Bulletin of Siberian Medicine / Бюллетень сибирской медицины
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АЛГОРИТМ ДИАГНОСТИКИ И ЛЕЧЕНИЯ ВОЗРАСТНОЙ МАКУЛЯРНОЙ ДЕГЕНЕРАЦИИ У ПАЦИЕНТОВ С ХРОНИЧЕСКИМ ПЕРИФЕРИЧЕСКИМ УВЕИТОМ
Get PDFThe results of clinical trial of various approaches in treatment the exudative forms of macular degenerations, including age-related, against chronic slow intensity inflammatory process on the extreme retinal periphery of an eye are described in represented material. There were 91 patients (105 eyes) in the research with different types of an exudative macular degeneration. The general criteria of inclusion were: age of 18–80 years old, complaints to discomfort in eyes, a spot before an eye, distortions and decrease in the central sight, ophthalmoscopic symptoms of hypostasis in the central and peripheral areas of a retina. It is analyzed the general criteria of diagnostics and treatment of the disease in the article. Considering defeat of the chorioretinal structures located near the ora serrata at persons of young and advanced age. Practical recommendations to a choice of methods of diagnostics and treatment of various clinical and morphological forms of the disease are made. Screening methods of identification of patients with the peripheral uveitis are offered. The scheme of risk calculation of development the macular pathology at persons with changes on the extreme periphery of a retina, that can be used as a method of prevention of development predictively adverse of “wet" forms of an age-related macular degeneration, by means of timely sparing treatment at patients with chronic inflammatory diseases of eyes is given
ПРИМЕНЕНИЕ БИОДЕГРАДИРУЕМОГО МАТЕРИАЛА ДЛЯ ЗАМЕЩЕНИЯ КОСТНОЙ ТКАНИ В ТРАВМАТОЛОГИИ
Get PDF20 men (medium age (31.5 ± 13.5) years) were studied. All patients underwent arthroscopic auditing plastic anterior cruciate ligament of the knee. Osteoregeneration dynamics were determined by biochemical testing of blood serum and X-ray computed tomography (CT) of the fracture in 1–4 months after surgery. As a result, an estimation of the bone tissue reparative regeneration according to CT data in 10 patients with a defect of the patella, treated with the material is provided. The obtained results of the clinical study indicate the reparative effect of the biodegradable material for bone replacing on bone regenerationВ исследовании приняли участие 20 мужчин (средний возраст (31,5 ± 13,5) года). Всем пациентам была выполнена ревизионная артроскопическая пластика передней крестообразной связки коленного сустава. Динамику остеорегенерации определяли с помощью биохимического исследования сыворотки крови и рентгеновской компьютерной томографии (РКТ) места перелома в сроки через 1–4 мес после операции. Представлена оценка репаративной регенерации костной ткани по данным РКТ у 10 больных с дефектом надколенника, леченных с применением материала. Полученные результаты клинического исследования свидетельствуют о репаративном влиянии биодеградируемого материала для замещения костной ткани на регенерацию кости
СЦИНТИГРАФИЯ МИОКАРДА С 123I-МЕТАЙОДБЕНЗИЛГУАНИДИНОМ В ОЦЕНКЕ СИМПАТИЧЕСКОЙ ИННЕРВАЦИИ МИОКАРДА ЛЕВОГО ЖЕЛУДОЧКА У БОЛЬНЫХ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА С ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ
Get PDFThe aim of this study was assessment of cardiac sympathetic activity in patients with atrial fibrillation by planar scintigraphy with 123I-metaIodbenzilguanidine (123I-MIBG).Material and Methods. The study included 28 (average age (57.4 ± 11.6) years) patients with suspected coronary artery disease. All patients to divide 3 groups: 13 patients (group 1) with paroxysmal AF (PAF),6 patients (group 2) with long-standing persistent AF (LSPAF) and 10 patients with no signs of AF (group 3).Planar imaging was performed to study initial (imaging started 20 minutes after MIBG injection 148 MBq 123I-MIBG) and delayed (imaging started 4 hours after 123I-MIBG injection). For the anterior planar 123I-MIBG images, regions of interest were constructed for the heart and upper mediastinum, and the heart-mediastinal ratio (HMR).Results. The delayed HMR in patients with PAF and LSPAF was significantly lower compared that in patients third group (1.59 ± 0.16, 1.54 ± 0.17 and 1.82 ± 0.11 respectively, p < 0.05). The washout rate of 123I-MIBG in patients with PAF and LSPAF was significantly highest compared that in patients with no signs of AF (33.4 ± 17.5, 29 ± 11.7 and 17.2 ± 9.6 respectively, p < 0.05). In assessment of regional sympathetic activity in patients with LSPAF defect accumulation 123I-MIBG in both the early and delayed scintigrams was significantly higher compared with groups of patients with PAF and without AF.Results of this study indicated, that the patients with atrial fibrillation has of regional LV myocardial changes, according with 123I-MIBG imaging. More sympathetic innervation abnormality was observed in patients with long-standing persistent AF
РАЗРАБОТКА ИНФОРМАЦИОННОЙ МОДЕЛИ КЛИНИЧЕСКИХ СЦЕНАРИЕВ НА БАЗЕ ОБУЧАЮЩЕГО СИМУЛЯЦИОННОГО ЦЕНТРА
Get PDFКОГНИТИВНЫЕ НАРУШЕНИЯ У ПАЦИЕНТОВ С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА
Get PDFCoronary artery bypass graft surgery (CABG) is one of the most effective methods of surgical treatment of ischemic heart disease (IHD). However, even improvement of life quality is evident in patients underwent CABG, some neuropsychological, cognitive alterations may appear. Therefore, the problem of neurological complications in cardiac surgery is still of current interest. Prevalence of cognitive dysfunction after CABG varies from 12 to 79%. One third of the patients have alterations of cognitive functions for 1 year and more after the operation. In this review, we will discuss the current understandings on etiology, pathogenesis and prevalence of cognitive dysfunction in patients with IHD after CABG. The following factors determine development of long-lasting cognitive deficiency: lower educational level, advanced age, significant alterations of cognitive functions in preoperative period. At present, age, comorbid pathology (arterial hypertension, diabetes mellitus, vascular diseases, lung diseases), heart failure, alcohol and drug abuse, preoperative cognitive dysfunction are considered as major risk factors for CABG-induced neurological complications. Importance of timely diagnostics and early beginning of treatment of cognitive dysfunction will be discussed
ФАКТОРЫ, АССОЦИИРОВАННЫЕ С РАЗВИТИЕМ ВТОРИЧНОГО ГИПЕРПАРАТИРЕОЗА У БОЛЬНЫХ САХАРНЫМ ДИАБЕТОМ 1-ГО ТИПА С ДИАБЕТИЧЕСКОЙ НЕФРОПАТИЕЙ
Get PDFObjective. To identify factors associated with the development of secondary hyperparathyroidism in patients with type 1 diabetes mellitus with diabetic nephropathy.Materials and methods. One hundred and one patients (males) with type 1 diabetes mellitus with diabetic nephropathy who were treated in endocrinology department of the Regional clinical hospital were examined. For the study of calcium and phosphorus metabolism in patients with type 1 diabetes mellitus, we investigated the following parameters in the blood plasma: level of intact parathyroid hormone, total calcium, ionized calcium, serum phosphorus.Results. The study showed that in patients with type 1 diabetes mellitus with diabetic nephropathy factors associated with the development of secondary hyperparathyroidism are: the age above 30 years old, the duration of diabetes for more than 15 years, reduction of glomerular filtration rate of less than70 ml/min/1,73 m2 and the development of anemia. Factor associated with the reduction of secondaryhyperparathyroidism is the level of glycated hemoglobin of more than 8%.Conclusion. Thus, patients with type 1 diabetes mellitus with diabetic nephropathy represent a group of increased risk for development of violations of calcium and phosphorus metabolism. Analysis of the factors associated with the occurrence of secondary hyperparathyroidism in diabetic nephropathy allowed to identify a group of high risk of development of this pathology
ПРИМЕНЕНИ Е MN(II)-ТРАНС-1,2-ДИАМИНОЦИКЛОГЕКСАН-N,N,N',N'-ТЕТРААЦЕТАТА ДЛЯ ПАРАМАГНИТНОГО КОНТРАСТИРОВАНИЯ МЕНИНГИОМ ГОЛОВНОГО МОЗГА У СОБАК
Get PDFAim of research. We have evaluated the abilities of new original paramagnetic contrast agent Mn-DCTA (0,5 mol solution of Manganese(II) complex with trans-1,2-diaminocyclohexane-N,N,N',N'-tetraacetate, registered trade mark Cyclomang) for contrast-enhanced imaging of brain meningeomas in dogs.Material and methods. Twelve animals were included, all with brain tumors reveald during out-patient veterinary examinations. In ten of twelve the diagnosis was verified later by pathomorphologic study. The cerebral MRI has been carred out as set of axial, sagittal and coronal slices as thin as three to five mm, covering all the volume of brain.The scanning parameters in T1-weighted spin-ech mode were as follows: TR = 400–500 ms, TE = 15–20 ms, the dose of injected paramagnetic was standardised as 1 mmol per 10 kg of body weight. For quantitative analysis the index of enhancement was calculated.Results. In all cases the sure enhancement with clear visualization of cerebral tumor was obtained due to highly intensive uptake of Mn-DCTA to the tumor tissue. When evaluated quantitatively the uptake of Mn-DCTA to the tumor gave the index of enhancement in T1-weighted spin-echo mode as high as IE = 1,72 ± 0,18 for the central parts of tumor and IE = 2,08 ± 0,23 for the peripheral ones, where as in control animals it was far below these values. Intravenous injection of Mn-DCTA to dogs with cerebral tumors did not induce any detectable pathologic or even physiologic effects.Conclusion. Henceforth we conclude the Mn-DCTA provides highly available methodologically simple imaging of cerebral meningeomas and can be thought out as promising paramagnetic agent for clinical magnetic resonance imaging in humans
ОСЛОЖНЕНИЯ И ИСХОДЫ БЕРЕМЕННОСТИ ПРИ ГЕСТАЦИОННОМ САХАРНОМ ДИАБЕТЕ
Get PDFThe aim of the study was to analyze the complications and examine the outcomes of pregnancy in women with compensated gestational diabetes mellitus.We studied outcomes and complications of pregnancy in 50 pregnant women with gestational diabetes mellitus, the effects of gestational diabetes on the fetus.The average age of pregnant women was (33.7 ± 5.7) years. The incidence of gestoses and placental insufficiency in compensated gestational diabetes mellitus was 84%, polyhydramnios – 36%, the fetus fetopathy – 48% of cases. Births in period occurred in 96% of cases, the frequency of fetal malformations consistent with population-based indicators.Gestational diabetes mellitus affects the development of gestosis and fetoplacental insufficiency, even when the compensation of carbohydrate metabolism after the diagnosis of gestational diabetes mellitus.Цель исследования – провести анализ осложнений и изучить исходы беременности у женщин с компенсированным гестационным сахарным диабетом (ГСД).Изучены исходы и осложнения беременности у 50 беременных женщин с гестационным сахарным диабетом, влияние ГСД на плод. Средний возраст беременных составил (33,7 ± 5,7) года. При компенсированном ГСД частота развития гестоза и фетоплацентарной недостаточности составила 84%, многоводия – 36%, фетопатии плода – 48%. Роды в срок произошли в 96% случаев, частота пороков плода соответствовала общепопуляционным показателям.Установлено, что гестационный сахарный диабет влияет на развитие гестозов и фетоплацентарной недостаточности, даже при достижении компенсации углеводного обмена с момента его диагностики
