Perm Medical Journal最新文献

{"title":"Analysis of a clinical case of managing a patient with intraoperative bladder injury","authors":"O. Kalinkina, Y. Tezikov, I. Lipatov, Maria O. Mayorova, G. Sreseli","doi":"10.17816/pmj411148-153","DOIUrl":"https://doi.org/10.17816/pmj411148-153","url":null,"abstract":"To analyze a clinical case of successful treatment of a patient with intraoperative bladder injury. \u0000The results of examination and treatment of patient S., 39 years old, were studied. The reasons for iatrogenic bladder injury in this clinical case were two surgeries on the bladder in childhood, a pronounced adhesive process of the small pelvis, and the inability to foresee the atypical localization of the bladder welded to the anterior abdominal wall. A pronounced adhesive process might also be caused by endometriosis, which had not been diagnosed and treated in this patient. \u0000Timely referral of the patient to a gynecologist for a check-up with ultrasound examination of the pelvic organs would have allowed to reveal endometriosis, timely treat it and avoid the formation of a large endometrioid cyst, which required surgical treatment. In this clinical case attention is drawn to the lack of an interdisciplinary approach to the management of this patient, defects in dispensary supervision. Despite the complication occurred, performing the stages of operation together with an urologist, adequately prescribed postoperative therapy for the prevention of recurrence of endometriosis, rehabilitation in the urology department made a favorable course of the postoperative period possible, bladder function was restored and clinical manifestations of endometriosis were controlled.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"62 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A method of diagnosing non-alcoholic fatty liver disease with the calculation of the steatosis index","authors":"I. Bulatova, A. Sobol, I. L. Gulyaeva","doi":"10.17816/pmj411108-113","DOIUrl":"https://doi.org/10.17816/pmj411108-113","url":null,"abstract":"Objective. To work out the index for diagnosing non-alcoholic fatty liver disease (NAFLD) in women with metabolic syndrome (MS) in postmenopause using generally available markers. \u0000Materials and methods. 62 females with NAFLD and MS in early postreproductive period took part in the study. They were compared to 24 relatively healthy females not suffering from obesity in postmenopause. The average age of the patients was 49,9 ± 1,1. Hepatic steatosis was diagnosed by ultrasound examination. The mathematic model of hepatic steatosis index (HSI) calculation included: body mass index (BMI), waist size (WS), triglycerides and low-density lipoproteins (LDL). \u0000Results. BMI and WS in patients with MS and NAFLD in postmenopause were considerably more than in relatively healthy women. Hypertriglyceridemia and an increase of LDL in blood serum were noted in patients with steatosis. Biometric and laboratory data were included in the mathematical formula which allows to calculate HSI. With HSI 0,5 and more NAFLD is diagnosed in women in post menopause, when HSI is lower than 0,5 it is not diagnosed. Indicators of sensitivity and specificity of the method were 98,4 % and 95,85 % respectively. \u0000Conclusions. The minimally invasive method suggested above allows to reveal hepatic steatosis in females with MS in early postreproductive period. High diagnostic characteristics of the method are worth mentioning, as well as the possibility to be widely used thanks to simple biometric and laboratory data employed.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507935","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":"Risk factors for development of type 2 diabetes mellitus in patients with obesity in late post-COVID period","authors":"E. Yuzhakova, Z. G. Shanko, E. N. Smirnova","doi":"10.17816/pmj41181-89","DOIUrl":"https://doi.org/10.17816/pmj41181-89","url":null,"abstract":"Objective. To study the risk factors for developing type 2 diabetes mellitus in patients with obesity after COVID-19. \u0000Materials and methods. 61 case histories and outpatient card abstracts of patients with obesity, who suffered from moderate and severe forms of COVID-19 from 02.2021–04.2022 were analyzed. Demographic, laboratory and clinical parameters were studied during hospitalization and 12 months after discharge from the hospital. All patients initially were divided into 2 groups according to the glycated hemoglobin level. Group 1 consisted of 46 patients with prediabetes and group 2 included 15 patients without carbohydrate disorders. \u0000Results. The median age of all patients was 64 (59–66) years. Median of HbAlc was 6,0 (5,6–6,2) %, BMI –34 (33–35) kg/m2. 24 patients from group 1, who took DPP-4-inhibitors in early post-COVID-19 period constituted subgroup 1A and 22 patients, who refused treatment with these drugs, constituted subgroup 1B. Currently, 2 patients from subgroup 1A and 10 patients from subgroup 1B (χ2=8,2 р=0,004) have been diagnosed with DM2. In patients who developed DM2 in late post-COVID period the levels of HbAlc, fasting plasms glucose and BMI at the time of admission to the hospital were significantly higher (n=12) than in patients with persistent prediabetes (n=34), (p0,05). Positive correlation between these parameters and the risk of developing DM2 (R=0,5, p0,05; R=0,74, p0,05; R=0,54, p0,05, respectively) was determined. In group 2, DM2 is currently diagnosed in 2 male patients with BMI over 40 kg/m2. When comparing subgroup 1B and group 2, it was found out that DM2 in the post-COVID period occurs in every second patient with the previous initial carbohydrate disorders: in 10 people of 22 – in subgroup 1B (every 2nd patient) versus 2 patients from group 2 (every 7th patient), (χ2=4,2, p=0,04). Online calculator from medstatistic. ru was used to determine relative risk (RR). \u0000Conclusions. Thus, presence of impaired glucose tolerance increases the risk of development of DM2 in late post-COVID period. In patients with hyperlycemia on hospitalization for COVID-19, who did not receive incretin therapy (subgroup 1B) risk of DM2 was 3,4 times higher (CI 95 %=0,87–13,40). Patients, who received incretin (subgroup 1A) had risk of DM2 = 0,6 (CI 95 %=0,09–3,97). It should be assumed that incretin therapy prevents development of DM2 in patients with hyperglycemia/impaired glucose tolerance after COVID-19.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140506813","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":"Hypertensive disorders in pregnancy: problems of classification, differential diagnosis and management","authors":"Natalya V. Mostova, V. V. Kovalev, E. V. Kudryavtseva","doi":"10.17816/pmj41132-41","DOIUrl":"https://doi.org/10.17816/pmj41132-41","url":null,"abstract":"Objective. To study the features of hypertensive disorders formation in pregnancy depending on the period and clinical form on the example of the population of Sverdlovsk region. \u0000Materials and methods. The outcomes of 217 pregnant women with moderate and severe preeclampsia and gestational hypertension were analyzed (41, 74, and 102 cases, respectively). \u0000Results. The severe preeclampsia group had the highest rate of fetal growth restriction (14.6 %), low birth weight -2045 g (1640–2650), preterm delivery (63.4 %), and cesarean delivery (87.8 %). A detailed analysis of 28 cases of gestational hypertension lasting up to 34 weeks was performed. The analysis revealed significant challenges in the differential diagnosis of this pregnancy complication, not only in terms of clinical manifestations, but also in terms of timely diagnosis in general. \u0000Conclusions. The findings of this study spark a debate over the use of severity-based classification in clinical practice, which lessens the doctor's vigilance in milder forms that, however, result in equally serious complications. This raises the question of whether unified tactical approaches should be used in this pathology.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"27 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140506818","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":"Integrated approach to the study of biodegradation of composite materials for the restoration of hard dental tissues","authors":"O. Gileva, A. Levitskaya, O. E. Bekzhanova, T. Libik, M. Y. Kilina, M. Sycheva","doi":"10.17816/pmj41173-80","DOIUrl":"https://doi.org/10.17816/pmj41173-80","url":null,"abstract":"Objective. To study the stress-strain state of demineralized tooth enamel after its impregnation with a low-viscosity composite in a long-term period of functioning in the oral cavity in a series of equivalent cyclic tests; to study the correlation of the experimental results with clinical observations of the treatment of enamel caries using a modified infiltration technique. \u0000Materials and methods. The parameters of laser holographic interferometry and atomic force microscopy, reflecting the timing, type and severity of deformation defects in samples of demineralized tooth enamel were analyzed in a series of equivalent cyclic tests. During the experiment the samples underwent classical infiltration with composite using ICON technology (main group) and a 2-stage enamel caries treatment technique, including carrying out a time-modified conditioning of classical infiltration and the final stage (stages) of enamel coating with a bioactive hybrid glass ionomer (comparison group). \u0000Results. The first signs of the deformation defects generation in demineralized enamel filtered on the classical method (the appearance of perifocal microcracks) were recorded in 11.2 % of the tested samples after 0.9 · 106 cycles (equivalent to 9 months of functioning of a tooth with treated enamel caries in the oral cavity), during further cyclic tests the percentage of samples with local defects increased progressively. Signs of a violation of the stress-strain state in the enamel after combined treatment (samples of the comparison group) were revealed in cycles corresponding to 2–3 years of being in an artificial environment of the oral cavity. Experimental data correlated with the clinical observations both in time and frequency of complications (secondary/recurrent caries) in the long term after treatment of enamel caries by various methods. \u0000Conclusions. In the process of equivalent cyclic tests, heterogeneous elastic-plastic deformations develop in the thickness of a section of demineralized enamel impregnated with a flowing composite and along its perifocal zones, most pronounced at the interface between intact and treated enamel, which leads to the development of local defects, delaminations, cracks, and destruction of the structurally heterogeneous environment of tooth enamel. According to the results of the comparative analysis, the most favorable results in terms of the timing of development, frequency and severity of deformation defects were obtained in samples of demineralized enamel after its treatment using a modified caries infiltration technique followed by coating with a bioactive hybrid glass ionomer.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"9 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140508249","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":"Dynamics of main markers of protein metabolism and microelements in patients with new coronavirus infection","authors":"V. Nikolenko, I. Prelous, E. V. Belkina, P. A. Nikolenko, N. N. Vorobyova, O. Sumlivaya, A. P. Nebolsina, A. M. Bubnov, V. Y. Teterin","doi":"10.17816/pmj41142-49","DOIUrl":"https://doi.org/10.17816/pmj41142-49","url":null,"abstract":"Objective. To study the dynamics of the main markers of protein metabolism and microelements in patients with a new coronavirus infection. \u0000Materials and methods. A prospective clinical and laboratory study of the dynamics of the main markers of protein metabolism and microelements was carried out in 62 patients with a new coronavirus infection complicated by the development of pneumonia with a moderate course on the basis of Perm regional clinical hospital of infectious diseases in 2021–2022. On the 1st and 14th days of hospitalization all patients underwent general clinical and biochemical studies. The concentrations of total protein, albumin, transferrin, Fe, Zn and Cu was also determined. Statistic processing of the results was carried out using Microsoft Excel 2000 and “Statistica 10”. \u0000Results. A decrease in visceral pool proteins was revealed. It indicated their active consumption and formation of hypermetabolism - hypercatabolism syndrome in a moderate course of the infection. A progressive deficiency of Fe and Zn, correlating with life-threatening complications and deaths was revealed. \u0000Conclusions. The course of a new coronavirus infection contributes to the development of metabolic disorders, and the identified deficiency of macro- and microelements is a predictor of a severe course of the infection.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"7 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507139","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":"Cervical intraepithelial neoplasia: the current state of the problem in Yekaterinburg","authors":"E. A. Rosyuk, Aleksandra I. Shorikova, Tatyana E. Verba, Irina V. Salimova, A. V. Tureeva","doi":"10.17816/pmj41124-31","DOIUrl":"https://doi.org/10.17816/pmj41124-31","url":null,"abstract":"Objective. To determine the frequency of cervical intraepithelial neoplasia among female citizens in Yekaterinburg. \u0000Materials and methods. The retrospective analysis of the report forms of the cervical pathology office in Yekaterinburg Perinatal Center from January to September 2022 was carried out. Statistical data processing was conducted using descriptive statistical methods in the Excel programme. \u0000Results. 255 cases of precancerous cervical diseases and 7 cases of cervical cancer were revealed within 9 months of monitoring, among them 24 patients with precancerous pathology and 4 with cervical cancer had previously been followed up by a specialist. Most cases of cervical pathology were revealed in patients over 40. \u0000Conclusions. The women's consultations of Verkh-Isetsky and Leninsky districts refer patients to the specialized cervical pathology office most actively. Patients of the cervical pathology office are provided with the full range of therapeutic and diagnostic procedures, with colposcopy being most often performed (27 % of cases). The dispensary group of patients of the cervical pathology office is mainly represented by women with cervical dysplasia of the 2nd degree (HSIL, CIN II) – 43.5 %.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"29 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140506810","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 antiarrhythmic activity 2-(n-butylpyrrolidine)-N-(2-bromophenyl)carboxamide hydrochloride","authors":"I. P. Rudakova, S. V. Chashchina, A. Starkova","doi":"10.17816/pmj411154-161","DOIUrl":"https://doi.org/10.17816/pmj411154-161","url":null,"abstract":"Objective. To study the efficacy of a new derivative 2-(alkylpyrrolidine)-N-(aryl)carboxamide with high antiarrhythmic activity. \u0000Materials and methods. To study the antiarrhythmic activity of the compound, the experiment was carried out on models of arrhythmia caused by intravenous administration of aconitine and adrenaline. The effect was estimated by its ability to prevent the onset of arrhythmia, prolong the survival time of the animals or by the duration of an arrhythmia attack. In addition, the electrocardiogram of awake rats was analyzed. The studied compound and the comparison drug (lidocaine) were injected to the animals intravenously in effective antiarrhythmic doses. \u0000Results. In aconitine arrhythmia 2-(n-butylpyrrolidine)-N-(2-bromophenyl) carboxamide hydrochloride provides statistically significant limitation of the duration of arrhythmia attacks in experimental animals (1.7 times) in comparison with the control and also reduction of arrhythmia duration in comparison with \u0000lidocaine (2.5 times); besides, this compound guarantees animals’ survival in 100 % of cases. When causing \u0000arrhythmia by adrenaline administration, the compound does not prevent the occurrence of cardiac rhythm disorder. The electrocardiogram readings of animals do not change significantly. \u0000Conclusions. 2-(n-butylpyrrolidine)-N-(2-bromophenyl) carboxamide hydrochloride (compound K-23) shows visible activity in models of arrhythmia caused by administration of aconitine and calcium chloride, which may indicate its ability to impede the sodium flow through the cell membrane by slowing depolarization of cardiomyocytes. \u0000Since the compound studied, demonstrates high antiarrhythmic activity without changing the ECG readings, the drug created on its basis may be effective.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507642","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":"100th anniversary of perm scientific school of medical diagnostics","authors":"V. J. Mishlanov","doi":"10.17816/pmj411162-167","DOIUrl":"https://doi.org/10.17816/pmj411162-167","url":null,"abstract":"Department of Propaedeutics of Internal Diseases of E.A. Vagner Perm Medical University is celebrating its 100th anniversary. The original name was the Department of Medical Diagnostics. It was the development of medical diagnostic methods that became the key theme of the 100-years development of the scientific and pedagogical school in medicine. Modern scientific achievements of the department's employees are known in Russia and abroad. They include new principles of making a medical diagnosis in a remote consultation, remote monitoring of patients with the application of interactive questionnaires and use of biosensor data. New methods of studying the human body based on measuring electrical impedance are being used.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"96 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507798","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":"Horizons of international cooperation: medical science, practice and education","authors":"A. S. Blagonravova, Zh. A. Rizaev, O. Gileva","doi":"10.17816/pmj411168-170","DOIUrl":"https://doi.org/10.17816/pmj411168-170","url":null,"abstract":"","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"5 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140508462","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}