Vol 38, No 5 (2021)

Objective. To assess the levels of viral load, immune status as well as labor outcome depending on the absence or presence of pregravid preparation with the partner and without the latter.

Materials and methods. This cohort study included 90 women of reproductive age with stages 3 and 4A HIV infection. To compare the groups, Kruskal – Wallis, Mann – Whitney tests and correlation analysis were applied.

Results. The pregravid preparation of HIV-infected women without a partner was detected to three-fold decrease a viral load in the I trimester of pregnancy (p = 0.001), two-fold – in the II trimester (p = 0.02) and three-fold – in the III trimester (p = 0.002); with a partner – a two-fold decrease in the I trimester (p = 0.0018). The pregravid preparation of HIV-infected women reduces the probability of giving birth to a child with low body mass (p = 0.023); with a partner – it decreases the risk for the preterm labor (p = 0.02).

Conclusions. Thus, the presence of pregravid preparation in HIV-infected women, with a partner as well, decreases the probability of giving birth to a child with low body mass and preterm labor.

Objective. To assess the epidemiological manifestations of the incidence of respiratory system diseases (RSD) among the military personnel of the military units of the Central Military Region.

Materials and methods. The morbidity analysis was carried out according to official statistics for 2003–2019 with an assessment of long-term dynamics, structure and spatial characteristics.

Results. Despite the preventive measures taken, the incidence of respiratory diseases in the troops remains high and continues to grow. The conscript servicemen are at risk. In the structure of RSD incidence, acute respiratory viral infections (ARVI) take the leading place, tonsillitis and bronchitis are in the second place, and community-acquired pneumonia (CAP) is in the third place. Differences in the trends of long-term dynamics of morbidity in various clinical forms of RSD were revealed. The Siberian Federal Region is the most favorable regarding RSD incidence.

Conclusions. The incidence of respiratory diseases among conscripts is higher than that in contract servicemen, with downward trend for CAP and growth for ARVI and bronchitis.

Objective. To assess the use, safety and effectiveness of puncture-dilatational tracheostomy (PDT) performed immediately after the tracheal intubation in patients with cerebrovascular accident (CVA) and new coronavirus infection (NCI).

Materials and methods. Patients with CVA and NCI treated at ICU underwent PDT using the Ultraperc kit according to the Ciaglia technique immediately after the tracheal intubation.

Results. The results of treatment of 12 patients with CVA and 21 patients with NCI were investigated, the safety of manipulation, treatment results, and mortality in groups were evaluated.

Conclusions. The puncture-dilatational tracheostomy, performed as early as possible, allows improving disease outcomes in CVA, facilitating patients’ care, and ensuring greater safety of patients and staff.

Objective. To study the features of the course of pregnancy and childbirth in women after ART programs. Medical care for families with infertility, in particular through assisted reproductive technologies (ART) programs, is an important area of comprehensive government policy to promote fertility.

Materials and methods. The retrospective study was carried out on the basis of GBUZ TO “Perinatal Center”, Tyumen. We analyzed 237 birth histories of women whose pregnancies occurred with the use of ART and 237 birth histories of patients whose pregnancies occurred on their own. The material for the study was the birth histories of patients.

Results. The results showed a higher incidence of pregnancy complications in women after ART programs. Thus, a higher number of premature births, placental disorders, isthmic-cervical insufficiency (ICI) were noted, as well as a significantly higher percentage of operative delivery by cesarean section.

Conclusions. The presence of an initially large "baggage" of concomitant and gynecological diseases in infertile patients, whose pregnancies occurred with the use of ART programs, leads to a higher percentage of pregnancy complications and a high number of surgical deliveries.

Turner syndrome (TS) in most cases leads to infertility. However, the literature describes cases of physiological pregnancy in the mosaic form of TS. Thanks to accessory reproductive technologies, the number of women who have become mothers is increasing. But effective treatment of infertility is impossible without hormone replacement therapy. A woman with TS during pregnancy and childbirth should be under supervision because of the increased risk for obstetric and somatic pathology.

This literature review is devoted to one of the topical multidisciplinary problems of modern clinical practice – the development of acute kidney injury after cardiac surgery. The prevalence of this pathology varies on average from 5 to 43 %, while the frequency of early hospital mortality increases significantly in the population of such patients compared with patients without cardiac surgery-associated renal damage. It is assumed that the work of the artificial circulatory system contributes to the development of such complications, but as shown by many studies, the etiology of such kidney damage is multifactorial and cannot be explained by only one pathogenetic mechanism. The article highlights the current understanding of the etiology, pathogenesis and risk factors of acute kidney injury after cardiovascular interventions, describes new markers of early detection of renal dysfunction, and describes some prognostic aspects of the disease. Early identification and stratification of risk groups will allow for a timely preventive strategy, which will significantly improve early and long-term postoperative outcomes in such patients.

Objective. To determine the blood serum β₂-microglobulin and α₂-macroglobulin concentration in patients undergoing renal replacement therapy (programmed hemodialysis) for the diagnosis of uremic pancreatitis and / or destructive pancreatitis.

Materials and methods. The study involved 52 patients admitted to the Surgical Unit of Astrakhan "RZhD-Medicine" Hospital and City Clinical Hospital № 3. The blood serum β₂-microglobulin and α₂-macroglobulin concentration was analyzed in patients admitted on an emergency basis with suspicion of uremic pancreatitis and destructive pancreatitis, who receive renal replacement therapy (programmed hemodialysis). The control group included 50 outpatients undergoing renal replacement therapy (programmed hemodialysis). The study did not include patients with suspected pancreatitis who were not receiving renal replacement therapy. The period of the study is 2019–2021.

Results. The concentration of blood serum β₂-microglobulin is statistically higher than normal in all patients, who had received renal replacement therapy (programmed hemodialysis) in anamnesis. The most statistically high concentration of β₂-microglobulin was revealed while studying patients with uremic pancreatitis (n = 34), and was (30.0 ± 2.75 mg/l) compared with the blood serum concentration in patients with destructive pancreatitis (8 ± 0.51 mg / l). The concentration of α₂-macroglobulin was statistically lower in destructive pancreatitis (n = 18) and was 615 ± 161 mg/l compared with uremic pancreatitis (980 ± 216 mg/l). In the control group of outpatients (n = 50) receiving renal replacement therapy (programmed hemodialysis), no statistically significant blood serum concentrations of β₂-microglobulin and α₂-macroglobulin were found.

Conclusions. A clear dependence of the concentration of β₂-microglobulin and α₂-macroglobulin on the severity of uremic pancreatitis and destructive pancreatitis was established. Statistically high values of β₂-microglobulin concentrations were obtained in patients with uremic pancreatitis, and the α₂-macroglobulin level was statistically low in destructive pancreatitis.

Objective. To study and analyze the contamination of environmental objects in the Astrakhan Region (by the example of soil, water, and washout samples from solid household surfaces) based on the results of laboratory studies of the Center for Hygiene and Epidemiology in the Astrakhan Region for 2011–2020.

Materials and methods. The work was carried out on the basis of the Laboratory of Bacteriological and Parasitological Research of the Center for Hygiene and Epidemiology in the Astrakhan Region and in the laboratories of the Branches of the Center for Hygiene and Epidemiology in the Astrakhan Region in 2011–2020.

As a whole, during the analyzed period, the laboratory and its branches conducted laboratory studies of 79 742 samples taken from various environmental objects, and 94 495 studies were performed. The number of samples that do not meet the hygiene standards was 1.01 % (806 samples).

Results. The objects of sampling for the study of their parasitic purity were water, soil and wash-out from solid household surfaces.

The share of water samples in the structure of all the studied samples taken from environmental objects was 7.3 % (5858 samples), of which 172 samples were contaminated with pathogens of parasitic diseases, the extent of invasion was 2.9 %.

The structure of positive findings in the water samples was represented by 6 nosological forms of helminths – 88.0 % (154 samples) and 3 nosoforms of protozoa – 12.0 %.

The share of the studied soil samples in the overall structure of sanitary and parasitological studies of the environment was 11.2 % (8895 samples). The number of unsatisfactory samples in the structure of all positive findings revealed during the study of soil, water and washouts during the analyzed period was 70.4 % (625 samples). The total soil contamination for the period of 2011–2020 was 7.0 % (625 samples).

In most cases, helminth eggs and larvae were detected – 99.8 % (624 samples). The proportion of pathogenic protozoan cysts detected in the soil was 0.2 % (1 sample).

In addition to water and soil samples, the washout samples, taken from solid household surfaces were studied – 81.5 % (64989 samples), of which 0.01 % (9 samples) were unsatisfactory.

All positive findings in the washout samples were represented by two nosological forms of helminthiasis: Enterobius vermicularis eggs – 0.012 % (8 samples) and teniid oncospheres – 0.002 (1 sample).

Conclusions. The presence of helminth eggs and cysts of pathogenic intestinal protozoa in the studied soil and water samples indicates contamination of these objects with the feces of infected persons and/or contamination by sewage runoff resulting from various accidents. The presence of toxocara eggs and strongylid larvae in the soil and water indicates contamination of these objects with the feces of infected animals (dogs, cats). The presence of positive findings in wastewater samples indicates poor-quality disinfection of these objects. The presence of contact helminth eggs in the studied samples of washout samples taken from hard surfaces indicates direct contact of infected persons with these samples.

The article describes the clinical observation of a patient operated on for obstructive jaundice with the localization of a stone in the lobar and common hepatic ducts. In anamnesis, there was cholecystectomy for acute cholecystitis 10 years ago.

The term "hemorrhoids" refers to a pathological increase in hemorrhoids, which is manifested by periodic "exacerbation", bleeding from the nodes and their prolapse from the anal canal. This pathology is one of the most common in adult coloproctological practice all over the world. The article presents a brief analysis of hospital case histories of patients with hemorrhoidal disease and complications after hemorrhoidectomy, who were treated in the Coloproctology Unit of the First Republican Clinical Hospital of the Udmurt Republic as well as the analysis of a clinical case.

The article is devoted to the outstanding surgeon, MD, PhD, Professor, Head of the Department of Normal, Topographic and Clinical Anatomy, an excellent lecturer, scientists and teacher Vladimir Nikolaevich Perepelitsyn. He is always in our hearts.