rates; municipalities with consistently higher prevalence and/or primary morbidity rates were identified.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124464001","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":"Identification of risk zones according to the rate of total mortality and lifestyle factors at the regional level","authors":"Викторовна Бобкова, Н. В. Ефимова","doi":"10.52420/2071-5943-2023-22-4-36-43","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-36-43","url":null,"abstract":"Introduction. Population mortality depends on a complex of man-made, social, and natural behavioral factors. Clustering of territories within large constituent entities of the Russian Federation according to the value of population losses makes it possible to determine the most significant of the controllable factors.The aim of the work was to identify the risk zones according to the level of total mortality rates of the population of municipalities of the Irkutsk region and the relationship of the index with lifestyle factors.Materials and methods. The data on 42 objects, including municipalities and cities of the Irkutsk region, in the dynamics from 2011 to 2021 were analyzed using linear regression analysis. Cluster analysis was used to identify the risk territories: the hierarchical Wards method and k-means method. The relationships between the studied attributes were evaluated using Spearman rank correlation analysis.Results. The mortality rate decreased in 2011−2019 and increased in 2020−2021, averaging 13.34 CI(13.22−14.81) ‰. Five clusters differing in mortality rate were identified: minimum in V − 11.7 CI(10.72−12.68)‰; maximum in IV − 18.5CI(17.91−19.09)‰. In these clusters the prevalence of drug addiction, tobacco smoking and alcoholism are statistically significantly different. Based on this classification, risk areas (with the highest proportion of the population above working age and a high prevalence of household intoxication) and “borderline areas” (clusters with an increased mortality rate) have been identified. Discussion In order to identify risk areas and priority factors, there remains a need to improve the information base, increasing the use of different statistical methods to identify the key factors influencing overall mortality at the regional level.Conclusion. The mortality rate is associated not only with an ageing population, but also with the prevalence of habitual domestic intoxications and low physical activity of the adult population.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"263 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133570795","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":"Efficiency of two-stage extensive resection interventions in the surgical treatment of patients with disseminated echinococcosis of the liver","authors":"A. O. Krasnov, K. A. Krasnov, V. A. Peltz, O. A. Krasnov, V. Pavlenko","doi":"10.52420/2071-5943-2023-22-4-18-26","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-18-26","url":null,"abstract":"Introduction. Surgical operations are the main and effective option for treatment of hepatic echinococcosis. The problem of the choice of the type of surgical intervention in the advanced form of hepatic echinococcosis in the conditions of supposed deficiency of the organ functional reserves and development of post-resection hepatic insufficiency remains topical.The aim of the study was to present and analyze the effectiveness of two-stage extensive resection interventions in patients with advanced liver echinococcosis.Materials and methods. The paper presents the results of surgical treatment of 22 patients, 8 male (36.4%) and 14 female (63.6%) operated in the surgical department № 2 of Kuzbass Clinical Emergency Hospital named after M.A. Podgorbunskiy in Kemerovo. The criterion for inclusion in the study was to use of a two-stage extensive resection protocol.Results. The surgical staging methods used in our study to prevent post-resection liver failure showed efficacy in the following parameters: CT volumetry (p < 0.05), residual concentration of indocyanine green at 15 minutes (p < 0.05), statistical predictive model value (p < 0.05) and allowed to prepare patients for resection extensive intervention with a sufficient level of safety. Specific postoperative complications after extensive resection were identified in nine patients (40.1 %) and non-specific complication in three patients (13.6 %). Specific complications are mainly represented by manifestations of PPN manifistations − six cases (66.7 %), including 5 cases (83.3%) with “A” category according to ISGLS, with “B” category − one case (16.7 %). There were no fatalities or relapses in any of the study groups. Discussion When analysing the literature, there is a tendency to search for effective and safe methods of stopping the blood flow of the liver portal system in order to achieve vicarious hypertrophy of the remnant. A common technique for obtaining vicarious hypertrophy of the future liver remnant is radiopaque endosurgical embolization of the portal blood flow. However, there are technical limitations to the availability of the procedure. Laparoscopic clipping of the right portal vein branch is an alternative surgical option.Conclusion. Techniques to achieve vicarious hypertrophy of the liver remnant have proven effective and have prepared patients for extensive liver resections. Two-stage extensive resection interventions for advanced liver echinococcosis are effective and sufficiently safe when performed in specialised hepatology centres.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"141 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122856173","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}