bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatic Alveolar Echinococcosis: the Possibilities of Ultrasonographyin the Planning of Surgical Operation
Authors: Ashivkina O. I. 
Published: February 2019

Alveolar echinococcosis (AE) is a rare anthropozoonotic parasitic disease, which can affects the liver, lungs and other organs. R0-radical liver resection is the sole curative therapy for the patients with AE. Size of the parasitic foci, distant dissemination, and involvement of main liver vessels – all this information allows the surgeon to make the right decision about practicability and volume of operation. Formerly, ultrasonography (US) was not method of choice for the qualitative pre-operative diagnostic of AE. Nevertheless nowadays development of new technologies allows US to be an equal to CT and MRI.The aim:to estimate the possibilities of US in the planning of surgery in patients with AE.Materials and methods.The data of 64 patients who were undergone complete liver resection or reduction surgery in A.V. Vishnevsky Surgery Institute in period from January 2008 to December 2016 we respectively analyzed. Specificity and sensitivity of US, CT and MRI were analyzed and ROC-curves were constructed. Statistical significance was calculated using Chi-square.Results.The efficiency of US was significantly comparable to CT and MRI when we analyzed the involved of porta hepatis, vena cava, hepatic veins. Assessment of involvement of liver arteries and vena porta was not statistical significant.Conclusion.Accumulated experience of A.V. Vishnevsky Surgery Institute shows the possibility of qualitative preoperationUS evaluation of AE-lesion, which has to include assessment of distant dissemination and involvement of the liver main vessels. In a big surgical hospitals, which has an experience of AE treatment, pre-operative US can become the method of choice in planning of surgical operation.
Possibilities of Ultrasound in Diagnosis of Kidney Cancer at the Stage of Surgery
Authors: Chekhoeva O. A. 
Published: February 2019

Despite the availability of a large number of state programs for the re-equipment of state medical institutions, ultrasonic research, due to the relative simplicity of the organization of the research process and the decisiveness, still remains relevant for the examination of patients and, in particular, kidney cancer. In recent years, a number of new ultrasound techniques have emerged – three-dimensional reconstruction of ultrasound imaging, tissue harmonic technology and echocontrast with intravenous contrast agents. Due to the continuous improvement of the capabilities of ultrasound scanners and ultrasound imaging techniques, a review of the significance of ultrasound in the diagnosis and differential diagnosis of renal cell carcinoma (RCC).The purpose:to evaluate the diagnostic possibilities of ultrasound in patients with kidney tumors at the preoperative stage.Materials and methods.136 patients with kidney tumors aged 21 to 73 years were examined and treated in A.V. Vishnevsky Institute of Surgery in the period from 2012 to 2017. The study slightly dominated by men – 65.4%. All patients underwent a complex clinical and laboratory examination, which included the analysis of complaints, data of anamnesis, clinical examination, laboratory data, as well as a wide range of instrumental studies (ultrasound, MSCT and MRI). Each of the study methods was evaluated according to three criteria (localization, prevalence, presence of vein thrombosis), which are key to assessing the feasibility of surgical intervention and subsequent tactics of surgery. Evaluation of the informative value of each of the radiation methods of the study (ultrasound, MSCT, MRI) was carried out on the basis of the following criteria: sensitivity, specificity and overall accuracy of the method. All patients underwent surgical operations in various volumes, the formations were morphologically verified as RCC. As a “control” for each of the parameters used the protocol of subsequent surgery. The effectiveness of ultrasound is significantly comparable with CT and MRI in assessing such preoperative parameters as tumor localization in the kidney, the prevalence of the pathological process and thrombosis of the inferior vena cava and the main trunk of the renal vein. In the evaluation of thrombosis of segmental renal veins, ultrasound is also comparable to other methods of investigation, but these data can not be considered statistically reliable (due to the small number of observations) and their confirmation requires further study. Conclusion.In the conditions of a specialized surgical hospital focused on the diagnosis and treatment of kidney cancer, ultrasound can be comparable to CT and MRI in its effectiveness, providing the surgeon with pre-operative information sufficient for planning surgical intervention.
Quantitative Perfusion Analysis and Time Intensity Curve Analysis in Differential Diagnosis of Solid Pancreatic Tumors by Contrast-Enhanced Ultrasound. A Pilot Study
Authors: Askerova N. N. , Stepanova Yu. A. , Timina I. E. 
Published: February 2019

Contrast-enhanced ultrasound began to develop rapidly in recent years inRussia. Due to the physical properties of contrast agents it is possible to differentiate malignant and benign lesions. However, this method only involves a subjective evaluation of the obtained results. For the objectification of ultrasound with contrast enhancement implemented the function “TIC-analysis” (time intensity curve analysis). The aim: to assess the clinical value of the TIC-analysis in the differential diagnosis of adenocarcinoma of the pancreas and chronic pseudotumoral pancreatitis by contrast – enhanced ultrasound.Materials and methods. In A.V. Vishnevsky Institute of surgery contrast – enhanced ultrasound and TIC-analysis was performed on 23 patients with focal lesions of the pancreas. All patients were operated on, tumors were verified morphologically: adenocarcinoma of the pancreas in 18 (78%) patients, chronic pseudotumoral pancreatitis – in 5 (22%) patients.Results. The results about intensity of the tumors obtained by the TIC analysis do not allow to differentiate these pathological processes statistically significant (p > 0.05), which, in all probability, due to the fact that pancreatic adenocarcinoma and chronic pseudotumoral pancreatitis have similar morphological characteristics in the form of pronounced desmoplastic stromal response and fibrosis-hyalinosis, respectively. The “Time to peak| parameter allowed us to determine statistically significant that pancreatic adenocarcinoma had an early accumulation of contrast agent (average 16 sec) and early washout (from an average of 17 sec); the chronic pseudotumoral pancreatitis had the slow accumulation of contrast agent (average 85 sec) and slow washout (from an average of 86 seconds) (p < 0.05).Conclusion. The “Time to peak” parameter at ultrasound examination with echocontrast allows statistically significantly differentiate adenocarcinoma of the pancreas and chronic pseudotumoral pancreatitis.
Analysis of X-Ray Research in Wards
Authors: Alekseeva O. M. 
Published: February 2019

Introduction.X-ray is a common diagnostic procedure in a multi-disciplinary hospitals. In the available scientific litera ture, there are some studies of the radiography in nonspecialized conditions. However, there are few aggregate data of these studies to date.Objectives.Analysis of the results of radiography in wards and resuscitation rooms, performed in multi-purpose hospitals, with the aim of forming requirements to the class of equipment for radiography in the conditions of the ward.Materials and methods.4081 X-ray studies were studied from 2015 to 2016.Results.During the analysis it was determined that in unspecialized conditions 75.0% of the shots fell to chest organs, studies of the musculoskeletal system were revealed in 22.0% of cases and abdominal organs were observed in 3%. Pathological changes were not detected for 2221 patients, which amounted to 54.4%. It was found that the most frequent disease of the chest were pneumonia of various genesis, complicated by the presence of hydro thorax.Conclusions.Based on the analysis of X-ray researches, the indications for the studies were refined and supplemented, medical requirements for X-ray machines for shooting under these conditions were formulated.
Oscillations of Bone Mineral Density in Peri-Prosthetic Zone after Total Hip Arthroplasty (Case Report)
Authors: Avrunin A. S. , Pavlychev A. A. , Doctorov A. A. , Kornilov N. N. , Karagodina M. P. 
Published: February 2019

The hundreds thousands total hip arthroplasties (THA) annually performed around the world with the number of revision procedures estimated around 10%. Dual-energy X-ray absorptiometry (DEXA) allows to control projectional bone mineral density (BMD) around hip stem dynamically with minor radiation exposure and in a cost-effective way. In routine practice there is a monthly interval between investigations that does not allow to evaluate activity and trends in short weekly oscillations of bone metabolism in peri-prothetic areas. Projectional BMD oscillations in peri-prosthetic zone after total hip arthroplasty in chrono-biological manner evalua ted for the first time. Therefore chronobiologic approach opens new opportunities for prognosis of tendencies in structural and functional skeleton reorganization in peri-prothetic zone after THA but there is need in further research that could give more insight.
Diagnostic Effectiveness of whole Body Diffusion- Weighted Magnetic Resonance Imaging in Focal and Diffuse Bone Marrow Involvement in Patients with Lymphoma
Authors: Kharuzhyk S. A. , Zhavrid E. A. , Sachivko N. U. 
Published: February 2019

Objective:to compare diagnostic effectiveness of whole body diffusion-weighted imaging (DWI), other magnetic resonance imaging (MRI) pulse sequences and iliac wing trephine biopsy in the diagnosis of focal and diffuse bone marrow (BM) involvement in patients with lymphoma.Materials and methods.Prospective study included 130 patients with lymphoma who underwent whole-body MRI-DWI and iliac wing trephine biopsy before treatment (64 (49,2%) men, 66 (50,8%) women, middle age 43,3 ± 16,3 years, interval of 18–79 years). Hodgkin's lymphoma (HL) was at 57 (44%) patients, non-Hodgkin lymphomas (NHL) – at 73 (56%). Diagnostic effectiveness of T1- weighted images (T1-WI), STIR, DWI and FIESTA was analyzed. BM apparent diffusion coefficient (ADC) values were measured.Results.BM involvement was found in 42 patients, including 9 with HL and 33 with NHL. In HL, BM involvement was only focal. Diffuse involvement occurred more often (64%) in the NHL as compared to focal one. In focal involvement, all pulse sequences showed high diagnostic sensitivity (90–100%), BM biopsy sensitivity was 33% only. The proposed new criterion for the diagnosis of diffuse BM involvement in NHL – diffuse signal increase of the spine on DWI above renal parenchyma – has the highest sensitivity (90%) compared to T1-WI and STIR (67%) and FIESTA (71%) (p < 0.05). In NHL, the ADC value ≤0.575 • 10−3 mm2/s discrimi nates cases of diffuse involvement and absence of BM involvement with a sensitivity of 86% and a specificity of 68% (p < 0.0001). In HL, the diffuse BM signal increase on DWI is not indicative of involvement.Conclusion.All pulse sequences showed high effectiveness in the diagnosis of focal BM involvement in patients with lymphoma, iliac wing biopsy effectiveness was low. The proposed new DWI criterion for diagnosing diffuse BM involvement in NHL is the most sensitive one. A new algorithm based on whole body MRI-DWI for the diagnosis of BM involvement allows to reduce the need for BM biopsy without reducing the diagnostic effectiveness.
Contrast-Enhanced MRI with Magnetization Transfer Effect in the Imaging of Brain Metastatic Lesions
Authors: Ermakova A. A. , Borodin O. Yu. , Sannikov M. Yu. , Koval S. D. , Usov V. Yu. 
Published: February 2019

Purpose: to investigate the diagnostic opportunities of contrast magnetic resonance imaging with the effect of magnetization transfer effect in the diagnosis of focal metastatic lesions in the brain.Materials and methods.Images of contrast MRI of the brain of 16 patients (mean age 49 ± 18.5 years) were analysed. Diagnosis of the direction is focal brain lesion. All MRI studies were carried out using the Toshiba Titan Octave with magnetic field of 1.5 T. The contrast agent is “Magnevist” at concentration of 0.2 ml/kg was used. After contrasting process two T1-weighted studies were performed: without T1-SE magnetization transfer with parameters of pulse: TR = 540 ms, TE = 12 ms, DFOV = 24 sm, MX = 320 × 224 and with magnetization transfer – T1-SE-MTC with parameters of pulse: ΔF = −210 Hz, FA(МТС) = 600°, TR = 700 ms, TE = 10 ms, DFOV = 23.9 sm, MX = 320 x 224. For each detected metastatic lesion, a contrast-to-brain ratio (CBR) was calculated. Comparative analysis of CBR values was carried out using a non-parametric Wilcoxon test at a significance level p < 0.05. To evaluate the sensitivity and specificity of the techniques in the detection of metastatic foci (T1-SE and T1-SE-MTC), ROC analysis was used. The sample is divided into groups: 1 group is foci ≤5 mm in size, 2 group is foci from 6 to 10 mm, and 3 group is foci >10 mm. Results.Comparative analysis of CBR using non-parametric Wilcoxon test showed that the values of the CBR on T1-weighted images with magnetization transfer are significantly higher (p <0.001) that on T1-weighted images without magnetization transfer. According to the results of the ROC analysis, sensitivity in detecting metastases (n = 90) in the brain on T1-SE-MTC and T1-SE was 91.7% and 81.6%, specificity was 100% and 97.6%, respectively. The accuracy of the T1-SE-MTC is 10% higher in comparison with the technique without magnetization transfer. Significant differences (p < 0.01) between the size of the foci detected in post-contrast T1- weighted images with magnetization transfer and in post-contrast T1-weighted images without magnetization transfer, in particular for foci ≤5 mm in size, were found. Conclusions1. Comparative analysis of CBR showed significant (p < 0.001) increase of contrast between metastatic lesion and white matter on T1-SE-MTC in comparison with T1-SE.2. The sensitivity, specificity and accuracy of the magnetization transfer program (T1-SE-MTC) in detecting foci of metastatic lesions in the brain is significantly higher (p < 0.01), relative to T1-SE.3. The T1-SE-MTC program allows detecting more foci in comparison with T1-SE, in particular foci of ≤5 mm (96% and 86%, respectively, with p < 0.05).
Acoustic Radiation Force Impulse Elastometry (ARFI Elastometry) in Chronic Viral Hepatitis
Authors: Megroyan A. A. , Kamalov Ju. R. , Filin A. V. , Semenkov A. V. , Morozova M. M. , Nekrasova T. P. 
Published: February 2019

Purpose:the aim of this study was to evaluate the reliabilityof ARFI elastometry for diagnosis of fibrosis severity stages in patients with chronic viral hepatitis.Material and methods.ARFI elastometry measurements were done in 103 patients. Mean age of patients was 39.2 ± 10.8 years. The study included 11 patients with HBV chronic hepatitis, 87 patients with HCV chronic hepatitis and 5 patients with В+D chronic hepatitis. Liver stiffness was measured using ARFI elastometry with following liver biopsy which was made 1–2 after US study and assessed according to the METAVIR score. Control group included 32 patients (20 (62.5%) volunteers and 12 (37.5%) potential liver fragment donors). Mean age of patients was 26.9 ± 5.3 years. None of the healthy subjects had a history of gastrointestinal, pancreatic or hepatic disease; all patients had a normal results of laboratory tests.Results.Significant correlation (r = 0.74, р < 0.001) was found between ARFI measurements and liver fibrosis stages. The values of ARFI elastometry for various stages of fibrosis were: F ≥ 2 – cut-off > 1.36 m/s (AUROC – 77%, sensitivity – 65.9%, specificity – 79%), F ≥ 3 – cut-off > 1.36 m/s (AUROC = 95%, sensitivity – 95,5%, specificity – 81.5%), F = 4 – cut-off > 1.66 m/s (AUROC – 97%, sensitivity – 93.3%, specificity – 100%). Liver stiffness measurements in stages F0–F2 reliably differ from stages F3–F4 (1.25 ± 0.18 m/s vs 2.0 ± 0.52 m/s, р < 0.05).Conclusion. ARFI elastometry is reliable diagnostic method for liver fibrosis detection in stages F ≥ 2. The best performance of this method was shown for the prediction of severe fibrosis and cirrhosis.
THE EVALUATION OF DELAYED ENHANCEMENT METHOD AS A TOOL FOR MAGNETIC RESONANCE DIFFERENTIATION BETWEEN THE METASTASES AND NEUROTOXOPLASMOSIS
Authors: Simeshchenko P. I. , Drozdov A. A. , Cheremisin V. M. , Kamishanskaya I. G. , Yakovlev A. A. , Musatov V. B. , Fedunyak I. P. , Danilov V. V. 
Published: February 2019

The aimof this study was to evaluate delayed enhancement as the tool for differentiation between metastatic brain lesions and neurotoxoplasmosis.Materials and methods.38 patients with multiple brain lesions with mass-effect and ring-type of contrast enhancement based on CT/MRI have been enrolled in the study. All cases were associated with metastatic brain lesions or toxoplasmosis. For every patient we performed contrast enhanced brain MRI and achieved axial T1WI immediately after contrast injection, in 15, 30 and 45 min. Acquired images were evaluated for the presence of contrast accumulation at delayed images in the central part of the lesions. Overall, we analyzed data for 153 lesions with 64 toxoplasmosis lesions and 89 metastatic.Results.Among 153 lesions with ring-type contrast enhancement central contrast enhancement at delayed images was determined for 83 lesions. Among 89 metastatic lesions 81 demonstrated delayed central enhancement. Among 64 neurotoxoplasmosis lesions only 2 demonstrated delayed central enhancement. The sensitivity of the sign was 88%, specificity 95%.Conclusions.The presence of central contrast enhancement at delayed images significantly increases the probability of metastatic nature of the lesions (specificity 95%). Consequently that sign might be effectively used for the differential between the metastases and neurotoxoplasmosis.
MR-VISUALIZATION IN PATIENTS WITH SYRINGOMYELIA ASSOCIATED WITH ADHESIVE ARACHNOPATHY
Authors: Karpov O. E. , Bronov O. Yu. , Kitaev V. M. , Vetshev P. S. , Zuev A. A. , Filippov Yu. A. 
Published: February 2019

Objective: to study the basic characteristics of changes revealed by MRI in patients with syringomyelia associated arachnopathy before and after surgery.Materials and methods. MRI was performed in 58 pat ients with syringomyelia before and after surgery in period from 2013 to 2016.Results.The diagnosis “syringomyelia” was approved in 41 patients. There was huge regression (more than 50% of volume) of syringomyelia cavity in 17 (41.4%) patients. In 20 (48.7%) patients marked decrease in size syringomyelia cavity (less than 50%), the volume expansion of the front and rear of cerebrospinal fluid spaces.Conclusions. The use of modern MRI Protocol in various types of syringomyelia allows not only to detect and give a comprehensive feature cavities, but also to detect adhesions, location and length, as well as to assess the dynamics of the disease after surgical treatment.
EVALUATION OF LIPID CONTENT IN PATIENTS WITH LIVER STEATOSIS AND STEATOHEPATITIS USING PROTON MR-SPECTROSCOPY
Authors: Ternovoy S. K. , Shiryaev G. A. , Ustyuzhanin D. V. , Abdurakhmanov D. T. 
Published: February 2019

Aim.Evaluation of proton MR spectroscopy in the diagnostics of non-alcoholic fatty liver disease.Materials and methods.70 patients (40 men, 30 women) with non-alcoholic fatty liver disease were included in the study. Average age of patients was 42 ± 11 years. All patients were divided in two groups. The first group included patients with liver steаthosis (n = 37). Patients with steatohepatitis detected by clinical data formed the second group (n = 33). All patients underwent MR spectroscopy for liver fat content evaluation in two time points (prescreening and after 6 months treatment).Results.MR spectroscopy showed fat content in patients with liver steatosis in the range from 7.5% to 58.4%, the median was 22.4% (lower and upper quartiles were 14.9% and 28.7%). After 6 months the liver fat content significantly decreased up to 1.5–43.7%, the median was 13.5% (the lower and upper quartiles were 5.54% and 18.9%). In patients with steatohepatitis the fat content calculated by MR spectroscopy ranged from 10.5% to 60%, the median was 28.8% (the lower and upper quartiles were 16.5% and 31.2%). There was no significant difference in fat content in this group after 6 months therapy (the median was 26.7%, the lower and upper quartiles were 14.2% and 28.7%, p = 0.22).Conclusion.Proton MR spectroscopy can be successfully used in patients with non-alcoholic fatty liver disease for liver fat content quantification in steatosis and steatohepatitis. MR spectroscopy can be discussed as a non-invasive biopsy alternative for dynamic evaluation during treatment.
Ohio Community Pharmacist Provision of Clinical Preventive Services
Authors: Alexander Scott , DiPietro Mager Natalie 
Published: February 2019

Objective: The primary objective of this study was to assess whether Ohio community pharmacists currently provide certain evidence-based clinical preventive services. Secondary objectives were to explore whether there were any differences in provision of services based on respondent education, position, employment status, location, practice setting, or years in practice and to gather information on how pharmacists provide specific services, barriers to providing specific services, pharmacists’ perceptions on specific services needed in their patient population, and pharmacists’ interests in providing services if not already doing so.
Methods: A random sample of 500 community pharmacists licensed in Ohio received a Qualtrics survey via email assessing current practices and perspectives regarding clinical preventive services. The U.S. Preventive Services Task Force (USPSTF) “A” and “B” recommended services that can be provided in a community pharmacy served as the framework for the survey questions. Reminders were sent every 3-4 days; data collection continued for a month. The study was IRB-approved.
Results: Ninety-three responses were included in the final analysis (18.9% response rate). Approximately 63% of respondents were female; 51.6% held a Doctor of Pharmacy degree. Only 21.5% of respondents were familiar with the USPSTF. However, many respondents were providing clinical preventive services in their pharmacy; the most common were blood pressure screening (51.6%), tobacco use screening or counseling (43%), and diet and/or physical activity counseling (22.6%). These services were provided in varied ways including patient counseling, medication therapy management sessions, screening events, and health fairs. Those who are not currently providing services showed interest in developing them. Pharmacists reported barriers such as lack of time, staff, and reimbursement by patients or third-party payers.
Conclusion: Many surveyed community pharmacists in Ohio reported providing clinical preventive services in a variety of ways. Many pharmacists who did not provide these services indicated an interest developing such services. Staffing concerns, time constraints, and a lack of reimbursement by patients and third-party payers were reported as barriers by community pharmacists in providing these services. As many respondents reported being unfamiliar with USPSTF recommendations, the opportunity to educate pharmacist on these recommendations and potentially increase their activity in these prevention activities exists.

Article Type: Original Research