Perm Medical Journal

The peer-review scientific and practical bimonthly medical journal.

Editor-in-Chief

  • Olga V. Khlynova, MD, Dr. Sci. (Medicine), Corresponding Member of the Russian Academy of Sciences (Wagner State Medical University). ORCID iD: 0000-0003-4860-0112 

Publisher

Founders

About

The journal was founded in 1923 by Medical Society of Perm University (ISSN Key title: Permskiĭ medit︠s︡inskiĭ zhurnal). The journal publish original researches and reviews, case reports and short communications on the following science fields:

  • Obstetrics and Gynecology
  • Oncology, X-ray therapy
  • Surgery
  • Endocrinology
  • Pediatrics
  • Pulmonology
  • Epidemiology
  • Clinical laboratory diagnostic

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Current Issue

Vol 41, No 1 (2024)

Cover Page

Full Issue

Original studies

The concentration of serum neopterin in patients with surgical treatment of spondyloarthrosis complicated byfacet syndrome
Pronin A.Y., Karakulova Y.V., Sosnin D.Y.
Abstract

Objective. To study the concentration of serum neopterin in patients before and after surgical treatment of pain syndrome caused by the formation of facet syndrome associated with spondyloarthrosis.

Materials and methods. The study involved 52 patients (32 men and 20 women) hospitalized to the neurosurgical department of the City Clinical Hospital No. 4. The main group consisted of 26 patients with spondyloarthrosis complicated by chronic pain associated with facet syndrome. The comparison group (n=26) consisted of patients with pain syndrome in radiculopathy. The control group (comparable in gender and age) consisted of 10 people who underwent periodic examination. The concentration of neopterin in blood serum was determined by solid-phase enzyme immunoassay (ELISA) using the Neopterin ELISA kit (cat. No. 59321; lot ENO230) ("IBL", Germany).

Results. Statistically significant differences in the level of serum neopterin concentration (p = 0.0016) were revealed between the studied groups. The highest concentration of neopterin was noted in the comparison group, where it was 10.31 ± 2.02 nmol/l, exceeding the results of the control group (p=0.02256) and the main group (p=0.04996). Three months after surgical treatment of patients in the main group, the median content of serum neopterin decreased by 1.161 times (p = 0.049029).

Conclusion. Further studies to clarify the influence of pain on metabolic processes and neopterin in particular are required.

Perm Medical Journal. 2024;41(1):5-12
pages 5-12 views
Dynamics of formation of anti- bodies to SARS-CoV-2 after coronavirus infection in children
Bogomolova I.K., Peregoedova V.N.
Abstract

Objective. To estimate the level of antibodies to SARS-CoV-2-IgM and SARS-CoV-2-IgG in children with COVID-19 in acute period and during 1 year period of follow-up after coronavirus infection.

Materials and methods. Blood samples for the presence of IgM and IgG antibodies to SARS-CoV-2 were analyzed in 119 children aged 11.0 [10.1; 11.2] with COVID-19 in the acute period (29.4 % asymptomatic, 51.3 % mild and 19.3 % moderate), and SARS–CoV-2-IgG in the dynamics of the follow-up after 1 (n=55), 6 (n=33) and 12 (n=32) months from the moment of discharge from the hospital in a prospective cohort study. The levels of SARS-CoV-2 surface glycoprotein S, including the receptor-binding domain – RBD were measured at different time by using enzyme-linked immunosorbent assay.

Results. The level of IgM positive rate for SARS-CoV-2 was initially negative in 86.6 % of children with COVID-19. The original seroconversion (on admission to the hospital) was 38.7 % and it increased to 96.7 % in 1 month and to 100 % in 12 months of observation. There were no statistically significant differences in IgG persistence depending on the age and course of COVID-19.

Conclusions. The new coronavirus infection causes a long-term response of IgG antibodies to SARS-CoV-2 which persists for one year of observation and increases by 12 months after the infection regardless of the severity of COVID-19.

Perm Medical Journal. 2024;41(1):13-23
pages 13-23 views
Cervical intraepithelial neoplasia: the current state of the problem in Yekaterinburg
Rosyuk E.A., Shorikova A.I., Verba T.E., Salimova I.V., Tureeva A.V.
Abstract

Objective. To determine the frequency of cervical intraepithelial neoplasia among female citizens in Yekaterinburg.

Materials and methods. The retrospective analysis of the report forms of the cervical pathology office in Yekaterinburg Perinatal Center from January to September 2022 was carried out. Statistical data processing was conducted using descriptive statistical methods in the Excel programme.

Results. 255 cases of precancerous cervical diseases and 7 cases of cervical cancer were revealed within 9 months of monitoring, among them 24 patients with precancerous pathology and 4 with cervical cancer had previously been followed up by a specialist. Most cases of cervical pathology were revealed in patients over 40.

Conclusions. The women's consultations of Verkh-Isetsky and Leninsky districts refer patients to the specialized cervical pathology office most actively. Patients of the cervical pathology office are provided with the full range of therapeutic and diagnostic procedures, with colposcopy being most often performed (27 % of cases). The dispensary group of patients of the cervical pathology office is mainly represented by women with cervical dysplasia of the 2nd degree (HSIL, CIN II) – 43.5 %.

Perm Medical Journal. 2024;41(1):24-31
pages 24-31 views
Hypertensive disorders in pregnancy: problems of classification, differential diagnosis and management
Mostova N.V., Kovalev V.V., Kudryavtseva E.V.
Abstract

Objective. To study the features of hypertensive disorders formation in pregnancy depending on the period and clinical form on the example of the population of Sverdlovsk region.

Materials and methods. The outcomes of 217 pregnant women with moderate and severe preeclampsia and gestational hypertension were analyzed (41, 74, and 102 cases, respectively).

Results. The severe preeclampsia group had the highest rate of fetal growth restriction (14.6 %), low birth weight -2045 g (1640–2650), preterm delivery (63.4 %), and cesarean delivery (87.8 %). A detailed analysis of 28 cases of gestational hypertension lasting up to 34 weeks was performed. The analysis revealed significant challenges in the differential diagnosis of this pregnancy complication, not only in terms of clinical manifestations, but also in terms of timely diagnosis in general.

Conclusions. The findings of this study spark a debate over the use of severity-based classification in clinical practice, which lessens the doctor's vigilance in milder forms that, however, result in equally serious complications. This raises the question of whether unified tactical approaches should be used in this pathology.

Perm Medical Journal. 2024;41(1):32-41
pages 32-41 views
Dynamics of main markers of protein metabolism and microelements in patients with new coronavirus infection
Nikolenko V.V., Prelous I.N., Belkina E.V., Nikolenko P.A., Vorobyova N.N., Sumlivaya O.N., Nebolsina A.P., Bubnov A.M., Teterin V.Y.
Abstract

Objective. To study the dynamics of the main markers of protein metabolism and microelements in patients with a new coronavirus infection.

Materials and methods. A prospective clinical and laboratory study of the dynamics of the main markers of protein metabolism and microelements was carried out in 62 patients with a new coronavirus infection complicated by the development of pneumonia with a moderate course on the basis of Perm regional clinical hospital of infectious diseases in 2021–2022. On the 1st and 14th days of hospitalization all patients underwent general clinical and biochemical studies. The concentrations of total protein, albumin, transferrin, Fe, Zn and Cu was also determined. Statistic processing of the results was carried out using Microsoft Excel 2000 and “Statistica 10”.

Results. A decrease in visceral pool proteins was revealed. It indicated their active consumption and formation of hypermetabolism - hypercatabolism syndrome in a moderate course of the infection. A progressive deficiency of Fe and Zn, correlating with life-threatening complications and deaths was revealed.

Conclusions. The course of a new coronavirus infection contributes to the development of metabolic disorders, and the identified deficiency of macro- and microelements is a predictor of a severe course of the infection.

Perm Medical Journal. 2024;41(1):42-49
pages 42-49 views
Predictors of changes in the course of breast cancer: the results of longitudinal study
Vazhenin A.V., Pakhomova Y.N., Ponomareva I.V., Tsiring D.A., Ryazhkin A.O.
Abstract

Objective. To investigate the predictors of changes in the course of breast cancer in a longitudinal study.

Materials and methods. Women with the diagnosis of breast cancer underwent psychological diagnostics at the stage of diagnosis (n=201 at the first section of the longitudinal study, n=149 at the second section, n=94 at the third section, n=81 at the fourth section five years after the diagnosis). Methods of research: scale of basic beliefs, life orientations test, questionnaire “Ways of coping behavior”, test of vitality, questionnaire of subjective control, personal helplessness questionnaire, quality of life questionnaire.

Results. Predictors of changes in the course of cancer are the basic belief “I-Image”, the level of vitality, the locus of control in relation to health, the course and stage of the disease.

Conclusions. While conducting the study, it was found out that the course of the disease is associated with medical and psychological indicators. The data obtained as a result of the study are necessary for solving practical problems of increasing life expectancy and providing psychological care to women with breast cancer who are a socially vulnerable category of the population of the Russian Federation.

Perm Medical Journal. 2024;41(1):50-58
pages 50-58 views
Association of polymorphic variants of HHIP, ADRB2 and IL-33 genes with clinical manifestations of bronchial asthma in children
Alieva Y.S., Furman E.G., Kondratyeva E.I., Loshkova E.V., Sheludko V.S., Sokolovsky V.S., Ponomareva M.S., Khuzina E.A., Aishauova R.R.
Abstract

Objective. To study the association of polymorphic variants HHIP, ADRB2 and IL-33 genes with phenotypes of clinical course of bronchial asthma in children and effective treatment.

Materials and methods. 90 patients aged from 5 to 17 with the diagnosis of bronchial asthma were included in the investigation. Diagnostic procedures were carried out in all the patients. They included the study of genetic polymorphism of HHIP, ADRB2 and IL-33 genes to establish the association with the clinical phenotypes, findings of laboratory and instrumental study determining the course of bronchial asthma and the degree of its control.

Results. The study of polymorphism of HHIP, ADRB2 and IL-33 genes in children with bronchial asthma with different phenotypes of the disease revealed the association of genetic polymorphism with the severity of course of the disease as well as concomitant diseases. It was determined that allele T of genetic variant rs12504628 (T>C) of HHIP gene reduces the risk of a severe course of BA. Its protective role in the development of drug allergy was also proved. Genotype AA of ADRB2 gene is associated with reduced risks of the development of congenital defects of the tracheobronchial tree in BA. Polymorphic variants in the 4th and 6th exon of IL-33 gene are more frequently associated with moderate and severe course of asthma and base substitution in the 4th and 6th exon are associated with the severe course.

Conclusions. Associations of polymorphic variants of HHIP, ADRB2 and IL-33 genes with clinical manifestations of BA in children are determined in this study. They can be considered in a personalized monitoring of the patients and can help to control the disease totally.

Perm Medical Journal. 2024;41(1):59-72
pages 59-72 views
Integrated approach to the study of biodegradation of composite materials for the restoration of hard dental tissues
Gileva O.S., Levitskaya A.D., Bekzhanova O.E., Libik T.V., Kilina M.Y., Sycheva M.A.
Abstract

Objective. To study the stress-strain state of demineralized tooth enamel after its impregnation with a low-viscosity composite in a long-term period of functioning in the oral cavity in a series of equivalent cyclic tests; to study the correlation of the experimental results with clinical observations of the treatment of enamel caries using a modified infiltration technique.

Materials and methods. The parameters of laser holographic interferometry and atomic force microscopy, reflecting the timing, type and severity of deformation defects in samples of demineralized tooth enamel were analyzed in a series of equivalent cyclic tests. During the experiment the samples underwent classical infiltration with composite using ICON technology (main group) and a 2-stage enamel caries treatment technique, including carrying out a time-modified conditioning of classical infiltration and the final stage (stages) of enamel coating with a bioactive hybrid glass ionomer (comparison group).

Results. The first signs of the deformation defects generation in demineralized enamel filtered on the classical method (the appearance of perifocal microcracks) were recorded in 11.2 % of the tested samples after 0.9 · 106 cycles (equivalent to 9 months of functioning of a tooth with treated enamel caries in the oral cavity), during further cyclic tests the percentage of samples with local defects increased progressively. Signs of a violation of the stress-strain state in the enamel after combined treatment (samples of the comparison group) were revealed in cycles corresponding to 2–3 years of being in an artificial environment of the oral cavity. Experimental data correlated with the clinical observations both in time and frequency of complications (secondary/recurrent caries) in the long term after treatment of enamel caries by various methods.

Conclusions. In the process of equivalent cyclic tests, heterogeneous elastic-plastic deformations develop in the thickness of a section of demineralized enamel impregnated with a flowing composite and along its perifocal zones, most pronounced at the interface between intact and treated enamel, which leads to the development of local defects, delaminations, cracks, and destruction of the structurally heterogeneous environment of tooth enamel. According to the results of the comparative analysis, the most favorable results in terms of the timing of development, frequency and severity of deformation defects were obtained in samples of demineralized enamel after its treatment using a modified caries infiltration technique followed by coating with a bioactive hybrid glass ionomer.

Perm Medical Journal. 2024;41(1):73-80
pages 73-80 views
Risk factors for development of type 2 diabetes mellitus in patients with obesity in late post-COVID period
Yuzhakova E.V., Shanko Z.G., Smirnova E.N.
Abstract

Objective. To study the risk factors for developing type 2 diabetes mellitus in patients with obesity after COVID-19.

Materials and methods. 61 case histories and outpatient card abstracts of patients with obesity, who suffered from moderate and severe forms of COVID-19 from 02.2021–04.2022 were analyzed. Demographic, laboratory and clinical parameters were studied during hospitalization and 12 months after discharge from the hospital. All patients initially were divided into 2 groups according to the glycated hemoglobin level. Group 1 consisted of 46 patients with prediabetes and group 2 included 15 patients without carbohydrate disorders.

Results. The median age of all patients was 64 (59–66) years. Median of HbAlc was 6,0 (5,6–6,2) %, BMI –34 (33–35) kg/m2. 24 patients from group 1, who took DPP-4-inhibitors in early post-COVID-19 period constituted subgroup 1A and 22 patients, who refused treatment with these drugs, constituted subgroup 1B. Currently, 2 patients from subgroup 1A and 10 patients from subgroup 1B (χ2=8,2 р=0,004) have been diagnosed with DM2. In patients who developed DM2 in late post-COVID period the levels of HbAlc, fasting plasms glucose and BMI at the time of admission to the hospital were significantly higher (n=12) than in patients with persistent prediabetes (n=34), (p<0,05). Positive correlation between these parameters and the risk of developing DM2 (R=0,5, p<0,05; R=0,74, p<0,05; R=0,54, p<0,05, respectively) was determined. In group 2, DM2 is currently diagnosed in 2 male patients with BMI over 40 kg/m2. When comparing subgroup 1B and group 2, it was found out that DM2 in the post-COVID period occurs in every second patient with the previous initial carbohydrate disorders: in 10 people of 22 – in subgroup 1B (every 2nd patient) versus 2 patients from group 2 (every 7th patient), (χ2=4,2, p=0,04). Online calculator from medstatistic. ru was used to determine relative risk (RR).

Conclusions. Thus, presence of impaired glucose tolerance increases the risk of development of DM2 in late post-COVID period. In patients with hyperlycemia on hospitalization for COVID-19, who did not receive incretin therapy (subgroup 1B) risk of DM2 was 3,4 times higher (CI 95 %=0,87–13,40). Patients, who received incretin (subgroup 1A) had risk of DM2 = 0,6 (CI 95 %=0,09–3,97). It should be assumed that incretin therapy prevents development of DM2 in patients with hyperglycemia/impaired glucose tolerance after COVID-19.

Perm Medical Journal. 2024;41(1):81-89
pages 81-89 views

Review of literature

Clinical and morphological features and unsolved issues in diagnosis of aggressive forms of papillary thyroid carcinoma
Korotovsky D.V., Sergiiko S.V., Lukyanov S.A.
Abstract

Differentiated thyroid cancer (DTC) is a disease with a favorable clinical course and high survival rate compared to other epithelial tumors. The majority of DTC (up to 85 %) is represented by various subtypes of papillary thyroid cancer (PTC). Aggressive forms of PTC characterized by early lymphogenous and hematogenous metastasis, low avidity to radioiodine therapy (RIT), low relapse-free survival rates and high mortality rate compared to other types of PTC occur among them. Preoperative diagnosis of PTC is based on the results of ultrasound (US) examination and fine-needle aspiration biopsy (FNA) with cytological examination of the aspirate. At the same time, the capabilities of cytological examination in determining the histological type of PTC are limited and it does not allow to predict its aggressiveness and plan adequate treatment. Molecular genetic tests of the tumor cytological and morphological material are effective in prognosis of aggressiveness of PTC due to the determination of specific mutations in the BRAF, TERT, RAS genes and the quantitative expression of oncogenic and tumor suppressive microRNAs. Some of these indicators are already used in the morphological classification of tumors of the endocrine system.

At the same time, there are contradictory data concerning the connection of the molecular genetic portrait of PTC, the clinical manifestations of its aggressiveness (extrathyroidal invasion, early metastasis, and radioiodine resistance) and its pathomorphological structure. We tried to summarize and analyze the literature data regarding the diagnosis of aggressive variants of PTC.

Perm Medical Journal. 2024;41(1):90-107
pages 90-107 views

Methods of diagnosis and technologies

A method of diagnosing non-alcoholic fatty liver disease with the calculation of the steatosis index
Bulatova I.A., Sobol A.A., Gulyaeva I.L.
Abstract

Objective. To work out the index for diagnosing non-alcoholic fatty liver disease (NAFLD) in women with metabolic syndrome (MS) in postmenopause using generally available markers.

Materials and methods. 62 females with NAFLD and MS in early postreproductive period took part in the study. They were compared to 24 relatively healthy females not suffering from obesity in postmenopause. The average age of the patients was 49,9 ± 1,1. Hepatic steatosis was diagnosed by ultrasound examination. The mathematic model of hepatic steatosis index (HSI) calculation included: body mass index (BMI), waist size (WS), triglycerides and low-density lipoproteins (LDL).

Results. BMI and WS in patients with MS and NAFLD in postmenopause were considerably more than in relatively healthy women. Hypertriglyceridemia and an increase of LDL in blood serum were noted in patients with steatosis. Biometric and laboratory data were included in the mathematical formula which allows to calculate HSI. With HSI 0,5 and more NAFLD is diagnosed in women in post menopause, when HSI is lower than 0,5 it is not diagnosed. Indicators of sensitivity and specificity of the method were 98,4 % and 95,85 % respectively.

Conclusions. The minimally invasive method suggested above allows to reveal hepatic steatosis in females with MS in early postreproductive period. High diagnostic characteristics of the method are worth mentioning, as well as the possibility to be widely used thanks to simple biometric and laboratory data employed.

Perm Medical Journal. 2024;41(1):108-113
pages 108-113 views
Prospects for induction of labor with oxytocin within 12 hours (perinatal center experience)
Baranova M.V., Ksenofontov A.M., Shestak E.V., Vagushchenko U.A.
Abstract

Objective. Demonstrate the expediency and effectiveness of labor induction for more than 6 hours (up to 12 hours of the latent phase).

Materials and methods. A cohort, descriptive, single-center study was conducted. The effectiveness of labor induction with oxytocin for more than 6 hours was estimated. The birth medical histories of 3265 patients of SBHI of Sverdlovsk Region "Yekaterinburg Regional Perinatal Center" from January 2020 to December 2022, who underwent pre-induction and induction of labor, were analyzed.

Results. The group of patients, who underwent induction of labor with oxytocin, was 2261 cases. In 1269 (56.13 %) patients, vaginal delivery occurred after less than 6 hours of labor induction with oxytocin. In 992 patients (43.87 %) induction of labor with oxytocin was continued for more than 6 hours. Only 320 labors resulted in abdominal delivery due to ineffective labor induction, which amounted to 32.3 % (of the number of labor inductions with oxytocin for more than 6 hours) and 14.2 % (of the total number of labor inductions with oxytocin).

Conclusions. Induction of labor with oxytocin for more than 6 hours (up to 12 hours of the latent phase) is reasonable and effective. It allows to avoid abdominal delivery in up to 30 % of patients of the study group.

Perm Medical Journal. 2024;41(1):114-119
pages 114-119 views
Analysis of hardware methods of treatment of patients with temporomandibular joint dysfunction
Dolgalev A.A., Khristoforando D.Y., Garus Y.N., Ivensky V.N., Brazhnikova A.N., Khorev O.Y., Bulycheva E.A., Geletin P.N., Kerefova Z.V., Chepurko Y.V., Uspenskaya O.A.
Abstract

Objective. To conduct a comparative analysis of effectiveness of treatment of patients with dysfunction of temporomandibular joint (DTMJ) using hardware methods of treatment with occlusive mouthguards of various types.

Materials and methods. 99 patients (88 females and 11 males aged 41,2 ± 10,7) with different combinations of revealed and confirmed signs of DTMJ were examined from 2013 to 2023. According to the personal clinical picture, complaints revealed, aetiology and pathogenesis of the disease all the patients of the comparison group and 2 main groups (99 patients) were administered individual complex treatment for DTMJ. The treatment was aimed at the elimination of pain, relief of masticatory muscles spasm, improvement of the extent of opening of mouth, correction of the lower jaw position, occlusive interference elimination and restoration of height of the lower third of the face.

While carrying out the hardware treatment, occlusive mouthguards of 3 types were made based on the jaw model of the patients. The models were got from the silicone imprints of the jaw.

Results. MR images of temporomandibular joints of the 99 patients showed that ventral dislocation of articular disk occurred most frequently (in 88 patients). Less frequently (4 % of cases) it was combined with dislocation of the disk laterally. Rarely distal dislocation of the articular disk occurred – 1,9 % of cases (2 patients). Study of the results of the appliance of different types of occlusive mouthguards demonstrates the necessity to work out the types of occlusive devices allowing decompression of temporomandibular joint elements, centering lower jaw position and orthodontic elimination of dentofacial abnormalities and deformities which lead to occlusive interference.

Conclusions. Analysis of occlusive devices used in the diagnosis and treatment of patients with DTMJ shows that the most effective devices are those that successfully combine elements of splints with a narrower purpose.

Perm Medical Journal. 2024;41(1):120-131
pages 120-131 views

Preventive and social medicine

The organization of emergency medical care for the children's population during the COVID-19 pandemic
Bogdanyants M.V., Minakova G.M.
Abstract

Objective. To analyze the work of the emergency medical care department (EMCD) of the largest children's polyclinic of the city in 2020-2022 and to evaluate the organization of the EMC for the attached children during the Covid-19 pandemic.

Materials and methods. Mathematical and statistical analysis of quantitative and qualitative indicators of EMCD activity based on a continuous sample of primary accounting and reporting medical documentation.

Results. A significant increase in the number of EMCD visits was demonstrated. In 2022, the growth was 40,96 % and 28,12 % compared to 2020 and 2021. It was found out that in 97,4–98,0 % of all cases provided with EMC, were the children with respiratory diseases. Their number in 2022 increased 1,3 times compared to 2021, and 1,43 times compared to 2020. In this group of patients, the number of children with pneumonia increased by 63.5 % in 2021 compared to 2020.

Conclusions. The proper organization of the work of the EMCD made it possible to provide children with available, timely and rapid primary medical social and emergency medical care during an increased workload in the context of the COVID-19 pandemic.

Perm Medical Journal. 2024;41(1):132-140
pages 132-140 views
Influence of vaccine prevention on the spread and serotype composition of Streptococcus pneumoniae in military collectives
Mukhachev I.S., Blagonravova A.S., Feldblyum I.V., Alyeva M.K.
Abstract
Objective. Study of the effect of vaccination against pneumococcal infection on the prevalence and serotype composition of S. pneumoniae in military personnel.
Materials and methods. The study was conducted among 369 military personnel of the military unit of the Sverdlovsk region. Determination of the frequency and serotype of S. pneumoniae was carried out upon admission and after 1.5 months of stay in the military collective using the multiplex PCR method.
Results. After 1.5 months of stay of servicemen in the military collective, a significant activation of pneumococcal circulation was established (χ2McNemar=24.038; p<0.001). The risk of S. pneumoniae infection among unvaccinated military personnel was 1.39 times higher compared to vaccinated military personnel (RR=1.39; 95% CI 1.209–1.596). In the group of unvaccinated military personnel, the frequency of occurrence of vaccine serotypes was 2.6 times higher than in vaccinated ones (χ2 = 6.25; p = 0.01).
Conclusions. The proactive influence of immunization against pneumococcal infection on the prevalence and serotype landscape of S. pneumoniae has been established: A low prevalence of vaccine serotypes and a predominance of non-typeable serotypes have been revealed among vaccinated individuals.
Perm Medical Journal. 2024;41(1):141-147
pages 141-147 views

Clinical case

Analysis of a clinical case of managing a patient with intraoperative bladder injury
Kalinkina O.B., Tezikov Y.V., Lipatov I.S., Mayorova M.O., Sreseli G.M.
Abstract

To analyze a clinical case of successful treatment of a patient with intraoperative bladder injury.

The results of examination and treatment of patient S., 39 years old, were studied. The reasons for iatrogenic bladder injury in this clinical case were two surgeries on the bladder in childhood, a pronounced adhesive process of the small pelvis, and the inability to foresee the atypical localization of the bladder welded to the anterior abdominal wall. A pronounced adhesive process might also be caused by endometriosis, which had not been diagnosed and treated in this patient.

Timely referral of the patient to a gynecologist for a check-up with ultrasound examination of the pelvic organs would have allowed to reveal endometriosis, timely treat it and avoid the formation of a large endometrioid cyst, which required surgical treatment. In this clinical case attention is drawn to the lack of an interdisciplinary approach to the management of this patient, defects in dispensary supervision. Despite the complication occurred, performing the stages of operation together with an urologist, adequately prescribed postoperative therapy for the prevention of recurrence of endometriosis, rehabilitation in the urology department made a favorable course of the postoperative period possible, bladder function was restored and clinical manifestations of endometriosis were controlled.

Perm Medical Journal. 2024;41(1):148-153
pages 148-153 views

Biology and experimental medicine

Study of antiarrhythmic activity 2-(n-butylpyrrolidine)-N-(2-bromophenyl)carboxamide hydrochloride
Rudakova I.P., Chashchina S.V., Starkova A.V.
Abstract

Objective. To study the efficacy of a new derivative 2-(alkylpyrrolidine)-N-(aryl)carboxamide with high antiarrhythmic activity.

Materials and methods. To study the antiarrhythmic activity of the compound, the experiment was carried out on models of arrhythmia caused by intravenous administration of aconitine and adrenaline. The effect was estimated by its ability to prevent the onset of arrhythmia, prolong the survival time of the animals or by the duration of an arrhythmia attack. In addition, the electrocardiogram of awake rats was analyzed. The studied compound and the comparison drug (lidocaine) were injected to the animals intravenously in effective antiarrhythmic doses.

Results. In aconitine arrhythmia 2-(n-butylpyrrolidine)-N-(2-bromophenyl) carboxamide hydrochloride provides statistically significant limitation of the duration of arrhythmia attacks in experimental animals (1.7 times) in comparison with the control and also reduction of arrhythmia duration in comparison with

lidocaine (2.5 times); besides, this compound guarantees animals’ survival in 100 % of cases. When causing

arrhythmia by adrenaline administration, the compound does not prevent the occurrence of cardiac rhythm disorder. The electrocardiogram readings of animals do not change significantly.

Conclusions. 2-(n-butylpyrrolidine)-N-(2-bromophenyl) carboxamide hydrochloride (compound K-23) shows visible activity in models of arrhythmia caused by administration of aconitine and calcium chloride, which may indicate its ability to impede the sodium flow through the cell membrane by slowing depolarization of cardiomyocytes.

Since the compound studied, demonstrates high antiarrhythmic activity without changing the ECG readings, the drug created on its basis may be effective.

Perm Medical Journal. 2024;41(1):154-161
pages 154-161 views

Memorial date

100th anniversary of perm scientific school of medical diagnostics
Mishlanov V.J.
Abstract

Department of Propaedeutics of Internal Diseases of E.A. Vagner Perm Medical University is celebrating its 100th anniversary. The original name was the Department of Medical Diagnostics. It was the development of medical diagnostic methods that became the key theme of the 100-years development of the scientific and pedagogical school in medicine. Modern scientific achievements of the department's employees are known in Russia and abroad. They include new principles of making a medical diagnosis in a remote consultation, remote monitoring of patients with the application of interactive questionnaires and use of biosensor data. New methods of studying the human body based on measuring electrical impedance are being used.

Perm Medical Journal. 2024;41(1):162-167
pages 162-167 views

EVENTS

Horizons of international cooperation: medical science, practice and education
Blagonravova A.S., Rizaev Z.A., Gileva O.S.
Perm Medical Journal. 2024;41(1):168-170
pages 168-170 views


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