Vestnik medicinskogo instituta "REAVIZ": reabilitaciâ, vrač i zdorovʹe最新文献

{"title":"Characteristics of lipid metabolism disorders in patients with coronavirus infection-COVID-19 with chronic hepatitis C","authors":"E. I. Temnik, D. Y. Konstantinov, L. L. Popova","doi":"10.20340/vmi-rvz.2023.5.clin.11","DOIUrl":"https://doi.org/10.20340/vmi-rvz.2023.5.clin.11","url":null,"abstract":"The aim of the study was to assess individual indicators of lipid metabolism in patients with novel coronavirus infection with chronic hepatitis C (CHC) depending on the severity of COVID-19 and liver fibrosis stage. Object and methods . A comparative analysis of the results of laboratory examination of patients of the following groups was carried out: group 1 (n = 147) – patients with COVID-19 and CHC, group 2 (n = 81) – patients with COVID-19, group 3 control (n = 94) patients with CHC without COVID-19. In turn, the patients of the first two groups were divided into subgroups according to the severity of the COVID-19: with moderate (A) and severe course (B). According to the liver fibrosis stage, patients with COVID-19 with CHC were divided into 3 subgroups: F1 (mild fibrosis), F2 (moderate fibrosis), F3 (severe fibrosis). In blood serum, lipid profile parameters (total cholesterol (TC), high-density lipoprotein cholesterol (CHDL), low-density lipoprotein cholesterol (CLDL), triglycerides (TG), apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B)) were evaluated. All parameters were assessed in the acute period, according to the severity of COVID-19 and the liver fibrosis stage. Results . In 100% of patients with COVID-19 and CHC, a decrease in Apo A1 and an increase in Apo B, the ratio of Apo B/Apo A1 were detected, regardless the severity of disease. In patients with severe COVID-19 with CHC, changes in the lipid spectrum were recorded: an increase in TG, Apo AI, Apo B, Apo B/Apo A1 ratio, and a decrease in CHDL, CLDL, Apo A1. In patients with COVID19 and severe liver fibrosis (CHC), a decrease in LDLC, Apo A1 and increase in CLDL, Apo B, ratio Apo B/Apo A1 was observed.","PeriodicalId":481396,"journal":{"name":"Vestnik medicinskogo instituta \"REAVIZ\": reabilitaciâ, vrač i zdorovʹe","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136376247","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":"Liver retransplantation in the modern concept of treatment of its terminal pathology (literature review)","authors":"A. R. Akhmedov, M. S. Novruzbekov, V. A. Gulyaev, O. D. Olisov, K. N. Lutsyk, K. M. Magomedov, B. I. Kazymov, K. F. Alekberov, E. Yu. Anosova, B. I. Yaremin","doi":"10.20340/vmi-rvz.2023.5.tx.1","DOIUrl":"https://doi.org/10.20340/vmi-rvz.2023.5.tx.1","url":null,"abstract":"The work is devoted to the analysis of modern literature data and approaches in performing repeated liver transplantation. The most frequent causes of liver graft loss are PNFT, HAT, recurrent initial disease and chronic rejection. The leading indication for retransplantation in children is HAT. The one-year survival rate after retransplantation is approximately 75%. Reducing the cost of organ retransplantation and the cost-effectiveness of the procedure are controversial issues. Mathematical modeling has identified several significant recipient and donor factors affecting the outcomes of retransplantation. Despite ethical and economic considerations, retransplantation is the only option for transplant patients whose grafts have failed to engraft. The decision to retransplant should be made with some caution, with full multi-type approach in large multidisciplinary transplant centers.","PeriodicalId":481396,"journal":{"name":"Vestnik medicinskogo instituta \"REAVIZ\": reabilitaciâ, vrač i zdorovʹe","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135252201","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":"Concept «grade-stage» in morphological diagnostics of chronic colitis in inflammatory bowel disease","authors":"A. S. Tertychnyy, Kh. M. Akhrieva, N. V. Pachuashvili, L. S. Urusova","doi":"10.20340/vmi-rvz.2023.5.morph.2","DOIUrl":"https://doi.org/10.20340/vmi-rvz.2023.5.morph.2","url":null,"abstract":"Purpose : to propose a new approach in the morphological diagnosis of colitis using the categories grade and stage to clarify and decipher the diagnosis of chronic colitis and improve the quality of biopsy diagnostics. Materials and methods . The study included 100 cases of inflammatory bowel disease (IBD) diagnosed between 2017 and 2021 (70 cases of ulcerative colitis and 30 cases of Crohn's disease). The age of the patients ranged from 19 to 53 years. In all cases, the diagnosis was established on the basis of a complex of clinical, laboratory and instrumental diagnostic methods. Multiple biopsies were obtained in all patients during colonoscopy. The processing of the biopsy material was carried out according to the generally accepted method. To evaluate plasma cells, an IHC study with antibodies to CD138 (syndecan-1) (Dako RTU) was additionally performed. Results . In the course of the study, a gradation of morphological criteria was carried out, which are decisive in the diagnosis of chronic colitis in patients with IBD. The concept of chronic colitis as a process characterized by the grade of severity and stage of chronic inflammation has been revised and re-formulated. Criteria of structural disorders (stage of colitis from 0 to 3) and criteria of severity of chronic inflammatory infiltrate (grade of colitis from 0 to 3) were identified and graded. Additionally, an attempt was made to objectify the selected criteria using an IHC study using antibodies to CD138 plasma cells (syndecan-1). Based on the material of colonobiopsies, the proposed degree-stage approach was tested in the group of colitis in patients with IBD, which showed the possibility of its practical application. Conclusion . The proposed concept will be able to improve the quality of biopsy diagnostics and avoid unjustified use of the term \"chronic colitis\" without further elaboration and, accordingly, its frequent unjustified use existing at the moment.","PeriodicalId":481396,"journal":{"name":"Vestnik medicinskogo instituta \"REAVIZ\": reabilitaciâ, vrač i zdorovʹe","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135547398","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":"Multiparametric ultrasound in thyroid nodules evaluation: risk-stratification (review of literature)","authors":"V. A. Solovov, O. N. Ablekova","doi":"10.20340/vmi-rvz.2023.5.clin.2","DOIUrl":"https://doi.org/10.20340/vmi-rvz.2023.5.clin.2","url":null,"abstract":"Ultrasound (US) is the first imaging modality for thyroid parenchyma evaluation. In the last decades, the role of ultrasound has been improved with the introduction of new US software, such as contrast-enhanced ultrasound and US-elastography. US-elastography is nowadays recognized as an essential part of the multiparametric ultrasound examination. More controversial is the role of contrast-enhanced ultrasound in thyroid evaluation, due to its high variability in sensitivity and specificity. We have therefore drawn up an updated representation of the current evidence in the literature for thyroid nodule multiparametric ultrasound evaluation with particular regard to US-elastography and contrast-enhanced ultrasound.","PeriodicalId":481396,"journal":{"name":"Vestnik medicinskogo instituta \"REAVIZ\": reabilitaciâ, vrač i zdorovʹe","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135353670","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":"Drug-induced arterial hypertension in a patient with ischemic stroke","authors":"G. R. Ramazanov, E. V. Shevchenko, R. Sh. Muslimov, I. S. Aliev","doi":"10.20340/vmi-rvz.2023.4.case.4","DOIUrl":"https://doi.org/10.20340/vmi-rvz.2023.4.case.4","url":null,"abstract":"Progressive ischemic stroke is the most frequent form of stroke with neurologic deterioration. The pathogenesis of progressive ischemic stroke is based on the expansion of the brain infarction zone and reduction of the \"penumbra\" zone in the area of focal ischemia. The leading role in maintaining the balance between irreversible and reversible ischemia belongs to cerebral collateral blood flow. Being a multifactorial phenomenon, collateral blood flow is caused by both morphological and functional characteristics of the collateral arterial channel and systemic factors, among which hemodynamics is of great importance. The tactic of purposeful increase in blood pressure to improve cerebral perfusion is called drug-induced arterial hypertension. A number of experimental studies have demonstrated the safety and efficacy of this method, but the small number and heterogeneity of data in the studies do not allow us to conduct a meta-analysis and form an optimal protocol for drug-induced arterial hypertension. In this article we want to describe the clinical observation of a patient with ischemic stroke on the background of critical stenosis of stroke-related internal carotid artery and atrial fibrillation, in the treatment of which we applied drug-induced arterial hypertension.","PeriodicalId":481396,"journal":{"name":"Vestnik medicinskogo instituta \"REAVIZ\": reabilitaciâ, vrač i zdorovʹe","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913767","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":"Amoebic liver abscess: description of the clinical case","authors":"B. I. Kazymov, P. O. Svishcheva, M. V. Olkhovskaya, L. V. Fedyanina, M. S. Maksimova","doi":"10.20340/vmi-rvz.2023.4.case.1","DOIUrl":"https://doi.org/10.20340/vmi-rvz.2023.4.case.1","url":null,"abstract":"Amoebic liver abscess is one of the forms of invasive amoebiasis. With untimely treatment, this disease can be complicated by peritonitis, dissemination of the pathogen with the development of sepsis. This article presents a clinical case of amoebic liver abscess in patient V., 40 years old with the results of a biopsy examination of the surgical specimens","PeriodicalId":481396,"journal":{"name":"Vestnik medicinskogo instituta \"REAVIZ\": reabilitaciâ, vrač i zdorovʹe","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913642","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":"Extrahepatic causes of morbidity and mortality of liver recipients in the long-term posttransplantation period","authors":"S. E. Voskanyan, V. E. Syutkin, A. I. Sushkov, Yu. V. Voskanyan, A. Yu. Veselkova, А. S. Luk'yanchikova, A. A. Kucherov","doi":"10.20340/vmi-rvz.2023.4.tx.1","DOIUrl":"https://doi.org/10.20340/vmi-rvz.2023.4.tx.1","url":null,"abstract":"Nowadays, the one-year survival rate of liver transplant recipients is 80-90 %. In the long term after surgery, there are increased risks of death compared with the general population. At the same time, in the structure of death of recipients, extrahepatic causes prevail over graft pathology. Cancers, cardiovascular diseases, infections, metabolic disorders, and kidney disease are key factors that negatively affect long-term outcomes of transplants. The article provides an overview and summary of current data on the prevalence, structure and prognostic value of various types’ of late post-transplant extrahepatic pathology in liver transplant recipients.","PeriodicalId":481396,"journal":{"name":"Vestnik medicinskogo instituta \"REAVIZ\": reabilitaciâ, vrač i zdorovʹe","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913768","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":"Marital status of a patient in the formation of his attitude to the organization of medical care provided on an outpatient basis","authors":"S. N. Cherkasov, A. V. Martirosov, A. V. Fedyaeva, L. V. Kudryashova","doi":"10.20340/vmi-rvz.2023.4.ozoz.1","DOIUrl":"https://doi.org/10.20340/vmi-rvz.2023.4.ozoz.1","url":null,"abstract":"Introduction. The marital status of the patient is an important factor that affects his behavior, attitude to health and the healthcare system. Family relationships can have a positive or negative impact on the level of self-esteem, general psychological stability and readiness for treatment. For example, many people in stable relationships are more likely to monitor their health, visit doctors regularly and receive the necessary medical care. However, there are also negative aspects of marital status that can affect the patient's attitude to the healthcare system. For example, some patients may experience fear and embarrassment when seeking medical care without their spouse or partner. There are also cases when a patient's unwillingness to go to doctors is due to the fact that he does not want financial or emotional help from his family, but prefers to cope with his problems on his own. Thus, marital status is an important factor that must be taken into account when analyzing the attitude of patients to the healthcare system. Studying this problem can help medical institutions develop more effective service strategies and increase patient satisfaction. Materials and methods . For the analysis, 495 patients of medical organizations in Moscow were obtained by questioning. Two comparison groups were formed, the main group (the presence of marital relations) 292 people, the control group (the absence of marital relations) 203 people. Taking into account the nonparametric distribution of the primary data, the criterion of the reliability of differences χ 2 was used to compare the groups, and the association coefficient was used to determine the dependence K a . Results. According to the results of the analysis, taking into account the literature data, data on different approaches to the assessment of the medical care management system in patients with different family status were obtained. Conclusions. Family patients are more critical of the organization of the activities of individual departments of the polyclinic, but their criticism does not lead to a significant decrease in the overall assessment of the medical organization. Lonely patients make fewer specific claims, but reduce the overall assessment of the medical organization's activities.","PeriodicalId":481396,"journal":{"name":"Vestnik medicinskogo instituta \"REAVIZ\": reabilitaciâ, vrač i zdorovʹe","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913641","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":"Mathematical modeling of ethanol distribution in body fluids","authors":"G. V. Nedugov","doi":"10.20340/vmi-rvz.2023.4.ictm.1","DOIUrl":"https://doi.org/10.20340/vmi-rvz.2023.4.ictm.1","url":null,"abstract":"The aim of the study is to build a kinetic model of ethanol distribution in biological body fluids, as well as its implementation in the format of computer programs. Analytical mathematical modeling of ethanol kinetics in body fluids after single and multiple oral alcohol intake was performed. An equation for the distribution of ethanol in internal media and other body fluids has been developed based on a kinetic model of zero-order elimination with absorption and irrevocable absorption deficiency, as well as achieving an equilibrium state with first-order blood plasma. On the basis of this kinetic model, computational algorithms are constructed for estimating the concentration of ethanol in body fluids at a given time, the peak concentration of ethanol and the time of its achievement, the time of complete removal of ethanol, the beginning and end of the false elimination period. Solutions to the problem of determining the amount of ethanol taken by its concentration in the biological fluid and the level of etholemia at this point in time with the possibility of calculating their maximum absolute errors are obtained. The constructed kinetic model is generalized to any number of ethanol receptions separated by time intervals of any duration. The developed computational algorithms are implemented in the format of the computer programs 'Alcohol Calculator V 7.0\" and \"Alcohol Calculator V 6.0\", which are recommended for use in the forensic medical expert assessment of acute alcohol intoxication.","PeriodicalId":481396,"journal":{"name":"Vestnik medicinskogo instituta \"REAVIZ\": reabilitaciâ, vrač i zdorovʹe","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913773","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":"Emergency endovascular treatment of cardioembolic stroke in the early post-infarction period with subsequent direct myocardial revascularization","authors":"A. G. Arutyunyan, L. S. Kokov, M. Kh. Mazanov, N. M. Bikbova, G. R. Ramazanov, А. V. Anisimov","doi":"10.20340/vmi-rvz.2023.4.case.3","DOIUrl":"https://doi.org/10.20340/vmi-rvz.2023.4.case.3","url":null,"abstract":"Introduction. Ischemic stroke (IS) remains one of the significant problems of modern medicine to this day. Cardioembolic stroke (CEI) accounts for 20 % of all cases of IS and is characterized by acuteness, severity of the disease and high mortality. Aim of study. An observation is presented in patient Sh., 51 years old, who was urgently transferred from another medical institution on the 3rd day after the development of acute recurrent anterior myocardial infarction with ST segment elevation complicated by early post-infarction angina pectoris. During the additional examination, in addition to severe multifocal atherosclerosis and multivessel coronary artery disease, a floating thrombus in the cavity of the left ventricle was detected. At the stage of preparing the patient for coronary artery bypass grafting, the patient developed stroke. Thrombextraction from the basilar artery (BA) was performed urgently. As a result, a complete regression of neurological symptoms was achieved. This made it possible to continue the preparation and successfully perform coronary artery bypass grafting. The patient was discharged on the 10th day after the operation, the entire hospitalization period was 28 bed-days. Discussion . In the presented case, a patient with a clinic of unstable angina pectoris, severe multifocal atherosclerosis, and multivessel coronary artery disease was in a specialized multidisciplinary hospital at the time of the development of stroke. The well-coordinated work of the multidisciplinary team, the possibility of performing thromboaspiration in the shortest possible time allowed not only to save the patient's life and achieve complete regression of neurological symptoms, but also to improve the quality of life through surgical treatment of coronary heart disease.","PeriodicalId":481396,"journal":{"name":"Vestnik medicinskogo instituta \"REAVIZ\": reabilitaciâ, vrač i zdorovʹe","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134913644","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}