Perm Medical Journal

”Perm Medical Journal” (ISSN Key title: Permskiĭ medit︠s︡inskiĭ zhurnal) is a referred scientific and practical journal. It was founded in 1923 by Medical Society of Perm University. Since 2001 the founders of “Perm Medical Journal” are Perm State Academy of Medicine and Perm Research Center of Russian Academy of Medicl Sciences and Administration of Perm Region. Since 2017, the founder is Academician E.A. Vagner Perm State Medical University.

Editor-in-Chief: Evgeny G. Furman, MD, PhD, Corresponding Member of the Russian Academy of Sciences (Wagner State Medical University, Ministry of Health of the Russian Federation, Vice-Rector for Research)

The journal is registered by the Roskomnadzor agency (licensee ЭЛ № ФС 77-75489 on 05.04.2019).

“Perm Medical Journal” is included into the list of the leading scientific journals and editions of the Russian Federation intended for publication of basic scientific results of theses for a degree of Doctor of Science.

01.14.01 - Obstetrics and gynecology (medical sciences)
01.14.02 - Endocrinology (medical sciences)
3.1.21 - Pediatrics (medical sciences)
01.14.12 - Oncology (medical sciences)
3.1.9 - Surgery (medical sciences)
01.14.25 - Pulmonology (medical sciences)
3.2.2 - Epidemiology (medical sciences)
03.14.09 - Clinical immunology, allergology (medical sciences)
03.14.10 - Clinical laboratory diagnostics (medical sciences)

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Current Issue

Vol 38, No 6 (2021)

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Full Issue

Original studies

Effect of preoperative atrial fibrillation on long-term results after Off Pump Coronary Artery Bypass
Enginoev S.T., Kondratiev D.A., Magomedov G.M., Rashidova T.K., Kadyraliev B.K., Chernov I.I., Tarasov D.G.
Abstract

Objective. To study the effect of preoperative atrial fibrillation (AF) on the risk of stroke and long-term mortality after Off Pump Coronary Artery Bypass (OPCAB).

Materials and methods. A retrospective analysis of the results of OPCAB in 212 patients with coronary artery disease (CAD), who were operated on from May 2009 to November 2013, was carried out. After propensity score matching, patients were divided into 2 groups: Group I – 82 patients with sinus rhythm (SR) before surgery, Group II (control) – 102 patients with AF before surgery. The average age of the included patients was 61 ± 6.7 years, with 95 % CI: 60–62. Fifty-four (29.3 %) patients were over 65 years of age. There were 162 men (88 %) and 22 women (12 %). The median follow-up was 93.5 (66.7–102.0) months.

Results. The time spent in the clinic was statistically significantly shorter in the SR group than in the AF group (10 (9–11) and 14 (11–16) hours, respectively, p < 0.001). There was no statistically significant difference in the number of perioperative myocardial infarctions (in the group with SR it occurred in 1 (1.2 %) patient, in the group with AF – 2 (2 %), p = 0.7), strokes (in the group with SR – 1 (1.2 %), in the group with AF – 3 (2.9 %), p = 0.6), as well as a 30-day mortality (in the group with SR it was 0 %, in the group with AF – 3 (2.9 %), p = 0.2). In the long-term postoperative period, there were statistically significantly fewer strokes in the group with SR than in the group with AF (in the group with SR, the 10-year stroke freedom was 88.8 %, and in the group with AF – 71.8 %, p = 0.018), and also better long-term survival in the group with sinus rhythm (in the group with SR, the 10-year survival rate was 79 %, in the group with AF – 63.9 %, p = 0.016).

Conclusions. In the group with preoperative AF, the frequency of distant strokes and deaths is higher than in patients with sinus rhythm.

Perm Medical Journal. 2021;38(6):5-15
pages 5-15 views
Results of the use of selective adsorption of endotoxin in the complex treatment of surgical sepsis and septic shock.
Vereshchagin A., Kotelnikova L.P.
Abstract

Objective. To estimate the results of the use of LPS-adsorption in the complex treatment of surgical or obstetric sepsis and septic shock and to determine the risk factors for the development of lethal outcomes.

Materials and methods. Since 2014, twenty-nine patients with surgical or obstetric sepsis and septic shock have been treated at the Perm Regional Clinical Hospital using selective endotoxin adsorption in addition to conventional medical therapy. Endotoxin elimination was performed using hemoperfusion with the Alteco LPS Adsorber (Sweden). The patients were divided into two groups according to the final results of the treatment. The data of clinical and laboratory examinations were compared before and 24 hours after LPS elimination.

Results. Based on the correlation analysis, the most significant risk factors for the development of fatal outcomes are identified. It was found that neither the initial scores on the APACHE, SOFA scale, nor the level of CRP, PCT, EAA have a significant correlation with the lethal outcome. The only indicator before LPS-adsorption that has a direct correlation of the average value with the fatal outcome is the initial dose of norepinephrine. In our study, the mortality rate depends on the decrease in SOFA scores and its components in 24 hours after the procedure. Patients with the lower score after LPS-adsorption would have lower mortality. The predictors of ineffectiveness of treatment, despite the LPS-adsorption, were an unreliable decrease in the dose of vasopressors and the level of PCT, light improvements in the oxygenation index, the presence of bacteremia, septic shock and the delayed procedure.

Conclusion. In surviving patients with surgical sepsis and septic shock, the use of LPS-adsorption in complex treatment significantly improved the function of the cardiovascular and respiratory systems, reduced the level of PCT. The risk factors for the development of lethal outcomes were the initial severity of cardiovascular insufficiency, the selective sorption of endotoxin with a delay, the presence of bacteremia, septic shock, insignificant decrease in SOFA scores and the level of PCT after selective sorption of endotoxin.

Perm Medical Journal. 2021;38(6):16-24
pages 16-24 views
Effect of ozonotherapy on clinical and immunological indicators in children with allergic rhinitis
Illek Y.Y., Suetina I.G., Solovieva G.V., Tarasova E.Y., Khlebnikova N.V., Mishchenko I.Y., Ryseva L.L., Leushina N.P., Vyaznikova M.L.
Abstract

Objective. To determine the effect of ozonotherapy on the clinical indicators and immunological reactivity state in children with a moderate course of persisting allergic rhinitis.

Materials and methods. Children aged 5–10 years with a moderate persisting allergic rhinitis were under observation. They were divided into two groups depending on the therapy applied. Group I of allergic rhinitis patients received a complex generally accepted therapy, group II of allergic rhinitis patients – a complex therapy associated with ozonotherapy. Clinical indices and immunological reactivity parameters were studied during exacerbation and clinical remission in allergic rhinitis children.

Results. Ozonotherapy, included into a complex treatment of group II patients, was established to promote a faster occurrence of full clinical remission and normalization of most parameters of immunological reactivity. Duration of a full clinical remission in the group of allergic rhinitis patients, who received a complex therapy associated with ozonotherapy, more than twofold exceeded its duration in the group of allergic rhinitis patients receiving a complex generally accepted therapy.

Conclusions. The data obtained indicate high clinical, immunomodulating and antirelapsing effect of ozonotherapy that allows recommending its wide use in complex of medical measures among children with persisting allergic rhinitis.

Perm Medical Journal. 2021;38(6):25-34
pages 25-34 views
Clinical variants of chronic gastritis in childhood
Spivak E.M., Manyakina O.M., Akkuratova-Maksimova I.S., Shkolina O.V.
Abstract

Objective. To establish the features of various clinical variants of chronic gastritis in childhood.

Material and methods. 415 children aged 6–17 years with chronic Hp-associated gastritis were examined. The clinical and anamnestic data, the results of laboratory, endoscopic and morphological studies of gastrobioptates were analyzed. Genetic typing of Hp was carried out with the determination of 16 pathogenicity factors. The persistence of human herpes viruses of types 6 and 8 and Epstein – Barr viruses in the gastric mucosa was determined.           

Results. The clinical heterogeneity of chronic gastritis in children with the allocation of four topical variants was established: isolated duodenitis, duodenogastritis, antrum gastritis, pangastritis. It was found that with the first two, a high frequency of giardiasis is registered, with antrumgastritis and especially pangastritis, a significant contamination of the gastric mucosa with Hp is detected, mainly of CagA and VacA-positive strains. It is proved that the persistence of the type 6 human herpes virus does not affect the severity of inflammation, while the presence of the Epstein-Barr virus increases it. Colonization of the gastric mucosa by highly pathogenic Hp strains significantly increases the severity and activity of inflammation. It is shown that atrophy of the gastric mucosa in children is uncertain, and true atrophic gastritis occurs only in 0.61 % of cases.

Conclusions. Chronic gastritis in children is a heterogeneous pathology, and its individual variants differ significantly in etiological factors including infectious, pathogenetic mechanisms and features of the morphology of gastric mucosa. This should be taken into account when carrying out medical support for patients.

Perm Medical Journal. 2021;38(6):35-42
pages 35-42 views
Peculiarities of karyotype in patients with miscarriage
Olina A.A., Sadykova G.K., Shirinkina E.V.
Abstract

Objective. To study the features of the karyotype in patients with miscarriage. This article is devoted to the role of maternal chromosome polymorphisms and their role in the genesis of miscarriage.

Materials and methods. A comparative assessment of the karyotypes in women, whose pregnancy proceeded without complications and ended in the birth of a healthy child (75 persons, group I), and a group of patients with NB (135 persons, group II) was carried out. Group IIa consisted of 68 women with the first pregnancy that ended in spontaneous abortion in the first trimester, group IIb - 67 women with the first and subsequent pregnancy, interrupted in the first trimester. Statistical processing of the obtained material was carried out using the Exel program, and StatTech v.2.1.0.

Results. A significantly greater number of patients with normal karyotype was in group I – 72 persons (98.1 %). Data on the structure of chromosome polymorphisms showed that in patients of group II, changes in one chromosome are found in 8.8 % (3 people), two chromosomes – in 23.5 % (8 persons). Analysis of the data of group II showed significant differences in the subgroups in the frequency of chromosome polymorphisms, in patients of group IIa changes were noted only in one chromosome, and in IIc, every fifth patient had polymorphism of two chromosomes.

Conclusion. Despite the fact that genetic breakdowns are uncontrollable factors and it is not possible to directly influence them, the search for possible mechanisms leading to them is promising.

Perm Medical Journal. 2021;38(6):43-51
pages 43-51 views
Correlation assessment of gender and thyroid hormones in patients with primary oligomenorhea in anamnesis
Ibadullaeva-Adygezalova K.P.
Abstract

Objective. To determine the concentration of pituitary, ovarian and thyroid hormones in the blood and the correlation between them in women with a history of primary oligomenorrhea.

Material and methods. The study involved 56 women of reproductive age with primary oligomenorrhea. Control – 50 women of fertile age with an undisturbed rhythm of menstruation. An ultrasound of the uterus, ovaries and thyroid gland was performed. Concentrations of luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, estradiol, testosterone dehydroepiandrosterone sulfate (DHEA-S), triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH) were determined by ELISA.

Results. The average age of women in the main and control groups was 30.0 ± 1.34 and 30.52 ± 5.92 years (p > 0.05), respectively. The average age of menarche in women of the main group was 13.27 ± 0.80 years; duration of menstruation – 3.4 ± 0.40 days and 5.2 ± 0.82 days (p = 0.051), respectively; duration of the menstrual cycle was 33.90 ± 0.70 days (p = 0.001). Length and width of the uterus – 3.99 ± 0.19 cm (p = 0.055) and 4.51 ± 0.11 cm, respectively; endometrial thickness – 9.78 ± 1.20 mm. The sizes of thyroid lobes did not differ between the groups. The LH level and the LH / FSH ratio were higher than the control values by 50.79 % (p = 0.052) and 52.66 % (p = 0.045), respectively. Testosterone and TSH concentrations were 38.33 and 34.36 % higher, respectively. The estradiol level was reduced by 56.67 % (p = 0.113). A weak correlation was revealed between sex and thyroid hormones.

Conclusions. In women with a history of primary oligomenorrhea, the concentration of luteini-zing hormone and the LH / FSH ratio in the blood serum are significantly higher (p < 0.05). In women with primary oligomenorrhea, there was a weak correlation between sex and thyroid hormones. The results will provide insight into the relationship between the thyroid function and the menstrual cycle.

Perm Medical Journal. 2021;38(6):52-58
pages 52-58 views
Micronutrient deficiency in menstrual dysfunction among women of reproductive age
Sandakova Е.А., Zhukovskaya I.G.
Abstract

Objective. To determine whether inorganic menstrual dysfunction (MD) is associated with magnesium, iron and vitamin D deficiency in women of reproductive age.

Materials and methods. The study group I consisted of 50 women with MD: dysmenorrhea (16 women), oligomenorrhea (12 women), functional hypothalamic amenorrhea (3 patients) and acyclic abnormal uterine bleeding (19 women), the comparison group II was composed of 30 patients with normal menstrual function. The methods of study included history taking using a questionnaire to detect the signs of magnesium deficiency, physical examination, echography of pelvic organs, full blood count, blood tests to determine the concentration of magnesium, vitamin D and ferritin as well as consulting a therapeutist.

Results. Magnesium deficiency was registered significantly more often in patients with MD (93.0 ± 3.6 %, 73.0 ± 8.1 %, respectively; p < 0.05). The most typical signs of magnesium deficiency were the central symptoms: headache (58.0 ± 7.1 %, 22.0 ± 7.6 %; p < 0.001), irritability (53.0 ± 7.1 %, 26.0 ± 8.0 %; p < 0.01), dyssomnia (45.0 ± 7.0 %, 17.0 ± 6.9 %; p < 0.01), dizziness (42.5 ± 7.0 %, 22.0 ± 7.6 %; p < 0.05), a decrease in libido (34.0 ± 6.7 %, 13.0 ± 6.1 %; p < 0.05), as well as trophic disturbances including hair loss (38.0 ± 6.9 %, 13.0 ± 6.9 %; p < 0.01). Similar findings were obtained when we studied the iron supply: the frequency of latent iron deficiency (according to ferritin concentration) was 77.0 ± 5.9 and 35.7 ± 8.4 % respectively; p < 0.001. Deficiency or insufficient supply of 25(ОH)D was registered significantly more often in women with MD in comparison with healthy women (45.0 ± 7.0 %, 20.0 ± 7.3 %; p < 0.05).

Conclusions. In summary, determination of the level of micronutrients and adequate compensation of their deficiency can be important factors in physiological correction of endocrine imbalance leading to functional disorders in the reproductive system and a decrease in fertility.

Perm Medical Journal. 2021;38(6):59-68
pages 59-68 views

Clinical studies

Study of wound-healing activity of sodium 2-(adamantane-1-yl)-2-hydrazino-5-phenyl-4-oxobutanoate
Kuznetsov A.S., Pulina N.A., Chashchina S.V.
Abstract

Objective. To study a wound-healing activity of the earlier synthesized ‘compound-leader” sodium 2- (adamantan-1-yl)-2-hydrazino-5-phenyl-4-oxobutenoate (1), as well as to establish the possibility of its practical application in the ointment dosage form.

Materials and methods. The “substance-leader” 1 was synthesized by the chemical methods described earlier. The experimental 5 % ointment composition based on an aqueous solution of sodium alginate was developed in compliance with the rules for preparing homogeneous ointments. Its effect on the healing of linear aseptic skin wounds in white rats was studied by the method of wound-tensiometry.

Results. The experimental 5 % ointment composition with compound 1 was found to significantly increase the scar tensile strength compared to control without treatment. The developed model ointment showed wound-healing activity comparable to that of the reference drug (Levomekol ointment).

Conclusions. The selected “substance-leader” 1 in the composition of a model 5 % hydrophilic ointment based on sodium alginate exhibits pronounced biological activity and is a candidate for further research as a potential pharmaceutical substance with complex wound-healing and anti-inflammatory property.

Perm Medical Journal. 2021;38(6):69-73
pages 69-73 views

Methods of diagnosis and technologies

Role of interactive survey in early diagnosis of chronic kidney diseases
Burtseva E.A., Mishlanov V.Y., Anikeeva A.V., Selezneva V.I., Koshurnikova E.P., Chugainov S.V.
Abstract

Objective. To conduct a comparative study of the prevalence of specific symptoms in patients with kidney damage using the automated program "Electronic Polyclinic" to optimize the algorithm for early diagnosis of chronic kidney disease.

Materials and methods. 18 patients of the therapeutic unit with kidney lesions, confirmed by laboratory and instrumental studies, as well as 7 healthy persons were examined. The main problems of patients were identified by the method of interactive questioning with the help of the program "Electronic Polyclinic". Further, a statistical analysis of the data and a comparative study with the control group of healthy persons were carried out using STATISTICA 12.0 program.

Results. The main symptoms of kidney damage were reliably determined and a low sensitivity of individual symptoms in the diagnosis, in contrast to the syndromic approach, was revealed. It showed that in 100 % of cases the automated program "Electronic Polyclinic" detected the syndromes, that indicates its high efficiency. An algorithm for early diagnosis of chronic kidney disease was proposed, which consists in an initial interactive survey followed by examination formulated by the computer program.

Conclusions. The method of interactive survey using the automated program "Electronic Polyclinic" allows you to effectively identify the syndromes of kidney damage, makes a preliminary diagnosis and draws up a plan of examination for further confirmation of the diagnosis. Symptomatic diagnosis has a number of disadvantages including low sensitivity and specificity, so it yields to syndromic diagnosis.

Perm Medical Journal. 2021;38(6):74-82
pages 74-82 views
Evaluation of effectiveness of complex treatment of chronic generalized periodontitis using original splinting design
Astashina N.B., Rogozhnikova E.P., Arutyunov A.S., Malginov N.N., Kazakov S.V.
Abstract

Relevance. The relevance of the study is dictated by the high prevalence of periodontal disease among young people and by the need to search for new approaches to periodontitis treatment in order to increase the effectiveness of treatment at early stages of pathological process.

Objective. To evaluate the effectiveness of complex treatment of chronic generalized periodontitis (CGP) of mild severity using a removable splinting construction made according to the author's technique.

Materials and methods. At the orthopedic stage of the complex treatment of mild CGP, splinting constructions were used for 47 young patients: in the main group (n = 16) – the author’s treatment and preventive splint, in the first comparison group (n = 15) – a removable metal splint, in the second comparison group (n = 16) – a fixed adhesive fiber splint. Periodontal hemodynamics was assessed using ultrasound Doppler analysis 1, 6 and 12 months after the therapeutic measures and tooth immobilization. To identify the possible negative impact of the treatment on the quality of life (QOL) in patients with splint constructions, we used the OHIP-14-Ru questionnaire; the follow-up period was 1.3, 6, and 12 months.

Results. Dental immobilization contributed to the improvement of blood flow in the periodontal tissues in the short and long term follow-up, so after 12 months: Vam in the main group increased by 39,8 % and amounted to 0,397 ± 0,004 cm / s, in patients of the comparison groups – Vam was 0,329 ± 0,006 cm / s and 0,335 ± 0,003 cm / s, respectively, that is 15,4 % and 18,4 % higher compared with the figures before treatment. The quality of life index for patients using splinting constructions made according to the author's technique, by the OHIP-14-Ru questionnaire was assessed as good 1 year after (3.46 ± 0.59).

Conclusions. The use of the proposed original orthopedic design in a complex plan for mild periodontitis treatment helps to improve regional blood circulation and stabilize the pathological process.

Perm Medical Journal. 2021;38(6):83-93
pages 83-93 views

Preventive and social medicine

Analysis of publication activity of periodicals on specialty 14.02.04 – occupational medicine
Malyutina N.N., Eremeev R.B., Shumatova N.V., Vatolin D.M., Sosnin D.Y.
Abstract

The article is devoted to the analysis of journals included in the list of peer-reviewed publications recommended by the Higher Attestation Commission for the publication of materials of works on the specialty 14.02.04 “Occupational Medicine” (edition 12.07.2021). The data on the characteristics and publication activity of these journals are presented from the point of view of choosing a printed publication for publishing the materials of the dissertation research and when choosing a journal for publishing the results of scientific research in accordance with the requirements for the indicators of publication activity of scientific and pedagogical workers.

Perm Medical Journal. 2021;38(6):94-102
pages 94-102 views
Provision of population of the republic of Sakha (Yakutia) with medical personnel
Burtseva T.E., Arzhakova V.V., Gogolev N.M., Douglas N.I., Borisova E.A., Afanasyeva L.N.
Abstract

Objective. To analyze the provision of the population of the Republic of Sakha (Yakutia) with medical personnel.

Materials and methods. The article presents an analysis of the human resources of the healthcare of the Republic of Sakha (Yakutia) for 2000–2020. The main trends in the medical personnel provision of the Republic of Sakha (Yakutia) are determined according to the data of the Yakut Republican Medical Information and Analytical Center.

Results. The personnel resource of healthcare is its fundamental component. The problem of providing the population with medical personnel is one of the key factors in the socio-economic development of the regions, especially the regions of the Arctic zone of Russia. The national project "Healthcare" includes the federal project "Providing Medical Organizations of the Healthcare system with Qualified Personnel". The key goal of the national project on staffing the medical service is to achieve almost full staffing of doctors and nurses in healthcare institutions. The article analyzes the provision of the population with medical personnel in the Republic of Sakha (Yakutia) for the period 2017-2019. In dynamics, there is an increase in the indicator of providing the population with doctors and nurses in general; provision with therapeutists and pediatricians in the primary healthcare sector is growing. The article describes the qualification characteristics of medical personnel in the Republic of Sakha (Yakutia).

Conclusions. The indicators of the provision of the population of the Republic of Sakha (Yakutia) with medical personnel according to official reports of the Ministry of Health of the RS (Y) are higher than the average in Russia. This is due to the territorial, logistical characteristics, features of the network and healthcare system of the region.

Perm Medical Journal. 2021;38(6):103-108
pages 103-108 views
Air ozonization for prevention of bacterial and viral infections
Prylutskyi A.S., Kapranov S.V., Tkachenko K.E., Yalovega L.I.
Abstract

Objective. To assess the effectiveness of the low-dose air ozonation for disinfection of the air in the working room.

Materials and methods. We investigated 90 air samples (3 samples were taken weekly before and after the production meeting using the automatic sampling device of biological aerosols of air PU-1B). The total bacterial contamination, the content of staphylococci and mold spores were determined. Ozonation of the room (83.3 m3) was carried out for 20 minutes by means of domestic ozonator. The accumulated dose of ozone was 133.3 mg (1.6 mg/m3). Statistical data processing was carried out using the MedStat licensed program. The median, median error (Me ± me), left and right 95 % confidence intervals (95 % CI) were calculated. Paired comparisons were made using Wilcoxon's T-test.

Results. After the meeting, the total bacterial contamination of the air was 56.0 ± 9.3 (47.0–78.0) CFU. The content of staphylococci and mold spores in the air was 85.5 ± 12.5 (76.0–100.0) and 44.5 ± 6.5 (32.0–54.0) CFU, respectively. After ozonation, the total bacterial contamination of the air was 14.5 ± 3.6 (10.0–21.0) CFU. The content of staphylococci and mold spores in the air after ozonation was 35.5 ± 6.7 (25.0–52.0) and 26.0 ± 5.0 (18.0–32.0) CFU, respectively. Ozonation of the room provided a significant decrease (p < 0.001) in all three of the above indicators. The room ozonation carried out promoted a reliable decrease (p < 0.001) in all the above mentioned parameters.

Conclusions. The above data and analysis of the literature show the possibility of using low doses of ozone for the prevention of bacterial, fungal and viral infections including SARS-CoV-2. Further study and development of reasonable modes of ozone disinfection, including low doses of ozone, is needed, as well as determination of the efficiency degree of air disinfection with non-toxic gas concentrations.

Perm Medical Journal. 2021;38(6):109-119
pages 109-119 views
Features of depopulation in perm krai: state and trends
Titova E.Y., Bankovskaya L.A.
Abstract

Objective. To study the features of depopulation in Perm Krai.

Materials and methods. The data of Perm Krai official statistics for 2005–2019 were used; dynamics of vital rate compared to mean indicators in the Russian Federation were studied.

Results. Since 2005 to 2019, the population in Perm Krai decreased by 5.7 %, whereas in the Russian Federation for the same period it grew by 2.1 % at the expense of migration processes; birth rate in Perm Krai reduced by 6.4 %; mortality rate in Perm Krai is 13.23 %. There is a growth trend of the natural population loss in both Perm Krai and the Russian Federation.

Conclusions. In Perm Krai, there is observed an unfavorable demographic situation, which is characterized by a continuing decrease in the population and natural population loss. To improve the demographic situation in Perm Krai, it is expedient to develop a complex of measures directed to reduction of mortality, stimulation of birth rate, support of families with children as well as restoration of traditional family values and moral principles.

Perm Medical Journal. 2021;38(6):120-126
pages 120-126 views

Clinical case

Two-staged tactics of treatment of postoperative sternomediastinitis using technique of negative pressure followed by two-flap omentoplasty according to K. Yoshida
Kasatov A.V., Arutyunyan V.B., Minasian V.N., Vronsky A.S.
Abstract

This article presents an observation of a clinical case in a patient with the postoperative sternomediastinitis. In cardio-thoracic surgery this complication ranges from 1 to 10 % [2, 3, 14, 16, 19] depending on who the work is done by and the ratio of deaths can reach up to 40 % [13]. Due to untimely diagnosis of the pyoinflammatory process in the tracheostomy orifice, the patient developed progressive instability of the sternum followed by sternomediastinitis.

A two-staged tactics of treatment of the postoperative sternomediastinitis using the technique of negative pressure followed by two-flap omentoplasty according to K. Yoshida in this case is the technique of choice for surgical treatment, which allows to restore the integrity of the chest wall frame in the shortest possible time and ensure tightness for the mediastinum. This technique is the most effective in the treatment of destructive forms of purulent complications of the sternum after a median sternotomy. The relevance and expediency of the use of omentoplasty is also justified from a financial and medico-social position, since the procedure reduces mortality among patients of this category, as well as the risk of severe disability at the able-bodied age.

Perm Medical Journal. 2021;38(6):127-136
pages 127-136 views

Anniversaries and information on events

In memory of outstanding physician, doctor of medical sciences, professor Trusov Victor Vasilyevich
Kazakova I.A., Styazhkina S.N., Zarivchatsky M.F., Chernysheva T.E., Galyautdinova A.I.
Abstract

The article is devoted to the 85-th anniversary of the birth of Professor Viktor Vasilyevich Trusov (1936-2012), one of the prominent representatives of the therapeutic scientific school of Izhevsk State Medical Academy. In the range of diverse scientific interests and developments of Viktor Vasilyevich, the issues of practical assistance to patients with endocrinological pathology, including patients with diabetes mellitus, occupied a significant part. Professor Trusov V. V. was a member of the Board of Endocrinologists of Russia, a member of the European Association of Diabetologists, a member of the American Association of Diabetologists. He worked on the problems of optimizing care for patients with diabetes.

Perm Medical Journal. 2021;38(6):137-139
pages 137-139 views

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