This journal is
indexed in Scopus
Year 2021 Vol. 29 No 3
I.V. MAIBORODIN 1, 2, S.V. MARCHUKOV 2, V.I. MAIBORODINA 1
SOME FEATURES OF THE KIDNEY SCAR FORMATION AFTER SURGERY IN THE EXPERIMENT
Federal Research Center of Fundamental and Translational Medicine of the Ministry of Science and Higher Education of Russia, Institute of Molecular Pathology and Pathomorphology 1
Institute of Chemical Biology and Fundamental Medicine of the Russian Academy of Sciences, Siberian Branch2;
The Russian Federation
Objective. To study the features of scar formation and structural changes in the remaining renal parenchyma in rats after the kidney resection in various terms.
Methods. A layered closure of midline laparotomy and the caudal part of the left kidney removal was performed in rats under general inhalation ether anesthesia in a clean operating room. The morphology of the remaining kidney part after resection was studied using light microscope in different terms.
Results. A thrombus from blood leaking out of the cut vessels is formed on the damaged surface of the kidney immediately after the resection. This clot with the parenchyma is gradually replaced by the connective tissue along the edge of the defect with the subsequently formation of a thin connective or fibrous tissue scar. However, in many cases, the number of which in rats can reach 40%, the processes of kidney damage continue for a long time after surgery, and leading to total or subtotal nephrosclerosis. The detected cystic change in tubular structures, apparently, occurred firstly due to their intersection during the resection, clamping by a blood clot and / or compression by edema distal to the observation site. Then, the forming extensive scar again clamped the adjacent tubular structures with subsequent cystic degeneration and sclerosis. In this case, detritus formed from non-viable renal tissues is eliminated by macrophages, which can form multinucleated cells with fused cytoplasm.
Conclusion. Structural changes in the nephrosclerosis progression after kidney resection consist in the gradual replacement of the all renal cortical and medullar parenchyma by the connective tissue. This is not associated with the autoimmune process, but is more likely due to both impaired urine outflow after intercut of the tubular structures at resection and/or compression by edema, inflammatory infiltrate, forming or organizing scar, and vascular disorders associated with these causes. The inflammation accompanying necrosis and sclerosis of the renal structures can become granulomatous.
- Vogel H, Tödt HC. Scar tissue, organ atrophy and hypertrophy in the computed tomogram after abdominal surgery. Digitale Bilddiagn. 1985 Sep;5(3):138-41. https://www.ncbi.nlm.nih.gov/pubmed/4053498 [Article in German]
- Gebauer A, Antes G, Pfeifer KJ, Staehler G, Pielsticker K. Angiographic and isotopic studies following pole resection of kidneys in dogs and hemostasis performed by infrared-contact-coagulation. Röfo. 1981;134(6):649-52. doi: 10.1055/s-2008-1056433 [Article in German]
- Vtorenko VI, Trushkin RN, Lubennikov AE, Kolesnikov NO. Laparaskopicheskaia rezektsiia transplantirovannoi pochki po povodu pochechno-kletochnogo raka T1aN0M0. Urologiia. 2017;(1):71-75. doi: 10.18565/urol.2017.1.71-75 (In Russ.)
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- Popov SV, Novikov AI, Zaitsev EV, Guseinov RG, Topuzov TM. Opyt vypolneniia monoportovykh laparoskopicheskikh operatsii v lechenii zabolevanii pochek. Urologiia. 2013;(1):74-81. https://urologyjournal.ru/ru/archive/article/11601 (In Russ.)
- Nozaki T, Watanabe A, Fuse H. Laparoendoscopic single-site surgery for partial nephrectomy without ischemia using a microwave tissue coagulator. Surg Innov. 2013 Oct;20(5):439-43. doi: 10.1177/1553350612459682
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630090, Russian Federation,
Novosibirsk, Akad. Lavrentyev Aven., 8,
Institute of Chemical Biology and Fundamental Medicine of the Russian Academy of Sciences, Center of New Medical Technologies,
tel. mob. +7-913-753-0767
Maiborodin Igor V.
Maiborodin Igor V., MD, Professor, Chief Researcher of the Laboratory of Health Management Technologies, the Center of New Medical Technologies, Institute of Chemical Biology and Fundamental Medicine, the Russian Academy of Sciences, Novosibirsk, Russian Federation.
Marchukov Sergey V., Ph.D, Doctoral Student of the Laboratory of Health Management Technologies, the Center of New Medical Technologies, Institute of Chemical Biology and Fundamental Medicine, the Russian Academy of Sciences, Novosibirsk, Russian Federation.
Maiborodina Vitalina I., MD, Leading Researcher of the Laboratory of Ultrastructural Bases of Pathology, Institute of Molecular Pathology and Pathomorphology, Federal Research Center of Fundamental and Translational Medicine, Novosibirsk, Russian Federation
GENERAL & SPECIAL SURGERY
A.V. KOROTKIKH 1, 2, A.M. BABUNASHVILI 3, A.L. KALEDIN 4, R.V. AKHRAMOVICH 5, V.V. DERKACH 6, R.M. PORTNOV 6, A.V. SOZYKIN7
ANALYSIS OF INTERMEDIATE RESULTS OF A COMPARATIVE MULTICENTER RANDOMIZED TENDERA STUDY INVESTIGATING THE DISTAL RADIATION ACCESS
Regional Clinical Hospital No1 1, Tyumen,
Amur State Medical Academy 2, Blagoveshchensk,
Center for Endosurgery and Lithotripsy 3, Moscow,
I.I. Mechnikov North-West State Medical University4, St. Petersburg,
Mytishchi City Clinical Hospital 5, Mytishchi,
Clinic of Innovative Surgery 6, Klin
Central Clinical Hospital of the Russian Academy of Sciences 7, Moscow,
The Russian Federation
Objective. To prove the safety and efficacy of distal radial artery (DRA) puncture for endovascular interventions versus the traditional forearm radial artery (RA) puncture site by comparing immediate and long-term results.
Methods. In 2017, a multicenter, open, randomized (1:1) study TENDERA (Comparison between Traditional Entry Point and Distal Puncture of Radial Artery) was started. During 2 years, 520 patients were included, mean age 63.4±10.0 years. The observation group (DRA puncture) included 271 patients, the comparison group (RA puncture) – 249 patients. The study included both stable patients and those with NSTEMI: the observation group – 39 (14.4%), the comparison group – 34 (13.7%), p=0.809. The primary endpoint is immediate (hospital) or late radial thrombosis. Secondary endpoints are: 1 – composite point, complications from the access artery; 2 – puncture parameters.
Results. The average difference in the diameters of the RA and DRA was 0.3 mm and 0.4 mm, in some patients the DRA diameter corresponded to the RA or even exceeded it. The diameter of RA and DRA in men and women significantly differs, 2.65±0.44 mm and 2.36±0.36 mm (p=0.001), 2.31±0.39 mm and 2.13±0.38 mm (p=0.001). Technical success of DRA access requre the number of attempts. 94.1% – the percentage of successful cardiac catheterization performed through the distal radial artery approach, which is significantly less than via RA – 100% (p<0.001). In the observation group, significantly fewer rebleedings and rehemostasis were occured. In the long-term period, there were registered outstandingly more hematomas in the observation group at the time of discharge and after 1 week.
Conclusion. Intermediate analysis of the results of the TENDERA study shows that there is no significant difference in the primary endpoint, but the number of complications in the observation group associated with the puncture markedly – hematoma more than 5 cm to the day of discharge and after 7 days.
- Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferović PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. 2018 ESC/EACTS Guidelines on myocardial revascularization. Euro Intervention. 2019 Feb 20;14(14):1435-34. doi: 10.4244/EIJY19M01_01
- Valgimigli M, Gagnor A, Calabró P, Frigoli E, Leonardi S, Zaro T, Rubartelli P, Briguori C, Andò G, Repetto A, Limbruno U, Cortese B, Sganzerla P, Lupi A, Galli M, Colangelo S, Ierna S, Ausiello A, Presbitero P, Sardella G, Varbella F, Esposito G, Santarelli A, Tresoldi S, Nazzaro M, Zingarelli A, de Cesare N, Rigattieri S, Tosi P, Palmieri C, Brugaletta S, Rao SV, Heg D, Rothenbühler M, Vranckx P, Jüni P; MATRIX Investigators. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. Lancet. 2015 Jun 20;385(9986):2465-76. doi: 10.1016/S0140-6736(15)60292-6
- Hamon M, Pristipino C, Di Mario C, Nolan J, Ludwig J, Tubaro M, Sabate M, Mauri-Ferré J, Huber K, Niemelä K, Haude M, Wijns W, Dudek D, Fajadet J, Kiemeneij F; European Association of Percutaneous Cardiovascular Interventions; Working Group on Acute Cardiac Care of the European Society of Cardiology; Working Group on Thrombosis on the European Society of Cardiology. Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology. Euro Intervention. 2013 Mar;8(11):1242-51. doi: 10.4244/EIJV8I11A192
- Korotkikh AV, Bondar VYu. Using a deep palmar branch of radial artery in the ragion of anatomical snuffbox during angiography. Dal’nevostoch Med Zhurn. 2016;(1):24-27. http://www.fesmu.ru/dmj/20161/2016105.aspx (In Russ.)
- Petroglou D, Didagelos M, Chalikias G, Tziakas D, Tsigkas G, Hahalis G, Koutouzis M, Ntatsios A, Tsiafoutis I, Hamilos M, Kouparanis A, Konstantinidis N, Sofidis G, Pancholy SB, Karvounis H, Bertrand OF, Ziakas A. Manual versus mechanical compression of the radial artery after transradial coronary angiography: the memory multicenter randomized trial. JACC Cardiovasc Interv. 2018 Jun 11;11(11):1050-58. doi: 10.1016/j.jcin.2018.03.042
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- Kaledin AL, Kochanov IN, Seletskii SS, Arkharov IV, Burak TIa, Kozlov KL Peculiarities of arterial access in endovascular surgery in elderly patients. Uspekhi Gerontologii. 2014;27(1):115-19. https://pubmed.ncbi.nlm.nih.gov/25051767/?from (In Russ.)
- Oliveira MDP, Navarro EC, Kiemeneij F. Distal transradial access as default approach for coronary angiography and interventions. Cardiovasc Diagn Ther. 2019 Oct;9(5):513-19. doi: 10.21037/cdt.2019.09.06
- Frolov AA, Sorokin IN, Sharabrin EG, Bekhterev AV, Frolov IA, Savenkov AG. Comparison of traditional and distal radial approach in percutaneous coronary interventions. Kardiologiia i Serdechno-Sosudistaia Khirurgiia. 2019;12(5):410-17. doi: 10.17116/kardio201912051410 (In Russ.)
- Kim Y, Lee JW, Lee SY, Bae JW, Lee SJ, Jeong MH, Lee SH, Ahn Y. Feasibility of primary percutaneous coronary intervention via the distal radial approach in patients with ST-elevation myocardial infarction. Korean J Intern Med. 2021 Mar;36(Suppl 1):S53-S61. doi: 10.3904/kjim.2019.420
- Hadjivassiliou A, Cardarelli-Leite L, Jalal S, Chung J, Liu D, Ho S, Klass D. Left distal Transradial Access (ldTRA): a comparative assessment of conventional and distal radial artery size. Cardiovasc Intervent Radiol. 2020 Jun;43(6):850-57. doi: 10.1007/s00270-020-02485-7
- Rajah GB, Lieber B, Kappel AD, Luqman AW. Distal transradial access in the anatomical snuffbox for balloon guide-assisted stentriever mechanical thrombectomy: technical note and case report. Brain Circ. 2020 Feb 18;6(1):60-64. doi: 10.4103/bc.bc_22_19. eCollection 2020 Jan-Mar.
- Kühn AL, Rodrigues KM, Singh J, Massari F, Puri AS. Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study. J Neurointerv Surg. 2020 Aug;12(8):798-801. doi: 10.1136/neurintsurg-2019-015604
- Sgueglia GA, Di Giorgio A, Gaspardone A, Babunashvili A. Anatomic Basis and Physiological Rationale of Distal Radial Artery Access for Percutaneous Coronary and Endovascular Procedures. JACC Cardiovasc Interv. 2018 Oct 22;11(20):2113-19. doi: 10.1016/j.jcin.2018.04.045
- Coomes EA, Haghbayan H, Cheema AN. Distal transradial access for cardiac catheterization: A systematic scoping review. Catheter Cardiovasc Interv. 2020 Dec;96(7):1381-89. doi: 10.1002/ccd.28623
- Boumezrag M, Ummat B, Reiner J, Venbrux A, Sarin S. Pseudoaneurysm: a rare complication of distal transradial access in the anatomical snuffbox. CVIR Endovasc. 2019 Jun 29;2(1):21. doi: 10.1186/s42155-019-0064-2
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- Hadjivassiliou A, Kiemeneij F, Nathan S, Klass D. Ultrasound-guided access to the distal radial artery at the anatomical snuffbox for catheter-based vascular interventions: a technical guide. Euro Intervention. 2021 Mar 19;16(16):1342-48. doi: 10.4244/EIJ-D-19-00555
675001, Russian Federation,
Blagoveshchensk, Gor’kii Str., 97,
Amur State Medical Academy
of the Ministry of Health of Russia,
Cardiac Surgery Clinic,
tel. +7 922 079 06 22,
Korotkikh Alexandr V.
Korotkikh Aleksandr V., Head Physician, Cardiovascular Surgeon, Specialist in X-ray Endovascular Diagnosis and Treatment, Cardiac Surgery Clinic, Amur State Medical Academy, Blagoveshchensk, Russian Federation.
Babunashvili Avtandil M., MD, Professor, Head of the Vascular Center, Center for Endosurgery and Lithotripsy, Moscow, Russian Federation.
Kaledin Alexandr L., PhD, Surgeon of the unit of X-ray endovascular methods of diagnosis and treatment, I.I. Mechnikov North-West State Medical University4, St. Petersburg, Russian Federation.
Akhramovich Ruslan V., Physician of X-ray Endovascular Diagnosis and Treatment Mytishchi City Clinical Hospital, Mytishchi, Russian Federation.
Derkach Vladislav V., Head of the Endovascular Surgery unit, Clinic of Innovative Surgery, Klin, Russian Federation.
Portnov Roman M., Physician of X-ray Endovascular Diagnosis and Treatment, Clinic of Innovative Surgery, Klin, Russian Federation.
Sozykin Alexey V., MD, Professor of the Cardiology Department, N.I. Pirogov Russian National Research Medical University, Head of the Unit of X-ray Endovascular Methods of Siagnosis and Treatment, Central Clinical Hospital of the Russian Academy of Sciences, Moscow, Russian Federation
V.F. RYBALCHENKO 1, A.A. PEREYASLOV 2, I.G. RYBALCHENKO 3, O.M. NYKYFORUK 2
STRATEGY AND EXPERIENCE OF INFANTILE HEMANGIOMA TREATMENT
P.L.Shupyk National Academy of Postgraduate Education, Kiev, Ukraine,
Danylo Halytsky Lviv National Medical University, Lviv, Ukraine,
National Children Specialized Hospital «OXMATDYT», Kiev, Ukraine
Objective. To analyze the treatment results of patients with infantile hemangiomas using various methods.
Methods. The study is grounded on the treatment results of children (n=189) with infantile hemangiomas during the period of 2000-2018 years. All patients were divided into the groups: 1) dynamic observation – 23 (12.2%) children; 2) local destruction – 78 (41.3%); 3) surgical treatment – 22 (11.6%); 4) drug therapy – 66 (34.9%) patients. The interstitial coagulation (n=28) and electrocoagulation of hemangioma (n=50) were applied for the local destruction. 18 patients underwent the complete removal of hemangioma and 4 - segmental resection of tumor with the subsequent propranolol treatment. Propranolol was used for the drug treatment and it was combined with the topical application of timolol (n=13).
Results. Hemangioma regression was registered in 18 (78.3%) patients of the first group. Among the patients of the second group, involution of hemangioma was observed in 26 (92.6%) patients when the interstitial coagulation was applied and 2 (7.4%) children had hemangioma recurrence.
A strong positive effect can be reached by electrocoagulation of superficial hemangiomas (all patients). With primary radical intervention, complete cure was noted in all children, and with segmental resection only one (4.5%) child had a relapse. Keloid scars were formed in 3 (13.6%) children after surgery. Propranolol seemed to be effective in treating hemangiomas in children of all ages, and in 41 (62.1%) patients hemangiomas completely disappeared.
Conclusion. Before initiating therapy, the children need to be assessed for the contraindications and the treatment strategy. In case of infantile hemangioma should be individual based on the results of clinical investigation. Systemic propranolol treatment has gained rapid popularity as the treatment of choice for infantile hemangiomas and may be applied not only as the basic treatment, but also in combination with other methods. Surgical removal of hemangioma remains one of the common treatments components for children with infantile hemangiomas.
- Ding Y, Zhang JZ, Yu SR, Xiang F, Kang XJ. Risk factors for infantile hemangioma: a meta-analysis. World J Pediatr. 2019 Dec 18. doi: 10.1007/s12519-019-00327-2. Online ahead of print.
- Harter N, Mancini AJ. Diagnosis and Management of Infantile Hemangiomas in the Neonate. Pediatr Clin North Am. 2019 Apr;66(2):437-59. doi: 10.1016/j.pcl.2018.12.011
- Cazeau C, Blei F, Gonzáles Hermosa MDRF, Cavalli R, Boccara O, Fölster-Holst R, Berdeaux G, Delarue A, Voisard JJ. Burden of infantile hemangioma on family: an international observational cross-sectional study. Pediatr Dermatol. 2017 May;34(3):295-302. doi: 10.1111/pde.13133
- Vacirca SR, Nardi P, Ferlosio A, Orlandi A, Ruvolo G. Multifocal cardiac hemangioma. J Card Surg. 2018 Jun;33(6):310-12. doi: 10.1111/jocs.13719
- Léauté-Labrèze C, Baselga Torres E, Weibel L, Boon LM, El Hachem M, van der Vleuten C, Roessler J, Troilius Rubin A. The infantile hemangioma referral score: a validated tool for physicians. Pediatrics. 2020 Apr;145(4):e20191628. doi: 10.1542/peds.2019-1628
- Léauté-Labrèze C, Harper JI, Hoeger PH. Infantile haemangioma. Lancet. 2017 Jul 1;390(10089):85-94. doi: 10.1016/S0140-6736(16)00645-0
- Léaute-Labrèze C, Boccara O, Degrugillier-Chopinet C, Mazereeuw-Hautier J, Prey S, Lebbé G, Gautier S, Ortis V, Lafon M, Montagne A, Delarue A, Voisard JJ. Safety of oral propranolol for the treatment of infantile hemangioma: a systematic review. Pediatrics. 2016 Oct;138(4):e20160353. doi: 10.1542/peds.2016-0353
- Tangtatco JA, Freedman C, Phillips J, Pope E. Surgical treatment outcomes of infantile hemangioma in children: Does prior medical treatment matter. Pediatr Dermatol. 2018 Nov;35(6):e418-e419. doi: 10.1111/pde.13658
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- Hoeger PH, Harper JI, Baselga E, Bonnet D, Boon LM, Ciofi Degli Atti M, El Hachem M, Oranje AP, Rubin AT, Weibel L, Léauté-Labrèze C. Treatment of infantile haemangiomas: recommendations of a European expert group. Eur J Pediatr. 2015 Jul;174(7):855-65. doi: 10.1007/s00431-015-2570-0
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- Darrow DH, Greene AK, Mancini AJ, Nopper AJ. Diagnosis and management of infantile hemangioma. Pediatrics. 2015 Oct;136(4):e1060-e104. doi: 10.1542/peds.2015-2485
- Robert J, Tavernier E, Boccara O, Mashiah J, Mazereeuw-Hautier J, Maruani A. Modalities of use of oral propranolol in proliferative infantile haemangiomas: an international survey among practitioners. Br J Dermatol. 2020 Mar 27. doi: 10.1111/bjd.19047. Online ahead of print.
- Streicher JL, Riley EB, Castelo-Soccio LA. Reevaluating the need for electrocardiograms prior to initiation of treatment with propranolol for infantile hemangiomas. JAMA Pediatr. 2016 Sep 1;170(9):906-7. doi: 10.1001/jamapediatrics.2016.0824
- Lund EB, Chamlin SL, Mancini AJ. Utility of routine electrocardiographic screening before initiation of propranolol for infantile hemangiomas. Pediatr Dermatol. 2018 Jul;35(4):e233-e34. doi: 10.1111/pde.13508
- Chan H, McKay C, Adams S, Wargon O. RCT of timolol maleate gel for superficial infantile hemangiomas in 5–24-week-olds. Pediatrics. 2013 Jun;131(6):e1739-47. doi: 10.1542/peds.2012-3828
04112, Ukraine, Kiev,
Dorogozhitskaya Str., 9,
P.L. Shupyk National Academy of Postgraduate Education of the MH of Ukraine,
the Pediatric Surgery Department,
tel. mobile +380 50 412-26-89,
Rybalchenko Vasyl F.
Rybalchenko Vasyl F., MD, Professor of the Pediatric Surgery Department, P.L.Shupyk National Academy of Postgraduate Education, Kiev, Ukraine.
Pereyaslov Andriy A., MD, Professor of the Pediatric Surgery Department,.Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
Rybalchenko Inna G., PhD, Pediatric Surgeon, Neonatal Surgery Department, National Children Specialized Hospital «OXMATDYT», Kiev, Ukraine.
Nykyforuk Olesya M., PhD, Assistant of the Pediatric Surgery Department, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
I.M. IHNATOVICH 1, D.M. BONTSEVICH 2, B.A. MASLIANSKI 3, YU.S. NEBYLITSYN 4, N.M. NOVIKAVA 5, A.V. KOSINETS 6, A.V. MIKHNEVICH 4, A.G. PAVLOV 4
THE APPLICATION OF COMPRESSION THERAPY IN PATIENTS WITH VARICOSE VEINS OF THE LOWER EXTREMITIES
Belarusian State Medical University 1, Minsk,
Medical Center «ELMED»2, Gomel,
Gomel Regional Clinical Hospital 3, Gomel,
Vitebsk State Medical University 4, Vitebsk
Minsk 5th City Clinical Hospital 5, Minsk
Vitebsk Regional Clinical Specialized Center 6, Vitebsk
The Republic of Belarus
Objective. To study the implementation of medical recommendations regarding the use of compression therapy in patients with varicose veins of the lower extremities.
Methods. A prospective comparative study, Patients Commitment to Compression Therapy (POMP), was conducted with the participation of phlebologist-surgeons who treat patients with chronic venous diseases in Minsk, Vitebsk, and Gomel. During 5 weeks each of the phlebologists included in the study patients with varicose veins who sought advice and needed compression therapy. 30-35 days after the consultation of the surgeon-phlebologist, an outsourcing call center conducted a telephone survey of patients in order to obtain information about the specifics of fulfilling medical recommendations.
Results. The registration data base of the study contained individual data on 394 patients with varicose veins (C1-C6) who received recommendations to use compression therapy. After 30-35 days, 302 patients (aged 43, 18-84 (Me, IQR)) were available for telephone survey. There were 58 men (19.2%), 244 women (80.8%). Among them, class C1 was registered in 39 (12.9%), C2 – in 113 (37.4%), C3 – in 122 (40.4%), C4 – in 25 (8.3%), C5 – in 1 (0.3%), C6 – in 2 (0.7%) patients.
It was found that 245 (81.5%) of the respondents either already had compression hosiery at the time of the consultation, or purchased it within 30 days. 228 (75.2%) respondents reported compliance with the recommendations. Patients who had already experience with compression therapy and patients with the history of venous thromboembolism showed higher commitment to compression therapy (p<0.001). There were no significant differences in the compliance of patients with different levels of education and professional characteristics.
Conclusion. A high commitment of patients to compression therapy was established 1 month after receiving recommendations. To obtain more information about patient compliance, it is necessary to enlarge the follow-up period.
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- Nicolaides A, Kakkos S, Baekgaard N, Comerota A, de Maeseneer M, Eklof B, Giannoukas AD, Lugli M, Maleti O, Myers K, Nelzén O, Partsch H, Perrin M. Management of chronic venous disorders of the lower limbs. Guidelines According to Scientific Evidence. Part I. Int Angiol. 2018 Jun;37(3):181-54. Int Angiol. 2018 Jun;37(3):181-54. doi: 10.23736/S0392-9590.18.03999-8
- Wittens C, Davies AH, Bækgaard N, Broholm R, Cavezzi A, Chastanet S, de Wolf M, Eggen C, Giannoukas A, Gohel M, Kakkos S , Lawson J, Noppeney T, Onida S, Pittaluga P, Thomis S, Toonder I, Vuylsteke M. Management of chronic venous disease: clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2015;49:678-37. doi: 10.1016/j.ejvs.2015.02.007
- Kakkos SK, Timpilis M, Patrinos P, Nikolakopoulos KM, Papageorgopoulou CP, Kouri AK, Ntouvas I, Papadoulas SI, Lampropoulos GC, Tsolakis IA. Acute effects of craduated elastic compression stockings in patients with symptomatic varicose veins: a randomised double blind placebo controlled trial. Eur J Vasc Endovasc Surg. 2018 Jan;55(1):118-25. doi: 10.1016/j.ejvs.2017.10.004
- Huang TW, Chen SL, Bai CH, Wu CH, Tam KW. The optimal duration of compression therapy following varicose vein surgery: a meta-analysis of randomized controlled trials. Eur J Vasc Endovasc Surg. 2013 Apr;45(4):397-402. doi: 10.1016/j.ejvs.2013.01.030
- Kirienko AI., Stoyko YUM, Zolotukhin IA. Patients’ Compliance to compression treatment of chronic venous disease. Flebologija. 2018;12(4):244-51. DOI: 10.17116/flebo201812041244 (In Russ.)
- World Health Statistics 2019. Geneva: World Health Organization; 2019. [Internet]. Available from: https://apps.who.int/iris/bitstream/handle/10665/311696/WHO-DAD-2019.1-eng.pdf
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- Cataldo J L, Pereira de Godoy J M, de Barros N. The use of compression stockings for venous disorders in Brazil. Phlebology. 2012 Feb;27(1):33-37. doi: 10.1258/phleb.2011.010088
- Kankam HKN, Lim ChS, Fiorentino F, Davies AH, Gohel MS. A summation analysis of compliance and complications of compression hosiery for patients with chronic venous disease or post-thrombotic syndrome. Eur J Vasc Endovasc Surg. 2018 Mar;55(3):406-16. doi: 10.1016/j.ejvs.2017.11.025
- Uhl JF, Benigni JP, Chahim M, Fréderic D. Prospective randomized controlled study of patient compliance in using a compression stocking: Importance of recommendations of the practitioner as a factor for better compliance. Phlebology. 2018 Feb;33(1):36-43. doi: 10.1177/0268355516682886
220083, Republic of Belarus, Minsk,
Dzerzhinskii Avenue, 83,
Belarusian State Medical University,
the 1st Department of Surgical Diseases,
Ihnatovich Igor N.
Ihnatovich Igor N., MD, professor of the 1st Department of Surgical Diseases, Belarusian State Medical University, Minsk, Republic of Belarus.
Bontsevich Dmitry N., PhD, Associate Professor, Angiosurgeon, Medical Center «ELMED», Gomel, Republic of Belarus.
Maslianski Boris A., Surgeon, the 2nd Surgical Department, Gomel Regional Clinical Hospital, Gomel, Republic of Belarus.
Nebylitsyn Yury S., PhD, Associate Professor, Head of the Plastic Surgery and Cosmetology Department of the Clinic of VSMU, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Novikova Natalya M., Ph, Surgeon, Minsk 5th City Clinical Hospital , Minsk, Republic of Belarus.
Kosinets Alexandr V., Surgeon of the Surgery Unit, Vitebsk Regional Clinical Specialized Center, Vitebsk, Republic of Belarus.
Mikhnevich Alexey V., Senior Lecturer of the Hospital Surgery Department with the Course of Urology and Pediatric Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Pavlov Alexandr G., PhD, Associate Professor of the Hospital Surgery Department with the Course of Urology and Pediatric Surgery, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
TRAUMATOLOGY AND ORTHOPEDICS
S.V. ZYBLEVA, S.L. ZYBLEV
IMMUNOLOGICAL PREDICTORS OF RENAL GRAFT REJECTION IN THE EARLY POSTOPERATIVE PERIOD
Republican Research Center for Radiation Medicine and Human Ecology, Gomel,
The Republic of Belarus
Objective. To determine the immunological predictors of renal graft rejection in the early postoperative period.
Methods. Three groups were formed out of the 197 renal graft recipients. The group PGF (n=101) was made up of patients with satisfactory primary graft function. The group PGD (n = 82) included patients with primary graft dysfunction without episodes of rejection. The group RGR (n=14) consisted of patients with primary dysfunction and renal graft rejection. On the 7th day after transplantation the early kidney graft function was assessed on the basis of serum creatinine levels. When the serum creatinine value was lower than 300 μmol/L the function was considered to be primary, at a creatinine concentration was equal to or higher than 300 μmol/L, as well as in the case of need for maintenance dialysis on the first week after transplantation, the state was classified as the renal graft dysfunction. In the early postoperative period, the number of LIN-HLA-DR+ dendritic cells with the LIN- HLA-DR+CD11c+CD123- and LIN-HLA-DR+CD11c-CD123+ phenotypes in the fluid from the drainage installed to the kidney graft during surgery was determined. Predictive characteristics of the mDC and pDC levels in the drainage fluid were determined to predict renal graft rejection, and diagnostic capability of this indicator were identified.
Results. It has been revealed that renal graft rejection is characterized by a significant growth of the total number of dendritic cells in the drainage fluid, mainly due to myeloid ones. Predictive characteristics were determined by the level of myeloid and plasmacytoid dendritic cells in the drainage fluid. The cut-off point of the level of myeloid dendritic cells was determined at the level of 60.32%, and for plasmacytoid dendritic cells it corresponded to 39.68%.
Conclusion. With the level of myeloid dendritic cells in the drainage fluid greater or equal 60.32%, and plasmacytoid cells lower or equal 39.68%, renal graft rejection is predicted with a sensitivity of 99% and 93%, respectively, and a specificity of 89% and 91%, respectively.
- Zhuang Q, Lakkis FG. Dendritic cells and innate immunity in kidney transplantation. Kidney Int. 2015 Apr;87(4):712-18. doi: 10.1038/ki.2014.430
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- Ezzelarab M, Thomson AW. Tolerogenic dendritic cells and their role in transplantation. Semin Immunol. 2011 Aug;23(4):252-63. doi: 10.1016/j.smim.2011.06.007
- Belz GT, Nutt SL. Transcriptional programming of the dendritic cell network. Nat Rev Immunol. 2012 Jan 25;12(2):101-13. doi: 10.1038/nri3149
- Morelli AE, Thomson AW. Tolerogenic dendritic cells and the quest for transplant tolerance. Nat Rev Immunol. 2007 Aug;7(8):610-21. doi: 10.1038/nri2132
- Solari MG, Thomson AW. Human dendritic cells and transplant outcome. Transplantation. 2008 Jun 15;85(11):1513-22. doi: 10.1097/TP.0b013e318173a768
- Matta BM, Castellaneta A, Thomson AW. Tolerogenic plasmacytoid DC. Eur J Immunol. 2010 Oct;40(10):2667-76. doi: 10.1002/eji.201040839
- Maldonado RA, von Andrian UH. How tolerogenic dendritic cells induce regulatory T cells. Adv Immunol. 2010;108:111-65. doi: 10.1016/B978-0-12-380995-7.00004-5
- Pulendran B, Tang H, Manicassamy S. Programming dendritic cells to induce T(H)2 and tolerogenic responses. Nat Immunol. 2010 Aug;11(8):647-55. doi: 10.1038/ni.1894
- Cantaluppi V, Dellepiane S, Tamagnone M, Medica D, Figliolini F, Messina M, Manzione AM, Gai M, Tognarelli G, Ranghino A, Dolla C, Ferrario S, Tetta C, Segoloni GP, Camussi G, Biancone L. Neutrophil gelatinase associated lipocalin is an early and accurate biomarker of graft function and tissue regeneration in kidney transplantation from extended criteria donors. PLoS One. 2015 Jun 30;10(6):e0129279. doi: 10.1371/journal.pone.0129279. eCollection 2015.
- Zhou H, Wu L. The development and function of dendritic cell populations and their regulation by miRNAs. Protein Cell. 2017 Jul;8(7):501-513. doi: 10.1007/s13238-017-039
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- Colonna M, Trinchieri G, Liu YJ. Plasmacytoid dendritic cells in immunity. Nat Immunol. 2004 Dec;5(12):1219-26. doi: 10.1038/ni1141
- Zuidwijk K, de Fijter JW, Mallat MJ, Eikmans M, van Groningen MC, Goemaere NN, Bajema IM, van Kooten C. Increased influx of myeloid dendritic cells during acute rejection is associated with interstitial fibrosis and tubular atrophy and predicts poor outcome. Kidney Int. 2012 Jan;81(1):64-75. doi: 10.1038/ki.2011.289
246000, Republic of Belarus,
Gomel, Ilyich Str., 290,
Republican Research Center
for Radiation Medicine and Human Ecology
tel. mobile: +375 44 547-69-85,
Zybleva Svetlana V.
Zybleva Svetlana V., PhD, Immunologist, Scientific Secretary, Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
Zyblev Sergey L., PhD, Associate Professor, Surgeon of the Surgery Unit (Transplantation, Reconstructive and Endocrine Surgery), Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus.
S.I. PANIN, A.V. BYKOV, A.B. DORONIN, A.A. KUZNETSOV, S.V. SHCHELKOV, A.A. PANINA, E.A. MOROZOV, S.N. KARPENKO
EVALUATION OF TREATMENT RESULTS OF UROLITHIASIS COMPLICATIONS AMONG COVID-19 PATIENTS
Volgograd State Medical University, Volgograd,
The Russian Federation
Objective. To study the peculiarities of diagnostics and treatment of urolithiasis complications among patients with new coronavirus infection COVID-19.
Methods. The prospective cohort study evaluated the treatment outcomes of patients (n=146). The first group (n=30) included patients treated in infectious diseases hospital with a complicated urinary calculi disease and a new coronavirus infection COVID-19, the second group (n=116) included patients treated in the urological department of multidisciplinary non-infectious hospital due to complicated urinary tract stone disease who were not infected by new coronavirus infection COVID-19. As for COVID 19 diagnostics, patients of the first group were done PCR tests that were positive in 19 (63,3%) cases, and thoracic cavity computer tomography scanning (upon admission the percentage of pulmonary tissue involvement varied since 5% up to 90%).
Results. Among the patients of the first group, elderly people prevailed (61+15 years) and there were more women among them (66%). The characteristic features of complicated urinary calculi disease in patients with COVID-19 are the prevalence of infectious and inflammatory complications (50%) and a combination of several complications of urolithiasis (40%). Among peculiarities of treatment, patients of the first group in 6.6% of cases underwent the lumbotomy with open nephrostomy, due to the spread of secondary suppurative process over the retroperitoneal space. According to the Clavien-Dindo scale, in the first group of patients the incidence of complications after surgery was 40%, in the second - 13.8%. Mortality rate in the first group reached 30%, in the second – 0.9%. The duration of hospital treatment among patients of the first group reached 21 (5-39) days, among patients of the second group – 8 (1-56) days.
Conclusion. The specificity of the course associated with significant morbidity and mortality require further optimization therapeutic approaches to achieve success in patients with complications of urolithiasis during COVID-19 outbreak.
- Timerbulatov MV, Timerbulatov SHV, Sibaev VM, Gainullina EN. Laparoscopic surgery in pandemic Covid-19. Endoskop Khirurgiia. 2020;26(3):59-64. doi: 10.17116/endoskop20202603159 (In Russ.)
- Pushkar DYu, Kasyan GR, Malkhasyan VA, Sazonova NA, Shaderkin IA, Shaderkina VA.. COVID-19: impact on the urological service of the Russian Federation. Eksperim i Klin Urologiia. 2020;(2):13-17. doi: 10.29188/2222-8543-2020-12-2-13-. (In Russ.)
- Naspro R, Da Pozzo LF. Urology in the time of corona. Nat Rev Urol. 2020 May;17(5):251-53. doi: 10.1038/s41585-020-0312-1
- McDermott A, O’Kelly J, Quinlan MJ, Little DM, Davis NF. A prospective study on the incidence of postponed time-sensitive urological procedures during the SARS-CoV-2 pandemic due to patient preference. Ir J Med Sci. 2020 Nov 17:1-5. doi: 10.1007/s11845-020-02438-6. Online ahead of print.
- Prikaz Ministerstva zdravookhraneniia RF ot 28 fevralia 2019 g. N 103n “Ob utverzhdenii poriadka i srokov razrabotki klinicheskikh rekomendatsii, ikh peresmotra, tipovoi formy klinicheskikh rekomendatsii i trebovanii k ikh strukture, sostavu i nauchnoi obosnovannosti, vkliuchaemoi v klinicheskie rekomendatsii informatsii” [Elektronnyi resurs] [data obrashcheniia: 2020 Dek 16]. Available from: http://base.garant.ru/72240714/. (In Russ.)
- Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19), versiia 9 (26.10.2020). Vremennye metodicheskie rekomendatsii Minzdrava Rossii [Elektronnyi resurs] [data obrashcheniia: 2020 Dek 16]. Moskva, RF: Minzdrav RF; 2020. 236 s. Available from: https://medvestnik.ru/content/documents/9-ot-26-10-2020.html. (In Russ.)
- Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae
- COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020 Jul 4;396(10243):27-38. doi: 10.1016/S0140-6736(20)31182-X
- Sánchez MD, Sánchez M, De La Morena JM, Ogaya-Pinies G, Mateo E, Moscatiello P, Sánchez S, Rubio V, Bueno C, Barba R, Carracedo D. Nosocomial SARS-CoV-2 infection in urology departments: Results of a prospective multicentric study. Int J Urol. 2020 Oct 13:10.1111/iju.14402. doi: 10.1111/iju.14402
400131, Russian Federation,
Volgograd, Pavshie Bortsy Square, 1
Volgograd State Medical University,
the Department of the General Surgery
with the Course Of Urology,
tel. +7 903 375-57-95,
Kuznetsov Alexandr A.
Panin Stanislav I., MD, Associate Professor, Head of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
Bykov Alexandr V., MD, Professor of the Department of Surgical Diseases No 1 of Institute of Continuing Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation.
Doronin Andrey B., PhD, Associate Professor of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
Kuznetsov Alexandr A., PhD, Associate Professor of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
Shchelkov Sergey V., PhD, Associate Professor of the Department of Surgical Diseases No1 of Institute of Continuing Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation.
Panina Anna A., PhD, Associate Professor of the Department of Radiation, Functional and Laboratory Diagnostics of Institute of Continuing Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation.
Morozov Egor A., Assistant of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
Karpenko Svetlana N., PhD, Associate Professor of the Department of the General Surgery with the Course of Urology, Volgograd State Medical University, Volgograd, Russian Federation.
S.V. VOLKOV, S.L. LOBANOV, B.S. ERDINEYEVA, A.A. DUTOVA
THE ROLE OF THE INTESTINAL MICROBIOTA IN THE COLON CANCER DIAGNOSTICS
Chita State Medical Academy, Chita,
The Russian Federation
Objective. To determine the composition of the the parietal microflora of the colon under the condition of a tumor process and to assess the possibility of using these data from this study in the diagnosis of the colon cancer.
Methods. The main group included patients (n=75) operated on in the Trans-Baikal Regional Oncology Center for the colon cancer. Among them are 38 men and 37 women aged 20 to 75 years. Control group consisted of 25 patients.
The material of the main group, biopsies of tumor tissue and visually unchanged colon mucosa was taken intraoperatively during tumor removal. In patients of the control group, the material was taken during the colonoscopy. process. The detection of Helicobacter pylori in the biopsy of the mucous membrane was carried out by determining the urease activity, as well as by the method of polymerase chain reaction. The composition of the intestinal microbiota was determined by the bacteriological method.
Results. As a result of comparison of the colon microbiota of the cancer patients and the control group, statistically significant differences in the quantitative composition of Lactobacillus spp., Bifidobacterium spp., Bacteroides spp., Clostridium spp., Enterococcus spp., E. coli (typical), E. coli (lactose-negative), Enterobacteriaceae, Staphylococcus spp. (CNS), Candida spp. were revealed. Moreover, a clear tendency of changes in the level of certain microorganisms (Bifidobacterium spp., E. coli (typical), Clostridium sp.) was detected when comparing the mucous membrane of a healthy person, unchanged mucous membrane of a patient with colorectal cancer, tumor tissue. A statistically significant dependence of the level of microorganisms on the sex of a patient, as well as the form of tumor growth, was revealed.
Conclusion. Thus, a reliable correlation between the clinical and morphological characterization of the colon malignant tumor and the composition of the intestinal microbiota has been revealed. The microbiological features established within in the course of the study, which arise precisely under the conditions of colon cancer, can be used as an additional diagnostic marker in the diagnosis of a malignant process.
- Dai Z, Zhang J, Wu Q, Chen J, Liu J, Wang L, Chen C, Xu J, Zhang H, Shi C, Li Z, Fang H, Lin C, Tang D, Wang D. The role of microbiota in the development of colorectal cancer. Int J Cancer. 2019 Oct 15;145(8):2032-41. doi: 10.1002/ijc.32017
- Hernández-Luna MA, López-Briones S, Luria-Pérez R. The four horsemen in colon cancer. J Oncol. 2019 Sep 29;2019:5636272. doi: 10.1155/2019/5636272
- Bahmani S, Azarpira N, Moazamian E. Anti-colon cancer activity of Bifidobacterium metabolites on colon cancer cell line SW742. Turk J Gastroenterol. 2019 Sep;30(9):835-42. doi: 10.5152/tjg.2019.18451
- Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, Malfertheiner P, Graham DY, Wong VWS, Wu JCY, Chan FKL, Sung JJY, Kaplan GG, Ng SC. Global prevalence of helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017 Aug;153(2):420-29. doi: 10.1053/j.gastro.2017.04.022
- Butt J, Epplein M. Helicobacter pylori and colorectal cancer-A bacterium going abroad? PLoS Pathog. 2019 Aug 8;15(8):e1007861. doi: 10.1371/journal.ppat. 1007861
- Volkov SV, Lobanov SL. Criteria of clinical aggressiveness of colorectal cancer. Zabajkal Med Vestn. 2018;(2):69-76. http://zabmedvestnik.ru/arhiv-nomerov/nomer-2-za-2018-god/kriterii-klinicheskoj-agressivnosti-kolorektalnogo-raka (In Russ.)
- Kountouras J, Kapetanakis N, Polyzos SA, Katsinelos P, Gavalas E, Tzivras D, Zeglinas C, Kountouras C, Vardaka E, Stefanidis E, Kazakos E. Active Helicobacter pylori infection is a risk factor for colorectal mucosa: early and advanced colonic neoplasm sequence. Gut Liver. 2017 Sep 15;11(5):733-34. doi: 10.5009/gnl16389
- Sivan A, Corrales L, Hubert N, Williams JB, Aquino-Michaels K, Earley ZM, Benyamin FW, Lei YM, Jabri B, Alegre ML, Chang EB, Gajewski TF. Commensal Bifidobacterium promotes antitumor immunity and facilitates anti-PD-L1 efficacy. Science. 2015 Nov 27;350(6264):1084-89. doi: 10.1126/science.aac4255
- Wei Y, Li F, Li L, Huang L, Li Q. Genetic and biochemical characterization of an exopolysaccharide with in vitro antitumoral activity produced by Lactobacillus fermentum YL-11. Front Microbiol. 2019 Dec 17;10:2898. doi: 10.3389/fmicb. 2019.02898
- Dai Z, Zhang J, Wu Q, Chen J, Liu J, Wang L, Chen C, Xu J, Zhang H, Shi C, Li Z, Fang H, Lin C, Tang D, Wang D. The role of microbiota in the development of colorectal cancer. Int J Cancer. 2019 Oct 15;145(8):2032-41. doi: 10.1002/ijc. 32017
- Zamani S, Taslimi R, Sarabi A, Jasemi S, Sechi LA, Feizabadi MM. Enterotoxigenic Bacteroides fragilis: a possible etiological candidate for bacterially-induced colorectal precancerous and cancerous lesions. Front Cell Infect Microbiol. 2020 Jan 17;9:449. doi: 10.3389/fcimb.2019.00449
- Sheng QS, He KX, Li JJ, Zhong ZF, Wang FX, Pan LL, Lin JJ. Comparison of gut microbiome in human colorectal cancer in paired tumor and adjacent normal tissues. Onco Targets Ther. 2020 Jan 21;13:635-46. doi: 10.2147/OTT.S218004
- Zorron Cheng Tao Pu L, Yamamoto K, Honda T, Nakamura M, Yamamura T, Hattori S, Burt AD, Singh R, Hirooka Y, Fujishiro M. Microbiota profile is different for early and invasive colorectal cancer and is consistent throughout the colon. J Gastroenterol Hepatol. 2019 Oct 23;35(3):433-37. doi: 10.1111/jgh.14868
- Butt J, Varga MG, Blot WJ, Teras L, Visvanathan K, Le Marchand L, Haiman C, Chen Y, Bao Y, Sesso HD, Wassertheil-Smoller S, Ho GYF, Tinker LE, Peek RM, Potter JD, Cover TL, Hendrix LH, Huang LC, Hyslop T, Um C, Grodstein F, Song M, Zeleniuch-Jacquotte A, Berndt S, Hildesheim A, Waterboer T, Pawlita M, Epplein M. Serologic response to helicobacter pylori proteins associated with risk of colorectal cancer among diverse populations in the United States. Gastroenterology. 2019 Jan;156(1):175-86.e2. doi: 10.1053/j.gastro.2018.09.054
- Changxi C, Mao Y, Du J, Xu Y, Zhu Z, Cao H. Helicobacter pylori infection associated with an increased risk of colorectal adenomatous polyps in the Chinese population. BMC Gastroenterol. 2019 Jan 21;19(1):14. doi: 10.1186/s12876-018-0918-4
672090, Russian Federation,
Chita, Gor’kii Str., 39a,
Chita State Medical Academy
of the Ministry of Health of Russia,
tel.: +7 924 370-99-65,
Volkov Stepan V.
Volkov Stepan V., Assistant, the Oncology Department, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
Lobanov Sergey L., MD, Professor, Head of the Department of Faculty Surgery with the Course of Urology, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
Dutova Anastasiya A., PhD, Senior Researcher, the Laboratory of Molecular Genetics, RI of the Molecular Medicine, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
Erdineyeva Beligma S., PhD, Assistant, the Department of Microbiology, Virology, Immunology, Chita State Medical Academy of the Ministry of Health of Russia, Chita, Russian Federation.
A.V. KADOMTSEVA, P.A. ZARUBENKO, L.B. LOGINOVA
THE ROLE OF IMMOBILIZED METAL-ORGANIC COMPOUNDS IN THE COMPLEX TREATMENT OF PURULENT-INFLAMMATORY DISEASE OF SKIN AND SOFT TISSUES
Privolzhsky Research Medical University, Nizhny Novgorod,
Objective. To study the current Russian and foreign literature dedicated to the problem of application of organometallic compounds immobilized on drug delivery in the treatment of purulent-inflammatory disease of the skin and soft tissues.
Methods. The modern Russian and foreign literature, available in the Pubmed, Medline, Springer, Scopus, e-LIBRARY databases were reviewed according to the problems of purulent-inflammatory diseases, skin and soft tissue infections, the integrated approach to the treatment of purulent-inflammatory diseases, synthesis, immobilized organometallic compounds.
Results. The observational study of the specific recent achievements in the modification of antimicrobial biomaterials is presented. Metal ions have a broad range of antimicrobial activity (especially on proliferation and remodeling), possess by bacteriostatic and bactericidal effect, demonstrate multiple inhibitory effects against bacterial strains and have been proven effective in improving wound healing in all its phases. Natural products and especially biologically active metals such as silver, copper, zinc and germanium, are believed to be an alternative for the development of perspective biomaterials with antimicrobial properties. In recent years, new approach for the production and application of therapeutic and diagnostic drugs based on the immobilization or grafting of drug substances on polymer carriers has been developed. At present, namely the immobilized compounds that have opened the way to the creation of prolonged-action drugs with low toxicity and allergenicity.
Conclusion. Template synthesis of new organometallic drug compounds is considered to be a promising direction in the wound infection treatment, which requires further experimental and clinical study.
- Ostapiuk L. Analysis of the Risk Factors of the Development of Purulent-Inflammatory Diseases. Online Journal of Gynecology and Reproductive Medicine. 2020;1(1):1-3.
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603950, Russian Federation,
Nizhny Novgorod, Minin Square, 10/1,
Privolzhsky Research Medical University,
General Chemistry Department,
Kadomtseva Alena V.
Kadomtseva Alena V., PhD, Senior Lecturer of the General Chemistry Department, Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation.
Loginova Lyubov B., Head of the Laboratory of the General Chemistry Department, Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation.
Zarubenko Polina A., Assistant of the General, Operative Surgery and Topographic Anatomy Named after A.I.Kozhevnikov, Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation.
R.N. KOMAROV, A.M. ISMAILBAEV, P.P. FROLOV, B.M. TLISOV
AN AORTIC VALVE-SPARING OPERATION: INDICATIONS, TECHNICAL ASPECTS AND RESULTS
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow,
The Russian Federation
Reconstructive valve-sparing procedures on the aortic valve are one of the most dynamically developing directions in the cardiac surgery. Today cardiac surgeons all over the world prefer the aortic valve sparing operation using autologous tissues instead biological and mechanical prosthetics. The Ross, Yakub, David, Ozaki procedures have proved their effectives, and their indicators of long-term freedom from reoperations are not inferior to classical prosthetics. In this review the authors describe the key points of the native aortic valve reconstruction. Especially, from the surgical point of view the issues of anatomy of the aortic root and the determination of the optimal «patients» for the valve-sparing procedure are discussed. The principles of reconstruction of various variants of valve development, such as uni-, bi-, three-, and quadricuspid valve anatomy, are presented in details. The approaches to aortic valve repair are described step by step, including a description of the aortic root exposure technique, options for correcting prolapse, eliminating fenestration, and annuloplasty. The evaluation of literature data showed that the overall risks of aortic valve repair in isolation or as a component of a combined intervention are nothigher than in patients with biological or mechanical prosthetics. The violation of the orientation of the commissures, the use of a pericardial catheter, long-term prolapse, as well as expansion of the annulus fibrous are considred as an independent risk factors of significant regurgitation and reoperations in the long term after reconstruction.
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119435, Russian Federation, Moscow,
Bolshaya Pirogovskaya Str., 6,1,
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University),
the Faculty Surgery Department
tel. +7 915 335-10-06,
Tlisov Boris M.
Komarov Roman N., MD, Head of the Faculty Surgery Department No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
Ismailbaev Alisher M., PhD, Assistant of the Faculty Surgery Department No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
Frolov Pavel P., Cardiovascular Surgeon of the Cardiac Surgery Unit of the University Clinical Hospital No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
Tlisov Boris M., Cardiovascular Surgeon of the Cardiac Surgery Unit of the University Clinical Hospital No1, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
A.S. TOLSTOKOROV, A.N. KULIKOVA, I.V.LARIN
CURRENT ASPECTS OF DIAGNOSIS AND TREATMENT OF ATHEROSCLEROSIS OF THE LOWER EXTREMITIES ARTERIES IN PATIENTS WITH DIABETIC FOOT SYNDROME
Saratov State Medical University named after V.I.Razumovsky, Saratov,
The Russian Federation
Atherosclerosis of lower-extremity arterial disease is a common pathology in diabetes mellitus, contributing to the development of ischemic and neuroischemic forms of diabetic foot syndrome. Early diagnosis of vascular lesions helps to reduce the number of cardiovascular complications, performed amputations and improves the quality of life in these patients.The review presents the current arsenal of modern comprehensive examinations of patients with diabetic foot syndrome, including clinical and functional screening, non-invasive and invasive methods of radiological diagnosis, as well as specific assessment scales and new classifications that allow detailing and systematizing trophic foot changes with the ability to predict the course of the pathological process occurring at sites. The using of open revascularization methods helps to achieve the healing of diabetic ulcers in a large percentage of cases, but the point is the problems associated with the localization of the lesion, the choice of conduit for bypass surgery and technical aspects significantly limit the possibilities of this treatment method. Recent technological advances in the development of endovascular surgery have expanded the indications for successful revascularization. The article highlights the results of shunting and endovascular methods in the treatment of atherosclerotic process in infrainguinal area in patients with diabetic foot syndrome.
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410012 Russian Federation,
Saratov, Bolshaya Kazachya Str., 112,
Saratov State Medical University
named after V.I. Razumovsky,
the Department of Surgery and Oncology,
tel. office: 898-73-07-84-31,
Larin Igor V.
Tolstokorov Aleksandr S., MD, Professor, Head of the Department of Surgery and Oncology, Saratov State Medical University Named after V.I.Razumovsky of the Ministry of Health of Russia, Saratov, Russian Federation.
Kulikova Alla N., MD, Professor of the Hospital Surgery Department of the Medical Faculty, Saratov State Medical University Named after V.I.Razumovsky of the Ministry of Health of Russia, Saratov, Russian Federation.
Larin Igor V., Post-Graduate Student of the Department of Surgery and Oncology, Saratov State Medical University Named after V.I.Razumovsky of the Ministry of Health of Russia, Saratov, Russian Federation.
A.N. NECHIPORENKO 1, N.A. NECHIPORENKO 1, D.M. VASILEVICH 2, V.A. BASINSKY 1, A.S NECHIPORENKO 2, N.L. GAVINA 2
XANTHOGRANULOMATOUS PYELONEPHRITIS – A RARE FORM OF CHRONIC CALCULOUS PYELONEPHRITIS
Grodno State Medical University 1,
Grodno University Hospital 2, Grodno,
The Republic of Belarus
The article represents the authors’ own observation of the patient with xanthogranulomatous pyelonephritis (XPN). Xanthogranulomatous pyelonephritis is a rare form of chronic bacterial calculous pyelonephritis. Factors predisposing to the development of xanthogranulomatous pyelonephritis include the following: the impairment of the urinary flow along the urinary tract, type II diabetes mellitus, and chronic inflammation of the kidney.
XPN is an uncommon cause of chronic pyelonephritis resulting in non-functioning kidneys and poses a preoperative diagnostic dilemma which may mimic other malignant diseases of a kidney (renal cell carcinoma, leiomyosarcoma) and acute pyelonephritis as a bacterial infection causing inflammation of the kidneys (a renal carbuncle). The patient was examined at the urology clinic of .Grodno State Medical University: general clinical blood and urine tests, ultrasound examination, X-ray computed tomography – native and with contrast enhancement, magnetic resonance imaging were performed. The patient underwent nephrectomy due to the impossibility of organ-preserving surgery – removal of a volumetric formation located at the hilum of the kidney and adjacent to the vessels. Histopathology of the specimen was concluded as xanthogranulomatous pyelonephritis. The patients underwent MR examinations, ultrasound examination and X-ray computed tomography with contrast enhancement, but a diagnosis of xanthogranulomatous pyelonephritis was not confirmed unequivocally. The final diagnosis is usually established only after histologic examination of biopsy specimens of removed kidney.
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230009, Republic of Belarus,
Grodno, Gor’kii Str., 80,
Grodno State Medical University,
the Department of Surgical Diseases No2,
tel. +375 29 651-35-69,
Nechiporenko Alexandr N.
Nechiporenko Alexandr N., MD, Professor of the Department of Surgical Diseases No2, Grodno State Medical University, Grodno, Republic of Belarus.
Nechiporenko Nikolay A., MD, Professor of the Department of Surgical Diseases No2, Grodno State Medical University, Grodno, Republic of Belarus.
Vasilevich Daniil M., Urologist of the Urological Department, Grodno University Hospital, Grodno, Republic of Belarus.
Basinsky Victor A., MD, Professor, Head of the Department, Grodno State Medical University, Grodno, Republic of Belarus.
Nechiporenko Anna S., Radiologist, CT Department, Grodno University Hospital, Grodno, Republic of Belarus.
Gavina Natalya L., Head of MRI Department, Grodno University Hospital, Grodno, Republic of Belarus.
R.V. UKRAINETS 1, 2, YU.S. KORNEVA 1, 2, A.V. SERGEEV 1, 3
PARTIAL DUPLICATION OF VERMIFORM APPENDIX AS A CAUSE OF THE APPENDICEAL INFILTRATE
Smolensk State Medical University 1,
Smolensk Regional Institute of Pathology 2,
Emergency Clinical Hospital 3, Smolensk,
The Russian Federation
The appendix anomalies are extremely rare malformations. Preoperative diagnosis of appendiceal duplication is often difficult and usually discovered incidentally during surgery for appendicitis. A clinical case of the development of chronic residual appendicitis in a 32-year-old woman with the abnormality of the vermiform appendix identified duplicity, type A according to the Cave-Wallbridge classification is described. During the first hospitalization, the patient was treated conservatively with a diagnosis of «a dense appendiceal infiltrate»; later, a planned appendectomy was performed. A duplication of the vermiform appendix type A was revealed during the examination of the removed appendix. Histopathological examination detected the underdevelopment of the wall of the accessory vermiform appendix - a complete absence of the outer longitudinal layer of the muscular membrane. The abnormally thin wall of the accessory appendix, as well as the related with it hypoperistalsis provoked the onset of chronic inflammation in the wall, which easily spread to the periappendiceal adipose tissue with the formation of a dense appendiceal infiltrate, which required surgical intervention. Thus, a rare clinical case of duplication of the vermiform appendix type A with forming of appendiceal infiltrate, associated with abnomality of muscular tissue, shown by the surgical findings and corroborated by pathology samples of intestinal tissue has been presented.
- Panda SK, Prasad C, Tirkey R, Rajesh V, Mishra J, Dora RK. Unusual association of Meckel’s diverticulum with double appendix – A rare finding. Int J Surg Case Rep. 2014;5(11):879-81. doi: 10.1016/j.ijscr.2014.09.009
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214019, Russian Federation,
Smolensk, Krupskaia Str., 28,
Emergency Clinical Hospital, Surgery Unit;
tel. +7(4812)242000, additional number 280,
tel. +375 29 651-35-69,
Sergeev Alexey V.
Ukrainets Roman V., Pathologist, the Department of Clinical Pathology No2, Smolensk Regional Institute of Pathology, Assistant of the Department of Pathological Anatomy, Smolensk State Medical University, Smolensk, Russian Federation.
Korneva Yulia S., PhD, Associate Professor of the Department of Pathological Anatomy, Smolensk State Medical University, Pathologist, the Department of Clinical Pathology No2, Smolensk Regional Institute of Pathology Smolensk, Russian Federation.
Sergeev Alexey V., PhD, Associate Professor of the Department of Hospital Surgery, Smolensk State Medical University, Head of the Surgical Unit of the Emergency Clinical Hospital, Smolensk, Russian Federation.
EXCHANGE OF EXPERIENCE
S.E. GRYAZNOV 1, G.G. MELKONYAN 1, 3, A.M. SHULUTKO 2, V.I. SEMIKOV 2, E.G. OSMANOV 2, E.G. GANDYBINA 2
TRANSORAL THYROIDECTOMY AND PARATHYROIDECTOMY: SERIES OF CASES
City Clinical Hospital No4, Moscow Health Department 1,
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University) 2,
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation3, Moscow
The Russian Federation
Objective. To present the results of the author’s own series of transoral operations in patients with pathology of the thyroid and parathyroid glands.
Methods. Transoral surgery was performed in women (n=20) and man (n=1). All patients were operated on for the primary disease and met the selection criteria based on ultrasound and cytological examinations, hormonal levels, and somatic status. Indications for surgery were: nodular goiter in 17 cases, diffuse toxic goiter – in 2 cases, parathyroid adenoma – in 2 cases. The surgical technique included a three-port approach in the lower fornix of the vestibule of the mouth and a gas technique for maintaining the working cavity. Standard laparoscopic instruments and an energy based ultrasonic device were used for the operation. In the postoperative period, patients underwent a test for subjective assessment of the aesthetic result of the operation using the survey of the dermatology life quality index.
Results. Thyroidectomy was performed in 4 patients, hemithyroidectomy – in 15 patients and parathyroidectomy – in 2 patients. In one patient, transoralparathyroidectomy was performed as a part of a simultaneous operation for multiple endocrine neoplasia type 1 syndrome. Papillary cancer T1N0M0 was verified in two patients after surgery. The mean operation time was 196.1 min (range 110 – 300 min). Average blood loss – 39.5 ml (range 10 – 300 ml). The nineth operation required the conversion due to severe bleeding. In one case, the temporary recurrent laryngeal nerve (RLN) injury was reported, in one case – hematoma. After surgery, the median and average values of the dermatology life quality index were 1 (IQR 0-4) and 2.05, respectively, which indicates an insignificant effect on the quality of life.
Conclusion. Transoral endoscopic surgery on the thyroid and parathyroid glands would be the promising optimal choice in patients to avoid scarring on the neck.
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115093, Russian Federation,
Moscow, Pavlovskaya Str., 25,
City Clinical Hospital No 4,
Moscow Health Department
tel.: +7 916 299-26-88,
Gryaznov Sergey E.
Gryaznov Sergey E., PhD, Surgeon, City Clinical Hospital No4, Moscow Health Department, Moscow, Russian Federation.
Melkonyan Georgiy G., MD, Professor of the Surgery Departmentr, Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation , Head physician, City Clinical Hospital No4, Moscow Health Department, Moscow, Russian Federation.
Shulutko Alexandr M., MD, Professor of the Surgery Department No2, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
Semikov Vasily I., MD, Professor of the Surgery Department No2, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
Osmanov Elkhan G., MD, Professor of the Surgery Department No2, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.
Gandybina Elena G., PhD, Associate Professor of the Surgery Department No245, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.