bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrated Approach in the Treatment of a Patient with Tuberculosis of the Lungs and Tracheobronchial Tree
Authors: Chumovatov N. V. , Komissarova O. G. , Chernyh N. A. 
Published: May 2024

Introduction.According to the World Health Organization data for 2021, there is an increase in the incidence of tuberculosis (TB) worldwide. There is also an unfavorable growth trend in drug-resistant TB. One of the complications of the tuberculosis process is tuberculosis of the tracheobronchial tree, which has tended to grow in recent years. Many studiesindicate the incidence of bronchial tuberculosis from 10 to 40 %, taking into account the level of endoscopic service.The purpose of the studyto demonstrate the high eﬀectiveness of an integrated approach in the treatment of a patient with tuberculosis of the lungs and tracheobronchial tree.Methods.The materials of the study were: the outpatient card of the advisory department of the Central Tuberculosis Research Institute, the medical history of the inpatient patient and the results of a comprehensive examination.Results.The presented clinical example demonstrates the high eﬀectiveness of an integrated approach in the treatment of a patient with a widespread tuberculosis process using anti-tuberculosis chemotherapy, inhalation and pathogenetic therapy. By 4 months of treatment, pronounced positive clinical and laboratory dynamics was observed, signiﬁcant resorption of focal inﬁltrative changes in the leﬅ lung was achieved radiologically, and endoscopically, inﬁltrative tuberculosis of the trachea, leﬅ main bronchus and leﬅ upper lobe bronchus was cured.Conclusion.This clinical observation demonstrates the need for an integrated approach in the management of this category of patients and shows the high eﬀectiveness of the treatment.
Central Retinal Vein Occlusion as the Debut of a Chronic Myeloproliferative Neoplasm
Authors: Moshetova L. K. , Egoryan L. B. , Vinogradova O. J. , Shikhbabaeva D. I. , Turkina K. I. 
Published: May 2024

Introduction. Most retinal vascular diseases are associated with systemic risk factors such as hypertension, diabetes mellitus, age and smoking. However, in their absence, further examination is required to identify possible hematological disorders.Purpose. Improve the diagnostic and management scheme for patients with occlusion of the central retinal vein or its branches.Materials and methods. A clinical case of the onset of polycythemia vera with the central retinal vein occlusion is described. As part of the study, a molecular genetic analysis was carried out to identify the driver mutation JAK2V617F in peripheral blood as a screening diagnosis of Ph-negative chronic myeloproliferative neoplasms (CMN), a cytological, cytogenetic study of bone marrow aspirate and a morphological study of bone marrow trephine biopsy.Results. A mutant allele of the JAK2V617F gene with a diagnostically signiﬁcant allele load of 14.61 % was determined in a patient hospitalized in the ophthalmology department with a diagnosis of central retinal vein occlusion (CRVO) of the right eye. The patient was referred for further examination to the Moscow City Hematology Center of Botkin City Clinical Hospital, where, aﬅer examination, the diagnosis was established: True polycythemia.Discussion. CMN are a group of tumor diseases of hematopoietic tissue characterized by malignant transformation of bone marrow stem cells with their subsequent clonal proliferation. Cytogenetic and molecular genetic disorders play a signiﬁcant role in the pathogenesis of chronic CMN. True polycythemia, essential thrombocytemia, primary myeloﬁbrosis belong to the group of classical Ph-negative CMP, Thrombotic, vascular and hemorrhagic complications are the most common causes of death in patients with this pathology.Conclusion. Previously, various ophthalmological manifestations and symptoms have been described in patients with CMN. The observed complications are diverse and oﬅen secondary to the pathognomonic hematological disorders for these diseases. It is worth considering the clinical value of molecular genetic analysis to detect the JAK2V617F mutation in patients with central retinal vein occlusion for early diagnosis of CMN and timely administration of appropriate therapy.
Hysteroscopy with Endometrial Vacuum Aspiration in Repeated Implantation Failure: Diagnostic Significance and the Effect on IVF Success
Authors: Kuznetsov S. I. , Opatovskaya Ya. V. , Askerova M. G. , Askerov R. A. 
Published: May 2024

Introduction. This study raises the issue of diagnostic and therapeutic value of hysteroscopy with endometrial vacuum aspiration in patients with recurrent implantation failure (RIF) in IVF programs.The purpose of the study is to determine the structure of uterine pathology in women with RIF according to hysteroscopy with endometrial aspiration biopsy and to study the eﬀect of hysteroscopy with subsequent endometrial vacuum aspiration in patients with a history of repeated implantation failures on clinical pregnancy rate.Materials and methods. In this retrospective cohort study we investigated a sample of 143 patients who passed the program of IVF at the Clinical Institute of Reproductive Medicine (Ekaterinburg, Russia). We studied the frequency of detection of uterine pathology using hysteroscopy and endometrial vacuum aspiration in patients with RIF (n = 36) and in the control group without RIF (n = 89). We analyzed the diﬀerences in the chance of clinical pregnancy aﬅer embryo transfer (s) in the IVF program in patients with RIF aﬅer hysteroscopy with endometrial vacuum aspiration (n = 30) and in the control group (n = 18).Results. The structure of intrauterine pathology was not statistically diﬀerent in patients with RIF and without this condition (p > 0.05 for all pathologies). Hysteroscopy with endometrial vacuum aspiration signiﬁcantly increased the incidence of clinical pregnancies in patients with RIF compared with the control group (23/30 (77.0 %) and 8/18 (44.0 %), p = 0.032).Discussion. The obtained data on the structure of the pathology of the uterus correlate with the results of similar studies. The therapeutic eﬀect of hysteroscopy in infertility remains a matter of controversy.Conclusion. Hysteroscopy with pathomorphological examination of the aspirated endometrium is the same intervention in terms of diagnostic eﬃciency for patients without identiﬁed uterine pathology on ultrasound, regardless of RIF status. Hysteroscopic examination with curative endometrial injury may increase the success rate of embryo transfer implants in patients with RIF.
Allotendoplasty in Treatment of Habitual Patella Dislocation in Adults
Authors: Gyulnazarova S. V. , Kutepov S. M. 
Published: May 2024

Background. Habitual dislocation of patella is a congenital disease that manifests in early childhood or adolescent age and requires surgical treatment. In case this condition has not been rectiﬁed timely, the congenial patellar luxation develops the properties of a habitual dislocation accompanied by pain syndrome and osteoarthrosis development in the patellofemoral and knee joints. In most cases reconstructive surgery is used for this disease treatment; it is aimed at the strengthening of the knee joint interval compartment, with the formation of a ﬁbrous graﬅ or a vertical strip of it, which are moved to the knee joint outside compartment and ﬁxed to adjacent tissues with sutures. However, such surgery is possible only in case of preserved anatomic structures of the knee medial compartment. In adult patients, aﬅer multiple patellar dislocations, the interval joint capsule and medial aponeurosis lose their normal structure, become weakened, strained, and loose. That is why the patient’s own tissues from that area cannot be used for reconstructive surgery.The purpose of the study is to develop the new low-traumatic method of treatment for habitual dislocation of kneecap in adult patients to ensure its reliable stabilization as related to the joint surface on distal femoral epimetaphys, and to prevent patella dislocation relapse.Material and methods. Surgery technique consists of the lateral release of knee joint, mobilization of patellar ligament and its excision together with the fragment of tibial tuberosity osseous. On 1.5–2.0 cm medially from the area of own patellar ligament harvesting in tibia epimetaphys, the new bed with the similar form and shape is formed, and the excised tibial tuberosity fragment with patellar ligament is introduced there and ﬁxed with a Cancellous screw.The area of own patellar ligament harvestingis ﬁlled up with autogenous osseous tissue taken from the medial part of tibia epimetaphys when forming the new bed for the excised tibial tuberosity fragment. Transversal tunnelis formedin the quadriceps tendon above the patella; allotendonis pulledvia this tunnel. The allotendon ends are sutured together, thus forming the duplication, analogous to the ligament, and ﬁxit, stretched to “pes anserinus” of the shin onits anterior-interior surface.Conclusion. The new technology of allotendoplasty for the treatment of habitual kneecap dislocation in adult patients facilitates the surgical technique, additionally strengthens medial compartment tissues of the knee, reliably stabilizes the patella as related to its joint surface on distal femoral epimetaphys, eliminates patella dislocation relapse, normalizes the knee and patellofemoral joints functioning by preventing osteoarthrosis progression in them.
Predictors of Precancerous Diseases of the Cervix
Authors: Rosyuk E. A. , Oboskalova T. A. , Askerova M. G. , Bakurinskikh A. B. , Yakushev A. M. , Kiseleva M. K. , Sevostyanova O. Yu. , Konovalov V. I. 
Published: May 2024

Introduction. The incidence of malignant neoplasms in the population has increased by 1.66 times over the past 15 years, and the incidence of cancer of the cervix and body of the uterus, placenta — by 1.3 times.Materials and methods. 2 groups were formed by the continuous sampling method: 30 women with a diagnosis of cervical intraepithelial neoplasia (CIN) and 30 women without a diagnosis of CIN, who made up the control group. Statistical analysis was carried out using the StatTech 3.1.7 program (Stattech LLC, Russia).Results. Risk factors for precancerous diseases of the cervix include the presence of a history of cardiovascular diseases(p = 0.043), surgical interventions (p = 0.039), sexually transmitted infections (p = 0.023), a large number of pregnancies (regardless of the outcome) (p = 0.013), the presence of abortions (p = 0.04), a large number of sexual partners during life (p = 0.022).Discussion. Frequent change of sexual partners, and as a consequence — a high risk of STIs are also well-known risk factors for cancer and precancerous cervix, in these conditions HPV passes from free to episomal form faster and starts the process of transformation of cervical epithelial cells.Conclusion. The features of the anamnesis of women with precancerous diseases of the cervix are high parity and the presence of abortions, STIs, cardiovascular diseases and surgical interventions in the anamnesis, a large number of sexual partners in life, low adherence to the use of combined oral contraceptives (COCs).
Comparison of the Assessment of Respiratory Disorders Using the Downes and Silverman Scales in the Delivery Room in Newborns Over 35 Weeks of Gestation with CPAP Respiratory Therapy as a Predictor of Transfer to the Intensive Care Unit. Cohort Study
Authors: Fedotova O. I. , Shestak E. V. , Kovtun O. P. 
Published: May 2024

Rationale. Respiratory distress (RD) aﬅer birth is the leading cause of neonatal intensive care unit (NICU) admission. To determine the degree of RD, scales based primarily on clinical symptoms have been developed, but the prognostic value of RD scales remains incompletely studied.Purpose of the study — to determine and compare the prognostic value of the Downes and Silverman RD scoresin the delivery room in neonates ≥35 0 weeks of gestation with CPAP therapy as a predictor of NICU admission.Materials and methods. The study included newborns ≥35 0 weeks of gestation with RDin the delivery room. The study was conducted at the Ekaterinburg Clinical Perinatal Center from March 1 to August 15, 2023. The predicted outcome was hospitalization from the delivery room to the NICU. In the general sample (n = 73), subgroups were identiﬁed according to the studied predictor at the start of CPAP therapy: subgroup D1 — Downes scale score n = 24); subgroup D2 — Downes scale score ≥4 points (n = 49); subgroup S1 — Silverman scale score n = 31); subgroup S2 — Silverman score ≥4 points (n = 42).Results. In subgroup D2, the relative risk of NICU admission was 3.9with a 95 % conﬁdenceinterval (CI) of 1.3–11.7, sensitivity of 88.9 % and speciﬁcity of 45.7 %; in subgroup S2–2.1with 95 % CI 1.021–4.300, sensitivity 74.1 % and speciﬁcity 52.2 %.Conclusion. Assessment of RD in newborns ≥35 0 weeks of gestation in the delivery room on the Downes scale ≥4 points at the start of CPAP therapy allows predicting the ineﬀectiveness of respiratory therapy and transfer of the child to the NICU. The accuracy of the forecast when assessed using the Downes scale is higher than that using the Silverman scale.
Melatonin Level and Activity of Nucleolar Organizer Regions in the Prognosis of Infertility in Women with Ovarian Endometriosis
Authors: Kachurina M. S. , Zainetdinova L. F. , Kurenkov Ye. L. , Medvedev B. I. , Shamaeva T. N. , Telesheva L. F. , Kanaykina A. Yu. 
Published: May 2024

Introduction. Endometriosis is a multifactorial disease, aﬀecting about 10 % of women of reproductive age. The purpose of the work is predicting the development of infertility in women with ovarian endometriosis by determining urine melatonin levels and activity indicators of nucleolar organizer regions in endometrioid ovarian heterotopias.Materials and methods. In the Clinic of South Ural State Medical University from 2018 to 2020, 2 groups of women with ovarian endometriosis were studied: group 1 — with infertility (n = 22); group 2 — without it (n = 27). The level of urinary 6-SMT and the activity of ribosomal synthesis were determined.Results. The level of 6-SMT is reduced in patients with stage I ovarian endometriosis. At stagesII and III, the level of 6-SMTis lower in women with infertility than without it: Stage II — (38.82±1.49) ng/ml and (93.04±3.64) ng/ml (p < 0.001); Stage III — (42.84±1.85) ng/ml and (58.06±1.65) ng/ml (p = 0.340). The activity of ribosomal synthesis in epithelial cells of endometrioid heterotopias increases at stage III. In ﬁbroblasts of the stroma of endometrioid heterotopias, the activity of ribosomal synthesis is higherin women with stage III infertility, and in histiocytes— in women with stage II infertility. A logistic stepwise regression analysis was carried out and the most important predictors inﬂuencing the development of infertility were identiﬁed.Discussion. The decrease in melatonin in women with ovarian endometriosis, suﬀering from infertility, as well as in stage I ovarian endometriosis is consistent with the research of M. I. Yarmolinskaya et al. (2019). In the presence of infertility, activation of connective tissue histiocytes begins in the early stages. The results obtained may reﬂect the immunomodulatory eﬀect of melatonin, which is expressed inincreased functional activity of connective tissue histiocytes and ﬁbroblasts.Conclusion. Using mathematical analysis, the most important indicators that inﬂuence the reproductive prognosis in women with ovarian endometriosis (activity of nucleolar organizer regions, urine 6-SMT level) were determined, which makes it possible to create a model for calculating an individual reproductive prognosis.
Robot-Assistant Radical Cystectomy as a Modern Method of Personalized Treatment for Patients with Muscle-Invasive Bladder Cancer
Authors: Pavlov V. N. , Urmantsev M. F. , Bakeev M. R. 
Published: May 2024

Introduction. Radical cystectomy (RC) is the “gold standard” treatment for muscle-invasive bladder cancer (MIBC). Robot-assisted RC (RARC) can act as a safe and eﬀective method of treating MIBC.The aim of the study was to analyze our own experience with the use of RARC with intraoperative indocyanine green ﬂuorescence (ICG) and postoperative determination of tumor macrophage levels in the treatment of patients with MIBC.Materials and methods. A study was conducted at the Clinic of the Bashkir State Medical University with the participation of 202 patients aﬅer RARC. 30 patients underwent intraoperative ICG ﬂuorescence testing. The levels of tumor macrophages in the removed macropreparations were determined in all patients. In the postoperative period, a survival analysis was performed.Results. The sensitivity of the ICG ﬂuorescence method was 94.4 %, and the speciﬁcity was 83.3 %. High levels of expression of macrophage markers CD68 and CD163 signiﬁcantly predominate in the group with the cN+ stage (according to the clinical TNM classiﬁcation, there are signs of damage) (p = 0.027 and p = 0.018, respectively). ICG ﬂuorescence of regional lymph nodes (100 %) was observed in all patients with high CD68 and CD163 levels. A signiﬁcant decrease in survival was recorded in patients with high pathomorphological stage T (pT according to the TNM classiﬁcation) (r = 0.952, p < 0.05) and statistically signiﬁcant survival rates were obtained for pT1–pT4 groups (p < 0.05 for overall, cancer-speciﬁc and recurrence-free survival (OS, CSS, RFS, respectively)).Discussion. More and more studies are appearing in the world literature proving the eﬀectiveness of RARC in the treatment of patients with MIBC. Compared with open and laparoscopic techniques, better surgical and comparable oncological results are demonstrated.Conclusion. The results of the analysis of the RARC’s own experience indicate the eﬀectiveness of this method of treating MIBC. The use of ICG ﬂuorescence and veriﬁcation of tumor macrophages makesit possible to provide personalized care to oncourological patients.
Nephrotransplantectomy Using Radiosurgical Techniques
Authors: Akhtyamov R. R. , Ionin V. P. 
Published: May 2024

Introduction. Aﬅer the loss of kidney transplant function, patient curation can be a diﬃcult task. Nephrotransplantectomy (NTE) is the method of choice between reduction of immunosuppression with the abandonment of a non-functioning kidney transplant and embolization. This is an operation with potentially signiﬁcant indicators of blood loss, complications and mortality. Along with traditional NTE, we began to use endovascular isolation of the allograﬅ as a method of preoperative preparation before its removal.The aim of the work is to investigate the eﬀect of the use of radiosurgical minimally invasive techniques on the surgical tactics of nephrotransplantectomy, the degree of blood loss, the frequency of complications and blood transfusion.Materials and methods. A retrospective analysis of the data of 52 patients aﬅer NTE was performed. Depending on the method, patients are divided into two groups. In group 1 (main, n = 22), the operation was performed with pre-performed endovascular embolization of the graﬅ arteries (EEAT), in group 2 (control, n = 30) — without EEAT. The analysis of the results of the examination, intra- and postoperative indicators in patients by groups was carried out.Results. In group 1, intraoperative blood loss was 10–80 ml, on average (35.4±19.9) ml; in group 2 — from 100 to 600 ml, on average (289.7±138.4) ml (p < 0.001). In group 2, damage to the main vessels occurred more oﬅen (n = 4) (13.3 % vs. 0 %), hemotransfusion was performed in 53.3 % of cases (n = 16) to correct posthemorrhagic anemia. Postoperative complications in the control group were recorded in 8 patients (26.7 %).Discussion. Preventive endovascular embolization of the arteries of a kidney transplant signiﬁcantly reduces the frequency ofintra- and postoperative complications, allows nephrectomy to be performed on a planned basis andin a delayed manner.
Variability of Knee Joint Anatomy and the Impact of Its Individual Parameters on the Topography of the Anterior Cruciate Ligament
Authors: Volodin I. V. , Malanin D. A. , Kalitin K. Y. , Mukha O. Y. , Suchilin I. A. , Cherezov L. L. 
Published: May 2024

Introduction. The anatomical features of the knee joint are signiﬁcant as potential predictors of various diseases and injuries. However, the relationship between the anatomical position of the ACL and the structural parameters of the knee remains insuﬃciently studied. This work aims to identify statistically signiﬁcant correlations between individual knee parameters and their association with the topography of the ACL within the joint.Purpose of the study. To determine statistically signiﬁcant relationships between individual knee parameters and their potential impact on the positioning of the ACLin the joint based on MRI data.Materials and methods. The study involved the analysis of MRI images of 391 knee from patients of diﬀerent sexes. Measurements were taken for 19 parameters using standard tools for linear and angular measurements. The data underwent statistical processing.Results and discussion. Six factors inﬂuencing the positioning of the ACL were identiﬁed. The study results challenge the validity of existing knee structure classiﬁcations, highlighting the need to explore the relationships between joint parameters. Factor analysis of the measured knee values allows for the identiﬁcation of new systems of interrelated parameters, including those independent of patient sex. The study emphasizes the importance of developing new MRI analysis methods for the knee using multiparametric models.Conclusion. Our research highlights important correlations between knee parameters and the positioning of the ACL. Factors aﬀecting this dynamic underscore the need for an individualized approach to planning ACL reconstruction. The results provide a basis for developing more accurate analysis methods and personalized treatment strategies for orthopedic diseases, enhancing the eﬃcacy of clinical practice.
Hemocoagulation Disorders and Intoxication in Severe Acute Post-Manipulation Pancreatitis in the Experiment
Authors: Prudkov M. I. , Rantsev M. A. , Sarapultsev P. A. , Chupakhin O. N. 
Published: May 2024

Introduction. Acute post-manipulation pancreatitis (APMP) is a frequent complication aﬅer interventions on the major duodenal papilla. The APMP incidence reaches 15 %, of which 5–10 % are severe. The goal of the research is to determine the possibility of correcting hemocoagulation disorders and reducing endogenous toxemia syndrome severity in APMP.Materials and methods. A comparative study was performed in 40 animals (nonlinear albino rats) with severe acute pancreatitis on APMP experimental model. L-17 compound from a new group of organic compounds substituted thiadiazines at a daily dose of 40 mg/kg was used.Results. The development of hemocoagulation disorders and severe toxemia in animals with an experimental model of APMP has been shown. The indicators of the severity of hemocoagulation disorders and toxemia were studied in experimental APMP against the background of the introduction of the compound L-17 from the group of substituted thiadiazines.Discussion. The course of APMP in the experiment is accompanied by the development of severe hemocoagulation disorders and severe toxemia. Eﬀective indicators reﬂecting the severity of APLP are D-dimers (hemocoagulation) and albumin binding capacity (toxemia).Conclusion. The course of experimental severe APMP is accompanied by pronounced hemocoagulation disorders development involved in the pathogenesis and progression of multiple organ dysfunction, that is characterized by a high level of endogenous toxemia. The course of experimental APMP against the background of the introduction of the compound L-17 is marked by a decrease in the severity of hemocoagulation disorders and the level of endogenous toxemia.