bluuebunny/crossref_metadata_2025 huggingface dataset:
Foreign body cases in obstetrics and gynecology practice
Authors: Zabolotnov V.O. , Zablotska O.S. , Donets V.Ye. , Morenets K.V.
Published: June 2024

The article presents cases that took place in obstetrics and gynecology practice, the detection of a foreign body after surgical operations, childbirth through the natural birth canal.Patient safety is one of the most pressing issues in healthcare. Promoting safety requires that all those involved in health care recognize that the potential for error exists and that teamwork and communication are essential to preventing errors.Retention of surgical objects such as a gauze pad, instrument, or needle after surgery or an invasive procedure is a rare but potentially serious phenomenon associated with significant morbidity and mortality.Gauze swabs and napkins are the most common finds, while surgical instruments and needles are rare.We will present cases of foreign bodies in the practice of obstetrician-gynecologists.In the first case, the foreign body was left in the anterior abdominal wall. Two cases of napkins being left in the abdominal cavity after gynecological and surgical operations. In the fourth case, a needle was left in the cervix after delivery through the natural birth canal and suturing of soft tissue tears in the birth canal. Moreover, the needle was not detected either after childbirth, or outside of pregnancy, or during pregnancy, but was detected during examination of the cervix in mirrors in the early postoperative period.The problem of finding a foreign body after surgery remains unsolved. According to statistics, one patient per year in each hospital suffers from a forgotten foreign body. A foreign body left behind can give rise to a lawsuit for damages against the surgeon and medical staff.Pre- and post-operative object counting is the most common foreign body screening method used in the world.Careful surgical technique should be routinely followed, which includes counting sponges, tampons, napkins, and instruments aimed at preventing postoperative foreign material in body cavities. A patient with significant gastrointestinal symptoms and a history of surgery should have a high index of suspicion for postoperative foreign body retention. Perioperative counting of equipment and materials is the most common method of foreign body screening.
Current understanding of the aetiology and pathogenesis of inflammatory bowel diseases (Part 1): the role of the immune system, genetic and epigenetic factors
Authors: Khavkin A. I. , Nikolaychuk K. M. , Shrayner E. V. , Shaimardanova D. R. , Veremenko A. S. , Levchenko I. D. , Platonova P. Ya. , Novikova M. F. , Dudurich V. V.
Published: June 2024

Inflammatory bowel diseases (IBD) have become the subject of numerous scientific studies in clinical practice in recent years. The review is examines in detail key aspects of IBD pathogenesis, including the role of the immune system, stromal components and genetic factors. Particular attention have been paid to the interaction of these factors and influence on the development and course of the disease. The review’s aims to provide a comprehensive understanding of the mechanisms of IBD development and identify potential avenues for diagnosis, therapy and prevention. The main content of the article covers the latest scientific data and clinical observations in the field of gastroenterology, emphasizing the integration of various disciplines in the understanding and treatment of IBD.
The effect of Helicobacter pylori on the morphological picture of the gastric mucosa in patients with chronic gastritis
Authors: Bulgar K. I. , Pavlovich I. M. , Parcernyak A. S. , Chumak B. A.
Published: June 2024

Helicobacter pylori (H. pylori) is one of the most common infections worldwide. According to modern ideas, it is the main cause of a number of diseases of the stomach and duodenum (peptic ulcer, chronic gastritis, MALT lymphoma) and the leading risk factor for stomach cancer. In the hospital therapy clinic of the Kirov Military Medical Academy, we observed 118 patients. The study groups included patients with various types of chronic gastritis (atrophic and non-atrophic). The patients were comparable in gender and age. Infection H. pylori was verified in 22 patients (68.8%) suffering from chronic non-atrophic gastritis and in 34 patients (37.2%) suffering from chronic atrophic gastritis. In the course of the study, the relationship between the contamination of H. pylori and the presence of dysregenerative changes in the gastric mucosa was evaluated. It was found that H. pylori infection does not significantly affect the development and progression of atrophy in the mucous membrane of the antrum of the stomach. Also, no convincing data on the effect of H. pylori on dysregenerative processes (intestinal metaplasia and dysplasia) in the gastric mucosa. At the same time, the presence of pathogenicity factors H. pylori Vac A and Cag A significantly affects the progression of atrophic changes in the gastric mucosa. At the stage of formed atrophy, the intensity of H. pylori invasion is significantly reduced.
Lipomatosis of the ileocecal valve as a cause of acute abdomen in a patient with aplastic anemia
Authors: Korneva Yu. S. , Monahova I. A.
Published: June 2024

Ileocecal region can be affected by many pathological conditions, such as benign and malignant tumors, inflammatory processes (appendicitis, diverticulitis, Crohn’s disease) and infectious diseases, which determines the importance of knowledge of differential diagnosis. Lipomatous lesions in intestine may be single or multiple, encapsulated lipomas or diffuse, discrete, uncapsulated areas of adipose tissue called lipomatosis, occurring in 0.04 to 4.5% of cases according to autopsies and more often affecting the cecum. A case of lipomatosis of the ileocecal valve in a patient with aplastic anemia, manifested by symptoms of an acute abdomen due to massive hemorrhage into it due to severe thrombocytopenia, regarded intraoperatively as a malignant tumor that was not removed due to the high risk of bleeding on the background of severe thrombocytopenia, is presented. Preoperatively, CT scans of the abdominal cavity, retroperitoneal space, and pelvis revealed thickening of the colon walls throughout up to 14 mm with smoothness, straightening of contours, and moderate infiltration of surrounding fiber. In the area of the dome of the cecum, an infiltrate with dimensions of 10,0×6,0 cm, with areas of liquid density, is determined. The diameter of the cecum is 6,0 cm, its walls are sharply thickened to 2.5 cm, the lumen is deformed, narrowed. Retroperitoneal lymph nodes are not enlarged. Finally, the nature of the process was established by histological examination of autopsy material. Intestinal lipomatosis is a rare pathology with nonspecific manifestations from the gastrointestinal tract and certain diagnostic difficulties. It is necessary to remember about its possible presence for inclusion in the differential diagnosis.
Etymology of Russian terms in anatomy of digestive system. Part I - oral cavity
Authors: Kutia S. A. , Ponomarenko E. A.
Published: June 2024

The article presents data on the origin of the Russian names of the structures bounding or located in the oral cavity: mouth, lip, cheek, palate, gum, tooth (incisor, canine, molar (premolar)), tongue, fauces, tonsil.
Helicobacter infection and hepatobiliary cancer: epidemiology and pathogenesis
Authors: Kugler T. E. , Taradin G. G. , Rakitskaya I. V. , Khristulenko A. L. , Gnilitskaya V. B.
Published: June 2024

Hepatobiliary cancer is one of the leading causes of cancer death and a major public health problem in both developed and developing countries. Chronic infections are common risk factors for cancer. Animal studies have shown that Helicobacter pylori (H. pylori) infection can cause hepatitis, colitis, and liver cancer in susceptible individuals. Data from clinical and experimental studies point to the involvement of the gastrointestinal microbiota in the pathogenesis of the non-alcoholic fatty liver disease, including H. pylori infection. The researchers included H. pylori infection in the list of etiopathogenetic factors of primary biliary cholangitis due to the detection of its DNA in the liver tissue and antibodies to H. pylori in the bile and serum of patients with primary biliary cholangitis. A growing body of evidence suggests that H. pylori may be a risk factor for the development of liver cirrhosis and hepatocellular carcinoma in patients with viral hepatitis B and C. The contribution of H. pylori infection to the development of hepatic encephalopathy and hyperammonemia has been identified. H. pylori infection is associated with liver inflammation, fibrosis, and necrosis by inducing the synthesis of systemic inflammatory mediators and increasing intestinal permeability. Along with these consequences, bacterial translocation through the biliary tract can also lead to direct liver damage, predisposing or even triggering the carcinogenic process. The study of subspecies of Helicobacter shows that they can lead to the development of not only hepatocellular carcinoma but also other malignant neoplasms of the hepatobiliary system. This review presents current data on the epidemiology and mechanisms of the influence of H. pylori infection on malignant neoplasms of the hepatobiliary tract, with an emphasis on possible prevention strategies.
Whipple’s disease and Helicobacter pylori: current state of the problem
Authors: Kupriyanova I. N. , Postnikova E. A.
Published: June 2024

Tropheryma whipplei and Helicobacter pylori share common transmission routes and epidemiological risk factors. A review of the current literature reflecting the relationship between Whipple’s Disease and Helicobacter pylori is presented.
Interaction of SARS-CoV-2 with gut microbiota
Authors: Soldatova O. V. , Goryanskaya I. Ya. , Namazova L. E. , Abramova K. I.
Published: June 2024

To determine the influence of the gut microbiota to the severity and development of complications during COVID-19. Consider the importance of taking pro- pre- and metabiotics in increasing the body’s resistance to viral infections. Recently, much attention has been paid to the influence of the gutl microbiota on the course of many internal diseases of an infectious and non-infectious nature. The pathogenetic influence of changes in the gut microbita on the initiation and maintenance of the inflammatory response of the body, as well as the immune response, has been proven. A number of studies have noted a direct correlation between the increased susceptibility of the human gut microbiota to a new coronavirus infection and the occurrence of complications from the respiratory system. Microbiome’s changes lead to increase gut permeability, weak protective barrier and immune mechanisms of the gastrointestinal mucosa, lead to easier and faster penetration of the SARS-CoV-2 virus into the blood stream, followed by dissemination and damage to the lungs. In light of the available data, a close relationship between the severity of the novel coronavirus infection and the composition of the gut microbiota is highly likely. The article presents the results of some studies, on the basis of which it can be concluded about gut microbiota changes in COVID-19 patient and efficiency of pro-, pre- and metabiotics, including strains of Lactobacilli and antimicrobial peptides (AMP), in the treatment of patients with COVID-19 in order to improve prognosis and prevent complications. The information presented can be useful for those who are faced with the effect of the virus on the gastrointestinal tract and respiratory system and for those who, for preventive purposes, want to increase the resistance of their body.
The effect of the intestinal microbiota on the development of diabetes mellitus
Authors: Chervinets V. M. , Chervinets Yu. V. , Ganzya D. V. , Belyaev V. S. , Zaitseva V. S.
Published: June 2024

The aim of the study was to identify the pathogenetic role of intestinal microflora in the development of diabetes mellitus. The review presents data on the peculiarities of the development of the intestinal microflora (MC), factors that determine the occurrence of dysbiosis, as well as the effect of dysbiotic changes in MC on the pathogenesis of various types of diabetes mellitus. The role of MC in the occurrence of insulin resistance, as well as the metabolism of peptides that determine eating behavior, has been studied. The contribution of short-chain fatty acids produced by microorganisms to the regulation of metabolism in diabetes mellitus is considered, and the role of pathogenicity factors of MC representatives is studied. Conclusion. The gut microbiota makes a significant contribution to the regulation of metabolism through various mechanisms. The resulting dysbiotic changes can negatively affect metabolic processes and be a risk factor for the development of diabetes mellitus. The identification of new pathogenetic pathways can be useful in finding points of application of drug therapy, which will contribute to improving the results of DM treatment.
Comparative results of treatment of superior mesenteric artery syndrome in children by forming bypass anastomoses
Authors: Amanova M. A. , Kholostova V. V. , Razumovsky A. Yu. , Smirnov A. N. , Mitupov Z. B. , Khavkin A. I.
Published: June 2024

Introduction. Superior mesenteric artery syndrome (SMAS) is a rare cause of chronic duodenal obstruction in children. It is defined as a compression of the inferior horizontal branch of the duodenum (DU) between aorta and the superior mesenteric artery (SMA). Various methods of surgical correction of the disease have been proposed in the literature, but a comparative analysis of their effectiveness has not been carried out. Objective: the comparative analysis of using various options of bypass anastomoses (side-to-side duodenojejunostomy, Roux-en-Y duodenojejunostomy) for SMAS in children was carried out. Materials and methods: thirty-four patients were treated with SMAS at the clinic of the Federal State Budgetary Institution of Children’s City Clinical Hospital named after. N.F. Filatov for the period from 2012 to 2023. Patients were divided into 2 groups: operated on by forming a side-to-side bypass duodenojejunostomy (group 1 - 21 children (61.8%)) and Roux-en-Y (group 2 - 13 children (38.2%). A retro- and prospective analysis of the results of their treatment was carried out. The average age was 15 years 7 months (from 8 years 5 months to 17 years 8 months). Girls were predominant 85.3%. Standard investigations were performed: ultrasound, fluoroscopy, and computer tomography of the organs of the abdominal cavity with contrast, esophagogastroduodenoscopy, laboratory research methods. The WHO AntroPlus program was used to assess the physical condition of the children. Results: the groups were assessed in terms of anthropometric indicators, gender composition and age. The following causes of SMAS were identified in both groups: weight loss caused by neuropsychiatric diseases - 29.4%; growth spurt - 26.5%; weight loss due to other reasons (repeated surgeries, diseases accompanied by weight loss, etc.) - 23.5%; without an obvious reason - 17.6% (6 people), correction of scoliotic deformity - 2.9%. The analysis showed that statistically significant differences were identified in the duration of surgery. The average duration of the operation in group 1 was 78.10±21.53 minutes, in group 2 - 103.46 ±18.19 minutes (p=0.001*). There was no statistically significant difference between groups in the postoperative period and in the complications (bleeding from the surgical site 8.8% (3 people) and reactive pancreatitis 5.9% (2 people)). Conclusion: no statistically significant difference was found in the results of both types of operations. However, the laparoscopic side-to-side duodenojejunostomy bypass is preferable due to the simplicity and quickness of performing.
Clinical and epidemiological features of ulcerative colitis in children of the Rostov region
Authors: Eliseeva N. D. , Panova I. V. , Dombayan S. Kh.
Published: June 2024

Russian data on the prevalence of inflammatory bowel diseases (IBD), including ulcerative colitis (UC), confirm the general global trend towards an increase in IBD, taking into account age-related as well as regional characteristics, which determined the purpose of this study. The purpose of the study. To evaluate the clinical and epidemiological features of the course of ulcerative colitis in children of Rostov-on-Don. Materials and methods. We observed 42 children aged from 1 to 14 years with a diagnosis of UC, which was made on the basis of anamnesis, clinical picture, laboratory test results, colonoscopy data, and morphological examination of the colon mucosa. UC activity was assessed taking into account the PUCAI index. Results. For the period from 2014 to 2023 On the basis of the pediatric somatic department of city hospital No. 20 in Rostov-on-Don, UC was diagnosed in 42 children aged 1 to 14 years, which amounted to 1.48% of the total number of patients with chronic intestinal diseases (2822 people). There was an increase in the incidence of ulcerative colitis from 2014 to 2023 (from 0.32% to 2.52%) with maximum values in 2021-2023. Conclusion. Clinical and epidemiological studies have shown an increase in the incidence of UC in children of Rostov-on-Don over the past 10 years. It has been established that ulcerative colitis is more often detected in the preschool group of children. The incidence of ulcerative colitis was higher in boys than in girls. A high degree of family history of children with UC was revealed for diseases of the digestive system, delivery by Caesarean section, artificial feeding in the first year of life, and acute intestinal infections. In the UC clinic, milder, erased forms of the disease dominated, which determined the later diagnosis of the disease at the prehospital stage.
Obesity and menstrual disorders in adolescent girls -is there a relationship?
Authors: Liskina A. S. , Nikitina I. L.
Published: June 2024

The development of menstrual cycle disorders (MCD) in adolescent girls is often combined with obesity, therefore, it seems relevant to study the effect of pathological body weight gain on pubertal development. The purpose of the study. To study the association of obesity and menstrual disorders in adolescent girls. Materials and methods. Group 1 (40 people): obese and MCD, group 2 (40 people): with obesity without MCD. Laboratory tests: assessment of carbohydrate and lipid metabolism, calculation of the HOMA index; blood plasma levels of kisspeptin, thyroid-stimulating hormone (TSH), free thyroxine, total testosterone, prolactin, free androgen index (ISA), anti-muller hormone (AMH), 17-0H Progesterone(17-OHP), lutenizing hormone (LH), follicle stimulating hormone (FSH), estradiol (Е2). The obtained data were analyzed by constructing a mathematical model of the pathogenetic mechanisms associated with MCD in obese adolescent girls. Results. There were no differences in the degree of obesity in the groups: SDS BMI (Me1=2.9; Me2=2.94, p=0.459). In group 1, significantly more often: impaired glucose tolerance (1 g.=15%; 2 g.=2.5%, p=0.048) (NTU), hypertriglyceridemia (1 g.=37.5%; 2 g.=15%, p=0.048). Significantly higher in the group with MCD: levels of LH (Me1=8.85 mIU/ml; Me2=6.70 mIU/ml, p=0.022), kisspeptin (Me1=55.4 pg/ml; Me2=38.3 pg/ml, p=0.001), total testosterone (Me1=1.90 nmol/l; Me2=1.25 nmol/l, p=0.026), ISA (Me1=14.5; Me2=8.65, p=0.027), AMG (Me1=6.61 ng/ml; Me2=24.26 ng /ml, p=0.014), with a significantly lower level of Е2 (Me1=33.5 pg/ml; Me2=5.0 pg/ml, p=0.012). Conclusions. 1. Adolescent girls with obesity and MCD are significantly more likely to have NTU and hypertriglyceridemia compared with girls with similar severity of obesity without MCD; 2. When obesity and MCD are combined, significantly higher levels of kisspeptin, LH, AMH, total testosterone, ISA are noted; 3. Among the pathogenetic mechanisms associated with MCD, hormonal and matabolic independent associations have been established, the effect of which is independent; hormonal: kisspeptin - LH - testosterone, and metabolic: BMI - insulin and BMI - leptin.
Studying the genetic causes of hearing loss of children
Authors: Lobanov M. E. , Chursina E. M. , Posled T. E. , Chernenkov Yu. V. , Gumeniuk O. I.
Published: June 2024

The study of the genetic aspects of hearing loss is an important area in medical genetics and pediatrics. Congenital sensorineural hearing loss can manifest itself in various forms and degrees of severity and in some cases is associated with various genetic syndromes. Studying the genetic nature of hearing loss makes it possible to better understand it and develop effective diagnostic and therapeutic approaches. The purpose of the study: to study the genetic causes of SHL (sensorineural hearing loss of children). Material and methods. The examination, analysis of medical histories and results of molecular genetic research (clinical exome sequencing, complete exome sequencing, complete genome sequencing) of patients aged 1-18 years (n=24) with SHL were carried out. According to the results of the work, it was found that 79% of cases of NST are caused by genetic reasons. The most common (n=3) pathogenic variants in the ARID gene associated with Coffin-Siris syndrome of various types, for which NST is a characteristic feature, were found. NST is a typical sign of diseases such as Kabuki syndrome, Pendred syndrome, KBG syndrome, mucopolysaccharidosis of Type 1, primary ciliary dyskinesia which were diagnosed in the examined patients. Also, pathogenic variants of various genes were quite common (n=6), leading to impaired development of the nervous system and encephalopathy. In two cases, mutations in the genes SLC26A4 and GJB2, responsible for the development of nonsyndromic NST, were identified. Conclusion. Sensorineural hearing loss is an indication for a molecular genetic examination. Knowing the cause of NST allows you to make personalized decisions on the treatment and correction of this disease in children.
Maternal history in preterm newborns: pathogenetic features and nosological structure
Authors: Malysh V. M. , Bryksina E. Yu. , Letifov G. M.
Published: June 2024

Of particular clinical importance at present is a detailed study of perinatal history, since the pathological obstetric-gynecological, infectious and somatic status of the mother causes dysfunctions in the fetoplacental complex, increases the risk of premature birth, disrupts the vital functions of the fetus and reduces the reserve capabilities of all organ systems in the newborn. Purpose. Analyze obstetric-gynecological, infectious and somatic status of mothers in premature babies, to optimize postnatal observation tactics. Materials and methods. The study included 60 children born prematurely with the determination of the features of obstetric-gynecological, infectious and somatic history of their mothers by retrospective analysis. Depending on gestational age (GV), children were divided into 3 groups: 1 group - GV 34.1-36.9 weeks (20 children); Group 2 - GV 30.1-34 weeks (21 children); Group 3 - GV 26-30 weeks (19 children). Results. The most pronounced burden of obstetric-gynecological and somatic history occurred in mothers in the 2nd and 3rd groups, where the birth of premature babies was significantly more common (23.8%; 31.6%) and abortion (28.6%; 57.9%) in the history. Antenatal fetal death occurred only in mothers in the 2nd and 3rd groups (4.8%; 10,5%). The maximum burden for inflammatory diseases of the sexual sphere occurred in the 3rd group. Infectious pathology of other organ systems, represented by acute gestational or chronic pyelonephritis in the stage of exacerbation, tonsillitis, bronchitis, was significantly more common in patients in the 3rd group (52.6%, 47.4%, 21.1%). Operative delivery in the study groups was quite frequent: 45% in group 1, 47.6% in group 2, 31.6% in group 3, in general - 41.7% of the total number of mothers (including 16% indication for caesarean section had premature placental detachment). Conclusion. Thus, the study of perinatal history revealed the presence of a wide range of pathological factors that aggressively act on the fetus, having both a direct damaging effect on the tissue and disrupting the functional activity of various organ systems.
Pathology of the respiratory system in children with Down syndrome
Authors: Shmeleva I. O. , Starevskaya S. V. , Melnikova I. Yu.
Published: June 2024

Down’s syndrome is the most frequent chromosomal abnormality. According to the literature, respiratory diseases are the most frequent reasons of hospitalization of children with Down’s syndrome. Also, respiratory diseases are diagnosed for 42% of patients with Down’s syndrome during first two years of life. Objective. Objective is to define features of respiratory diseases course for children with Down’s syndrome to determine the best cure tactics. Materials and methods. Six patients with Down’s syndrome and damage to respiratory system at age of from 2 month to 7 years were under observation. Medical documentation, anamnesis data, CT scan of the thorax organs and objective examination data has been analyzed. Results. Abnormal pregnancy has been confirmed for 4 patients, 50% of patients had been born premature. Congenital heart defects had been diagnosed for 5 patients. Four patients suffered lower respiratory tract diseases with respiratory failure at an early age, cure in intensive care unit or pulmonary department has been required. Later recurrent respiratory diseases were observed. One patient was referred to a pulmonologist by a doctor of another specialty in early childhood. Shortness of breath of mixed or insular type, cough, cyanosis, night apnea, physically observed strengthening wheezing during respiratory infections, for 4 patients - mosaic performance of breathing has been clinically recorded. According to the results of the X-ray examination, the changes are - «ground-glass opacity» - 5 patients, subpleural cysts - 4 patients, uneven ventilation - all. Two patients have radiological evidence of lymphoid interstitial pneumonitis. subsequently all patients were observed by a pulmonologist, prescribed pathogenetic treatment with inhalation glucocorticostroids, and two children received systemic glucocorticosteroids with positive effects. The X-ray dynamics showed a regression of alveolar infiltration for 6-9 months, as well as a decrease in shortness of breath, an improvement in physical activity tolerance, objectively - no strengthening wheezing by four years for 4 patients. Conclusion. Children with Down’s syndrome and respiratory failure from an early age require specialized pulmonological care. Timely diagnosis and optimal therapeutic strategies are critical to ensure treatment outcomes.
A complication during chemotherapy of recurrence of acute lymphoblastic leukemia in a child
Authors: Shevchenko A. A. , Popova O. Yu. , Chernenkov Yu. V. , Vorotnikova N. A.
Published: June 2024

Acute lymphoblastic leukemia (ALL) is one of the most common malignant diseases of the hematopoiesis system in childhood, characterized by uncontrolled proliferation of a tumor clone from lymphocyte progenitor cells. At the same time, as a result of total immunosuppression, the most common complications are infectious. The purpose of the work: to describe a clinical case of nosocomial pneumonia, formed against the background of chemotherapy relapse of ALL. Materials and methods. A retrospective analysis of the medical records of patient L., 6 years old, who was being treated at the Department of Pediatric Pulmonology of the UKB No. 1 of the Razumovsky SSMU with the main diagnosis: Nosocomial polysegmental pneumonia with obstructive syndrome, acute course. Complications: 1. RF III art., 2. Pulmonary edema, 3. Exudative pleurisy. Background: ALL III phenotype; late bone marrow relapse, isolated (30.12.2022). Results. At the age of 2 (2019) - he made his ALL debut, received induction courses, and achieved remission within the prescribed consolidation period. In 2022, a reinduction course was conducted, and it was removed from the D-register. Relapse of leukemia (28.12.2022) - hospitalized in the V.Ya. Shustov UCB No. 3, 1 block of anti-relapse therapy of ALL in combination with hemotransfusion, massive antibacterial (AB) therapy was performed. On the 23rd day of hospitalization in the hematology clinic, nosocomial 2-sided polysegmental pneumonia was diagnosed, complicated by pulmonary edema, exudative pleurisy, RF III art. On 23.01.2023, the patient was urgently taken to the children’s Intensive care Unit (DORIT) in extremely serious condition UKB No. 1 named after S.R. Peacemakers SSMU, where over the next 15 bed days he received: erythrocyte suspension transfusion, oxygen therapy, combined AB therapy, GCS, bronchodilator and mucolytic therapy, against which the condition improved: symptoms of intoxication, DN were stopped, the inflammatory process in the lungs was resolved. For further treatment of relapse, ALL was transferred to the hematology clinic. Conclusion: The course of chemotherapy for relapse of ALL in the patient provoked a severe infectious complication - nosocomial pneumonia with DN III art., pulmonary edema, pleurisy. Timely diagnosis of pneumonia and intensive therapy in DORIT conditions contributed to a favorable outcome of the infectious process in the lungs. Taking into account the above, the tactics of ALL management were changed - allogeneic transplantation of hematopoietic stem cells from a haploidentical donor (father) was performed, 19.07.2023 - engraftment was achieved.
The current state of the problem of seronegative autoimmune hepatitis in children
Authors: Volynets G. V. , Potapov A. S. , Khavkin A. I.
Published: June 2024

Seronegative autoimmune hepatitis (AIH) is a poorly understood problem in both adult patients and children. The key to the diagnosis of AIH is the presence of circulating autoantibodies, which are not detected in seronegative AIH. There is insufficient data on the contribution of autoantibodies to hepatocyte damage in seronegative AIH. The presence of plasma cells in liver biopsies of patients with seronegative AIH suggests that its pathogenesis involves physiopathological mechanisms similar to those of seropositive AIH. Unlike adults, in whom acute manifestations of the disease are rare, in children’s acute manifestations of seronegative AIH were observed in three quarters of patients. In addition to the absence of autoantibodies, the diagnosis is complicated by the low level of gammaglobulins in the blood in seronegative AIH. In seronegative AIH, hepatitis-associated aplastic anemia often develops. Morphological examination of liver biopsies may reveal infiltration with a predominance of CD8+ T cells. Treatment of seronegative AIH includes immunosuppressive therapy, as for seropositive AIH. The prognosis for seronegative AIH is usually favorable. Although seronegative autoimmune hepatitis is not uncommon, little is known about its diagnosis and treatment.
New approaches to the diagnosis and tactics of surgical treatment of intestinal intussusception in children
Authors: Shamsiyev J. A. , Yusupov Sh. A. , Suvonkulov U. T. , Togaev I. U.
Published: June 2024

Intestinal intussusception (IR) is an urgent problem of pediatric surgery. The relevance is high due to the incidence of the disease, which ranges from 1.5 to 4 per 1000 children and tends to increase cases over the past 10 years, as well as diagnostic difficulties and a high frequency of relapses of the disease. The frequency of diagnostic mistakes reaches 75-85%, and the mortality rate for intussusception ranges from 0.5 to 1%, reaching from 6 to 14.5% in complicated forms. The aim of the study is to improve the results of treatment of intestinal intussusception in children by optimizing approaches to diagnosis and tactics of surgical treatment. Materials and methods. Over the past 20 years, 237 children aged 3 months to 12 years were hospitalized in the Department of Emergency Surgery, Specialized Pediatric Surgical Clinic of Samarkand State Medical University, with a diagnosis of intestinal intussusception, of which 116 were confirmed during a clinical examination. Depending on the applied therapeutic and tactical approaches, all examined patients with intestinal intussusception are divided into 2 groups. Group 1 (comparison group) consisted of 43 patients treated in the period from 2000 to 2013. In this group, the diagnosis was based on plain radiography and pneumoirrigoscopy. Group 2 (main group) consisted of 73 patients treated for the period from 2014 to the present. In this group, diagnosis and conservative treatment was based on the method of hydroechocolonographic disinvagination under ultrasound control.
Endoscopic and morphological changes in eosinophilic enteritis in children: current concepts and own observations
Authors: Budkina T. N. , Lokhmatov M. M. , Makarova S. G. , Fisenko A. P. , Khavkin A. I. , Vyazankina S. S. , Oldakovsky V. I. , Tupylenko A. V. , Korolev G. A. , Kulikov K. A.
Published: June 2024

Eosinophilic enteritis (EoEn) is a rare disease, the key diagnostic method for which is upper endoscopy with biopsies and histological examination. The article presents criteria of the diagnosis of EoEn, the range of detected endoscopic (including video capsule and balloon-assisted enteroscopy) and morphological lesions; emphasis is placed on the specific endoscopic sign of this pathology. Clinical examples with our own endoscopic examinations in children with EoEn are also presented. The article will improve the awareness of gastroenterologists and endoscopists about EoEn for timely diagnosis of the disease and treatment.
The phenomenon of metabolically associated fatty liver disease in the pathogenesis of cholelithiasis and hypertension
Authors: Molchanova N. D. , Shreiner E. V. , Khavkin A. I. , Denisov M. Yu. , Nikolaychuk K. M. , Kovaleva A. Ya. , Lifshits G. I.
Published: June 2024

Nonalcoholic fatty liver disease (NAFLD) is a rapidly progressive disease in terms of prevalence. It is most common in male individuals, with an average age of onset around 50 years of age. People suffering from overweight, obesity, type 2 diabetes mellitus are particularly susceptible to the development of NAFLD due to common pathophysiological processes of development. Genetic and epigenetic factors determine the occurrence and progression of NAFLD. Among genes there are those that predominantly affect the development of NAFLD: PNPLA3, TM6SF2, GCKR, MBOAT7, HSD17B13. There are also ongoing studies on the following genes: APOB, PCSK9, APOC3, MTP, SOD2, TNF-a, TGF-b. Among the factors associated with the development of NAFLD, special attention is paid to insulin resistance and obesity, mitochondrial dysfunction, lipotoxicity and release of pro-inflammatory cytokines. The common mechanisms of development of NAFLD, hypertension (HT) and cholelithiasis (CHD) explain their frequent concurrent course. The modern presentation of pathogenesis excludes the possibility of further use of the diagnosis «nonalcoholic fatty liver disease», as it has become clear that liver damage is multifactorial and cannot be defined as a «diagnosis of exclusion». The need to optimise the term NAFLD into «metabolically associated fatty liver disease» is being actively discussed.
Analysis quality of life of Crohn’s disease patients based on the sf-36 questionnaire
Authors: Khavkin A. I. , Novikova V. P. , Nalyotov A. V. , Iotova Yu. T. , Bogdanova E. A. , Yablokova E. A. , Erokhina M. I.
Published: June 2024

Introduction: the relevance of the problem of quality of life (QOL) in Crohn’s disease (CD) is due to the increasing prevalence of inflammatory bowel diseases (IBD), the progressive course of this disease, frequent exacerbations, the presence of complications, which leads to early disability and increases the risk of surgical interventions. Purpose: To analyze publications describing the quality of life of patients with Crohn’s disease. Materials and methods: A search was conducted for publications carried out from 2003 to 2023 on databases using keywords: inflammatory bowel diseases (IBD), quality of life (QOL), Crohn’s disease, SF-36 questionnaire. X articles were found. X papers were selected for the review, where the SF-36 questionnaire was the main tool for studying the quality of life of patients. 13 papers were found and selected for the review, where the SF-36 questionnaire was the main tool for studying the quality of life of patients. Result: Most researchers had convincing confirmation that the quality of life of patients with CD is worse during exacerbation on all studied scales in comparison with healthy people, while during remission it does not differ from the quality of life of people without this disease. Factors that improve and worsen QOL in CD have been identified. Conclusion: in people of different ages with the active course of Crohn’s disease, the quality of life is significantly impaired, but the quality of life of children and adolescents requires additional study.
Transport of enzymes by lymph flow digestive glands
Authors: Korotko G. F.
Published: June 2024

The exosecretes of the digestive glands contain two pools of hydrolytic enzymes - newly formed in the secretory cycle of glandulocytes and recreted from blood flowing to the glands. The second pool of enzymes is repeated many times due to the incretor transport and resorption of hydrolases and zymogens from the secretions of the ductal system of the glands and the chyme of the gastrointestinal tract into the composition of the interstitial fluid and the lymph formed by it. These processes ensure the recycling of digestive gland enzymes, reusable delivery of hydrolases and their inclusion in the composition of exosecretes. The key role in providing enzyme digestion is played by the transport of resorbed and increted enzymes by the lymph flow. This is the digestive role of lymph and lymph flow.
A rare case of bleeding in diverticular disease of the small intestine
Authors: Natalsky A. A. , Ogoreltsev A. Yu. , Kochetkov F. D. , Koshkina A. V. , Borzov A. A. , Pronkin V. A.
Published: June 2024

The article describes a clinical case of bleeding from diverticula of the small intestine in patient E. 1957, who entered the State Budgetary Institution RO OKB on 10/03/2023. with clinical picture gastrointestinal bleeding of unspecified etiology. In the result of a diagnostic study, collection of anamnestic data and clinical picture, a diagnosis was made: gastrointestinal intestinal bleeding of unspecified origin. After FGDS and no visible sources of gastric bleeding, and lack of positive effect from conservative therapy, increasing hypotension, deterioration of general condition with hemoglobin 82 g/l. a decision was made to perform a blood transfusion and combined hemostatic therapy. Conservative treatment turned out to be ineffective, and therefore it was accepted decision on emergency surgical treatment. Urgent patient a diagnostic laparotomy was performed. During revision of the abdominal organs cavity, the source of bleeding was identified. A section of the small intestine was resected at a distance of 15 cm from the ligament of Treitz over a distance of 70 cm with multiple diverticula. An interintestinal side to side anastomosis. In the postoperative period, data for relapse. There is no gastrointestinal bleeding. On day 9 the patient was discharged under the supervision of a surgeon at the place of residence in satisfactory condition.
Difficulties in research and treatment of ulcerative colitis and Crohn’s disease
Authors: Styazhkina S. N. , Klimentov M. N. , Bessonov A. G. , Davletgaraeva K. R. , Kuznetsov E. E.
Published: June 2024

Aim. To demonstrate the stages of development of the clinical picture, methods of diagnosis and treatment of Crohn’s disease during pregnancy, hepatocellular cancer and ulcerative colitis. The study uses clinical trial data and biomarkers, and explores new imaging techniques to develop more accurate approaches to diagnosis. Methods. A detailed analysis of several representative patients representing different aspects of the disease. Results. The first clinical case is a patient diagnosed with Crohn’s disease. The study provides data on primary symptoms such as abdominal pain, diarrhea, and weight loss. The course of the disease, the results of laboratory and instrumental studies are analyzed, and the effectiveness of the applied treatment methods is also highlighted. The second case is dedicated to a patient diagnosed with ulcerative colitis and hepatocellular cancer. In this context, the characteristic symptoms of ulcerative colitis are considered: abdominal pain, frequent changes in the type of stool and inflammatory changes in various parts of the intestine. The results of gastroscopy and colonoscopy are analyzed. The third clinical case is a combined diagnosis, when the patient simultaneously shows signs of ulcerative colitis and Crohn’s disease. This case highlights the complexity of differential diagnosis and the importance of an individualized approach to treatment. Conclusion. The research work devoted to the differential diagnosis and treatment of ulcerative colitis and Crohn’s disease has revealed several important aspects that doctors face in such clinical cases. These include: the complexity of differential diagnosis, the role of additional diagnostic methods, and an individualized approach to treatment.
Assessment of the clinical effectiveness of use of hymecromone in combination with ursodeoxycholic acid in biliary pathology
Authors: Karimov M. M. , Rustamova M. T. , Sobirova G. N. , Khairullaeva S. S.
Published: June 2024

The article presents the results of a clinical evaluation of the comparative effectiveness of monotherapy with urosodeoxycholic acid and its combination with himecromone at dosages of 600 mg and 1200 mg in 368 patients with biliary pathology. The study revealed a significant improvement in the indicators of the majority of patients in the observed groups (84.7% in the UDCA group, 85.9% in the UDCA + Gimecromone 600 mg group, 87.9% in the UDCA + Gimecromone 1200 mg group). Evaluation of the effectiveness of gimecromone at a dosage of 600 mg/day and 1200 mg/day in combination with UDCA showed that the relief of symptoms of biliary dysfunction had a dose-dependent effect and the use of gimecromone at a dose of 1200 mg /day had a more pronounced clinical effect.
Application of a hybrid approach to the removal of large esophageal schwannoma
Authors: Starkov Yu. G. , Vagapov A. I. , Zamolodchikov R. D. , Dzhantukhanova S. V. , Badakhova A. B. , Amaliev I. T. , Glotov A. V.
Published: June 2024

Introduction. Esophageal schwannoma is a rare spindle cell tumor derived from Schwann cells. To date, only 17 cases of esophageal schwannoma have been reported, with most of them occurring in women over the age of 50 years. Surgical interventions using open (cervical approach, extirpation of the esophagus with simultaneous plasty of the gastric tube) and thoracoscopic approaches have long been considered standard methods of treating patients with nonepithelial tumors of the esophagus, but currently minimally invasive endoscopic interventions are widely used. Clinical case. The patient, 64 years old, was treated at the Vishnevsky National Research Medical Center for Surgery for a large schwannoma of the esophagus. Results. This article presents a rare clinical observation - removal of a large schwannoma of the esophagus using a hybrid approach. During a control endoscopic examination 4 months after surgery, no signs of residual tumor fragments, narrowing or pathological changes in the mucosa were found in the area of the previously performed dissection. Conclusion. The use of a hybrid approach for removing a large non-epithelial tumor of the esophagus using endoscopic dissection in the submucosal layer and subsequent extraction through the cervical approach made it possible to perform organ-saving surgery, minimize the risks of possible intraoperative and postoperative complications, thereby leading to a good clinical and functional result.
Experience in the use of intraductal radiofrequency ablation for adenomas of the major duodenal papilla with intraductal spread
Authors: Starkov Yu. G. , Vagapov A. I. , Zamolodchikov R. D. , Dzhantukhanova S. V. , Badakhova A. B.
Published: June 2024

Background. Due to the high risk of malignancy, all adenomas of the major duodenal papilla, regardless of morphological structure, must be removed. Currently, the method of choice for adenomas of the major duodenal papilla is endoscopic surgery, with neoplasms of the major duodenal papilla with intraductal spread (types III and IV according to the endoscopic classification of neoplasms of the major duodenal papilla) representing particular difficulty for endoscopic techniques. The introduction of intraductal radiofrequency ablation into clinical practice provides new opportunities for minimally invasive treatment of patients with adenomas of the major duodenal papilla, including those with extensive spread to the bile and pancreatic ducts. Material and methods. From 2022 to 2024, 14 patients with adenomas of the major duodenal papilla with extension to the common bile and main pancreatic ducts underwent intraductal radiofrequency ablation. The extent of spread of the adenoma to the common bile duct ranged from 10 to 30 mm, to the main pancreatic duct - from 3 to 11 mm. Results. Technical success of intraductal RFA was achieved in all cases. Postoperative complications were noted in 3 cases, in which moderately severe post-manipulation pancreatitis developed. During a follow-up examination after 3-6 months, residual adenomatous growths were detected in 3 patients, which required a repeat session of intraductal RFA. All patients underwent stenting of the main pancreatic duct and the common bile duct was achieved in all cases. Conclusion. Intraductal radiofrequency ablation has opened up the possibility of endoscopic treatment of patients with adenomas of the major duodenal papilla, characterized by extensive spread to the common bile and main pancreatic ducts.
The role of scientific ideas in the self-consciousness of the Russian nobility in the second half of the 18th — early 19th centuries
Authors: Kunts Evgeny
Published: June 2024

The article examines the cultural features of the reception by Russian nobles of the second half of the 18th - early 19th centuries of scientific and artistic representations in the field of nature and science. Revealed the importance of views on the world of nature in the context of the development of social consciousness of the nobility in the period under consideration.
A variable template matching algorithm for anomaly detection versus kernel density and gradient convolution algorithms and ResNet-50
Authors: Xu Qinwu
Published: June 2024

This study first proposes a variable template matching algorithm for anomaly detection. Variational forms of template for defect with multiple scales, rotations and perspective transformations are included to improve its variational robustness. The normalized cross correlation between the template and the sliding window on the image is computed as the matching result. Secondly, it proposes a kernel density algorithm, in which a lower kernel density index (intensity percentile/range) of the sliding window indicates a potential anomaly. Lastly, it proposes a gradient convolution algorithm. These three traditional computer vision algorithms are implemented for anomaly detection of a group of biological images, and results are compared with that of the convolutional neural network ResNet-50. Results show that the variable template matching algorithm achieves superior performance (true positive 82% and false positive 4.9%) than both the kernel density and gradient convolution algorithms. Its detection rate is lower than the prediction of ResNet-50 (true positive 86%), but it is much faster and does not need any train images as an unsupervised learning. Therefore, it can be a potential candidate for object detection of small dataset or for a quick solution.