ASTRAKHAN MEDICAL JOURNAL最新文献

{"title":"Gastric resection in emergency surgery","authors":"K. N. Gadzhiev, R. D. Mustafin, S. V. Antonyan, Yu. R. Molchanova, I. Malafeev, А. A. Antonyan","doi":"10.17021/1992-6499-2023-4-19-24","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-19-24","url":null,"abstract":"The success of the therapeutic treatment of gastric and duodenal ulcers has also changed the attitude of surgeons to the complications of peptic ulcer. Currently, the main aim of the surgeon is to eliminate the life-threatening consequences of perforation or bleeding. In addition, methods of intraluminal endoscopy continue to develop vigorously, in some cases competing with both open and laparoscopic surgeries for perforated ulcers, and endoscopic and endovascular hemostasis is increasingly used for ulcer bleeding.Purpose. To analyze the immediate and long-term results of surgical treatment of complicated gastric and duodenal ulcers and to evaluate the place of gastric resection in emergency surgery.Results. The paper analyzes the results of resection and organ-preserving gastric surgeries in perforated and bleeding ulcers using modern instruments that improve the results of the operation. As a reserve for improving the results of this intervention, one should consider performing optimal mobilization and a full revision of the ulcer defect zone, and, of course, involving a more experienced surgeon.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139160086","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":"Erythrocyte antigen kel1 in a new form of disease history","authors":"D. S. Pokhabov, A. Y. Fomina, E. B. Shestakov, E. B. Zhiburt","doi":"10.17021/1992-6499-2023-4-6-10","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-6-10","url":null,"abstract":"The accumulated scientific data on the clinical significance of phenotyping antigens of the Kell blood group system were studied. The Elibrary and Pubmed libraries were searched for articles using the keywords “Kell” and “transfusion”, and the validity of the requirement to determine the antigen of the Kell blood group system by current regulations was assessed.The purpose of the determination of the K antigen (KEL1) is practically not very clear. Theoretically, in a K-positive patient, zygosity should be determined by determining the k antigen (KEL2). With the KK phenotype, there is a risk of alloimmunization with the k antigen. However, it is extremely difficult to find a KK-positive donor compatible with ABO and RhD phenotypes. In fact, the risk of alloimmunization with the KEL2 antigen of a KK-positive recipient is considered acceptable and individual donor selection can be made for recipients of multiple transfusions or alloimmunized individuals.In the Elibrary library, 62 publications were found for the term “Kell”. None of them described a patient with the KK phenotype, let alone alloimmunization with the k antigen.Anti-k is rare, even in large laboratories 1 case is detected within several years of observation. The last transfusion hemolytic reaction caused by immunization to KEL2 was described in 1969.Conclusion. Russian regulations require the transfusion of RBCs that are compatible for the KEL1 antigen, but there is no definition of such “compatibility”. World and domestic historical experience testify to the possibility of transfusion to K-positive recipients, both K-positive and K-negative erythrocytes. If there are no K-positive donor erythrocytes in the hospital, the mandatory determination of the KEL1 antigen in potential recipients of donor blood can be excluded.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139160488","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":"Neural network technologies in prediction the effectiveness of treatment of patients with pulmonary tuberculosis","authors":"M. A. Alymenko, R. S. Valiev, N. R. Valiev, V. M. Kolomiets, S. N. Volkova, А. V. Polonikov, G. S. Mal, I. N. Tragira, V. A. Ragulina, E. V. Popova, E. P. Pavlenko, N. P. Balobanova, А. V. Batishchev","doi":"10.17021/1992-6499-2023-4-11-18","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-11-18","url":null,"abstract":"The study used predicting the effectiveness of treatment of patients with pulmonary tuberculosis using neural network technologies. The most optimal neural network model was obtained, which allows predicting the effectiveness of treatment with a forecast accuracy of at least 78.4%. As a result of constructing a neural network model, the most significant «input» parameters of the neural network were identified: the presence of hepatotoxic reactions, the level of IL-1ß, IL-6, IL-4, IL-10, IFN-γ, C-reactive protein before the start of the intensive phase of chemotherapy, the presence of antibiotic resistance, the presence of mycobacterium tuberculosis before the appointment of a specific chemotherapy by seeding, the volume of lung tissue damage, the chemotherapy regimen, the clinical form of pulmonary tuberculosis, as well as the genotype of ЕЕ gene GSTT1.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139160937","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":"Clinical significance of micronutrient status and vaginal microbiocenosis in pregnant women and correction of indentified disorders","authors":"Y. V. Kukharchyk, L. Gutikova","doi":"10.17021/1992-6499-2023-3-81-87","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-3-81-87","url":null,"abstract":"Objective: to conduct a clinical analysis and evaluate the significance of micronutrient status and vaginal microbiocenosis in pregnant women and develop a method for correcting the identified disorders based on the use of Bellakt Mama+ powdered milk product.   Materials and methods. We conducted a prospective study on the basis of the professorial advisory center of the EE “Grodno State Medical University”. In the course of the work, we examined 110 pregnant women, 55 of whom took Bellakt MAMA + dry milk product for 3 months, and the second half were observed only according to the clinical protocol. The assessment was made: anamnestic - assessment of the anamnesis of life and disease; generally accepted clinical, laboratory and instrumental (ultrasound examination of the pelvic organs) research methods. Performed blood sampling from the cubital vein in the morning on an empty stomach with the determination of the levels of ferritin, calcium i, iron, total vitamin D, folic acid, osteocalcin. An assessment of the biocoenosis of the urogenital tract was carried out “Femoflor Screen”; statistical processing of the results was carried out.   Results. We found that in patients who took a dry dairy product of Belarusian production, a persistent positive trend in the increase in the level of folic acid (p = 0,0049), total vitamin D (p = 0,0041), serum iron (p = 0,0041) was established, ferritin (p = 0,0040), as well as improvement of the vaginal biocoenosis (p = 0,0040). There were no statistically significant differences in the levels of ionized calcium and osteocalcin. It should be noted that the patients of the main group had no complaints of discomfort in large joints, bones and cramps in the calf muscles, in contrast to the women of the control group.   Conclusion. The above results confirm the need to control and correct micronutrient deficiency and vaginal dysbiosis in women at the stage of preconception preparation and in the first trimester of pregnancy.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139314529","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 technologies in treatment of pilonidal sinus","authors":"V. S. Groshilin, E. I. Kharabet, A. A. Pogosyan, V. D. Kuznetsov, O. A. Dubinskiy","doi":"10.17021/1992-6499-2023-3-67-74","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-3-67-74","url":null,"abstract":"Objective. Improvement of treatment results and reduction of the number of relapses in patients with pilonidal disease, by developing and substantiating a two-stage treatment method (with the use of laser treatment and subsequent radical surgical intervention).   Materials and Methods. A prospective analysis of the treatment results of 76 patients at the clinical sites of the Rostov State Medical University was carried out. The patients were divided into three clinical observation groups: In Group I (the main group, 26 patients), two-stage treatment was carried out according to the original technique (patent № 2770283). In Group II (the first control group, 28 observations), we used the \"сleft lift\" procedure according to the Bascom authentic method Bascom II method modified by Karydakis). In Group III (the second control group, 22 observations), the pilonidal sinus was dissected with the traditional technique of plastic surgery of the sacrococcygeal region with \"deaf\" sutures along the gluteal cleft.   Results. Analysis of the results showed that the postoperative period was smoother in Group I patients due to the smaller size of the surgical defect and the radical surgical stage in the absence of local inflammatory tissue reaction. There were no significant infiltrative-inflammatory complications in the patients operated on according to the original two-stage method. There were no recurrences during the one-year outpatient follow-up period. According to the VAS score, postoperative pain syndrome was significantly lower in Group I patients. The duration of hospitalization and period of disability were reduced in the patients of the main group in comparison with the same parameters in the control groups. The indicated pharmaco-economic effect in comparison with the traditional methods of surgical treatment was obtained due to early healing of the operative wounds with a smaller inflammatory reaction of the soft tissues and a reduced risk of suppurative complications.   Conclusion. The developed method of two-stage surgical treatment of pilonidal sinus helps to increase the effectiveness of radical treatment, reduce the number of relapses and complications, and reduce the duration of patients' disability. The described efficacy of the technology is achieved with early healing and stable qualitative aesthetic result.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139314554","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":"Evaluation of the effect of extrasystolic arrhythmia in pregnant women on fetal condition","authors":"O. P. Vinogradova, F. K. Rakhmatullov, M. Ostanin, R. Rakhmatullov","doi":"10.17021/1992-6499-2023-3-56-66","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-3-56-66","url":null,"abstract":"Relevance much attention is paid to the problem of the effect of extrasystolic arrhythmia in pregnant women on the condition of the fetus.   The aim of the study is to study the effect of extrasystolic arrhythmia in pregnant women on the condition of the fetus by cardiotocography.   Material and methods. 32 pregnant women with extrasystole (group 1) and 30 without arrhythmia (group 2) were examined in the 3rd trimester from the 32nd week of pregnancy. All pregnant women of both groups underwent daily registration of electrocardiography (ECG), ultrasound examination of the heart, fetal cardiotocography (CTG of the fetus), determination of the level of human chorionic gonadotropin (hCG), prolactin and thyroid hormones.   Results. The correlation analysis revealed a close relationship between the number of fetal cardiotocography scores and the level of thyroid-stimulating hormone (TSH) (r = 0,917, p <0,01), free thyroxine (T4c) (r = -0,877, p < 0,01) and the number of extrasystoles (r = -0,872, p < 0,01) in pregnant women.   Conclusion. In pregnant women with and without extrasystole, there are differences between reproductive hormones and electrocardiography indicators within the reference values. It was found that in pregnant women with and without extrasystole, fetal cardiotocography indicators do not significantly differ. A quantitative threshold value of ventricular extrasystole was revealed to reduce the number of fetal cardiotocography scores in the third trimester from week32. The threshold value of extrasystole was 1500 per day, AUC (area under curve) – 0,792, sensitivity – 81,3 %, specificity – 100,0 %.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139314910","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":"Analysis of the outcomes of myocardial infarction against the background of chronic obstructive pulmonary disease among residents of the Astrakhan region","authors":"T. V. Prokof'eva, O. S. Polunina, E. Polunina, I. V. Sevost’yanova","doi":"10.17021/1992-6499-2023-3-95-102","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-3-95-102","url":null,"abstract":"Objective. To analyse the course of coronary heart disease within a year after the development of myocardial infarction in residents of Astrakhan region with chronic obstructive pulmonary disease.   Materials and Methods. We examined 325 patients with myocardial infarction, residents of Astrakhan region. 195 patients had heart attacks against the background of COPD and 130 patients without COPD. During 12-month follow-up 30 people dropped out - 19 in the group of patients with myocardial infarction against COPD, 11 in the group of patients with myocardial infarction without COPD. Correspondingly, by the end of the observation period the number of patients under observation was: 176 - in the group of patients with myocardial infarction against COPD, and 119 - in the group of patients with myocardial infarction without COPD.   Results. It was found that in patients with myocardial infarction against COPD the annual mortality from conditions associated with cardiovascular pathology was twice as frequent as in patients with MI without COPD. There was also a tendency to more frequent development of recurrent myocardial infarction. In the structure of mortality in patients with myocardial infarction against COPD and without COPD and there was a tendency to a more frequent occurrence of acute heart failure expressed stages (Killip III-IV) and decompensation of chronic heart failure as causes of mortality. The odds of developing a combined endpoint, including recurrent myocardial infarction, stroke and mortality from cardiac causes, among patients with myocardial infarction against COPD were 2.7 times higher compared to patients with myocardial infarction without COPD. The combined endpoint, which combines clinically significant events in patients with myocardial infarction, makes the existing differences in the outcomes of infarction in patients with and without COPD evident.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139314411","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 endoscopic vacuum therapy for esophageal rupture","authors":"D. A. Demal’dinov, R. D. Mustafin, A. D. Ganyushkin","doi":"10.17021/1992-6499-2023-3-115-119","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-3-115-119","url":null,"abstract":"The authors are demonstrating a positive outcome of treatment of a 52-year-old patient using endoscopic vacuum therapy for spontaneous rupture of the esophagus (Burhave syndrome). The patient was discharged after 15 days with epithelization of the defect. Thus, this method, in the form of a combination of use of a special polyurethane sponge and constant aspiration, prevented the development of complications and contributed to the reparation of esophageal rupture.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139314557","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 the nootropic effect of the extract of Scutellaria baicalensis Georgi in modeling anxiety and depressive disorders in rats during the development of a conditioned reflex of passive avoidance","authors":"V. Uranova, N. A. Lomteva, O. Bliznyak, M. Mazhitova, E. I. Kondratenko","doi":"10.17021/1992-6499-2023-3-103-114","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-3-103-114","url":null,"abstract":"Experimental study is devoted to the study of the nootropic effect of the extract Scutellaria baicalensis Georgi in normal conditions and in modelling anxiety-depressive disorders by creating \"social\" stress in rats during the development of a conditioned passive avoidance reflex.   Materials and methods. The study was made of the extract obtained by maceration of the underground part (rhizomes with roots) of the plant Scutellaria baicalensis Georgi. The experimental work involved the study of the behavioural characteristics of laboratory animals (non-linear rats) in the amount of 159 males aged 7-9 months, divided into groups in accordance with the stages of the study. The study of nootropic activity in the norm formed the basis of the first stage and included work with animals divided into 4 groups: receiving water for injection (intact); Scutellaria baicalensis Georgi extract, medicinal product «Tetramethyltetraazocycloocyandione»; medicinal product «Piracetam+Cinnarizine». The creation of conditions providing for paired sensory contact of individuals, contributing to the development of inter-male confrontations, was achieved by modelling “social” stress in groups identical to the normal state at the second stage of experimental work. The use of the standard setting of the passive avoidance conditioned reflex made it possible to analyse the cognitive functions of the animals.   Results. The nootropic effect of Scutellaria baicalensis Georgi extract has been proven. The decrease in the consequences of stress in the form of a deterioration in memorization and reproduction of a conditioned reflex of passive avoidance was shown when it was administered to laboratory animals. Extension of the latent period of entry into the dark chamber of the passive avoidance conditioned reflex test, an increase in the total time spent in the illuminated compartment, and a decrease in the percentage of animals that visited the dark \"aversive\" compartment under the influence of the extract were described.   Conclusion. The preservation of a memory trace in laboratory animals after the introduction of an extract made on the basis of Scutellaria baicalensis Georgi has been established. The presence of a complex of various groups of biologically active substances in the composition of the Scutellaria baicalensis Georgi determines this plant object as a source of obtaining new drugs recommended for use as nootropic drugs that reduce the reactions that develop during “social” stress.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139314801","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 the microbiota of the gastrointestinal tract in the pathogenesis of inflammatory bowel diseases","authors":"A. V. Zhestkov, Yu.A. Khalitova, Yu.V. Myakisheva","doi":"10.17021/1992-6499-2023-3-33-42","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-3-33-42","url":null,"abstract":"In recent years, with the rapid development of molecular biology, genomics, high-performance sequencing technology and bioinformatic analysis technology, there has been an active study of a previously overlooked “organ” – the intestinal microbiota (GM). It is known that the microbiota of the human gastrointestinal tract plays a key role in metabolic, physiological, immunological and digestive processes. Microbial composition and colonization, in turn, depend on factors such as the neonatal delivery method, breastfeeding, nutrition, antibiotic treatment and environmental exposure at an early age. Also, one of the factors influencing the maintenance of homeostasis is the relationship between bacterial species or communities of species inside and outside the microbiome. Dysbiosis is the key to understanding the etiology of various diseases. Although the pathogenesis of IBD has not been fully studied, in patients with this pathology, inflammation of the gastrointestinal tract is a common sign of intestinal dysbiosis. Currently, there is a lot of evidence that intestinal dysbiosis leads to a violation of immune tolerance, which can cause or complicate the course of IBD. Thus, research is needed to clarify the role of microbiota in the pathogenesis of diseases. Based on changes in the intestinal microbiota, new diagnostic tools and possible treatment methods can be developed.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139314679","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}