Ural Medical Journal最新文献

{"title":"Principles of diagnosis and choice of treatment tactics for patients with pancreatic-pleural fistulas","authors":"И. Ремизов, В. Андреев, В. М. Дурлештер, С. А. Габриэль, О. В. Засядько, Краевая клиническая больница","doi":"10.52420/2071-5943-2023-22-4-11-17","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-11-17","url":null,"abstract":"Introduction. Pancreatic-pleural fistula is a rare complication of pancreatitis that has no pathognomonic symptoms and unified approaches to the choice of treatment tactics.The aim of the study was to formulate the principles of diagnosis and choice of treatment tactics in patients with pancreatic-pleural fistulas.Materials and methods. Five patients with pancreatic-pleural fistulas were treated from 2012 to 2022. All patients underwent standard clinical-laboratory and instrumental methods of investigation.Results. The diagnosis of pancreatic-pleural fistula was made at 18−65th day from the disease on the basic of amylase activity in the pleural effusion from 29462 to 51328 U/L. Surgical treatment consisted of pleural cavity and pancreatic pseudocyst drainage in two patients, in one patient we performed pleural cavity drainage and Virsung’s duct stenting, one patient underwent pancreatic duct stenting and repeated pleural punctures, one patient had papillosphincterotomy, video-thoracoscopy and pleural cavity drainage. Discussion Diagnosis of pancreatic-pleural fistulas is based on a set of criteria: history of acute attacks or exacerbation of chronic pancreatitis, presence of pancreatic pseudocyst, recurrent hydrothorax, brown pleural effusion, and high amylase activity in it. Surgical treatment tactics can be staged and characterized by the principle “from simple to complex”.Conclusion. The diagnostic algorithm of pancreatic-pleural fistulas is based on the data on acute pancreatitis, recurrent hydrothorax, hemorrhagic nature of the effusion and high level of amylase in it. The choice of surgical treatment tactics implies combination of pleural cavity drainage with Virsung’s duct stenting, as well as external drainage of pancreatic pseudocyst (if any).","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121483226","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":"Retrospective analysis of cases of transient global amnesia admitted to the hospital","authors":"A. Y. Ryabchenko, A. Dolgov","doi":"10.52420/2071-5943-2023-22-4-5-10","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-4-5-10","url":null,"abstract":"Introduction. Transient global amnesia (TGA) is a clinical syndrome, the main clinical manifestation of which is sudden development of anterograde and retrograde amnesia, lasting not more than 24 hours, without other general cerebral or focal neurological symptoms.The aim of the work was to reveal the peculiarities of clinical manifestations and data of additional methods of examination of patients with TGA syndrome referred to the primary vascular department with suspected acute cerebral circulation disorder (ACCD).Materials and methods. The study included 16 patients with transient global amnesia diagnosed according to the diagnostic criteria of Hodges and Warlow (1990). All patients underwent a detailed neurological and general medical examination. Electrocardiography, multispiral computer tomography of the head, echocardiography, ultrasound duplex scanning of the main arteries of the head and neck, laboratory examination (lipid spectrum) were performed. The Brief Mental Status Rating Scale was used to assess cognitive impairment.Results. The majority of patients had elevated blood pressure (BP). The leading trigger factor of transient global amnesia was stress. The duration of amnesia ranged from 1.5 to 5 hours. There was a significant impairment of short-term memory. On the first and second days of hospitalization, 50% of patients had normal cognitive functions on a brief mental status assessment scale, but by the 5th−7th day only 12.5 % of patients had abnormalities. Ultrasound markers of atherosclerosis in the form of intima-media complex thickening and dyslipidemia were found in 6 patients. Signs of left ventricular hypertrophy were found in the majority of patients. Discussion TGA is a relatively rare condition and an understudied syndrome. Due to its suddenness of clinical manifestation, TGA requires differential diagnostics with acute cerebral circulatory disorders, epilepsy, acute hypertensive encephalopathy and psychogenic amnesia.Conclusion. The clinical features of TGA identified in the patients were a history of arterial hypertension, elevated BP during an episode of TGA. The leading provoking factor was stress. TGA episode occurred predominantly in the first half of the day. The majority of patients had complaints of headache on admission. Cognitive disorders detected in patients on the first and second days of the disease quickly regressed to normal. Left ventricular hypertrophy was detected in most patients.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127229742","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 urokinase, T-cadherin and adiponetin in the development of endogenous depressive disorders","authors":"D. Sheleg, M. Karagyaur, A. Primak, E. A. Neyfeld","doi":"10.52420/2071-5943-2023-22-3-96-107","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-3-96-107","url":null,"abstract":"Introduction The prevalence of depression averages approximately 6 % of the total population. The heritability of depression ranges from 28 % to 44 %. Genetic predisposition may be due to polymorphisms of genes involved in the processes of functioning and morphogenesis of the brain: the balance of monoamines, the action of navigational molecules and their receptors.Purpose of the study To determine the role of genes that regulate the processes of nerve cell migration and directed growth of nerve fibers of navigation receptors (PLAUR and CDH13) or their ligands (PLAU, PLAT, ADIPOQ) in the development of endogenous depression and schizophrenia in the Russian population.Materials and methods At the first stage of the study, the scientific literature was searched in the MEDLINE database. The primary prevalence of genomic variants will be established using whole genome sequencing of 20 patients with severe forms of schizophrenia and endogenous depression. Further, at least 100 patients in each group and 100 healthy donors will take part in the study.Results and discussion The urokinase receptor (uPAR) is involved in neurogenesis by regulating the trajectory of axonal growth. The level of suPAR in blood plasma can act as a biomarker of mild inflammation underlying the etiology of depression. The level of suPAR in plasma can be considered a predictor of the effectiveness of combination therapy with antidepressants and anti-inflammatory drugs. Molecules of the cadherin superfamily are involved in the development of the nervous system, the transmission of intercellular signals, and the regulation of neuronal plasticity. Polymorphisms of the CDH7, CDH9, CDH13, CDH17 genes demonstrate a correlation with the presence of depression. Adiponectin is a hormone secreted by adipose tissue. One of the adiponectin receptors, AdipoR2, stimulates neuronal plasticity and inhibits inflammation and oxidative stress. Plasma concentrations of adiponectin are reduced in depressed patients.Conclusion The results accumulated by researchers testify in favor of the important role of uPAR and T-cadherin in the processes of brain development, and most importantly, in the pathogenesis of the development of endogenous depressions.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115069516","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":"Occupational health issues and respiratory toxicity of a complex of harmful factors in electrolytic and hydrometallurgical copper production","authors":"S. R. Guselnikov, O. Gogoleva, G. Lipatov, E. G. Plotko, V. I. Adrianovsky, A. A. Samylkin, E. E. Shmakova, Yu. N. Naritsyna, I. A. Ryzhkova, Yu.N. Nefedova","doi":"10.52420/2071-5943-2023-22-3-64-73","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-3-64-73","url":null,"abstract":"Introduction. In recent decades, there has been a decrease in occupational morbidity at enterprises producing rough and refined copper, in the structure of which, nevertheless, bronchopulmonary pathology retains a leading position.The aim is to study the occupational risk of developing respiratory pathology in workers engaged in obtaining cathode copper by electrolysis and electorowinning methods, based on the study of working conditions of workplaces and clinical observation.Materials and methods. The object of the study were: Uralelectromed, V. Pyshma (UEM); Uralhydromed, Polevskoy (RMK). The subject of the study were 100 employees of the electrolysis shop of UEM – the 1st observation group; 102 people of the auxiliary workshops of UEM – the 2nd observation group; 92 workers of the extraction and electorowinning department of UGM – the 3rd observation group.Results.  During electrolytic refining of copper, the leading harmful factors with respiratory toxicity are sulfuric acid aerosol, selenium dioxide, nickel, arsenic, and during electrovinig – sulfuric acid aerosol. Violations of ventilation function and pulmonary gas exchange were observed in 21.0 % of cases in persons of the 1st and in 15.7% of cases in patients of the 3rd observation group).Discussion. Changes in the function of external respiration (FVD) were established mainly by the obstructive type, namely, an increase in RV, FRC and RV/TLC and a decrease in FEV1, VC, FEV1/VC, FEV25-75 of mild and moderate severity were noted. The bronchodilation test revealed the reversibility of bronchial obstruction in both groups 1 and 3. Obstructive disorders and dynamic hyperventilation of the lungs in copper refining workers are probably a consequence of hyperreactivity of the bronchi in response to the irritating properties of sulfur-containing gases, arsenic and nickel compounds.Conclusion. The results of the study indicate respiratory toxicity of harmful factors in workers of electrolysis and electrovining, which corresponds to a high and average occupational risk of class 3.3 and class 3.2 assessment of working conditions and the results of mandatory periodic medical examinations.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121996919","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":"Germline mutations in the PALB2 and CHEK2 genes and hereditary cancer","authors":"M. A. Golotyuk, A. A. Berezhnoj, N. V. Kazanceva, A. Dorofeev, T. I. Borzunova","doi":"10.52420/2071-5943-2023-22-3-126-136","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-3-126-136","url":null,"abstract":"Introduction. At least 3% of all cancer cases are associated with hereditary changes in genes predisposing to malignant neoplasms. In addition to the widely known BRCA1,2 genes, other genes involved equally with BRCA1,2 in the DNA repair system and maintenance of genome integrity, such as PALB2, CHEK2, are being introduced into routine diagnosis. In this review we present current information from recent studies on the structure and function of PALB2 and CHEK2 genes, and the diagnosis of mutations in these genes, as well as their clinical significance.The purpose of this work was to update and systematize the data on PALB2 and CHEK2 genes in order to better understand their significance in carcinogenesis, associated risks of malignant neoplasms, prevention and treatment tactics for mutation carriers.Materials and methods. PubMed, Google Scholar, Cyberleninka databases were searched. The criteria for inclusion of articles were the novelty and relevance of the data, compliance to the topic of the review. Based on this, 79 literary sources were selected.Results and discussion. Mutations in the PALB2 gene are common in 0.5 to 2.1 % of cancer cases and are associated with an increased risk of breast cancer (52.8 % by age 80), as well as ovarian cancer (5 %), pancreatic cancer (2.8 %). The frequency of changes in the CHEK2 gene reaches 5 % and is associated with a risk of breast cancer (up to 40 % by age 80) and colorectal cancer. Numerous studies have shown that mutations in these genes are associated with prostate, lung, kidney, and melanoma cancers.Conclusion. A better understanding of the spectrum of genetic predisposition and identification of genespecific cancer risks could lead to improved screening, prevention, and therapeutic strategies for patients with hereditary cancer and their families.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123929685","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":"Assessment of the legal regulation of forensic medical bureau activities in the field of anti-epidemic measures","authors":"D. E. Vasiliev, M. Timerzyanov, Y. Valeeva, E. Kiyasova","doi":"10.52420/2071-5943-2023-22-3-118-125","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-3-118-125","url":null,"abstract":"Introduction. The staff of the Bureau of Forensic Medicine (BFM) experience a high microbial load in the performance of their professional duties, which poses a serious health hazard. Cases of infectious diseases continue to be recorded among the medical personnel of the BFM, which requires the prevention of infection during professional activities. The process of legal regulation of BFM activities in terms of compliance with sanitary and hygienic measures ensuring the safety of BFM employees from infectious contamination and improving the quality of expertise is becoming highly relevant.The purpose of the study is to propose measures to improve the regulation of relevant procedures based on the analysis of the legal regulation of BFM activities in matters of infectious safety.Materials and methods. We studied laws and bylaws at the federal and departmental levels. The regulatory framework was evaluated at the following conditional stages of forensic medical examination: processing of the sectional table; processing of instruments used for autopsy; personnel hand hygiene; current and general cleaning in the sectional rooms of the BFM.Results It was noted that there are no recommendations for disinfection after each dissection when processing the sectional table, the disagreements in the documents regulating the processing and disinfection of sectional instruments were revealed, the necessity of processing the instruments by mechanized method with the help of ultrasonic washers was shown. The points requiring attention with respect to the use of personal protective equipment, treatment of experts’ hands and other antiepidemic measures in the light of the new regulatory documents that have come into force are listed: Sanitary Rules and Regulations 3.3686-21 and Sanitary Rules 2.1.3678-20.Discussion The identified contradictions in the issues determining the actions of the expert at each of the stages indicate that the sanitary and hygienic measures are covered insufficiently and require more detailed elaboration.Conclusion Changes are required at the legislative, subordinate, and regulatory levels. Standard operating procedures must be implemented for BSMSE staff, which must be carried out in compliance with the requirements of the legislation regulating the activities of BFM, as well as precautions to ensure the infectious safety of employees.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129739162","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":"Difficulties of diagnosis and the need for a comprehensive approach to treatment of patients with X-ray non-contrast orbital foreign bodies","authors":"A. Kolesnikov, D. S. Pshennikov, I. Kirsanova, D. D. Kochetygova","doi":"10.52420/2071-5943-2023-22-3-88-95","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-3-88-95","url":null,"abstract":"Introduction. An orbital foreign body, especially of an organic nature, is often difficult to diagnose during the initial examination. A thorough history taking, clinical examination, and the use of additional imaging techniques are of great importance. Due to the risk of purulent-inflammatory complications, foreign bodies must be surgically removed.The aim of the work was to demonstrate the importance of timely diagnosis and complex approach to treatment of patients with X-ray non-contrast foreign bodies of the orbit using the example of clinical observation.Materials and methods. Patient R. came in with complaints of redness, pain, lacrimation and lack of vision in the left eye after falling and hitting the left side of his face on a metal corner. Left eye visual acuity = 1/∞PrLinc, IOP = T−3 (palpatory).Results. Control X-ray computed tomography (CT) of the orbits and paranasal sinuses (PNS) suspected the presence of a radiopaque foreign body. A rhinoendoscopic examination was performed by an otorhinolaryngologist and a fragment of a large wooden foreign body was found in the nasopharyngeal arch. Surgeons of the ophthalmologic and otorhinolaryngologic departments performed surgery: removal of the foreign body, endonasal endoscopic opening of the labyrinth on the left, endoscopic endonasal maxillary sinus maxillary sinus maxillotomy on the left, left microcoidectomy, resection of trauma-exposed tissue. During his stay in the 2nd Ophthalmologic Department of the Regional Clinical Hospital named after N.A. Semashko. N.A. Semashko Regional Clinical Hospital, the patient’s condition improved, infection was eliminated, prevention of possible complications was carried out. The patient was referred to the Pirogov National Medical-Surgical Center, where the following surgery was performed: microinvasive vitrectomy + FEC + PFOS + retinotomy + endotamponade with silicone oil 1300 of the left eye, and a consultation with a laser surgeon was recommended for laser iridectomy.Discussion The clinical case considers a comprehensive approach to the treatment of intraorbital foreign bodies, the participation of a multidisciplinary team of specialists, while the patient still has a long road to rehabilitation.Conclusion In orbital trauma with penetration of a foreign body, an accurate history, timely diagnosis, and rational surgical and conservative treatment are important. This will help to avoid serious complications and prevent visual and oculomotor disorders of the visual organ.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130291203","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":"Efficacy of a shorter chemotherapy regimen in a patient with drug-resistant tuberculosis with early surgical intervention","authors":"N. Chumovatov, O. Komissarova, N. Chernyh, A. Ergeshov","doi":"10.52420/2071-5943-2023-22-3-74-80","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-3-74-80","url":null,"abstract":"Introduction. Treatment for multidrug-resistant tuberculosis lasts 18 to 24 months, so there is a high rate of therapy interruptions, including patient-initiated interruptions. In recent years, the use of shorter regimens for the treatment of multidrug-resistant tuberculosis has been actively discussed around the world. The first use of shorter chemotherapy regimens was conducted in three regions of the Russian Federation in 2019. However, the prevalence of the use of shorter chemotherapy regimens in our country remains low.The purpose of the study was to demonstrate the high efficacy of a shortened chemotherapy regimen with surgical intervention.Materials and methods. In the conditions of the Central Research Institute of Tuberculosis, the patient underwent a comprehensive examination, including mandatory, additional and optional methods of investigation. Based on the findings of the comprehensive examination and established broad drug resistance of Mycobacterium tuberculosis, a shorter course of chemotherapy was prescribed and surgical treatment was performed after 2 months of therapy.Results and Discussion It was decided to carry out anti-tuberculosis therapy according to a shortened scheme in the amounts: Linezolid, Bedaquiline, Cycloserine, Levofloxacin, Pyrazinamide. Taking into account positive radiological dynamics after two months of treatment and absence of contraindications, early surgery intervention was performed. At the end of a nine-month course of chemotherapy the patient had a stable radiological picture, “fresh” focal and infiltrative changes in the lungs were not detected. Early surgical treatment with a shorter chemotherapy regimen may become a highly effective method in the cure of drug-resistant tuberculosis in the Russian Federation.Conclusion. A shorter chemotherapy regimen with optimal timing of surgical intervention is highly effective and safe to use.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115090781","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 case of observing cardiac twins","authors":"A. V. Yakimova, N. M. Milyaeva, A. A. Pinchuk, N. S. Datsenko","doi":"10.52420/2071-5943-2023-22-3-81-87","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-3-81-87","url":null,"abstract":"Introduction. Reverse twin arterial perfusions, also known as cardiac malformation, is a uniquely rare complication of monochorionic multiple pregnancy due to the presence of a large arterio-arterial anastomosis, the formation of a rudimentary heart or its absence in one of the fetuses. The heart of a morphologically normal twin (fetus-pump, fetus-donor) provides blood circulation for both fetuses.The aim of the work was to determine a possible way to reduce perinatal mortality using the clinical example of monochorionic multiple pregnancy with the presence of cardiac twins.Materials and methods. Materials for clinical case analysis were the exchangenotification card of the pregnant and parenting woman, labor history, the results of functional and laboratory tests. Methods: analysis of anamnesis, results of functional and laboratory tests, peculiarities of pregnancy and delivery.Results. The analysis successfully demonstrates the possibility of improving perinatal outcomes in monochorionic twins complicated by the presence of acardia syndrome in the case of timely diagnosis of the complication, close dynamic monitoring of pregnancy and timely delivery in the case of functionally confirmed deterioration of the living fetus.Discussion. Monochorial type of placentation is recognized as a high risk factor for adverse perinatal outcomes (fetal-fetal hemotransfusion syndrome, the formation of discordant growth andfetal growth retardation, cardiac twins, increase frequency of preterm birth, perinatal morbidity and death). The presence of cardiac twins is the highest risk factor for antenatal death of a second fetus in the absence of timely surgical treatment and delivery. The presented clinical case demonstrates the possibility of improving perinatal outcomes by prolonging a multiple pregnancy complicated by cardiac malformation up to 33 weeks of gestation and delivery at decompensation of the placental complex.Conclusion. In the vector of reducing the incidence of perinatal mortality, individual management of pregnant women with monochorionic multiple pregnancy is necessary to enable timely diagnosis of its complicated course by cardiac malformation of one of the fetuses, dynamic functional examination of the placental complex, determination of indications for surgical correction and choice of term of delivery.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"335 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134158517","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":"Neurobiological factors of aggressive behavior in patients with multi-infarction dementia","authors":"I. Stepanova, G. Ivanova","doi":"10.52420/2071-5943-2023-22-3-28-36","DOIUrl":"https://doi.org/10.52420/2071-5943-2023-22-3-28-36","url":null,"abstract":"Introduction. In the modern literature, the problem of the influence of multifocal brain damage in vascular dementia on the development of aggressive behavior in patients is only partially covered.The purpose of this work is to study the influence of neurobiological factors (number, localization of lesions) on the development of aggressive behavior in multi-infarct dementia.Materials and methods. The study involved 98 subjects diagnosed in multi-infarct dementia (F 01.1), established according to the ICD-10 criteria (1992), in which 52 were men (53.1 %) and 46 women (46.9 %), aged 60 to 90 years, the average age was 74.5 [67; 81] years. Patients are divided into a main group – with aggressive behavior (n = 49), and a control group − without aggressive behavior (n = 49). The study used clinical-anamnestic, clinical-psychopathological, psychometric and neuroimaging methods.Results. The study showed that patients with aggressive behavior compared to patients without aggressive behavior have a greater number of lesions (p < 0.0001). The localization of which is statistically significantly more often determined in the left frontal lobe, subcortical nuclei on the left and in the left ventricular region (p = 0.0002, 0.0212, 0.0036), and patients without aggressive behavior often do not have frontal lobe lesions.Discussion. Patients who show aggression in general, or in isolation physical, verbal aggression, or irritability, have a statistically significantly greater number of lesions than patients without these symptoms (p < 0,0001). Each additional lesion increases the likelihood of developing aggression and its severity. In patients with irritability, lesions localized in the left frontal lobe and left ventricle.Conclusion The study suggests that the number of lesions from four or more, as well as their predominant localization in the left hemisphere of the brain, leads to the development of various types of aggressive behavior.","PeriodicalId":247511,"journal":{"name":"Ural Medical Journal","volume":"158 17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133306501","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}