Vol 26, No 3 (2023)

Endoscopic ultrasonography in the differential diagnosis of obstructive pathology of the major duodenal papilla using fuzzy diagnostic models

Vladimir A. Belozerov, Oleg I. Okhotnikov, Gennadiy A. Bondarev, Nikolay A. Korenevskiy, Nikolay N. Grigoriev

PDF (Rus)

4-12 357

Abstract

Objective: to improve the quality of endoscopic ultrasonography (EUS) in the diagnosis of obstructive pathology of the major duodenal papilla (MDP) using fuzzy diagnostic models. Materials and methods. The study included 189 patients treated at the Kursk Regional Multidisciplinary Clinical Hospital in 2013-2023. 134 people (70.9%) were diagnosed with MDP stenosis, 24 (12.7%) had single benign papillary neoplasms, 31 (16.4%) patients had malignant MDP tumors. Based on the analysis of treatment results, the possibility of differential diagnosis of duodenal papilla pathology according to endoscopic ultrasonography using fuzzy diagnostic models was studied. Differentiation was carried out using the methodology of synthesis of hybrid fuzzy decision rules, in which the lack of statistical data is filled with the clinical knowledge of experts, which determines the possibility of constructing a function of belonging to a differentiable pathology. Results. Within the framework of the methodology, informative echographic criteria for the diagnosis of various pathology of MDP have been developed based on endosonography data, systematized and presented in the form of reference endosonograms and reference schemes that fully reflect the characteristics of the diagnostic object. According to the expert assessment, the coefficients of confidence in the decisions made, which are the basis of the diagnostic algorithm, are determined. The results of mathematical modeling showed confidence in the correct diagnosis of pathological changes using synthesized fuzzy algorithms over 0.85, which is an acceptable result for clinical use. Conclusion. The use of the developed fuzzy model in combination with visual examination of the papillary zone (which provides the EUS method), brings the diagnostic accuracy of differential diagnosis to the maximum values.

Borreliosis as the cause of an acute symptomatic epileptic seizure in an inpatient patient: a clinical case

Nikolay V. Zhulin, Marina V. Kuandykova, Olesya I. Astakhova

PDF (Rus)

13-18 358

Abstract

Lyme disease (borreliosis) is a multisystem inflammatory infectious disease caused by the spirochete Borrelia burgdorferi, transmitted to humans transmissively through the bite of a tick of the ixodic group. Lyme disease is the most common tick-borne infectious disease in Europe. Depending on the time interval from the moment of the tick bite and before the development of clinical symptoms, both early and delayed symptoms are characteristic of borreliosis. Neurological manifestations (neuroborreliosis) occur in 3-15% of cases of infection with borreliosis [1] and, depending on the level of damage to the nervous system, they can manifest themselves in the form of polyradiculitis, meningitis and encephalitis. Neuroborreliosis is also characterized by both early (acute) and delayed clinical manifestations. Often, even after cured borreliosis, residual symptoms in the neurological status may persist. This clinical analysis will describe a clinical case of encephalitis in a patient with borreliosis and being treated in a coronavirus hospital.

Potential possibilities of bioengineering technologies and cellular implantation in hernioendoprosthetics (review article)

Viktor A. Lazarenko, Ilya S. Ivanov, Alexander A. Ushanov, Ekaterina S. Mishina, Evgenij G. Obedkov, Alexander G. Alexeev, Vitaly S. Kostin

PDF (Rus)

19-28 301

Abstract

The aim of this review is to determine the most effective way to improve hernioplasty in accordance with the literature data. Materials and methods. The scientific literature was analyzed using PubMed, Scopus, RINC, and Mendeley abstracting software. The review presents data reflecting the trends in the field under consideration over the last decade, according to the authors' opinion. Results. The use of cellular technologies can confirm the position of absorbable hernioprostheses by improving the quality of connective tissue of the postoperative scar and reducing the likelihood of postoperative complications. In the practice of wound treatment, collagen preparations and native fibroblasts are used, the use of which has positive data indicating a high potential of this type of therapy. The application of cell technologies could confirm the position of resorbable hernioprostheses by improving the quality of connective tissue of the postoperative scar and reducing the possibility of postoperative complications. Conclusion. Cellular implantation during hernioendoprosthetics is one of the most promising ways to solve the problem of preventive treatment of postoperative hernias of the anterior abdominal wall. The use of fibroblasts to enhance proliferative activity in the surgical wound will improve the quality characteristics of connective tissue and provide a more favorable long-term effect of the intervention, as well as prevent recurrence of hernias.

Dynamics of cognitive and psycho-emotional disorders in the early recovery period of ischemic stroke during rehabilitation measures using stabilometric training

Tatiana N. Suvorova, Natalia P. Gribova

PDF (Rus)

29-35 278

Abstract

Objective: to analyze post-stroke cognitive and psycho-emotional disorders in patients in the early recovery period of ischemic stroke, to assess the dynamics of these disorders during rehabilitation measures using stabilometric training. Materials and methods. The study involved 58 patients aged 35-75 years; the average age was 60.6 years. The study was conducted on the basis of Bryansk City Hospital No. 1 in the Department of Medical Rehabilitation. Stabilometric training was carried out on a computerized stabiloanalyzer with biofeedback "Stabilan-01-2" (Taganrog). The course included 7-10 sessions of stabilotherapy. The Montreal Cognitive Scale and the Hospital Anxiety and Depression Scale were used to assess cognitive and psychoemotional status before and after rehabilitation activities. Statistical analysis of the obtained data was carried out on a personal computer using MS EXCEL and IBM Statistica 12.0 application packages. The significance of differences between the studied groups was assessed using the nonparametric Mann-Whitney test. The dynamics in each group before and after treatment was assessed using the Wilcoxon test. Results. According to the results of the study, a significant improvement in the memory indicators of patients was revealed along with a decrease in the level of anxiety and depression. Conclusion. The positive effect of the use of a stabilometric training on the intellectual-mnestic and psycho-emotional functions of patients in the early recovery period of ischemic stroke revealed during the study allows us to recommend this method not only for motor rehabilitation, also to use it as a cognitive and psycho-corrective training.

Скорость окисления крови как предиктор развития фибрилляции предсердий в послеоперационном периоде при проведении шунтирования коронарных артерий

Марина Шерешнева, Михаил Ильин, Иван Староверов

PDF (Rus)

36-43 276

Effects of exercise on pelvic floor and perineal muscles. Main hypotheses and statements

Sergey N. Chemidronov, Galina N. Suvorova, Alexandr V. Kolsanov

PDF (Rus)

44-57 452

Abstract

Pelvic floor dysfunction is one of the key issues in modern medicine. Symptoms associated with insufficiency of the pelvic floor support apparatus, such as pelvic organ prolapse, urinary and fecal incontinence are increasingly observed in young women, and after giving birth to a third child, their frequency reaches 80%. Women who are professionally engaged in sports are of particular interest to modern medicine. Many of them, highly motivated to achieve results, do not give importance and do not focus on the problem of pelvic floor dysfunction. The question of strengthening the muscles of this area remains open. Currently, there are two main hypotheses related to the effect of physical exertion of the pelvic floor muscle. Objective: to review the literature to search for and discuss data in support of a hypothesis from the standpoint of the functional morphology of the pelvic floor and perineal muscles, the development of diseases in this area and the course of labor. Materials and methods. In our work, based on data from more than a hundred literature sources of the PubMed search engine, we are analyzing works on the topic of the pelvic floor support apparatus insufficiency in women engaged in intensive training (professional athletes, fitness instructors, military personnel, etc.) Results. According to research, we found out that the development of insufficiency of the pelvic floor support apparatus is formed in girls in adolescence with excessive physical exertion most often. Special exercises aimed at strengthening the muscles of this area contribute to the reduction of the first and second periods of labor, minimizing the likelihood of operative delivery. Conclusion. The lack of uniformity of methods for evaluating and interpreting data requires further elaboration of parameter registration and high-quality research.

State of nervous system functions of Wistar rats when using peptide taftsin-PGP (selank) in restraint stress

Igor I. Bobyntsev, Marina S. Krivoshlykova, Olga A. Medvedeva, Anton O. Vorvul, Liudmila A. Andreeva, Nikolai F. Myasoedov

PDF (Rus)

58-68 408

Abstract

The aim of the study was to investigate the state of functions of the nervous system of Wistar rats upon application of the peptide taftsin-PGP under conditions of chronic stress. Materials and methods. The experiments were performed on 45 male Wistar rats weighing 200-230 g. Selank peptide (Thr-Lys-Pro-Arg-Pro-Gly-Pro) was injected intraperitoneally at doses of 80, 250 and 750 μg/kg 15 min before stressor exposure. Animals were divided into 5 groups (n = 9): 1 - control (non-stressed animals injected with saline); 2 - stress (stressed animals injected with saline); 3-5 - stress+taftsin-PGP at doses of 80, 250 and 750 µg/kg. Animals were stressed for 28 days; from days 15 to 28, they were injected with selank/saline. The neurotropic effects of selank were evaluated in the elevated plus-maze, open field (OF) and forced swimming tests. To assess the severity of stress response, the concentration of corticosterone in rat serum was evaluated using enzyme immunoassay. Results. It was found that 28-day immobilisation stress caused disturbances of nervous system functions in the form of increased anxiety, horizontal, vertical, locomotor activity, emotionality and expression of depressive behaviour, as well as increased concentration of corticosterone in blood serum of experimental animals. Taftsin-PGP administration against the background of preliminary stressing (from the 15^th to the 28^th day of the experiment) contributed to a decrease in the severity of stress-induced behavioural changes in rats: at a dose of 750 µg/kg the peptide had anxiolytic effect, 250 µg/kg - antidepressant effect. At the same time, these changes occurred against the background of a significant decrease in serum corticosterone level. Conclusion. Thus, selank corrects stress-induced changes in the state of nervous system functions under 28-day restraint stress.

Applied anatomy of mandibular canal

Aleksandra G. Grigoryants, Asie E. Khatypova, Tatiana P. Makalish, Sergey A. Kutya

PDF (Rus)

69-75 597

Abstract

The mandibular canal (canalis mandibulae) runs in the thickness of the mandible from the mandibular foramen (foramen mandibulae) to the mental foramen (foramen mentale). The knowledge of its topography and relations with the dental root apices is of great practical importance for the prevention of iatrogenic injuries of the inferior alveolar neurovascular bundle during endodontic and orthodontic treatment and during a number of surgical procedures, such as extraction, resection of the apices of the roots of the teeth, cystectomy, removal of intraosseous neoplasms, as well as during conduction anesthesia. The purpose of this work is to summarize information about the variants of the structure and topography of the mandibular canal. The article considers variants of the structure, course, and topography of the mandibular canal, including in cases of adentia, revealed on the basis of various methods of research. In addition to the use of natural preparations (cuts of the lower jaws), modern radiation research methods, such as radiography, computed tomography and cone-beam computed tomography, are widely used to study the topography of the mandibular canal. The mandibular canal is characterized by significant variability in its course and complex relationships with surrounding structures. The most common variation in the structure of the canal is its bifurcation, which is associated with the peculiarities of embryonic development and is of great clinical importance. Up to date, there are several classifications of variants of its structure that can be used in clinical practice. Further accumulation and systematization of data on its anatomical and topographic features are important for the diagnosis and implementation of therapeutic manipulations in this area.

Use of polarization-interference microscopy to determine the optical properties of fetal erythrocytes in tissues

Ivan V. Geraskin, Vladimir A. Geraskin, Vladimir A. Trofimov, Tatyana I. Vlasova, Natalia V. Geraskin

PDF (Rus)

76-82 322

Abstract

Objective: to evaluate the possibility of using polarization interference microscopy for morphological diagnostics of fetal erythrocytes in tissues. Materials and methods. Blood smears used during the diagnostic and treatment process and histological sections prepared from autopsy material were used. During the diagnosis, a polarization-interference microscope PZO BIOLAR PI with a microphotometric nozzle UPI was used to determine the optical density and the measure of light transmission in erythrocytes. The method of polarization-interference microscopy contributed to the study of optical properties in individual erythrocytes. The optical properties of erythrocytes containing fetal-type hemoglobin and erythrocytes with adult-type hemoglobin were compared. The difference in the composition of the structure of erythrocytes determined the difference in light transmission and refraction. Based on the results of light transmission, the optical density of fetal and adult erythrocytes was calculated. In the conducted study of clinical blood smears, in neonatal patients, 60 measurements of the light transmission coefficient and 60 similar studies were performed in patients of the comparison group - persons older than 18 years. In the study of autopsy material, 120 measurements of the erythrocyte light transmission coefficient were carried out in placental tissue samples (chorionic villi and interstitial space). Results. The optical properties of erythrocytes were determined both in blood smears and in placental tissue preparations. Erythrocytes in blood smears with HbF had an increased light transmission coefficient in relation to the optical properties of erythrocytes with HbA in the control group. During the study of placental tissues, it was revealed that the indicators of the optical density of maternal erythrocytes with HbA in the erythrocytes of the interstitial space differed in higher values of indicators compared with the optical density of fetal erythrocytes with HbF in the vessels of chorionic villi. Conclusion. The determination of differences in the physico-optical properties of erythrocytes with fetal and adult hemoglobins makes it possible to determine the affiliation of erythrocytes both in blood smears and in the interstitial space of the placenta.

Stress tests of anthracene derivatives of plant origin

Anna A. Romanyuk, Dmitry V. Moiseev

PDF (Rus)

83-88 300

Abstract

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Humans and their health

CLINICAL MEDICINE

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Humans and their health

CLINICAL MEDICINE

MEDICOBIOLOGICAL SCIENCES

PHARMACEUTICAL SCIENCES

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