Vol 2, No 1 (2017)
- Year: 2017
- Articles: 10
- URL: https://journal-vniispk.ru/2500-1388/issue/view/1283
- DOI: https://doi.org/10.35693/2500-1388-2017-0-1
Articles
MODERN ASPECTS OF THE ETIOLOGY AND PATHOGENESIS OF UTERINE FIBROID TUMORS
Abstract
Uterine myoma is a benign, hormone-sensitive proliferating tissue. It is one of the most common tumors of women's reproductive system in most countries of the world, and it is often the main cause of hysterectomies, especially among fertile females, determining the social significance of this disease. Domestic and foreign researches are continuing to look for the reasons of this worldwide problem. The article describes the present view on the etiology, pathogenesis and morphogenesis of uterine fibroids. It presents the data on the role of steroid hormones and their receptors, processes of neoangiogenesis, their stimulants and inhibitors (VERGF, EGF, IGF-1, TGF, PDGF, MMPs), proliferation and apoptosis disorders (protooncogene Bcl-2, nuclear phosphoprotein p53). The influence of gene mutations, molecular-genetic markers, as well as immune system mechanisms on tumor growth and development were studied.
Science and Innovations in Medicine. 2017;2(1):6-12
6-12
UNIVERSAL APPROACH TO THE PREVENTION OF THE SYNDROME OF PATHOLOGICAL PREGNANCY
Abstract
Aim - the purpose of the study is the development of a method for prevention of pathological pregnancy syndrome from the perspective of integral genesis, determined by morphological and functional abnormalities in the fetoplacental system, assessing the effectiveness of methodological standards of evidence-based medicine. Materials and methods. Prospective study of 435 women with high risk of decompensation of placental insufficiency was conducted. Depending on the method of prevention of gestational complications 4 groups were formed: 1st group included 145 pregnant women, who were prescribed dydrogesterone on the 6-20 weeks of gestation, and starting with the 21st week - highly-purified diosmin 600 mg as vasoprotective; in the 2nd group 118 women received a course of preventive treatment with low doses of acetylsalicylic acid; 3rd group included 102 patients who underwent a course of preventive monotherapy with magnesium; 4th group comprised 70 pregnant women who refused preventive treatment. A control group encompassed 30 healthy pregnant women. Dynamic survey included definition of markers of endothelial and hemostasiological dysfunction, vascular-platelet dysfunction elements, apoptosis, inflammatory response, total reactive capacity of the organism, magnesium and carbon dioxide concentrations; a hystostereometric study of placenta was conducted. Standards of evidence-based medicine were applied for the objectification of the effectiveness of the developed method. Results. Method of preventing great obstetric syndromes by successive appointment of progestogen dydrogesterone on the early stage of pregnancy followed by vasoprotective diosmin 600 mg in the 2nd half of pregnancy showed high efficiency (NNT 1.4 (95% CI 1.1 -1.7); OSH 5.3 (95% CI 4.7 -5.8), namely reducing pre-eclampsia by 93%, placental insufficiency with intrauterine growth restriction and/or chronic fetal hypoxia - 95%, preterm birth - 86%, and no premature abruption of normally situated placenta, severe forms of pre-eclampsia and placental insufficiency. Higher clinical effectiveness of the proposed method of prophylaxis of pathological pregnancy syndrome, compared to the use of low-dose acetylsalicylic acid and preparation of magnesium, can be explained by the normalizing effect of dydrogesterone and highly-purified diosmin 600 mg on the immune and biochemical homeostasis, apoptosis and angiogenesis, activation of endothelial and hemostasiological system, adaptive compensatory reactions in the placenta. Conclusion. The method of choice for the prevention of pathological pregnancy syndrome at high risk of fetoplacental system decompensation is the application of progestogen dydrogesterone and vasoprotective diosmin according to the developed method. The study revealed the potential of targeted selection of preventive methods depending on special needs of pregnant women.
Science and Innovations in Medicine. 2017;2(1):13-23
13-23
REFRACTORY FORM OF GASTROESOPHAGEAL REFLUX DISEASE: EVOLUTION OF CONCEPTS
Abstract
Aim of the review - to illuminate the problem of proton pump inhibitor(PPI)-refractory form of gastroesophageal reflux disease (RFGERD) at a modern scientific level. It is shown that PPI remain the standard and the most effective therapy for GERD. Patients, whose GERD symptoms are refractory to PPI, should be further examined to exclude other diseases. It is possible to use different treatment options: medication, endoscopic or surgical treatment. The response to IPP therapy can be complete (no symptoms), partial or absent. In patients with complete response to treatment with PPI no other therapy is provided. Currently, new methods of RFGERD treatment are being actively developed. Patients with partial response may require endoscopic or surgical intervention.
Science and Innovations in Medicine. 2017;2(1):24-30
24-30
METHOD OF ESTIMATION OF PHYSIOLOGICAL ADAPTATION AND THE RATE OF AGING IN PATIENTS WITH A HISTORY OF EMOTIONAL STRESS IN COMBAT SITUATION
Abstract
Aim - to develop an automated program for the evaluation of physiological adaptation of the cardiovascular system for combat veterans. Materials and methods. The study included 60 male patients, average age 53.13 ± 2.9 years, who participated in combat operations in Afghanistan (1979 - 1989) and Chechnya (1994 - 2002). The study of adaptive homeostasis of the cardiovascular system is made on cellular, microvascular, cardiovascular and organ levels. Results. The veterans of combat operations are characterized by disturbances in the psychological, physiological and social adaptation, which leads to premature aging. The cardiovascular system is highly reactive and plays a major role in the adaptive changes of the functional state of the organism. Based on the model of canonical correlation with step-by-step inclusion and exclusion of predictors, parameters of the cardiovascular system, a computer system for assessment of the degree of adaptation was developed. Conclusion. The developed automated system can be used in treatment, prophylactic and rehabilitation institutions, as well as in research and education centers for the diagnosis and monitoring of the effectiveness of therapeutic and rehabilitation measures.
Science and Innovations in Medicine. 2017;2(1):31-36
31-36
COMPARATIVE ASSESSMENT OF REMOTE RESULTS OF NON-PHARMACOLOGICAL METHODS OF COMPLEX TREATMENT OF OBLITERATING ATHEROSCLEROSIS OF THE LOWER EXTREMITIES IN PATIENTS OF ELDERLY AND SENILE AGE
Abstract
Aim - to estimate the remote results of treatment of obliterating atherosclerosis of arteries of the lower extremities of the II stage in patients of advanced and senile age after the combined use of ozone therapy and gravitational therapy. Materials and methods. A prospective randomized study in three parallel groups comprised 139 patients. The first group (n = 57) received standard medical therapy in combination with ozone therapy; the group was divided into two subgroups: the patients of subgroup 1a (n = 28) received intravenous ozonated physiological solution, in subgroup 1b (n = 29) - major ozonated autohemotherapy (MOA). Patients of the second group (n = 62) underwent comprehensive treatment, including gravitational therapy (GT) in addition to medical ozone. In this group we also identified two subgroups: subgroup 2a (n = 31), in which the patients received standard medical therapy in combination with ozonated physiological solution and gravitational therapy, and subgroup 2b (n = 31), in which the treatment was amplified by MOA and GT. The third group was the control group (n = 20) that included patients who received only standard medical therapy. Dynamics of changes of disease stages and the number of surgeries in the remote period was estimated (up to 7 years). Results. After 6 months of follow-up observation, the distribution of the disease stages among the patients did not differ significantly (p> 0.05) from the initial amount. Analysis of survival and probable risks after 7 years of follow-up by Cox regression method in relation to the applied method of treatment revealed maximum efficiency of combined treatment in subgroup 2a. Conclusion. As a result of complex conservative treatment, including ozonotherapy and gravitational therapy, the probability of surgical interventions as well as disease stage advancing were effectively reduced.
Science and Innovations in Medicine. 2017;2(1):37-42
37-42
INNOVATIONS IN DIAGNOSTICS AND TREATMENT OF PATIENTS WITH HYPERTRIGLYCERIDEMIA
Abstract
This article presents innovative techniques for diagnostics, risk stratification and treatment of patients with hypertriglyceridemia. Hypertriglyceridemia is not only known as an independent risk factor of cardiovascular diseases, but also its high level can become a cause of acute pancreatitis.
Science and Innovations in Medicine. 2017;2(1):43-51
43-51
PECULIARITIES OF MORBIDITY WITH TEMPORARY DISABILITY AMONG POPULATION OF THE SAMARA REGION
Abstract
Aim - to study morbidity with temporary disability among the population of the Samara region in order to characterize the health status of the working population. Materials and methods. The form of statistical reporting No. 16-VN "Information on the causes of temporary incapacity for work" for 2013-2015 for the Samara region was analyzed. Analytical, statistical and epidemiological methods of research were used. Results. The characteristic of morbidity among the working population of the Samara region in dynamics for 2013-2015 is presented. The structure of temporary incapacity for work (TIW) in cases and in days, the average duration of one case of TIW, the number of cases and days of TIW per 100 workers were calculated. Conclusion. For the period 2013-2015 there was a decrease in the number of working population by 6.4% to 1366.4 thousand people in the Samara region. There was a slight increase (3.7% in cases and 3.4% in days) in the incidence of temporary disability for all reasons, as well as due to illness (4.0% in cases and 3.8% in days), mainly for account of the urban population. The incidence with temporary disability is almost half as high in rural areas of the region compared with cities. In the structure of morbidity due to diseases, cases of respiratory diseases, musculoskeletal system and connective tissue, as well as trauma and poisoning account for more than 70% of the total pathology. The duration of one case of temporary incapacity for work in the Samara region did not change and amounted to 12.3 days for all reasons and 13.2 days due to illness.
Science and Innovations in Medicine. 2017;2(1):52-56
52-56
CONGENITAL FOOT DEFORMITIES IN PRESCHOOL CHILDREN: CLINICAL ASPECTS AND ALGORITHMIC APPROACH IN THE WORK OF PEDIATRICIANS
Abstract
Aim - analysis of the incidence of musculoskeletal system diseases and comorbid pathology in children; development of an algorithm for the rehabilitation of young children with congenital foot deformities for their parents and primary care professionals. Materials and methods. 244 cards of complex rehabilitation in rehabilitation centers of the Samara region for the period from January 2013 to August 2016 were studied. The children were divided into two groups: I group - the core group - included children of senior preschool age who were born between 22-37 weeks of gestation with birth weight of 500-2499 g; group II - control group - included children of preschool age who were born at 38-41 weeks of gestation with birth weight 2500-4500 g. Results. The study revealed the incidence of diseases of the musculoskeletal system in children in rehabilitation centers of the Samara region. The number of children with congenital deformities of the foot was 49.7% in the group of prematurely born children; flatfoot composed 42.3%, which proves the importance of the background condition (prematurity) in the development of congenital diseases of the foot. Multivariate analysis showed that the following factors are statistically significant: infantile cerebral palsy (p = 0.004), varus and valgus foot deformity (p<0.001) and hypotension (p<0.001). According to the results of the study a program was established that enables to determine the tactics of the follow-up of children, including prematurely born ones, depending on the type of congenital foot deformities. Conclusion. Therefore, the pediatrician should take into account the presence of background diseases in children with congenital deformities of the foot and carry out primary preventive activities in cooperation with parents.
Science and Innovations in Medicine. 2017;2(1):57-60
57-60
CYTOKINE PROFILE AND IMPORTANCE OF ITS ASSESSMENT IN FORECASTING THE COURSE OF DUST DISEASES OF THE LUNGS
Abstract
Aim - study of cellular immunity and cytokine profile in dust lung diseases caused by exposure to aerosols of various degrees of fibrogenity; assessment of the role of immunological changes in the pathogenesis of occupational lung diseases of dust aetiology. Materials and methods. 161 patients from the contact group with chronic dust bronchitis, silicosis and pneumoconiosis due to exposure to welding aerosols were examined. The control group included 60 people who did not have contact with occupational hazards at work and who were declared healthy according to complete physical examination. The diagnosis was made on the basis of professional anamnesis, sanitary-hygienic characteristics of working conditions (work in contact with aerosols of various degrees of fibrogenity), and a complete clinical and instrumental examination of patients. The levels of cytokines IL-1a, IL-ф, IL-4, IL-8, TNF-a, IFN-y and fibronectin in the blood serum were determined using enzyme-linked immunosorbent assay. Results. The specific features of the course of dust diseases of the lungs were revealed (identified features of the cytokine profile, hypercytokinaemia of a significant number of cytokines), which allows us to characterize the occurrence and the progression of dust diseases of the lungs. Conclusion. Determination of the cytokine profile allows us not only to improve the quality of early detection, but also to optimize the strategy of primary and secondary prophylaxis of this disease, to predict the course of the disease, and to reduce the number of disabling forms.
Science and Innovations in Medicine. 2017;2(1):61-64
61-64
OPTIMIZATION OF INDICATIONS FOR THORACOSCOPY IN CHEST TRAUMA
Abstract
Background. The terms for application of video-assisted endosurgical interventions appear rather often in the surgery of chest trauma. There is a certain need for clear selection and differentiation of indications and contraindications for performing thoracoscopy and other operations. Materials and methods. The 3-years’ experience of treatment of patients with blunt chest trauma and penetrating wounds is described in the article. There was prevalence of patients with isolated blunt chest trauma (35.1%) and penetrating thoracic wounds (29.0%). We have performed thoracoscopy for 107 patients. Emergency thoracoscopy had been done in 38 cases (35.5%), urgent thoracoscopy in 27 (25.2%) and delayed thoracoscopy - in 42 patients (39.3%). The rate of thoracotomy was 14.9%. Results and discussion. The indications for thoracoscopy at chest trauma were defined. The analysis of treatment results depending on the kind of traumatic lesion and operation method was carried out. The best results were obtained in patients with isolated blunt chest trauma and those who underwent thoracoscopy. The role of thoracoscopy in case of urgent and delayed indications for surgery was emphasized. We registered complications in 13.5% of patients with blunt chest trauma and 6.1% of patients with penetrating wounds. The general mortality was 3.8%. Conclusion. We can conclude that the results of treatment of patients with blunt chest trauma and penetrating wounds depend on the severity of the trauma, terms and quality of special medical management and wide application of thoracoscopy.
Science and Innovations in Medicine. 2017;2(1):65-72
65-72