Perm Medical Journal最新文献

{"title":"Analysis of hardware methods of treatment of patients with temporomandibular joint dysfunction","authors":"A. A. Dolgalev, D. Y. Khristoforando, Ya. N. Garus, V. N. Ivensky, A. N. Brazhnikova, O. Y. Khorev, E. A. Bulycheva, P. N. Geletin, Z. V. Kerefova, Yu. V. Chepurko, O. A. Uspenskaya","doi":"10.17816/pmj411120-131","DOIUrl":"https://doi.org/10.17816/pmj411120-131","url":null,"abstract":"Objective. To conduct a comparative analysis of effectiveness of treatment of patients with dysfunction of temporomandibular joint (DTMJ) using hardware methods of treatment with occlusive mouthguards of various types. \u0000Materials and methods. 99 patients (88 females and 11 males aged 41,2 ± 10,7) with different combinations of revealed and confirmed signs of DTMJ were examined from 2013 to 2023. According to the personal clinical picture, complaints revealed, aetiology and pathogenesis of the disease all the patients of the comparison group and 2 main groups (99 patients) were administered individual complex treatment for DTMJ. The treatment was aimed at the elimination of pain, relief of masticatory muscles spasm, improvement of the extent of opening of mouth, correction of the lower jaw position, occlusive interference elimination and restoration of height of the lower third of the face. \u0000While carrying out the hardware treatment, occlusive mouthguards of 3 types were made based on the jaw model of the patients. The models were got from the silicone imprints of the jaw. \u0000Results. MR images of temporomandibular joints of the 99 patients showed that ventral dislocation of articular disk occurred most frequently (in 88 patients). Less frequently (4 % of cases) it was combined with dislocation of the disk laterally. Rarely distal dislocation of the articular disk occurred – 1,9 % of cases (2 patients). Study of the results of the appliance of different types of occlusive mouthguards demonstrates the necessity to work out the types of occlusive devices allowing decompression of temporomandibular joint elements, centering lower jaw position and orthodontic elimination of dentofacial abnormalities and deformities which lead to occlusive interference. \u0000Conclusions. Analysis of occlusive devices used in the diagnosis and treatment of patients with DTMJ shows that the most effective devices are those that successfully combine elements of splints with a narrower purpose.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"2 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140508340","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 and morphological features and unsolved issues in diagnosis of aggressive forms of papillary thyroid carcinoma","authors":"D. V. Korotovsky, S. Sergiiko, S. A. Lukyanov","doi":"10.17816/pmj41190-107","DOIUrl":"https://doi.org/10.17816/pmj41190-107","url":null,"abstract":"Differentiated thyroid cancer (DTC) is a disease with a favorable clinical course and high survival rate compared to other epithelial tumors. The majority of DTC (up to 85 %) is represented by various subtypes of papillary thyroid cancer (PTC). Aggressive forms of PTC characterized by early lymphogenous and hematogenous metastasis, low avidity to radioiodine therapy (RIT), low relapse-free survival rates and high mortality rate compared to other types of PTC occur among them. Preoperative diagnosis of PTC is based on the results of ultrasound (US) examination and fine-needle aspiration biopsy (FNA) with cytological examination of the aspirate. At the same time, the capabilities of cytological examination in determining the histological type of PTC are limited and it does not allow to predict its aggressiveness and plan adequate treatment. Molecular genetic tests of the tumor cytological and morphological material are effective in prognosis of aggressiveness of PTC due to the determination of specific mutations in the BRAF, TERT, RAS genes and the quantitative expression of oncogenic and tumor suppressive microRNAs. Some of these indicators are already used in the morphological classification of tumors of the endocrine system. \u0000At the same time, there are contradictory data concerning the connection of the molecular genetic portrait of PTC, the clinical manifestations of its aggressiveness (extrathyroidal invasion, early metastasis, and radioiodine resistance) and its pathomorphological structure. We tried to summarize and analyze the literature data regarding the diagnosis of aggressive variants of PTC.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"37 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140508118","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":"Influence of vaccine prevention on the spread and serotype composition of Streptococcus pneumoniae in military collectives","authors":"I. S. Mukhachev, A. S. Blagonravova, I. V. Feldblyum, Maia Kh. Alyeva","doi":"10.17816/pmj411141-147","DOIUrl":"https://doi.org/10.17816/pmj411141-147","url":null,"abstract":"Objective. Study of the effect of vaccination against pneumococcal infection on the prevalence and serotype composition of S. pneumoniae in military personnel.Materials and methods. The study was conducted among 369 military personnel of the military unit of the Sverdlovsk region. Determination of the frequency and serotype of S. pneumoniae was carried out upon admission and after 1.5 months of stay in the military collective using the multiplex PCR method.Results. After 1.5 months of stay of servicemen in the military collective, a significant activation of pneumococcal circulation was established (χ2McNemar=24.038; p0.001). The risk of S. pneumoniae infection among unvaccinated military personnel was 1.39 times higher compared to vaccinated military personnel (RR=1.39; 95% CI 1.209–1.596). In the group of unvaccinated military personnel, the frequency of occurrence of vaccine serotypes was 2.6 times higher than in vaccinated ones (χ2 = 6.25; p = 0.01).Conclusions. The proactive influence of immunization against pneumococcal infection on the prevalence and serotype landscape of S. pneumoniae has been established: A low prevalence of vaccine serotypes and a predominance of non-typeable serotypes have been revealed among vaccinated individuals.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"10 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507040","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 organization of emergency medical care for the children's population during the COVID-19 pandemic","authors":"Maya V. Bogdanyants, Galina M. Minakova","doi":"10.17816/pmj411132-140","DOIUrl":"https://doi.org/10.17816/pmj411132-140","url":null,"abstract":"Objective. To analyze the work of the emergency medical care department (EMCD) of the largest children's polyclinic of the city in 2020-2022 and to evaluate the organization of the EMC for the attached children during the Covid-19 pandemic. \u0000Materials and methods. Mathematical and statistical analysis of quantitative and qualitative indicators of EMCD activity based on a continuous sample of primary accounting and reporting medical documentation. \u0000Results. A significant increase in the number of EMCD visits was demonstrated. In 2022, the growth was 40,96 % and 28,12 % compared to 2020 and 2021. It was found out that in 97,4–98,0 % of all cases provided with EMC, were the children with respiratory diseases. Their number in 2022 increased 1,3 times compared to 2021, and 1,43 times compared to 2020. In this group of patients, the number of children with pneumonia increased by 63.5 % in 2021 compared to 2020. \u0000Conclusions. The proper organization of the work of the EMCD made it possible to provide children with available, timely and rapid primary medical social and emergency medical care during an increased workload in the context of the COVID-19 pandemic.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140508028","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 concentration of serum neopterin in patients with surgical treatment of spondyloarthrosis complicated byfacet syndrome","authors":"Artur Yu. Pronin, Yulia Karakulova, D. Sosnin","doi":"10.17816/pmj4115-12","DOIUrl":"https://doi.org/10.17816/pmj4115-12","url":null,"abstract":"Objective. To study the concentration of serum neopterin in patients before and after surgical treatment of pain syndrome caused by the formation of facet syndrome associated with spondyloarthrosis. \u0000Materials and methods. The study involved 52 patients (32 men and 20 women) hospitalized to the neurosurgical department of the City Clinical Hospital No. 4. The main group consisted of 26 patients with spondyloarthrosis complicated by chronic pain associated with facet syndrome. The comparison group (n=26) consisted of patients with pain syndrome in radiculopathy. The control group (comparable in gender and age) consisted of 10 people who underwent periodic examination. The concentration of neopterin in blood serum was determined by solid-phase enzyme immunoassay (ELISA) using the Neopterin ELISA kit (cat. No. 59321; lot ENO230) (\"IBL\", Germany). \u0000Results. Statistically significant differences in the level of serum neopterin concentration (p = 0.0016) were revealed between the studied groups. The highest concentration of neopterin was noted in the comparison group, where it was 10.31 ± 2.02 nmol/l, exceeding the results of the control group (p=0.02256) and the main group (p=0.04996). Three months after surgical treatment of patients in the main group, the median content of serum neopterin decreased by 1.161 times (p = 0.049029). \u0000Conclusion. Further studies to clarify the influence of pain on metabolic processes and neopterin in particular are required.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"33 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507126","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":"Predictors of changes in the course of breast cancer: the results of longitudinal study","authors":"A. Vazhenin, Y. N. Pakhomova, I. Ponomareva, D. Tsiring, A. O. Ryazhkin","doi":"10.17816/pmj41150-58","DOIUrl":"https://doi.org/10.17816/pmj41150-58","url":null,"abstract":"Objective. To investigate the predictors of changes in the course of breast cancer in a longitudinal study. \u0000Materials and methods. Women with the diagnosis of breast cancer underwent psychological diagnostics at the stage of diagnosis (n=201 at the first section of the longitudinal study, n=149 at the second section, n=94 at the third section, n=81 at the fourth section five years after the diagnosis). Methods of research: scale of basic beliefs, life orientations test, questionnaire “Ways of coping behavior”, test of vitality, questionnaire of subjective control, personal helplessness questionnaire, quality of life questionnaire. \u0000Results. Predictors of changes in the course of cancer are the basic belief “I-Image”, the level of vitality, the locus of control in relation to health, the course and stage of the disease. \u0000Conclusions. While conducting the study, it was found out that the course of the disease is associated with medical and psychological indicators. The data obtained as a result of the study are necessary for solving practical problems of increasing life expectancy and providing psychological care to women with breast cancer who are a socially vulnerable category of the population of the Russian Federation.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"94 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140507804","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 formation of anti- bodies to SARS-CoV-2 after coronavirus infection in children","authors":"I. K. Bogomolova, V. N. Peregoedova","doi":"10.17816/pmj41113-23","DOIUrl":"https://doi.org/10.17816/pmj41113-23","url":null,"abstract":"Objective. To estimate the level of antibodies to SARS-CoV-2-IgM and SARS-CoV-2-IgG in children with COVID-19 in acute period and during 1 year period of follow-up after coronavirus infection. \u0000Materials and methods. Blood samples for the presence of IgM and IgG antibodies to SARS-CoV-2 were analyzed in 119 children aged 11.0 [10.1; 11.2] with COVID-19 in the acute period (29.4 % asymptomatic, 51.3 % mild and 19.3 % moderate), and SARS–CoV-2-IgG in the dynamics of the follow-up after 1 (n=55), 6 (n=33) and 12 (n=32) months from the moment of discharge from the hospital in a prospective cohort study. The levels of SARS-CoV-2 surface glycoprotein S, including the receptor-binding domain – RBD were measured at different time by using enzyme-linked immunosorbent assay. \u0000Results. The level of IgM positive rate for SARS-CoV-2 was initially negative in 86.6 % of children with COVID-19. The original seroconversion (on admission to the hospital) was 38.7 % and it increased to 96.7 % in 1 month and to 100 % in 12 months of observation. There were no statistically significant differences in IgG persistence depending on the age and course of COVID-19. \u0000Conclusions. The new coronavirus infection causes a long-term response of IgG antibodies to SARS-CoV-2 which persists for one year of observation and increases by 12 months after the infection regardless of the severity of COVID-19.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"12 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140508438","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":"On applying “economical technologies” in children’s polyclinic","authors":"E. A. Kochergina, R. N. Trefilov, I. G. Shinkarik, N. V. Minaeva","doi":"10.17816/pmj402100-107","DOIUrl":"https://doi.org/10.17816/pmj402100-107","url":null,"abstract":"Objective. To analyze the work of childrens polyclinic within the framework of the projects Economical Production. An active prevalence and introduction of economical production concerns different spheres of human productive activities including office processes, service, management, social sphere and healthcare service.
 Materials and methods. The project Organization of entering stream of patients, visiting a district pediatrician at reception days for conditionally ill children was realized as the first one aimed at improvement of work of childrens polyclinic.
 Results. In April 2017, economical technologies in the sphere of community health protection were introduced in Perm Krai to improve the most problematic processes in the activity of polyclinics. Economic technologies help to raise the availability, quality and safety of medical care at the expense of creating optimal logistics of patients streams, organization of ergonomics of working space, effective use of medical technique and equipment. An important element of success regarding the economical production is involvement of workers in improvement of processes as well as devotion of the head of organization to design work. It was shown at the example of childrens polyclinic how the improvement projects were realized; the standards of the improved processes of other medical institutions were introduced.
 Conclusions. One of improvement projects, its stages and the list of countermeasures for elimination of the causes of the revealed problems is described in details; the results of the other realized projects are presented. The major part of solutions regarding the improvement within the framework of economical production in the sphere of public healthcare are organizational and do not require additional material costs.","PeriodicalId":490955,"journal":{"name":"Perm Medical Journal","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136000937","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}