bluuebunny/crossref_metadata_2025 huggingface dataset:
THE CLINICAL AND GENETIC ASPECTS OF DIFFUSE INFILTRATING RETINOBLASTOMA: A LITERATURE REVIEW AND CLINICAL CASE PRESENTATION
Authors: Saakyan S. V , Tsygankov Alexandr Yur’evich
Published: September 2020

Purpose. The objective of the present study was to provide a short review and summarize the available information concerning the main symptoms of diffuse infiltrating retinoblastoma encountered in the ophthalmological practice and compare them with the manifestations of typical retinoblastoma. The secondary objective was to discuss the genetic paradigm of diffuse infiltrating retinoblastoma that is frequently interpreted as a sporadic condition despite the evidence suggesting its genetic predisposition and inheritable etiology that have become increasingly widely recognized during the last years. A literature search for the information about diffuse infiltrating retinoblastoma in the Russian, English, German, and Spanish scientific journals made it possible to reveal a total of 77 patients described in the available literature. In addition, the main specific clinical and gender-related features of diffuse infiltrating retinoblastoma were identified. The results of initial working diagnostics and referral diagnoses are presented with special reference to the importance of the molecular-genetic analysis and the multidisciplinary approach to the treatment and examination of the patients and their relatives. It is concluded that the adequate medical follow-up care needs to be provided in order to diagnose the possible associated cancers. A clinical case of diffuse infiltrative retinoblastoma in a 6-year old male patient is presented.
THE SELECTED PAGES OF THE HISTORY OF PEDIATRIC OPHTHALMOLOGY IN SAINT PETERSBURG
Authors: Brzheskiy Vladimir Vsevolodovich , Konikova O. V
Published: September 2020

The history of pediatric ophthalmology in Saint Petersburg dates back to the opening of the city children’s hospital “in memory of the sacred coronation of their Imperil Majesties” under the patronage of Nikolas II, Emperor of Russia, in 1905. Based at this facility, the Russia’s first department of pediatric ophthalmology was founded in 1935 to be affiliated with Leningrad Pediatric Medical Institute. The department was successively headed by professors V.V. Chirkovsky, L.A. Dymshits, V.I. Grigor’eva, A.I. Gorban’, and E.E. Somov. The present head of the department is professor V.V. Brzheskiy. One more department of pediatric ophthalmology was opened in 1983 based at the Leningrad Institute of Advanced Medical Training. It was successively headed by the associate professor V.V. Kolotov, professors S.S. Saporovsky and R.L. Troyanovsky, E.I. Saidasheva, d-r med. sci. At present, an extensive network of children’s clinics and specialized kindergartens for the children suffering from visual impairment successfully operates in Saint-Petersburg, besides two schools for the blind and visually impaired children, the eye diagnostic centre for the children and adults, and three pediatric ophthalmological hospitals. The city pediatric ophthalmology service is headed by R.V. Ershova. N.N. Sadovnikova is in charge of the Ophthalmological Department of the Clinic of Saint Petersburg State Pediatric Medical University. The Ophthalmological Department of K.A. Raukhfus municipal city hospital No 19 is headed by A.V. Baranov, PhD, and the Department of Eye Microsurgery at the Leningrad regional Children’s Clinical Hospital by O.V. Diskalenko. The present-day clinical, scientific, and educational potential of the Saint-Petersburg pediatric ophthalmological community formed at the base of many-year experience of the preceding generations of physicians continues to further increase which creates conditions for the formulation and successful achievement of the new ambitious goals.
THE CHARACTERISTIC OF THE MAIN PARAMETERS OF COMPUTED ACCOMMODOGRAPHY FOR THE SCHOOL CHILDREN PRESENTING WITH MYOPIA AND EMMETROPIA
Authors: Ershova Regina Vladimirovna , Brzheskiy V. V , Sokolov V. O , Kravchenko E. A
Published: September 2020

Purpose. The objective of the present study was to estimate the possibilities for the application of objective computed accommodometry as a diagnostic tool for the examination of the school children presenting with myopia and emmetropia. Material and methods. 262 (524 eyes) children of 7-17 years were examined using accommodometry. The study involved 184 (368 eyes) children with myopia and 78 (156 eyes) ones with emmetropia. All the patients were examined with the use of the Righton Speedy-K ver. MF-1 autorefractometer. Results. The preliminary analysis of the results of 2321 accommodograms taken in the children presenting with emmetropia and myopia revealed various forms of the accommodation response (balanced, weak, superfluous and labile). The accommodation coefficients was calculated for each patient. Accomodograms suggesting the unbalanced response prevailed among the children with myopia whereas those indicative of the normal accommodation response were more frequently obtained in the children with emmetropia; moreover, the relative number of such accommodograms increased with the age of the patients. The children with myopia showed the enhanced accommodation response manifest as its increased strength in the combination with a rise in its growth intensity and the frequency of microfluctuations. However, both the strength and the intensity of the response decreased with the age in the children suffering progression of myopia. The progress of myopia was accompanied by the further enhancement of microfluctuations and was responsible for the tendency toward instability of the accommodation response whereas stationary short-sightedness was associated with the stronger and more stable accommodation response. The accommodograms suggestive of the weak accommodation response corresponded to the large absolute accommodation volume and reserve of accommodation for far distance vision. High values of the relative accommodation reserve in the children with myopia were associated with the unstable accommodograms and the high frequency of microfluctuations. At the same time, the high values of the relative accommodation reserve in the children presenting with emmetropia are combined with the weak accommodation response. Conclusion. The data obtained by means of objective accommodography allow to extend the existing understanding of the accommodation function in the children with progressive myopia and provide a basis for the recommendation of this technique for a wider application in the clinical practice.
THE USE OF THE BOTULINUM TOXIN A FOR THE TREATMENT OF OCULOMOTOR PATHOLOGY
Authors: Apaev Aleksandr Vyacheslavovich , Gubkina G. L , Tarutta E. P
Published: September 2020

The use of the botulinum toxin A can be the method of choice for the treatment of oculomotor pathology. In certain cases of strabismus, this technique provides the sole correct and justified tool for the management of this condition. There are numerous publication concerning this issue in the foreign literature, but they do not permit to develop the well defined criteria for the application of the botulinum toxin A in the ophthalmological practice Specifically, such issues as the timing and dosages of botulinum toxin A administration remain to be addressed and solved. Of special interest is the application of the botulinum toxin A for the treatment of nystagmus. The expediency of the application of the botulinum toxin A for the treatment of oculomotor pathology should be estimated on an individual basis.
THE POSSIBILITY OF USAGE MOXIFLOXACIN 0.5% SOLUTION IN PERIOPERATIVE PROPHYLAXIS IN CHILDREN
Authors: Zaytseva Maria V. , Brzheskiy V. V , Malysheva M. O , Baranova T. V , Smol’janinova T. V
Published: September 2020

Introduction. Nowadays the problem of postoperative endophthalmitis after intraocular operations remains unresolved. The aim of our research was to study the efficacy of a 0.5% solution of moxifloxacin in the perioperative prophylaxis of children. Material and methods. The study included 97 healthy children (113 eyes) aged from 1 month to 17 years. The swabs from conjunctival sac were taken three times. Results. The growth of microflora was detected in the conjunctival sac at 67.3% of cases. At 45.6% of cases Staphylococcus epidermidis was observed. The highest sensitivity of isolated microorganisms to Antibacterial drugs that are used topically in ophthalmology was shown to the moxifloxacin (95.8 %), ciprofloxacin (94,83%) and levofloxacin (90,5%). Staphylococcus epidermidis was discovered more often in the conjunctival cavity (53,3%, n=16) on the first swab in the second stage of the study. All microorganisms were sensitive to moxifloxacin. After taking a swab, the installation of 0.5% solution of moxifloxacin 1 drop 4 times daily the day before surgery was prescribed. The same drops were used and the second swab was taken in 1 hour and 30 minutes before surgical operation. In 9 cases (30%) Microflora was detected again, at 88.9% of the cases Staphylococcus epidermidis (n=8) was observed. 1 drop 4 times a day for 7 days of 0.5% solution of moxifloxacin was prescribed after surgery and after the course of antibiotic therapy third swab was taken. Microflora was detected in the eyes of two children also in the third study. Instillation of 0.5% solution of moxifloxacin is quite effective in the perioperative antibiotic prophylaxis of infectious complications of intraocular operations and significantly reduces the frequency of detection of microflora in the conjunctival cavity.
ROLE OF OCT-ANGIOGRAPHY IN STUDYING OF PATHOGENESIS, DIAGNOSTICS AND MONITORING THE MACULAR TELANGIECTASIES IN CHILDREN
Authors: Katargina L. A , Denisova E. V , Osipova Natal’ja A. , Kogoleva L. V , Tarasenkov A. O , Belova M. V , Novikova O. V
Published: September 2020

The purpose. to assess the potential of OCT-angiography in studying pathogenesis, diagnosing and monitoring macular telangiectasias of various genesis in children and adolescents. Material and methods. We examined and treated 4 children (5 eyes) aged from 12 to 17 years with idiopathic macular telangiectasias (2), developed against the background of Coat’s disease (1) and diabetic retinopathy (1). The examination included standard ophthalmologic inspection, as well as optical coherence tomography and OCT-angiography (RS-3000 Advance AngioSca, Nidek, Japan). Two children underwent transpupillary laser coagulation of telangiectasias (2 and 3 sessions), two received an intravitreal injection of an inhibitor of angiogenesis. Results. Ophthalmoscopically in all children microaneurysms were localized in the macular and paramacular zones and were accompanied by the development of retinal edema. According to OCT-angiography, all children had pathological structural changes (microaneurysms, vascular artery abnormalities, changes in the density of the vascular pattern) of superficial and to a greater extent deep retinal capillary plexuses. As a result of the treatment, 3 children (4 eyes) had clinically noted decrease in the number of microaneurysms. According to the data of optical coherence tomography, there was positive dynamics in decrease of the height of the retinal edema from 49 to 320 μm, аccording to OCT angiography, showed a decrease in the number of microaneurysms in the superficial and especially in the deep plexus, and in a child with diabetic retinopathy there was also a slight increase in the vascular density of the deep capillary plexus. Сonclusion. According to OCT-angiography, development of macular telangiectasias in children is accompanied by preferential changes in the deep capillary plexus, which indicates the pathogenetic significance of microcirculatory disturbances at this level. The method also reveals its value in monitoring the disease.
CLINICAL-GENETIC FEATURES OF THE KNOBLOCH SYNDROME IN THE RUSSIAN FAMILY
Authors: Khlebnikova Olga V. , Dadali E. L , Bessonova L. A , Konovalov F. A
Published: September 2020

The article presents the clinical and genetic characteristics of a patient with Knobloch syndrome caused by the previously indescried combination of mutations in the compound heterozygous state c.4054_4055delCT / c.1469-2A>G in the gene COL18A1. The peculiarity of the presented case is the absence of symptoms of central nervous system damage, found in most patients with this syndrome.
IMPORTANCE OF IMMUNOLOGICAL FACTORS IN THE DEVELOPMENT OF RETINOPATHY OF PREMATURITY
Authors: Kuznetsova Julia Dmytrievna , Balashova L. M , Bykovskaya S. N
Published: September 2020

Retinopathy of prematurity is one of the most severe multifactorial diseases eye deeply in preterm infants is associated with general and local morfofunkcional’noj immaturity and vazoproliferasion, often leading to blindness and low vision project and progressing during the entire life. Our review article focuses on the role of immunolological factors in the development of retinopathy of prematurity. The data obtained and further research to study the role of immunological parameters in the pathogenesis of retinopathy of prematurity and develop, on the basis of this, it caused by correction techniques to prevent the occurrence and progression of the disease remain a burning issue at present.
PATHOLOGY OF THE VITREOUS BODY IN CHILDREN. POSSIBILITIES OF INSTRUMENTAL AND LASER SURGERY
Authors: Kalinichenko Roman Vladimirovich , Arestova N. N , Egiyan N. S
Published: September 2020

Despite the rather active use of YAG-laser surgery in adult patients, it is practically not used on children. At the same time, some children have a vitreous pathology what can be operate with laser surgery - changes in the vitreous body can be a manifestation of the congenital persistent fetal vasculature syndrome, retinopathy of prematurity, effects of the injuries, operations and uveitis. The opacites and synechia forming of the vitreous body reduce acuity and often adduce to the traction, which can lead to detachment of the retina, ciliary body, progress of eye subatrophy. The review presents the main pathological conditions of the vitreous body with syndromes, congenital and systemic diseases in children, the possibilities of instrumental and laser vitreal surgery in children. A literature search for the review was conducted using the Medline and RINC database.
CLINICAL-ANATOMICAL FEATURES OF CONGENITAL ANOPHTHALMUS IN CHILDREN
Authors: Sudovskaya Tatyana V. , Kogoleva L. V , Utkina O. A
Published: September 2020

Purpose. to study the clinical and anatomical features of congenital anophthalmus in children, indication and timing of prosthetic orbit. Material and methods. 17 children with congenital anophthalmus aged 1 - 6 month were examined. Routine ophthalmological examination, ultrasound diagnostic including the measurements of axial length of the rudiment of the eye, if available, and B-scan, the computed tomography (CT) scan of the orbit and cranium, immunological investigations with serological infectious disease testing were performed in all patients. Results and discussion. Based on the complex examination we determined types of congenital anophthalmus in children. The step method prosthesis for the symmetric growth of bones and orbital tissues and cosmetic rehabilitation was developed. The indications and contraindications for ocular prosthesis in children with congenital anophthalmus were identified. Findings. the step methods for ocular prosthesis in children with congenital anophthalmus is the main method. Surgical interventions in the early years of children are contraindicated.
COMPLEX THERAPY OF INFECTIOUS CONJUNCTIVITIS, ACCOMPANIED BY AN ALLERGIC REACTION
Authors: Pozdnyakova Victoriya V. , Yani E. V , Vakhova E. S
Published: September 2020

Complex therapy of infectious conjunctivitis (adenovirus, herpetic, bacterial, chlamydial), complicated by toxic-allergic reaction, developing during the acute infectious process or long-term vigorous treatment, includes several treatment algorithms. The method of therapy consists in the use of systemic and local anti-allergic drugs against the background of a specific etiological antibacterial, antiviral or anti-herpetic therapy in combination with symptomatic therapy (anti-infectious, anti-inflammatory, reparative and tear replacement agents). The use of the developed algorithms of therapy can improve the effectiveness of treatment by 12-25%.
HERPETIC BLEFAROCERATOCONJUNCYVITIS. CLINICAL CASES
Authors: Vakhova Elena S.
Published: September 2020

Purpose. Remind practitioners of the clinical picture of herpetic blepharoconjunctivitis, the clinical features of the three forms of herpetic conjunctivitis and its difference from adenoviral conjunctivitis. Material and methods. In the description of clinical cases it is shown that the rash of vesicles of herpes on the skin of the eyelids with blepharoconjunctivitis, allows to identify the etiology of the pathological process and choose the correct treatment strategy. Examines modern approaches to the treatment of herpes skin rashes and prophylactic measures for the eyes. It emphasizes the high risk of corneal damage and the development of herpetic keratitis during primary ofothalmus herpes, as well as the need for systemic and local antiherpetic therapy. Discussion. It is important to note that the alertness of the pediatric ophthalmologist in terms of detecting herpes blepharkeratoconjunctivitis, as the debut of a herpetic eye infection, is reduced. Laboratory confirmation is not always possible, which probably leads to the underdiagnosis of this disease. Conclusion. Inadequately selected therapy contributes to the further course of recurrent herpetic keratitis already in the adult patient’s age.
HYPERTENSIVE ANGIORETINOPATHY IN A CHILD WITH PHEOCHROMOCYTOMA. CLINICAL CASE
Authors: Denisova E. V , Osipova N. A , Katargina L. A
Published: September 2020

Purpose: to present a clinical case of a child with hypertensive retinopathy developed against the background of undiagnosed pheochromacytoma and primarily regarded as neuroretinitis. The description of the case shows that a comprehensive examination of the child together with a pediatrician and endocrinologist allowed to identify the etiology of the pathological process and choose the right treatment strategy. Discussion. It is important to note that the alertness of the pediatric ophthalmologist in terms of the development of hypertensive retinal angiopathy is reduced. Arterial hypertension in children is much less common than in adults, and cases of hypertensive retinal lesions in children are rare. This can lead to a number of errors in the diagnosis and treatment of eye pathology, as well as underestimation of the severity of the General somatic condition of the child, in this connection it is important to emphasize the importance of close interdisciplinary cooperation in the examination and treatment of children of ophthalmic profile.
Comparative assessment of peripheral blocade of sciastic nerve performed by subgluteal and popgluteal access using electrical stimulation of peripheral nerve under us guidance
Authors: Piacherski Valery G. , Marochkov A. V
Published: September 2020

Goal. Compare the area of the sensor unit with the blockade of the sciatic nerve subgluteal and classic access. Achieved 60 blockades of the sciatic nerve in combination with femoral nerve blockade. In group A (30 patients) the blockade of the sciatic nerve was performed classical access, in group B (30 patients) - subgluteal access with the patient lying on his stomach. All of the blockade of the sciatic nerve were performed with 30 ml of 1% lidocaine (epinephrine 1: 200 000). Sensory block was evaluated in the foot, ankle, lower leg, popliteal fossa and hamstring. Evaluation of the sensory block was performed using prick. In group A complete motor block of the sciatic nerve occurred in all 30 patients. In those same 30 patients (100%) developed a full sensory block (++) in the area of the foot, lower leg, popliteal, posterior thigh. All patients had complete motor block of the sciatic nerve. In group B complete sensory block in the area of the foot, lower leg developed in all patients. In the popliteal fossa a full sensory block (++) did not develop in any patient, a partial unit + occurred in 22 patients (73.3%) and in 50 patients (26.7%) did not develop a sensor unit. In group B the sensor unit in the lower, middle and upper third Femur not developed (-) no patient. When the blockade of the sciatic nerve subgluteal access full sensor unit is not developed in the popliteal fossa and hamstring. When using the classic access sensor unit is developed in the popliteal fossa and hamstring
THE CASE OF THE SPECIALIZED ANESTHETIC AND SURGICAL CARE OF THE PATIENT WITH POLYTRAUMA IN THE NORTHERN TERRITORY
Authors: Chuvakov Igor V. , Ovcharenko I. Yu , Gubarev A. G , Gritsan A. I
Published: September 2020

Presents a clinical case of treatment of the patient living in remote Northern territories of Krasnoyarsk region, demonstrates the dependence of the prognosis and outcome of the disease for early diagnosis and making the correct tactical decisions in the primary treatment of the patient to a medical facility. The provision of effective specialized anesthetic and surgical polytrauma care at the present stage is possible only in conditions of existence of the system of medical care for such a difficult category of patients.
INTRAVENOUS LIDOCAINE INFUSION AS A PERSPECTIVE COMPONENT OF MULTIMODAL ANALGESIA, WHICH AFFECTS ON EARLY POSTOPERATIVE OUTCOME
Authors: Ovechkin Alexei M. , Becker A. A
Published: September 2020

The review represents the analysis of literature data on the effectiveness of intravenous lidocaine infusion as a component of multimodal analgesia. The data suggests that intraoperative lidocaine infusion at the rate of 1-1.5 mg /kg /h (if it’s possible - with the prolongation to the early postoperative period) is an advisable component of the multimodal analgesia. This technique can reduce the intraoperative doses of propofol, MAC of inhalation anesthetics, also reduces the postoperative need for analgesics and the frequency of postoperative nausea and vomiting. Furthermore, lidocaine infusion permits to shorten the time of resolution of postoperative ileus (approaching in this the effect of epidural analgesia) and, perhaps, to reduce the frequency and severity of postoperative cognitive dysfunction. The most effective use of this technique is in laparoscopic surgery on the abdominal and pelvic organs.
REGIONAL ANESTHESIA FOR CHILDREN WITH THE DISEASES OF LOWER LIMBS
Authors: Manokhina Yuliya A. , Ulrikh G. E
Published: September 2020

The article presents an analysis of the publications devoted to the problems of anesthesia to surgical procedures at the diseases of the lower limbs in children. The article reviews the questions of anesthesia safety and the role of regional blockades in the structure of intra- and postoperative analgesia.
RESEARCH AND EVALUATION OF REFERENCE VALUES OF TEMPERATURE QUANTITATIVE SENSORY TESTING IN KARELIA RESIDENTS
Authors: Spasova A. P , Dorozhenko A. M , Tikhova G. P , Barysheva O. Yu
Published: September 2020

Relevance: Quantitative sensory testing is a promising method for evaluating mechanisms that promote the development of pain syndrome, the use of which can improve the diagnosis and effectiveness of pain management. Objective: to study and evaluate the reference values of temperature sensor testing. Methods: reference values of thresholds for cold and warm thresholds, cold and heat pain thresholds in sensory points L4, L5, S1, C5, C6, C7 and C8 in 34 healthy volunteers aged 18 to 40 years were determined. Results: The range of normal values of temperature values of QST for residents of Karelia is determined. Conclusion: The reference values of temperature quantitative sensory testing differ from those obtained for residents of other countries. These results must be taken into account in determining the normal and pathology in patients with pain syndromes.
BIOAVAILABILITY AND EFFICACY OF OPIOID USE WITH EPIDURAL BLOCKADE
Authors: Bayalieva Aynagul Zh. , Yankovich J. N
Published: September 2020

The article is devoted to the questions of epidural analgesia with the use of opioid analgesics. The work analyzes the clinical effectiveness of epidural use of opioids, lists possible complications and cautions of this method of anesthesia. Bioavailability of morphine and fentanyl for the spinal cord with epidural administration allows to achieve analgesic effects at a certain block level more effectively than with systemic administration. However, the side effects of opioids in the form of respiratory depression are also found with epidural administration (3%), so patient safety monitoring is necessary.
DEXAMETHASONE AND POSTOPERATIVE ANALGESIA
Authors: Ovechkin Alexei M. , Politov M. E
Published: September 2020

The review contains the analysis of analgesic and opioid-saving action of dexamethasone in its systemic administration. These effects are most evident in the preventive administration of the drug 1.5-2 hours before surgery. The most promising area of application of dexamethasone as a component of anesthetic support is laparoscopic surgery. In the orthopedic clinic, the use of dexamethasone can increase the duration of action of peripheral nerve blockades and plexuses (both sensory and motor block), while perineural administration (addition to the local anesthetics) has no advantages over intravenous injection. Single administration of a standard dose of dexamethasone (8 mg) is not accompanied by the occurrence of clinically significant side effects.
RANDOMIZED EVALUATION OF THE INFLUENCE OF INTRAVENOUS USE OF DEXAMETHASON ON POSTOPERATIVE ANALGESIA IN PATIENTS AFTER ARTHROSCOPIC OPERATIONS ON THE KNEE JOINT UNDER THE CONDITIONS OF THE PERIPHERAL REGIONARY BLOCKADE
Authors: Lakhin R. E , Tsygankov K. A , Doguzov F. V , Gemua I. A , Tsvetkov V. G , Bogdashin D. V
Published: September 2020

Aim: to evaluate the effects of intravenous dexamethasone on postoperative analgesia in patients after arthroscopic knee joint surgery in conditions of peripheral regional blockade. Material and methods: 60 patients were included in the study, divided into 2 groups. In the first group, patients underwent peripheral regional blockade of the femoral and sciatic nerves with a 0.5% solution of levobupivacaine. In the second, the traditional peripheral regional blockade was supplemented by intravenous administration of 8 mg (0.4% - 2 ml) of dexamethasone immediately after catarrhization of the peripheral vein. Results: The duration of the sensory blockade in the group using dexamethasone was 25% greater than in the first group. In the postoperative period, patients who were intraoperatively injected with dexamethasone required 33% less additional anesthesia. The duration of motor blockade in the group with dexamethasone was 26.5% higher than in the patients of the first group. Conclusion: intravenous dexamethasone injection with levobupivacaine peripheral regional anesthesia with arthroscopic knee joint surgery, increases the duration of the sensory block and the duration of postoperative analgesia. The use of dexamethasone led to a decrease in the need for additional anesthesia in the early postoperative period.
Analysis of critical incidents during spinal anesthesia in gynecologic patients with different sensitivity of peripheral chemoreflex
Authors: Golovataya Maria V.
Published: September 2020

The critical incidents of spinal anesthesia were analyzed in gynecologic patients with different sensitivity of peripheral chemoreflex. It was proved that high sensitivity of the peripheral chemoreflex is related to hemodynamic instability reflecting in developing vasoplegia that is the risk factor of intraoperative critical incidents (hypotension) and postoperative complications (postoperative nausea and vomiting).
Chronic postoperative pain syndrome - «a pitfall» of modern surgery
Authors: Ovechkin Alexei M.
Published: September 2020

The overview is devoted to the problem of chronic postoperative pain. At the moment every fifth patient undergone elective or emergency surgery suffers from chronic postoperative pain. The paper presents current data on epidemiology of chronic pain syndrome following different operations, as well as diagnostic criteria and pathophysiological mechanisms of transformation of acute postoperative pain into chronic pain syndrome. Risk factors responsible of formation of chronic postoperative pain are described in details, among which the most valuable are presence of pain before surgery, trauma of the surgery, intensity of pain in early postoperative period. The article discusses modern methods of prophylaxis of chronic postoperative pain. The most perspective drugs for preventive action include gabapentinoids and ketamine in subanesthetic doses. The main role in prophylaxis belongs to regional anesthesia and analgesia. The role of multimodal approach to perioperative analgesia is presented in the work as well.
Lactoferrin and Raman/fluorescent technologies: the role in pathogenesis and the course of the inflammatory diseases of the female reproductive system
Authors: Gulenkova Dariya G. , Zuev Vladimir M.
Published: September 2020

In the review there is reflected the new look at the introduction into clinical microbiology new methods of diagnosis (such as Raman/Fluorescence Technology), which made it possible to enlarge micro-ecological investigations. Suppression of the normal vaginal microflora was found to lead to a variety of causes of the pathology of both inflammatory and non-inflammatory genesis. Iron-binding glycoprotein from the family of transferrin (lactoferrin) gives rise to the decrease of the inflammatory response of the body, it can be used in treatment of vulvovaginal candidiasis and bacterial vaginosis.
Amenorrhea
Authors: Sosnova E. A
Published: September 2020

The lecture presents information about one of the leading disorder of the menstrual function - amenorrhea. Amenorrhea is not a substantive diagnosis, but a symptom that indicates to changes in the system of reproduction due to various physiological or pathological causes. There are considered various forms of this disease, their etiological factors. There are presented classification of amenorrhea, the algorithm of examination in this type ofpathology, recommendations on treatment.
Modern aspects of pathogenesis and treatment of endometrial hyperplasia, uterine fibroids and adenomyosis
Authors: Kudrina E. A , Zholobova Mariya N. , Masyakina A. V
Published: September 2020

In the review there are presented modern aspects of pathogenesis of benign diseases of the uterus (uterine fibroids, adenomyosis, endometrial hyperplasia). There are highlighted questions of a differentiated approach to the treatment of given diseases.
Profile features immunohistochemical endometrium in patients uterine form of infertility
Authors: Arutyunyan Narina A. , Dzhibladze T. A , Zuev V. M , Ishchenko A. I , Bryunin D. V , Khokhlova I. D
Published: September 2020

The article presented data of the complex examination of 79 women aged of 24-43 years with uterine form of infertility, including the determination of immunohistochemical markers (ER, PR, Ki-67, CD34, CD56, CD68, CD138, VEGF) in endometrium. As a result of the study there was revealed the decline in the number of CD56-positive cells, decrease or no expression of CD138, the increase in expression of CD34, decreased VEGF expression. The deterioration of implantation processes in patients with uterine form of infertility, presumably is related to the low content of immune competent cells and inhibition of angiogenesis, as well as a weak proliferative activity of the endometrium, as evidenced by a decrease expression of Ki-67.
Method of the sampling of biological material for the biological examination in the obstetric-gynecological practice
Authors: Kaptilnyy Valery A.
Published: September 2020

Overview describes the bacteriological method of the examination in the modern obstetric-gynecological practice. Particular attention is paid to the value of this method, the diagnostic relevance of results of the examination. There is described the preparation for the examination, aim, the technology of the performance. The accompanying photographs show in detail all the stages of the free vaginal discharge collection from the urogenital tract.
INTERRELATIONSHIPS OF ANTIBODIES TO THYROPEROXIDASE AND THYREOGLOBULIN AND THE SYSTEM OF HUMAN CHORIONIC GONADOTROPIN AND THEIR ROLE IN MISCARRIAGE
Authors: Movsesyan Marina Kh. , Torosyan Aiarpi O.
Published: September 2020

In a review there is provided information concerning the relationship between thyroid autoimmune disorders and miscarriage. In the presence of antibodies to thyroid peroxidase (AT-TPO) in the female patient, the incidence rate of miscarriage was established to increase twice if compared to that in negative indices of AT-TPO. There are considered various pathogenetic theories of the impact of AT-TPO and antibodies to thyroglobulin on the features of the course of pregnancy.
GESTATIONAL DIABETES MELLITUS
Authors: Blokhin N. G , Shevchenko D. M
Published: September 2020

In the modern world, gestational diabetes mellitus (HDM) is a common disorder of carbohydrate metabolism in pregnant women, that indicates to the undoubted relevance of this problem in women of the reproductive age. High values of glucose concentration adversely affect not only the pregnant’s body, but also the fetus, that confirms the importance of timely diagnosis of GDM. In the article there was executed analysis both of modern literature data, testifying the role of this pathology in the occurrence of complications during pregnancy, and modern methods of diagnostics and treatment.
OBESITY AND REPRODUCTIVE HEALTH OF THE WOMAN
Authors: Lukash E. E , Dzhamal Kh.
Published: September 2020

Women’s obesity and reproductive health are linked at the hormonal level. Against the background of the obesity, various disorders of the menstrual function occur, the cycle of ovulation is changing, that eventually leads to the endocrine infertility. The normalization of the body weight is the way both the o restoration of reproductive functions of the female body, as well as the solution of the problem of endocrine infertility.
PODOCYTURIA AS A MARKER FOR PREECLAMPSIA
Authors: Murashko Andrey V. , Faizullin L. Z , Murashko A. A
Published: September 2020

The role of kidneys in the pathogenesis of preeclampsia is still a matter of debate. There is strong evidence that a disturbance in the function of normal kidney due to the loss of podocytes is the main cause of the development of proteinuria and hypertension. The release of podocytes, podocytic proteins and podocytic matrix ribonucleic acid (mRNA) can both be used for the diagnostics of preeclampsia and serve as a marker of the active disease of the kidney. The performed in this review analysis of publications showed that podocytes and podocytic proteins can be detected long before the appearance of proteinuria and hypertension, which makes them promising markers for the early diagnosis of preeclampsia. Measurement of the concentration of nephrin and its mRNA allows both assess the risk of development of preeclampsia and make the differential diagnosis between preeclampsia and gestational hypertension with a sufficiently high efficiency already in the second trimester of pregnancy, long before the appearance of the main signs of the disease.
BIPOLAR VAGINAL HYSTERECTOMY IN THE FUTURE AND PRESENT
Authors: Slobodyanyuk A. I , Ishchenko Anton A. , Ishchenko A. I , Slobodyanyuk B. A
Published: September 2020

Vaginal hysterectomy seems to be the optimal access, but this method does not take a worthy place in operative gynecology. In this study, a prospective comparison of 2 different techniques of vaginal hysterectomy was performed in 125 patients with the use of vicryl ligatures and 215 patients using bipolar coagulation devices (Gyrus and Emed) in different clinics. In the analysis of immediate and remote results, in the group with electrosurgery, blood loss, operation time and pain syndrome at 4 and 48 hours were found to be statistically significantly less. Also, we did not discern any differences in the number of postoperative complications, which allows us to make conclusions regarding the safety and effectiveness of the use of modern bipolar coagulation devices by experienced surgeons.
GENETIC MARKERS OF METABOLIC DISORDERS AFTER RADICAL HYSTERECTOMY AND OOPHORECTOMY
Authors: Ginzburg E. B , Sosnova Elena A. , Tumbinskaya L. V
Published: September 2020

In 38 operated patients with benign uterine diseases, represented by such isolated forms as endometrial hyperplasia, uterine myomas and adenomyosis, as well as their combination, a clinical assessment of the quantitative indices of fat metabolism disorders, such as the average value of the body mass index (BMI) before treatment, 3, 6 and 12 months after surgery, as well as changes in blood pressure (BP). Clinical and laboratory analysis and analysis of genetic markers made it possible to identify alleles of high risk of arterial hypertension, as well as disorders of fat metabolism and the formation of metabolic syndrome (MS), to conclude that the identified candidate alleles allow predicting changes in BMI, BP and to form risk groups, to take preventive measures to prevent the formation of complications such as diabetes, myocardial infarction and stroke in overweight patients who have undergone surgery. The aim of the work is to identify prognostically significant genetic markers for the development of arterial hypertension, disorders of fat metabolism, and MS after subtotal hysterectomy. Material and methods. There were examined 38 patients after subtotal hysterectomy with bilateral adnexectomy or without it. Within 12 months after surgery, changes in BMI and systolic BP were observed in dynamics. The polymorphism of the following genes was studied in all patients in the studied groups: s.388T> C and p.526 C> T in the ApoE gene, pp. 306-109-2306-108insA288 in the ACE gene, p.176T> C in the IGBT3 gene. DNA samples obtained by the method of phenol-chloroform extraction from 10 ml of whole venous blood served as the material for the study of polymorphisms. Analysis of single nucleotide polymorphisms of genes (SNP) was performed by the method of minisequencing followed by mass spectrometric fractionation of oligonucleotide probes using time-of-flight (MALDI-TOF) mass spectrometry. Results. Specific alleles of the ACE and ApoE genes, characteristic of a high risk of developing hypertension, as well as prognostically significant candidate alleles of MS development, and the likelihood of impaired fat metabolism were established.
COLONIC PSEUDO-OBSTRUCTION: OGILVIE’S SYNDROME
Authors: Gasimova Ulviyya , Elhamamsy S.
Published: September 2020

Acute colonic pseudo-obstruction (Ogilvie’s syndrome) is a rare disorder associated with spontaneous colonic dilatation with signs and symptoms of mechanical bowel obstruction and dilatation on imaging. We report a 37 year-old female, with three-month history of Caesarian Section at 38th week of pregnancy due to fetal malpresentation. Abdominal CT-scan revealed chronic diffuse colonic distention, 17 cm in diameter. No cause of obstruction could be determined. A diagnosis of Ogilvie’s syndrome was made. The increased size of the colon with leukocytosis warranted urgent colonoscopic decompression. The patient recovered well. If not managed appropriately, Ogilvie’s syndrome can progress to bowel ischemia and perforation with significant morbidity and mortality. The first line of treatment of early disease is conservative management with neostigmine or colonoscopic decompression. Our purpose is to review the diagnosis and management of this potentially lethal rare condition.
TREATMENT OF UTERINE MYOMA IN WOMEN PLANNING PREGNANCY BY FOCUSED ULTRASOUND ABLATION UNDER MRI CONTROL
Authors: Malysheva Yana R. , Sosnova E. A
Published: September 2020

The purpose of this study is to evaluate the effectiveness of focused ultrasound (FUS) ablation as monotherapy for uterine fibroids in women planning a pregnancy. Of the 195 patients included in the study, long-term pregnancy occurred in 38. At the same time, immediately after FUS ablation, without prescribing additional methods of treatment, 7 patients became pregnant. Given the high frequency of additional surgical treatment methods (conservative myomectomy, hysteroresectoscopy), as well as additional procedures for FUS ablation, this method, despite its high efficacy in treating symptomatic myomas, cannot be recommended by us as the only treatment for uterine fibroids in women planning a pregnancy.
MODERN METHODS OF DIAGNOSTICS AND TREATMENT OF CHLAMYDIA INFECTION
Authors: Kaptilnyy Vitaliy A. , Lystsev D. V
Published: September 2020

The review reflects the current understanding of the etiology, pathogenesis, and treatment of chlamydia. The advantages of new methods for the diagnosis of chlamydial infection using methods such as real-time polymerase chain reaction (PCR-RV) and real-time NASBA transcription amplification (NASBA-Real-Time) are described. Comparison with older methods, such as bacteriological, immunomorphological and immunological, has been made; diagnostic and treatment algorithms for chlamydial infection in pregnant women have been compiled.
SINGLE-MOMENTAL OPERATION IN A PATIENT WITH COMBINED PATHOLOGY, COMPLICATED BY VENOUS MALFORMATION OF THE FRONT ABDOMINAL WALL
Authors: Bakhtiyarov K. R , Cherepenin M. Yu , Kalseidova Kristina Sh. , Agrba I. B
Published: September 2020

The article describes a clinical case of simultaneous surgical treatment of three gynecological and surgical nosologies in a patient with venous malformation of the vessels of the left half of the anterior abdominal wall, which complicated the possibility of using traditional laparoscopic access.
MODERN ASPECTS OF CERVICAL CANCER TREATMENT IN PREGNANCY
Authors: Silkina M. O , Sosnova Elena A.
Published: September 2020

Cervical cancer during pregnancy is the actual problem of XXI century in the gynecologic oncology. Statistics data have shown that cervical cancer takes the first place among gynecologic tumors associated with pregnancy. During the past decade a treatment plan for such patients has significantly changed in a favor of pregnancy prolonging and possibility to deliver a healthy child. We have made an informational analysis of PubMed database for 2010-2018 to assess an individual treatment of patient with diagnosed cervical cancer while prenatal screening and revealed progressive and effective therapeutic methods regarding tumor stage and gestational age. Based on learnt scientific articles and literature we have established that now the most appropriate treatment approach is managing platinum-based neoadjuvant chemotherapy to decrease a tumor size and performing opened or laparoscopic uterus-preserving surgeries during pregnancy if needed.
THE VALUE OF THE EXPRESS METHOD OF LASER CONVERSION DIAGNOSTICS (RAMAN-FLUORESCENT COMPONENT) OF THE PATHOLOGICAL PROCESSES OF ENDOMETRIUM IN WOMEN IN THE PERIMENOPAUSE
Authors: Osipova A. D , Zuyev Vladimir M. , Aleksandrov M. T
Published: September 2020

Conducted experimental and clinical studies on the implementation of the rapid diagnosis of endometrial morphofunctional state in perimenopausal women. The age-related features of the structural and functional state of the endometrium in women in this age period and in women with a reduced follicular reserve after ovarian surgery have been revealed. The developed medical diagnostic technology has confirmed its clinical efficacy in rapid diagnosis in the conditions of follow-up observation of perimenopausal women.
POSSIBILITIES OF ULTRASONIC MONITORING OF ENDOMETRIUM AND OVARIES IN PATIENTS AFTER CANCELLATION OF LONG-TERM RECEPTION OF COMBINED ORAL CONTRACEPTIVES WHEN PLANNING PREGNANCY
Authors: Bortsvadze Sh. N , Svidinskaya Evgeniya A. , Dzhibladze T. A , Khokhlova I. D , Van Yan
Published: September 2020

The article aims to assess the possibility of ultrasound scanning and dopplerstudy in the assessment of the condition of the ovaries and endometrial in patients after long intake of COC, predicting the restoration of reproductive function after the abolition of hormonal contraception. Material and methods. In 2018-2019, 37 women were examined after the abolition of oral contraceptives, which they took for a long period of time. At the time of the examination, all the patients stopped taking COC at least 2 months ago due to the fact that they were planning a pregnancy. UW the study was conducted on the apparat Voluson E8 Expert (General Electric), improving the quality of diagnostics used Automatic assessment of follicle condition based on ultrasonic echography (Sono AVCTM follicle) and tomographic ultrasound (TUI). Results. According to the study significant changes recorded 17 patients whose menstrual cycle did not recover within the first 6 months after the cancellation of COC. In a group of 20 patients with a regular menstrual cycle, the results of the study were within normal limits, pregnancy within 6 months occurred on their own in 8 of them. Conclusion. The possibilities of 3 dimensional reconstruction and programs for evaluating the follicular apparatus significantly improve the quality of ultrasound diagnostics, give more information about the presence of small follicles, blood flow in the ovarian tissue, the structure of the cortical apparatus substances and stroma, whichis the ability of a clinician to obtain a complete understanding of the condition of the ovaries and endometrial and predicting a good health of patients. The article may be of interest to obstetricians-gynecologists, ultrasound specialists, endocrinologists, reproductive specialists.
Editorial
Authors: Rocha de la Torre Prof. Dr. Alfredo
Published: September 2020

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De “A preta do acarajé” (Dorival Caymmi) a “Carioca” (Chico Buarque)
Authors: Garcia Walter
Published: September 2020

O artigo analisa recursos poéticos e musicais das canções “A preta do acarajé” (Dorival Caymmi) e “Carioca” (Chico Buarque), e busca interpretar dois momentos de passagem de um certo sistema da canção popular-comercial brasileira. Em sua etapa inicial, esse sistema assinala a transição de formas populares de tradição oral, dentre as quais se destaca o pregão de rua, para o disco e o rádio. Aspectos fundamentais da forma artística e da atuação mercadológica da canção são esclarecidos a partir dessa relação. Já no segundo momento de passagem, o jingle parece assumir o lugar do pregão. E a canção de Chico Buarque desempenha um papel semelhante ao da crônica jornalística. A fim de esclarecer essas transições, que apontam para um processo cultural e econômico mais amplo, “A preta do acarajé” e “Carioca” são examinadas na totalidade de sua forma, à luz tanto da formação da sociedade brasileira como de seus impasses atuais.
Palyatif bakım ünitesinde yatan hastalar için yapılan harcamalara genel bakış: Tek merkez deneyimi
Authors: KARAHAN İrfan , ÖZDEMİR Adnan
Published: September 2020

Amaç: Palyatif bakım, yaşamı tehdit eden hastalarda yaşam kalitesinin artırmayı hedefleyen yaklaşım olarak özetlenebilir. Ülkemizde palyatif bakım ünitelerinin sayısı son zamanlarda artmış olup, harcamalarıyla ilgili ayrıntılı veri bulunmamaktadır. Bu çalışmada hastanemiz palyatif bakım ünitesindeki harcama gruplarının belirlenmesi amaçlanmıştır.
Gereç ve Yöntem: Kırıkkale Üniversitesi, Tıp Fakültesi, İbn-i Sina Palyatif Bakım Ünitesi’nde Mart 2019- Aralık 2019 arasında yatan 333 hasta yatışının arşiv kaydı hasta harcamaları açısından retrospektif olarak incelendi. Gruplar; ilaçlar, laboratuvar incelemeleri, radyolojik inceleme ve girişimler, tıbbi malzemeler ve diğer harcamalar olarak gruplandı.
Bulgular: Gruplar arasında en pahalı harcama türü ilaç ve medikal tedaviydi. İlaçların içerisinde de en pahalı grubun antibiyotikler olması dikkati çekti.
Sonuç: Palyatif bakımın doğru kullanımı ve düzgün planlama için giderlerin belirlenmesi önemli olabilir. İlaç ve özellikle antibiyotik giderlerinin ön planda olması akılcı ilaç kullanımının önemini vurgulayabilir.