bluuebunny/crossref_metadata_2025 huggingface dataset:
METABOLIC DETERMINANTS OF IMMUNE REACTIVITY
Authors: Vologzhanin Dmitry A , Khalimov Yuriy Sh
Published: July 2021

As a result of the study of the dynamics of nutritional and immune status in patients with severe trauma in the first 30 days of the posttraumatic period, the interrelations between the parameters of metabolism and the immune system were revealed and the predominant influence of a number of nutrients on the state of the various type of immune response was revealed. Data were obtained indicating the change in the need for immunonutrients at different times from the moment of injury. Prospective approaches to nutritional immunocorrection in patients with trauma, consisting in the differential use of separate nutrients at different period after trauma, have been identified (9 figs, bibliography: 9 refs).
Diagnosis and differential diagnosis of pulmonary sarcoidosis
Authors: Kharitonov M A , Salukhov V V , Kazantsev V A , Shustov S B , Bogomolov A B , Nikolaev A V , Toporkov M M , Black M S , Ivanov V V , Menkov I A , Asyamov K V , Grozovsky Yu R , Yarovenko I I
Published: July 2021

Pulmonary sarcoidosis is one of the most common interstitial lung diseases. The prevalence in Russia is 10-20 per 100 thousand population. Overwhelmingly it is found among working age population, and the peak of morbidity is 30-40 years. In half of the cases, sarcoidosis occurs in oligosymptomatic form. According to research conducted by our scientists, the adverse course of the disease with exacerbations and progressive decrease in pulmonary function found in 27,3% of patients. The diagnosis is based on clinical, X-ray and histological examination. Material for histological study was prepared depending on the extent of the process. Preference is given to minimally invasive methods of biopsy: transbronchial puncture of intrathoracic lymph nodes, peripheral lymph nodes, bone marrow aspiration, skin sarcoid items, etc. In the case of the intrathoracic localization of the disease, the treatment of choice is videothoracoscopy. The detection of epithelioid cell granuloma without necrosis confirms the diagnosis of sarcoidosis. First of all it is necessary to exclude tuberculosis, oncohematological diseases, disseminated lung diseases, combined with alveolitis syndrome and mediastinal lymphadenopathy. The primary diagnosis should be carried out under conditions of a multifunctional clinic. The verification of the pulmonary sarcoidosis should be held in close cooperation of different specialists: pulmonologists, radiologists, thoracic surgeons, pathologists, etc. Further treatment of the patient should be implemented by the pulmonologist in the place of residence. A clinical case of late diagnosis of diffuse diseases of connective tissue, which at its beginning started under the mask of sarcoidosis is demonstrated. The main mistake that led to deep disability of the patient, was absence of timely histological verification of the diagnosis.
Research of innervation and function of shoulder joint stabilizer muscles and parts of deltoid muscles in patients with old fractures of proximal humerus
Authors: Zubareva T V , Gyulnazarova S V
Published: July 2021

Neurophysiological study of rotator cuff functions (m. biceps brachii, m. triceps, m. deltoideus dex. et sin.) and its innervation in patients with monolateral old fractures and fracture-dislocations of the proximal humerus are presented. Period after trauma was an average of one year. Significant neuritis of n. axillars and n. musculocutaneus were revealed on the traumatic side. Lowering of M-answers in comparison with individual norm was at 48,5% for n. axillaris, 59% - for n. musculocutaneus, 68% - for n. radialis. Strong degree of n. axillaris damage (M-answer 30% below normal) was observed in 39% of patients, that is more often than neuritis of other plexus nerves: similar effect on n. musculocutaneus was two times more often (18% of cases) and 8 times more often than еffect on n.radialis (5% of cases). An in-depth study of the functions of the anterior, middle and posterior parts of the deltoid muscle was carried out in these patients on both sides. Interferencial electromyography demonstrated significant irregularity of bioelectrical activity of different deltoid parts. Stimulating electromyography of m. deltoideus parts innervation recorded reduced activity of the front part of the muscle, caused by weak innervations of its n. axillaris branch in comparison with the norm. Reliable distinctions in function and innervation of deltoid parts were found between each other as well as between intact and damaged sides. The recommendation to carry out electromyography of each part of deltoid was substantiated for patients with complex old fractures of proximal humerus before reconstruction surgeries or shoulder arthroplasty.
Results clinical assessment of the application of nonsteroidal anti-inflammatory drugs for pain symptoms occurring after endodontic dental treatment
Authors: Nikitenko V V , Borisova E G , Polevaya L P , Soldatkina A S , Polevaya A V
Published: July 2021

Pain is one of the most common and most difficult on subjective perception of dental symptoms. These domestic and foreign literature stating a fact that more than 80% of patients after endodontic treatment there is a feeling «fullness» in the tooth, pain when biting on the tooth, radiating to neighboring teeth or along the branches of the trigeminal nerve. From the pathogenesis point of view, the above manifestations are acute toxic-traumatic neuropathy of the trigeminal nerve. This often leads to an unreasonable removal of a qualitatively and competently cured tooth. A comparison was made of the analgesic activity of ketanov in the relief of pain that occurs after root canal filling, with the analgesic activity of nimesulide in 57 patients aged 20 to 55 years. In acute pain, an analgesic effect with the administration of ketanov appeared within 15 to 20 minutes, with the administration of nimesil, the effect occurred within 30-40 minutes. After a course of treatment, patients in both groups significantly decreased irritability, sleep normalized. Patients believed in the success of treatment, because a decrease or a significant decrease in the pain syndrome reflexively leads to an improvement in the psycho-emotional sphere of patients, which in turn favors long-term remission.
Influence neurological complications that arose after the dental treatment on the quality of life of patients
Authors: Borisova E G , Yagmurov H O , Griga E S
Published: July 2021

The most common clinical symptom in dentistry is pain. Doctors-dentists of practical health care have to face symptoms that doctors-forensic experts regard as a defect or neurological complication after dental treatment. Quite often there is acute toxic-traumatic neuropathy of the lower alveolar and chin nerve, which occurs when a filling material enters the mandibular canal during treatment of pulpitis or periodontitis of the premolars of the lower jaw [1-3]. During the filling of the canals, the patient has a very intense acute pain in the area of the lower jaw with numbness of the lower lip and chin. In connection with the wide spread and availability of implantological dental care to the population, neuropathies of traumatic genesis occur, the causes of which are mistakes in the setting of implants. One of the earliest manifestations of the above complications is a painful symptom leading to sleep disruption, the inability to fully fulfill their professional duties, fully eat and communicate, that is, to reduce the quality of life of patients. Using the short form (SF-36) as a questionnaire, 86 patients of dental clinics, who according to the medical documentation, had complications after performing dental interventions with different degrees of pain, found that the quality of life in general, with an increase in pain up to 100%, decreases to an average of 60%.
Evaluation of some biochemical indicators of blood of high-qualified short-track sportsmen under the combined influence of specific physical load and low-intensive laser radiation
Authors: Strelycheva K A , Bruk T M , Osipova N V
Published: July 2021

Monitoring of biochemical parameters of blood allows to determine the individual characteristics of athletes’ body and evaluate the effectiveness of building a training process. The increasing volume of physical activity during the preparatory period forces us to search for means of rapid increase in the functional level state and physiological reserves of an organism. In this regard, as one of the methods, the physiotherapeutic course effect of low-intensity laser radiation can be used. It was revealed that a specific physical load leads to a significant increase in lactate and total blood protein levels. So, in short-trackers in a state of relative physiological rest, the concentration of lactate was 2,77±0,24 mmol/l, which is much higher than the norm (the norm is 1,3±0,35 mmol/l). After the course of low-intensity laser radiation, the lactate level decreased insignificantly (2,52±0,19 mmol/l), but did not reach normal values. After the action on the body of a specific physical load, lactate concentration increased significantly, reaching a level equal to 9,24±0,43 mmol/l. The conducted course laser therapy allowed to reliably (р 0,05) lower its level to 6,25±0,32 mmol/l. In this case, urea and creatinine had only a tendency to increase. Thus, low-intensity laser radiation against the background of a specific physical load makes it possible to bring the investigated parameters close to the boundary of the physiological norm.
Functional magnetic resonance imaging tomography in assessing the functional state of the brain in patients with opioid addiction
Authors: Tarumov D A , Abdulaev Sh K , Trufanov A G , Ushakov V L , Shamrey V K , Zheleznyak I S , Ipatov V V , Romanov G G , Kovalishin I M
Published: July 2021

The possibilities of functional magnetic resonance imaging in the diagnosis of opioid dependence syndrome are considered. It is known that opioid addiction is one of the leading problems of modern narcology. Despite the fact that the number of researches of the neurobiological effects of opioids is increasing every year, the pathogenetic effects of dependence on this narcotic substance are still not fully understood. Functional magnetic resonance imaging rest allows one to assess the functional connectivity of the remote from each other parts of the brain and makes a great contribution to understanding the mechanisms of development of addictive disorders in general. In patients with opioid dependence, an analysis was made of the neural network of the passive mode of the brain (default mode network). This resting network is associated with the processes of control and thinking, including emotional and cognitive components, and consists of medial frontal regions, posterior cingulate sections, precuneus, lower parietal and temporal divisions. It was found that, in comparison with the control group, in all patients suffering from opioid dependence, weakened functional connections of all structures of the cerebro-spinal cord system (p0,05). In this case, changes in the medial prefrontal cortex and precuneus are more pronounced in patients who are in the state of opioid intoxication, and in the parietal-temporal regions in patients who are in a state of remission up to 1 month. The correlation of cortical structures responsible for the «behavior control» system (orbitofrontal cortex, prefrontal cortex) with subcortical structures responsible for emotions in the limbic system was also evaluated. In comparison with the control group, in patients with early remission, weakened functional connections between cortical structures and left contiguous nucleus, almond-shaped body from two sides. In patients in a state of intoxication in addition to these changes, the functional relationship between the orbital frontal cortex and the shell on the left has been weakened. The weakening of functional links in the network of the passive mode of the brain in the groups of drug addicts suggests that they have violated the processes of control, thinking and making the right decision. The resulting functional changes can form the basis for creating biomarker maps for patients suffering from opioid dependence, which can be used to guide and evaluate the treatment of this pathology.
Influence of arterial hypertension on intrauterine development of the fetus
Authors: Garayeva K G
Published: July 2021

The results of monitoring the course of pregnancy in women suffering from arterial hypertension and preventive measures focused on problems associated with hypertension are analyzed. It is shown that hypertension does not occur in pregnant women under 18 years old, but with the increasing of age of pregnant women, its occurrence is sharply increased. It was revealed that arterial hypertension during pregnancy creates not only a threat of preeclampsia and eclampsia development, but also a threat of defective development of the fetus. It was found that 26 (46%) parturient women undergone cesarean section. In this case, in 12 (21%) pregnant pre-natal development of the fetus was abnormal. After giving birth, the women in childbirth were under the supervision of a cardiologist and received appropriate treatment. 25 (45%) of women had another pregnancy after the treatment. Among the re-pregnant women, who before the onset of pregnancy received treatment in a specialized cardiological clinic, only 5 (20%) were prescribed to caesarean section. The remaining 80% of parturients gave birth naturally. Stillbirth and spontaneous miscarriages were not observed. Out of 25 newborns, only 3 (12%) children were found to have congenital malformations. Thus, in women with arterial hypertension and receiving appropriate treatment in cardiology hospitals, the indications for cesarean section were 26% less, also there were 10% perinatal development defects less than in women who did not receive such a treatment. Consequently, pregnant women suffering from hypertension should be monitored not only by an obstetrician-gynecologist, but also by cardiologist, nephrologist, ophthalmologist and endocrinologist.
Diagnostic capabilities of electrocardiography systolic heart failure
Authors: Malov Yu S , Borisov I M , Galova E P , Yarovenko I I
Published: July 2021

The contractility of the myocardium is determined by the strength and speed of contraction of the ventricles. It can be estimated from the Q-T interval of the electrocardiogram, which is an electrical systole of the ventricles. Set the change in ventricular systole by the deviation of the actual interval of Q-T from the corrected one. Elongation of ventricular systole indicates a violation of myocardial contractility, which causes the development of systolic heart failure. When comparing this indicator with the results of echocardiography, reflecting the contractility of the left ventricle, their direct dependence was established. The greater the degree of breach of myocardial contractility, the higher the percentage of the deviation of the actual Q-T interval from the corrected one. The maximum figures were recorded in patients with a global contractility disorder. This indicator can be used to detect both acute and chronic systolic insufficiency. It was established that in all patients with heart failure there was an increase in the Q-T interval. The magnitude of it depended on the degree of manifestation of heart failure. The increase in the percentage deviation of the actual value from the control occurred in patients with heart failure from I functional class to IV. Only in 1/5 of patients with heart failure of I functional class, the actual value did not differ from the control one, but under physical load, it increased significantly, which indicates the presence of latent systolic insufficiency. It is also found in patients with heart failure with a preserved ejection fraction, the development of which is associated with diastolic dysfunction. Electrocardiography can be used as a method of diagnosing systolic heart failure, which is highly informative and specific.
Morphofunctional changes in the myocardium of the left ventricle at an early stage of the development of hypertension
Authors: Kuchmin A N , Galova E P , Kazachenko A A , Yaroslavtcev M Yu
Published: July 2021

Hypertension, as one of the most common diseases of the circulatory system in the world population, has a large number of complications, including leading to chronic heart failure and other serious complications and, as a result, of disability, deserves the attention of clinicians and scientists, working on techniques that allow early diagnosis of morphofunctional changes in the myocardium within this pathology. As soon as standard echocardiography evaluates the systolic function and is based on the indications of the ejection fraction, which reveals a violation of systolic function only at the late stages of the development of hypertension, often irreversible, in our special study we used a technique that allows us to estimate the longitudinal deformation to detect early violations of contractility myocardium of the left ventricle at the initial stage of the disease. The examination of 68 patients revealed uneven changes in the indices of longitudinal deformation of the left ventricle. It was discovered that the early stage of the development of the disease, the segments of the anterior and anterior-septal area, as well as the basal segment of the lower wall of the left ventricle, suffer. An interesting fact is that the vast majority of the above segments are supplied by blood from the anterior interventricular artery. A negative correlation was found between the thickness of the MES in relation to the longitudinal strain indicators in the respective segments, which confirms the development of systolic dysfunction as the hypertrophy of the walls of the left ventricle develops. Thus, it has been proved that the assessment of myocardial longitudinal strain is highly informative in the early diagnosis of disorders of its contractility among hypertensive patients with early stages.
Mathematical model of forecast successfulness of N.G. Kuznetsov Naval Academy cadets’ professional military adaptation
Authors: Zaytsev A G , Rezvantsev M V , Tegza V Yu , Yatmanov A N , Dergachev V B
Published: July 2021

The development of mathematical model for predicting forecast successfulness of N.G. Kuznetsov Naval Academy cadets’ professional military adaptation is substantiated. It is established that a group of the most successful cadets has a statistically significantly higher achievement and fitness score, higher discipline and lower morbidity. Thus, 66% (64,7%) of the most successful cadets have high discipline, 14 (13,7%) - moderately high. 6% (5,9%) of less successful cadets have average discipline, 14 (13,7%) - low, 2 (1,9%) - very low. 62 (60,8%) of the most successful cadets did not get sick during the last 2 semesters, 18 (17,6%) - rarely got sick. 4 (3,9%) of less successful cadets for the last 2 semesters also did not get sick, 8 (7,8%) - rarely got sick, 10 (9,8%) - often got sick. On the basis of discriminant modeling, a highly informative model for predicting the success of cadets’ educational adaptation in the framework of medico-psychological support activities was developed (λ-Wilks: 0,42842 F (6,75)=16,677 p0,0000, predictive power 84,3%). Predictors of successful military-professorial adaptation of military cadets are the combination of discrepancy between the value and availability of material welfare, the amount of discrepancy between the value and accessibility of the indicators of the methodology «The level of value and accessibility correlation in various life spheres», the accessibility of love, personal emotional attitude to the concept of family. For more successful cadets, there is a slight discrepancy between the value and availability of material welfare, the amount of discrepancy between the level of value and accessibility does not reach the level of intrapsychic conflict. Personal emotional attitude towards the future is more pronounced and the level of accessibility of love (spiritual and physical intimacy with a loved one) is lower. The mathematical model of the prognosis of the success of military-professorial adaptation of cadets of a military high school should be used as part of medical and psychological support for cadets of military universities.
Improvement of legal basis of life and health protection of military personnel
Authors: Zholus B I
Published: July 2021

Provisions and requirements of the Internal service regulations of the Armed Forces of the Russian Federation regarding the rights and obligations of military personnel for life and health protection are analyzed. Provisions in regulations of 1993 and 2007 years are compared. The compliance of articles of the Regulations to the Constitution of the Russian Federation, Federal laws from May 27th, 1998 No. 76 «Concerning the status of military personnel», from November 21st, 2011No. 323 «On fundamental healthcare principles in the Russian Federation» and from March 30th, 1999 No. 52 «Concerning the Sanitary and Epidemiological Welfare of the Population» are described. Insufficient legal confirmation of the duties of a serviceman in protection of his own health is noted. One of the problems of education and training of the military personnel of various classes is the lack of such subject as a military hygiene in the curriculum. In prerevolutionary military educational establishments, the hygiene was studied and at the course end there was examination. One of the important elements of the health protection of the servicemen is a sanatorium-resort therapy which can be treated as a part of preventive medical examination. Data on decline of sanatorium service of the military personnel in connection with the legislation changes are presented. Considering physical and mental health of servicemen as a guaranty of high-degree alert and military efficiency it is proposed to start studying the Instruction on life and health protection of the serviceman in the period of a basic military training (soldier, sailor, cadet). Proposals on hygiene studying in fostering and educational institutions of the Ministry of Defense.
Method for determining the functional state of peripheral nerves after their restoration in an experiment
Authors: Nisht A Yu
Published: July 2021

A simple method for assessing the functional state of peripheral nerves after performing experimental reconstructive-plastic interventions on laboratory animals has been developed. It is proposed to evaluate the functional state of the common peroneal nerve reconstructed in an experiment by comparing the amplitude of the animal’s toes spreading in the study of the unconditional statokinetic landing reflex. A reflex response to the preparation for landing from the pelvic limbs is manifested by flexion in hip joints, extension in knee joints, plantar flexion in hocks, and spreading of toes.Spreading of toes in rabbits is caused by the contraction of the external extensor of the toes innervated by the deep branch of the common peroneal nerve.If the conductivity of the common peroneal nerve is impaired, spreading of the toes on the side of the trauma fails to manifest.The advantages of the proposed test are: high speed set up and ease of implementation, as well as clear demonstration when comparing the operated and the intact limbs of the laboratory animal.
Comparative chemical composition analysis of femoral condyles bone tissue in health and in deforming arthrosis
Authors: Ihalainen E S , Gayvoronsky I V , Khominets V V , Semenov A A , Fandeeva O M
Published: July 2021

A comparative analysis of the chemical composition of the medial and lateral condyles of the femur in norm and with deforming arthrosis of the third degree is presented. It was found that when the bone tissue of the femur is degraded from the surface, a decrease in crystallinity is observed in depth, quantitative and qualitative changes in the organic bone matrix, in particular, a decrease in the proportion of the protein component, a change in the phase inorganic composition, and an increased degree of substitution of calcium in hydroxyapatite for ions of other metals. And the most dramatic changes are observed in bone tissue located near the pathologically deformed areas. It is shown that the data for normal bone tissue of the lateral and medial condyle of one specimen differ, which can be caused by different degrees of stress on the condyles themselves in the process of vital activity of the organism caused by asymmetry and a different shape of their articular surfaces. With deforming arthrosis in the surface layer of bone tissue, the concentration of calcium and a number of other metals increases, while the proportion of the protein component decreases. It was revealed that in the affected bone replacement of phosphate tetrahedra with carbonate ions occurs, as well as substitution of cations of divalent calcium with ions of other metals such as copper and manganese, and especially ferric cations. This breaks the overall structure of the crystal lattice of hydroxyapatite and affects the biomechanical properties of the surface, in particular, the reduction of trophism and the elasticity of the surface. In osteophyte tests, partial replacement of phosphate groups with carbonate groups occurs. Isomorphic structural substitutions caused by deposition of crystalline impurities lead to a change in the ratio of calcium and phosphorus concentrations. Excessive deposition of calcium salts leads to the formation of osteophytes.
Features of adaptation after psychical traumatic stress among servicemen who performed special tasks
Authors: Zelenina N V , Nazarov S S , Marchenko A A , Rantseva S A , Vyipritskiy P A , Yusupov V V , Kuzmin S G , Zubov A N
Published: July 2021

Features of adaptation after psychical traumatic stress in healthy military men who performed special tasks more than half a year ago were studied. It is shown that 40% of combatants have signs of partial posttraumatic stress disorder, which evidences about negative adaptation after psychical traumatic stress. Signs of partial posttraumatic stress disorder in all manifest as neurotic disorders, and in 7,5% of combatants are associated with signs of psychotic disorders. Among the signs of neurotic disorders, the manifestations of somato-vegetative disorder were encountered in 62,5%, affective tension - in 50%, sleep disorder - in 43,8% and anxiety-phobic disorder - in 43,8%. Among the signs of psychotic disorders, there were mildly pronounced manifestations of social phobia, panic disorder and depression. Soldiers with partial posttraumatic stress disorder have a statistically significant decrease in the self-assessment quality of life in such indicators as «general health», «mental health» and «social functioning». The negative correlation between scores of life quality and signs of partial posttraumatic stress disorder pieces of evidence that namely this disorder impacts on the quality of life in combatants. Comparison of servicemen groups with and without signs of partial posttraumatic stress disorder according to the expert evaluation indicators, exhibited by the unit commanders, and according to the indicators of the operator working, did not reveal a significant difference between them. Thus signs of partial posttraumatic stress disorder in combatants decrease self-assessment life quality but do not have an effect on the professional aspect of social functioning under favourable conditions. This military personnel are needed in medical and psychological correction and rehabilitation to prevent the development of maladaptation in stressful conditions.
Modern methods of the functional state assessing of the body and the physical performance of a serviceman in solving scientific research problems of biomedical direction
Authors: Geregey A M , Kovalev A S , Vetryakov O V , Malahova I S , Mavrenkov E M
Published: July 2021

The main issues related to the assessment of the functional state of the body and the physical performance of the serviceman are considered. The review of modern methods for assessing the functional state and physical working capacity of a person in sports medicine and the physiology of military labor both in Russia and abroad is presented. The choice of the methods allowing to unify approaches to an estimation of military-professional working capacity in stationary and field conditions is proved. It is established that in the scientific research practice of military medical specialists, it is expedient to evaluate the functional state of the serviceman’s organism and its physical working capacity under loads associated with both dynamic and static muscle work. It is determined that ergospirometry is the most acceptable method of assessing the functional state of the body and the physical performance of servicemen in the process of performing dynamic work. It is noted that with the help of ergospirometric testing, it is possible to predict the physical performance of a serviceman and the duration of its preservation at a given level, replacing or supplementing most standard load tests, which is a weighty argument in favor of its choice as a «gold standard». It has been established that to evaluate the functional state of the body and the physical performance of servicemen in the process of performing static work, the main method is stabilometry. A significant number of available stabilometric techniques, including those using biofeedback, significantly expands the possibilities of diagnosing the functional state of the body of a military specialist. It is determined that the most acceptable method for assessing the impact of dynamic loads on the locomotor system of a serviceman is the use of the “motion capture” technology. The main advantages and disadvantages of modern means and methods of studying the functional state and physical working capacity of a person are revealed. The modern hardware and software complexes used to solve scientific research problems of biomedical orientation are listed.
The preoperative and postoperative period when phalloendoprosthesis
Authors: Udalov Yu D , Kyzlasov P S , Martov A G , Zabelin M V , Kazhera A A
Published: July 2021

Аbstract. The recommendations on an integrated approach to the management of patients with penile prosthesis are presented. Penile prosthesis is one of the most effective and radical methods of erectile dysfunction treatment and is a common worldwide surgery, which gives a more predictable effect and allows to meet the expectations of 80-90% of patients and their partners. Currently, surgeons and urologists has quite a diverse choice of different models of phalloendoprosthesis and methodical surgical approaches for their installation. However, there are no clear clinical guidelines worldwide for the management of patients subjected to phalloendoprosthesis in the pre - and postoperative period. There is also no unified approach to the prevention of infectious complications of phalloendoprosthesis, including their preoperative antibiotic prophylaxis, based on clinical studies. The authors describe and structure the information about preparation stages and management of patients in pre - and post-operative period to prevent the most common complications. All the developed algorithms are based on extremely small selection and purely descriptive statistics, therefore further studies are needed on the scientific basis of management of patients with penile prosthesis, which should be based on in-depth statistical analysis. We consider it necessary to develop legal acts of management for this category of patients, the creation of Russian clinical guidelines for the prevention of infections in surgical intervention in penile prosthesis.
Circulation and resorption of cerebrospinal fluid: historic and up-to-date presentation
Authors: Valchuk S N , Alekseev D E , Gavrilov G V , Stanishevskiy A V , Svistov D V
Published: July 2021

It is analyzed historical development and current apprehension about cerebrospinal fluid. We are interested in all about liquor however the huge our attention concentrates on resorption of fluid. It is caused by many cases with expiration of liquor after operation but there isn’t answer about arrangement of this complication. It is notably but now the question about resorption of cerebrospinal fluid is still controversial. The part of scientists stands by classic speculation. They think that resorption of liquor arises by Pachioni’s granulations. Another part keeps to theory that the main role performs glymphatic system by the resorption of liquor. That’s why we make a decision that we need to make an investigation of nowadays literature about dynamic of cerebrospinal fluid and resorption of liquor.We think after neurosurgical operations cerebrospinal fluid’s resorpting ability decreases. We make these conclusion, because there are lots of science experiments. These experiments simulate real surgical procedures. That’s why intracranial pressure raises and then liquor runs out. We made a conclusion lots of scientists adhere to mind that after neurosurgical operations resorption of liquor decreases that’s why it starts hyporesorption. However even presently this problem is actually. There is a little bit experiments but there isn’t any clinical research.
Clinical significance of variant anatomy of the celiac trunk
Authors: Gaivoronsky I V , Kotiv B N , Kovalenko N A , Pelipas Yu V , Bahovadinova Sh B , Amelina I D , Kudryavtseva A V , Dzidzava I I , Verbitsky V V
Published: July 2021

Data on variant anatomy of the celiac trunk, typical and atypical variants of its architectonics, topography, existing classifications, morphometric characteristics, development of the vessels of abdominal aorta in embryogenesis and the clinical significance of anatomical features is presented. The issues under consideration are important for surgical practice, in particular, for abdominal surgery, transplantology, interventional X-ray endovascular surgery and oncosurgery. It is shown that the anatomy of the celiac trunk and its branches have a pronounced variability, and more than 15% of the population have significant deviations from the typical branching variant. A significant number of different variants of the celiac trunk dividing, a different frequency of occurrence of these variants, morphometric indices, apparently depends on the size of the sample of the investigated objects, gender and other reasons. Data on the development of branches of the abdominal aorta in embryogenesis and the causes of atypical variants is presented. In a comparative aspect, existing classifications of the most authoritative authors are considered. It is shown that, despite the large number, there is no universal, simplest in practice, classification of variants of the celiac trunk branching. Nosological examples that demonstrate the need to take into account the variant of formation of the celiac trunk and its morphometric features in operative and diagnostic manipulations on the organs and vessels of the upper floor of the peritoneal cavity are analyzed. Certainly without understanding the architectonics of the gastrosplenicpancreatoduodenal zone arteries, there is a significant risk of error, which can even lead to lethal complications.
Questions of medical and social examination and rehabilitation of disabled people with the consequences of military trauma
Authors: Andreeva O S , Karasaeva L A , Shkurko M A , Shahsuvaryan S B
Published: July 2021

The expert characteristics of the clinical and functional status of the military personnel for the first time recognized as disabled in 2016 because of «military trauma» are considered. It is known that the objectification of methods of expert rehabilitation diagnosis in the implementation of medical and social expertise in the establishment of disability and the development of individual programs of rehabilitation/habilitation of disabled people-one of the main objectives of the concept of «Improvement of the state system of medical and social expertise and rehabilitation of disabled people.» In accordance with this provision, clinical and expert indicators are analyzed, confirmed by the data of expert rehabilitation diagnostics, allowing to objectify the impaired functions and structures of the body of soldiers who have received a military injury, when examined in the Bureau of medical and social expertise. The main clinical and functional syndromes that have expert significance and have influenced the adoption of expert decisions in the establishment of disability groups are presented. The article describes in detail the contraindicated and shown factors of the recommended labor activity, which should be guided in the employment of disabled people from among the former soldiers. The use of evidence-based recommendations in practice makes it possible to determine the forms and conditions of employment in normal or specially created working conditions for the rational employment and socialization of servicemen who have become disabled. Referring to the updated normative legal acts, taking into account the principle of inseparability of the medical and social examination procedure from the formation of individual programs of rehabilitation/habilitation of disabled persons, the authors illustrate the possibilities of professional rehabilitation and employment of military personnel who have different groups of disability due to «military trauma».
The use of telemedicine in the organization and provision of medical care to patients in critical conditions
Authors: Goncharov S F , Fisun A Yu , Schegolev A V , Baranova N N , Shilkin I P , Bobiy B V , Shustrov V V
Published: July 2021

Organizational issues of the interdepartmental application of telemedicine technologies in the provision of medical care to patients are considered. The most significant provisions of the concept of interdepartmental application of telemedicine technologies in the organization and provision of medical care to patients in critical conditions are presented. In addition, data on telemedicine consultations on federal districts of the Russian Federation performed by the federal level of health care in 2017 are shown, the frequency of emergency telemedicine consultations is revealed depending on the disease profile of patients or the specialty of a consulting physician. Prospects for the further introduction of telemedicine technologies into daily practical activities and the possibility of their adaptation to crisis situations and military conflicts are substantiated. It has been established that in various natural disasters, accidents, catastrophes, terrorist acts and during military conflicts with a large number of victims, successful organization of medical care and medical evacuation is possible only when combined with the efforts of the Ministry of Health, the Ministry of Defense, the Ministry of internal affairs and the Ministry of the Russian Federation for Civil Defence, Emergencies and Elimination of Consequences of Natural Disasters. Thus, the adequate development of telemedicine systems will increase the level of their rational and effective interdepartmental use for the benefit of saving people as Russia’s human capital.
PECULIARITIES OF THE SURGICAL TREATMENT OF PATIENTS WITH DEEP FACE BURNS
Authors: Butrin Ya L , Petrachkov S A
Published: July 2021

The article is devoted to the study of different types of surgical approach in the treatment of patients with deep face burns. The data of the facial burns frequency in time of peace and in time of war in Russia, the United States are given, the most common reasons of burns are indicated. The data on the different specialists’ approaches in the surgical patients’ treatment with deep burns face have been presented. Pros and cons of each approach have been described. Specific features of facial burns treatment are indicated. The necessity of searching the optimal surgical tactics in the treatment of deep face burns has been justified
ORIGINAL METHOD OF MONOPOLAR GAS PLASMA COAGULATION IN EXPERIMENT AND CLINICAL USING
Authors: Golubev A A , Shepel E V , Sitkin S I , Eremeev A G
Published: July 2021

The results of the experimental study and the first results of the clinical use of krypton gas as a propulsive mass for inert-gas-enhanced monopolar plasma coagulation are discussed. A number of materials on preclinical testing of the original method of gas-plasma monopolar coagulation, obtained as a result of chronic experiments on pigs, are given. In the course of chronic experiments, standardized wounds were applied to the pig's liver, hemostasis and cholestasis were performed using gas-plasma monopolar coagulation using various inert gases and their mixtures used as propulsive mass. Interventions, sections of the liver parenchyma were subjected to gas-plasma exposure for various periods - from the first to the thirtieth days from the moment of exposure. The collected material was subjected to a morphological study, according to the results of analysis of which the nature of the course of the wound process was evaluated, the peculiarities of the morphological changes of the liver parenchyma at different time periods depending on the composition of the gas or gas mixture used as a propulsive mass. The results of the clinical use of krypton gas as a propulsive mass for gas-plasma coagulation are presented for the first time. The results of the use of kryptonoplasmic coagulation for hemostasis during laparoscopic cholecystectomy are considered. A comparative analysis of the nearest results of gas-plasma coagulation was performed in two groups of patients: using krypton and argon as the propulsive mass. For the first time, the issues of the possibility and experimental justification of using argot-krypton mixture as a propulsive mass for gas-plasma coagulation with the aim of reducing the cost of using this coagulation technique are considered.
OBSTRUCTION OF BILE DUCTS IN CHRONIC PANCREATITIS AND POSSIBILITIES OF ITS SURGICAL CORRECTION
Authors: Pryadko A S , Romashchenko P N , Maistrenko N A , Boiko I YU , Yaraliev V M , Kuznecov A I
Published: July 2021

Purpose of the study: optimize surgical tactics for bile duct obstruction in patients with various forms of chronic pancreatitis (CP). Materials and methods: The results of the examination and treatment of 503 patients with CP, 354 of whom were operated on, were analyzed. Mechanical jaundice was detected in 76 (21.5%) patients. The main type of relief of symptoms of biliary tract obstruction were transpapillary endoscopic and laparoscopic techniques or their combinations, which in 37 (47.4%) patients were the final treatment option, and in 35 (46.1%) - a preliminary stage before performing traditional surgical interventions. Traditional interventions were the only treatment method in 4 (6.4%) patients. Results: Based on the modified Marseille-Rome classification of CP (1988), a systematic approach was developed to assist this category of patients. It has been established that the use of endoscopic techniques in patients with obstructive CP allows not only to stop the symptoms of biliary hypertension, but also to influence the course of the underlying disease, by ensuring adequate drainage of both the bile and pancreatic ducts. The use of transduodenal and laparoscopic techniques for the relief of obstructive jaundice in patients with inflammatory CP, calcifying CP is best justified as a preliminary stage of treatment. The preferred option of surgical correction in patients with inflammatory and calcific CP with primary lesions of the pancreas head should be resection of the pancreas head according to Beger or Frey. Conclusion: The optimal combination of minimally invasive surgical treatment options and traditional surgical interventions, taking into account the shape and variation of CP, complicated by the development of obstructive jaundice, allows for maximum correction of the course of the disease in the near term and in the long term.
PROCALCITONIN OF EYACULATE AS A MARKER OF DISORDERS OF SPERMATOGENESIS
Authors: Gal’kovich K R , Sosnin D Yu , Nenasheva O Yu , Krivcov A V
Published: July 2021

The study of the protein composition of the ejaculate is devoted to a significantly smaller number of studies than the characterization of the cellular composition of sperm and the characterization of spermatozoa. Objective: to investigate the concentration of procalcitonin (PCT) in seminal plasma and serum in normal conditions and with oligozoospermia. Materials and methods. 88 men were examined (the main group - 40 men with oligozoostantenospermia, the comparison group - 48 men with a normal concentration of spermatozoa). Results and discussion. The concentration of PCT in seminal plasma in the examined patients (n = 88) was almost 10 times higher than its serum content and amounted to 0.349 ± 0.370 ng/ml versus 0.037 ± 0.027 ng/ml (p0.000001). In patients with oligozoospermia the contents of the PC has exceeded the value of the comparison group (p = 0,0095). Serum PCT concentrations in blood serum did not differ between groups (p = 0.605). There were no statistically significant correlations between the level of PCT and other indicators of sperm (sperm concentration, their total content and volume of ejaculate). Summary. The content of PCT in seminal plasma does not depend on its level in blood serum. A higher content of PCT in the ejaculate compared to serum indicates its local production in the reproductive system. The increased procalcitonin level in seminal plasma may indicate decreased fertility of the ejaculate.
Structural and functional characteristics of the right heart chambers in young patients with sarcoidosis
Authors: Bartosh-Zelenaya S. Yu. , Evsikova I. A. , Novikov V. I. , Nayden T. V. , Mamaeva O. P. , Shcherbak S. G.
Published: July 2021

The possibilities of assessing the right chambers of the heart and the estimated systolic pressure in the pulmonary artery at rest and against the background of physical activity in the early stages of pulmonary sarcoidosis in the absence of clinical manifestations and obvious complaints of patients are considered. Has been established that the most dangerous conditions for pulmonary sarcoidosis may be the progression of the disease with the formation of pulmonary fibrosis and heart damage. In addition to the primary involvement of the heart, which is less common in clinical practice, heart damage occurs in the form of an overload of the right chambers with the development of pulmonary hypertension. In the early stages of the disease, as a rule, little attention is paid to the examination of the heart in patients with sarcoidosis, due to the lack of clinical manifestations and complaints, therefore, it remains important to perform early diagnostic measures in order to prevent the development of the pathological process and correct treatment. According to the Federal Clinical Guidelines for the Diagnosis and Treatment of Sarcoidosis (2016), echocardiography is not included in the mandatory list of examination of patients suffering from lung sarcoidosis, and is prescribed at the discretion of the attending physician. There is a small amount of work in both domestic and foreign literature on the assessment of the right heart chambers in patients with pulmonary sarcoidosis using modern echocardiographic techniques such as global longitudinal deformation of the right ventricle and ejection fraction in 3D mode. One of the promising methods is the determination of global longitudinal myocardial deformation, the reduction of which can serve as an early predictor of myocardial dysfunction.
Modern approaches to evaluating the effectiveness of treatment of chronic heart failure
Authors: Potekhin N P , Fursov A N , Kazakov S P , Putkov S B , Pestovskaya O R , Lyapkova N B , Zakharova E G , Makeeva T G , Vereshchagina A V
Published: July 2021

The efficacy of therapy for patients with chronic heart failure, a new combination drug valsartan/sacubitrile according to the levels of biomarkers ST2 and NT-proBNP was evaluated. In all patients of the study group, valsartan/sacubitrile therapy improved the NYHA functional class, in the control group - only in 75%. The dynamics of indicators of biomarkers ST2 and NT-proBNP coincided with the improvement of the clinical status of patients against the background of therapy, and to a greater extent this trend reflects the indicator NT-proBNP.