Репозиторий Университета

© The authors team, 2018.All Rights Reserved. Due to its cardinal differences from the adult oncology the children's oncology takes a special place in the national cancer control program. The article analyzes up-to-date problems and suggests their solutions. It contains statistical indicators and a three-level model of medical care for children with cancer. The tasks of the national program stated in the article reflect the author's point of view and are to be further discussed.

© Springer Nature Switzerland AG 2018. Video games are often seen as a reason for numerous psychological changes, both positive and negative, in players. For instance, many authors believe that video games push children and adults towards risky behaviors and impulsivity. The study aimed to analyze both theoretical and empirical evidences of that sort, as well as to investigate parameters of personal and cognitive impulsivity and risk-readiness in adult video gamers. The sample of gamers included 223 participants, all from Russia. Impulsivity and related personal traits were measured with Eysencks’ Impulsiveness Scale (I-7) and Kornilova’s Personal Risk Factors Questionnaire. Impulsivity as cognitive style was measured by Kagan’s MFFT. No evidence of high impulsivity was found, though video game players, who played more than 12 h per week turned out to be more venturesome, compared to less active gamers. Sex-related differences were investigated: female gamers scored lower in empathy, while male gamers showed higher venturesomeness. In a cognitive style study, video gamers were more accurate compared to non-gamers, and thus showed no tendency for impulsivity. The results are contrasted to the published data, when applicable.

© Bionika Media Ltd. The authors have carried out a systems analysis of the data available in the current literature on the effect of micronutrients, such as iodine, polyunsaturated fatty acids, folic acid, and vitamin D, on a woman’s reproductive health. Due to its geographical location, climatic features, and eating habits, our country has the proven deficiency of a number of micronutrients that play an important role in the periconceptional period. These micronutrients include iodine, polyunsaturated fatty acids, folic acid, and vitamin D. The content of micronutrients should not exceed the physiological daily requirement in the basic complexes intended for the prevention of deficiency, The excessive content of components can cause undesirable reactions and contribute to the allergization of newborns. In clinically pronounced deficiency, the basal complex can be combined with a monocomponent vitamin preparation for the targeted correction of vitamin and mineral status.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To improve methods of surgical management of post-caesarean uterine scar defect and to justify the choice of an operative procedure depending on the clinical situation and condition of the deficient scar. Patients and methods. We examined 44 patients aged 24 to 42 years, diagnosed with «Defect of the uterine scar after caesarean section». A comparative analysis of two methods of metroplasty – abdominal and vaginal – was performed. For diagnosing the state of the scar we used: transvaginal ultrasound imaging in the 2D, 3D and high-sensitivity power Doppler modes, magnetic resonance imaging, hysteroscopy. Results. The advantage of the vaginal method was recorded by several characteristics (duration of surgery, volume of intraoperative blood loss, restoration of physical activity within the first 24 hours). But its application required a number of important conditions, among which a history of not more than two caesarean sections. Pregnancy occurred in 24 (54.5%) patients 9–26 months after surgery and ended with caesarean deliveries at term. Conclusion. Management of isthnocele per vaginalis is the least traumatic method among all known techniques. But at the slightest risk of complications associated with damage of the urinary tract, laparotomy should be used. Each patient with post-caesarean uterine scar defect needs an individual approach.

© 2018, Dynasty Publishing House. All rights reserved. The objective. Based on revealed changes in the parameters of the blood coagulation system and the functional state of the endothelium to propose pathogenetically justified therapeutic and diagnostic approaches ensuring a higher effectiveness of therapy of inflammatory bowel disease and prevention of complications. Patients and methods. We examined 78 children aged 3 to 15 years with newly diagnosed IBD, standard gastroenterological examination was performed to determine specificities of the coagulation system of IBD patients with administration of tests characterizing the state of all its components (number, size and aggregation of platelets, von Willebrand factor, international normalised ratio, activated partial thromboplastin time, thrombin time, fibrinogen, D-dimer, nitric oxide). Results. In the course of the study we found disorders in all components of the coagulation system. During exacerbation in children with ulcerative colitis and Crohn’s disease total concentrations of nitrates and nitrites in blood increase, in UC a reduced capability of the initial stage of thrombus formation with regard to the parameter «degree of platelet aggregation» can be found, which might account for frequent bleedings in this pathology. In CD, a significant decrease of platelet aggregation size was found, which is indicative of impaired functional properties of platelets. Investigating the coagulation component we found disorders of the final state of hemostasis – a prolonged time of fibrin clot formation resulting from prolonged TT, and also higher levels of D-Dimer, which is indicative of increased fibrinosysis processes. After alleviation of disease exacerbation the coagulation parameters only partially normalised: deviations in the platelet component remained. Conclusion. The processes of intestinal wall inflammation and disorders of the blood coagulation system in IBD exacerbation and in the course of its alleviation run parallel to each other. A developed clinical picture of IBD is accompanied by disorders of the initial (thrombus formation) and final (increased fibrinosysis) stages of blood clotting. A decreased degree and quality of platelet aggregation, increased fibrinosysis are evidently an important pathogenetic component of gastrointestinal bleeding.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To study the quality of life of feeding mothers and toe establish whether the adherence to breastfeeding influences physical and mental health of women. Patients and methods. We conducted a questionnaire survey of 151 mothers who had small infants. Their quality of life was studied with the help of the SF-36 questionnaire. Results. As we have found, the higher is the material wellbeing of the family, the less women adhere to breastfeeding (per capita income of the family of breastfeeding mothers are almost 2 times lower than in nonbreastfeeding women – 22500 ± 3.800 and 43958.33 ± 4.240 rubles, respectively, р < 0.05). Subjective perceptions of physical health (functioning), parameters of life activity (Vitality – VT) and subjective assessment of their health (General Health – GH) were similar in both breastfeeding and nonbreastfeeding mothers (VT 56.48 ± 3.77 and 58.33 ± 2.91; GH 68.52 ± 4.13 and 65.83 ± 1.95, р > 0.05). Irrespective of breastfeeding adherence, women after childbirth did not report of worsening of their health (50.93 ± 4.01 and 44.79 ± 2.61, respectively, р > 0.05). But in breastfeeding mothers parameters of the quality of life were demonstrative of a higher endurance (physical functioning 73.89 ± 1.66 and 85.22 ± 3.19, role functioning 52.78 ± 2.16 and 65.63 ± 3.73, р < 0.05). Breastfeeding mothers more rarely had difficulties in routine activities due to their physical condition and pain (bodily pain 73.89 ± 3.77 and131.35 ± 2.16, р < 0.05), physical and emotional condition did not interfere with communication and social activity (social functioning 67.13 ± 1.93 and 139.8 ± 6.92, р < 0.05, mental health 95.11 ± 7.18 and 58.17 ± 8.11, р < 0.05). They are less prone to depression and have higher values of the positive emotions parameter (role emotional functioning 64.08 ± 3.98 and 215.73 ± 12.67, р < 0.01). Conclusion. The results of the study can be used in programmes aimed at expanding breastfeeding.

© 2018, Dynasty Publishing House. All rights reserved. Literature data about biomechanical foundations of the development of foot pathologies in children and adolescents are analysed. The development and formation of anatomical structure of the foot as a flexible movable arch, and biomechanical specificities in human standing and walking are also considered. As has been noted, correct development and formation of the anatomical skeleton of the foot, its ligamentous-muscular apparatus and sole skin ensure its reliable functioning. As has been pointed out, understanding of the biomechanics of walking is extremely important for an orthopaedist when choosing a method of foot pathology correction, in particular, in rehabilitation of paediatric patients. The main functions of the foot have been specified – spring, balance, and propulsion. Most methods of diagnosing foot injury and disease, as a rule, are aimed at evaluating the spring function of the foot based on analysis of its anatomical structures. The conclusion has been made that the problem of correction and management of foot dysfunctions and pathologies should be solved as early as in childhood, which is possible only on the basis of complex consecutive implementation of a number of measures that include: diagnostics, choice of a way of correction, design and manufacturing of an individual orthosis (conservative method) or surgical treatment. Large-scale clinical testing of modern methods of podology and biomechanics in diagnosing and treatment of foot pathologies and correction of disorders of its stance function will contribute to progress in solving such a significant medico-social problem as foot disorders in childhood and adolescence.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To study the effectiveness of two-step treatment of female patients with cervical intraepithelial neoplasia (CIN) associated with papillomavirus infection (PVI). Patients and methods. 126 female patients of reproductive age were examined (mean age – 31.4 ± 2.1 years), in whom CIN was associated with papillomavirus infection (PVI). In all cases, cervical pathologies – low-grade squamous intraepithelial lesions (L-SIL) have been found. In all patients treatment included a surgical step (laser and plasma energy) and medication, which was employed in 101 (80.1%) patients (treatment group). 25 (19.9%) women comprised the control group, since they did not receive post-operative pathogenetic therapy. In the treatment group, patients received an immunostimulating and antiviral drug inosine pranobex (IP) – Isoprinosine. Results. The effectiveness of treatment was assessed after 60 and 120 days from the termination of complex therapy (treatment group), or surgical intervention (control group). After a 60-day period, complete elimination of virus was noted 97 (96%) patients of the treatment group and in 18 (72%) of the control group. After 120 days, PVI relapse was recorded in 3 women of the treatment group (3%) and in 4 (22%) – of the control group among patients with complete elimination of virus. Conclusion. The use of IP as monotherapy is an optimal solution ensuring minimal risks of relapses of pathological PVI. Preparations of pure IFN and their inductors do not always promote complete elimination of PVI owing to interferon resistance of HPV-infected patients.

© Saint Petersburg Pasteur Institute. All rights reserved. The aim of the present systematic literature review is to summarize data on the role of TLRs in maintaining homeostasis of the female genitals, in maintaining the physiological development of pregnancy, provision of anti-infective resistance in pregnant women with intrauterine infection. The review substantiates the importance of TLRs of female genitals as a necessary and determining factor in the reaction to various changes in the environment, and also responsible for changes in metabolic, structural, or energy, in the maintenance of anti-infective resistance and homeostasis. As universal regulators of vital activity of organism TLRs in conjunction with other receptors of innate immunity provide maintaining the general reactivity and anti-infective resistance at the physiological level. In physiologically developing pregnancy in a background of immunosuppression in response to pregnancy TLRs during contact with infectious and non-infectious pathogens stimulate the production of nonspecific adaptive immunity factors (defensins, cathelicidins, histatines, etc.), which together with the non-specific innate factors lysozyme, complement, properdin, etc. support anti-infective resistance of the female genitals at a high level at the beginning of the infectious process. Possible violations of the development of pregnancy may be accompanied by changes in the response of TLRs to infectious and non-infectious factors until hyper-reaction, excessive inflammation or apoptosis, which requires adequate management of pregnancy. Was established the significance of the influence of pathogens of infectious and noninfectious origin in intrauterine infection indirectly through TLRs in the homeostasis of the organism, on the formation of breaches in anti-infective resistance at the organism and community level the identification of new pathophysiological and immunological pathogenetic mechanisms of development of pathological processes. IUI is a penetration of microorganisms into the tissues of fetus and it's infection. The inhibition of the functional activity of TLRs is accompanied by the direct effect of the pathogen on the tissues, and during hyper-reaction of TLRs to pathogens revealed a pronounced inflammatory response in the fetus. The level of expression of TLRs correlates directly with the severity of the process that can be considered as early markers of infection. Depending on the nature of the pathogen an increased expression of one or the other TLRs is observed. Explained the lack of symptoms, the possibility of atypical manifestations, the asymptomatic course of infection.

© 2018 Tomsk National Research Medical Center of the Russian Academy of Sciences. All Rights Reserved. The differential diagnosis of pulmonary diseases is extremely difficult and requires high qualifications of the radiologist and clinician. The differential diagnosis is used to distinguish different lung diseases: nonspecific inflammatory lung diseases (empyema, abscess, pneumonia), tuberculosis, sarcoidosis, benign tumors, lung cancer, lymphogranulomatosis, metastatic changes, and inflammatory changes in lung tissue. We present a clinical case, in which the differential diagnosis between tumor and inflammatory changes in lung tissue allowed the choice of optimal treatment tactics.

© 2018 The Author(s). In this article, the requirements for a prospective register of assisted reproductive technologies are considered. The basis of such a register is a specialized data store - the electronic passport of the woman's reproductive health. This register will Serve as a basis to analyse the effectiveness of the use of assisted reproductive technologies and for Supporting the making of medical decisions about the likelihood of pregnancy.

AIM: To investigate the role of video-assisted subtotal esophageal resection in treatment of patients with benign esophageal diseases. MATERIAL AND METHODS: Fifty-one patients with benign esophageal diseases have undergone subtotal esophageal resection in our department for the period 2010-2017. Thoracoscopic technique was applied in 25 cases, open approach - in 26 patients. Total surgery time, thoracoscopic stage duration, length of hospital-stay (LOS), ICU-stay, Clavien-Dindo morbidity rates with separate registration of respiratory complications, mortality have been considered. RESULTS: Groups were similar in terms of age, gender, ASA status. Thoracoscopic stage duration gradually decreased from 175 to 65 min with average time of 102 (75; 123) min. Total surgery time was 390 (270; 495) min in group 1 and 465 (341; 561) min in the control group (р=0.035). Mean ICU-stay decreased up to 2 (1.25; 3.75) days compared with the control group (5 (3.92; 5.85) days, р<0.0001). Conversion rate was 8%. In the main group complications Clavien-Dindo grade 2 were detected in 10 (40%) patients compared with 20 (69%) cases in the control group (р=0.009). Respiratory complications occurred in 5 patients in group 1 and in 13 cases of the control group (р=0.039). Mortality was absent. CONCLUSION: Thoracoscopic subtotal esophageal resection may be advisable alternative to open surgery for patients with benign esophageal diseases due to lower postoperative morbidity and earlier rehabilitation followed by improved outcomes.

© 2018 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved. Aim. Assessment of the markers levels of endothelial dysfunction (ED): stable metabolites of nitric oxide (NOx), endothelin-1 (E1), homocysteine (HC), von Willebrand factor (vWF) and tissue plasminogen activator (tPA) in blood plasma of smoker and nonsmoker patients with arterial hypertension (AH) of low and moderate risk, not taking antihypertension therapy regularly. Material and methods. Totally, 124 AH patients included, 45 males and 79 females, mean age 51,4±6,5 y. O., mean AH duration 7,9±7,3 y. Controls included 35 healthy volunteers (20 males, 15 females). Concentration of NOx in plasma was measured with spectrophotometry, and of vWF, HC, E1 and tPA-with immune enzyme assay. Results. To evaluate the relation of smoking and ED markers levels, AH patients and controls were selected to subgroups according to smoking status: smoker (35,5%) and non-smoker (64,5%) AH patients; smoker (38%) and non-smoker (62%) controls. In smoker AH patients comparing to non-smoking there were significantly higher concentrations of NOx-48,2±18,8 mcM/L and 40,3±21,2 mcM/L, respectively (p<0,05), E1-1,2±0,16 and 0,6±0,2 fM/L, resp. (p<0,05), HC-25,7±6,04 and 16,2±6,5 mcM/L, resp. (p<0,05), vWF-1,39±0,7 and 1,1±0,6 mg/dL, resp (p<0,05) and tPA-13,05±6,2 and 8,5±6,2 mcM/L, resp. (p<0,05). There was correlation in the AH group, of NOx concentration and smoking (r=0,46, p<0,05), and tobacco smoking duration (r=0,83, p<0,05). Also, there were positive correlations of HC and smoking (r=0,4, p<0,05). In control group smokers had higher HC-20,7±5,3 and 17,2±4,7 mcM/L, resp. (p<0,05), vWF-1,3±0,8 and 0,8±0,6 mg/dL, resp. (p<0,05) and tPA-11,1±6,5 and 6,6±5,2 mcM/L, resp. (p<0,05). There were no significant changes in NOx and E1. Conclusion. In smokers of both AH and control groups the levels of HC, vWF and tPA were significantly higher in comparison with nonsmokers. In smoker AH patients the mean concentrations of NOx and E1 are higher than in non-smoker patients. Levels of ED are related with not only the fact of smoking itself (p<0,05), but smoking duration (p<0,05).

© 2018 Tuberculosis and Lung Diseases. All rights reserved. The article presents the review of latest studies devoted to assessment of the eosinophilic inflammation in chronic obstructive pulmonary disease (COPD) and opportunities for differential therapy of stable COPD and COPD therapy during exacerbation. Currently, there is no final definition what threshold blood level of eosinophils can be used for decision making in clinical practice. The only thing found out was that the high blood level of eosinophils could be a predictor of the risk of frequent exacerbations and the effectiveness of treatment with glucocorticosteroids.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To assess the possibilities of radiology diagnostics in patients with orbital trauma in postoperative period. Materials and methods: From 2015 to 2018 years in the clinic of Sechenov University 72 patients (100%) with traumatic injuries were examined. All patients (n = 72, 100%) were diagnosed with orbital trauma. After the admission all patients (n = 72, 100%) underwent multispiral computed tomography (MSCT) before and after the operation using Toshiba Aquilion One 640 modality, volume mode, slice thickness - 0.5 mm, bone and soft tissue reconstruction. Results: According to MSCT data in postoperative period with orbital volumes were reconstructed and symmetrical compared to the other side in 48 patients (64%). In 24 cases (33%) orbital volumes weren't reconstructed with remaining prolapse of orbital soft tissue structures in the maxillary sinus through the inferior orbital wall defect. Insufficient implantation of the inferior orbital wall prosthesis occurred in 7 patients (10%). Conclusion: MSCT is a method of choice in examining the patients with injuries of the midface. Computed tomography allows detailed determination of performed surgical treatment, to reveal the risk of postoperative complications and assess the dynamic of a patient in late periods.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Complications after hip/knee/other joint arthroplasty develop in approximately 1-1.5% of young people and in 2.5-3% of elderly patients. Despite the meager chance of developing negative consequences, they can affect anyone, especially those who did not follow the rigorous rehabilitation program. Complications after endoprosthetics of hip/knee/other joints results from incorrect postoperative care and physical activity after discharge from the hospital. The second reason is technical approach of the surgeon. And third is an inadequate preoperative examination. The aim of the article is to have a detailed description of short term, midterm and long-term complications after joint replacement surgeries and of the methods (clinical and radiological) to avoid those complications with all the required parameters.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To assess the role of modern imaging techniques in the planning and implementation of hybrid interventions for an aortic arch aneurysm in an elderly patient with a burdened comorbid background. Materials and methods: Hybrid intervention in patient, 80 years, with acute rupture of the thoracic aorta was performed - aortic arch endografting from the level of the brachiocephalic trunk with endoprosthesis Zenit Alpha endoprosthesis with simultaneous "chimney" stent-graft Advanta V12 implantation in left common carotid artery and left-side carotid-subclavian bypass with Gore-Tex 6 mm prosthesis. Results: A female of 80 years with acute rupture of the thoracic aorta, massive rightside hemothorax has been successfully treated with hybrid intervention - endoprosthetics of the aorta with a subclavian left subclavian shunt. On the second day after procedure the patient underwent puncture of the right pleural cavity with subsequent drainage because of persisting respiratory failure. On the fourth day the patient was transferred from intensive care unit in stable condition, on the twelfth day the patient was discharged on postoperative day 12. Multislice computed tomography (MSCT) is commonly used for diagnosis of acute aortic pathology and planning the optimal method of surgical treatment, as it allows to obtain detailed images of the entire aorta and surrounding anatomical structures, three-dimensional reconstructions of blood vessels, to give an accurate assessment of the morphological characteristics of the aneurysmal sac, proximal and distal neck, degree of calcification and parietal thrombus, localization and extent of aortic wall defect. Conclusion: The use of new methods of endovascular and hybrid surgery in the treatment of aortic rupture of thoracic aortic aneurysms makes it possible to achieve clinical success even in extremely severe patients of elderly and senile age. The leading role in the planning of these operations belongs to actual imaging methods, primarily MSCT.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: The aim of our work is demonstrating the efficacy of magnetic resonance imaging (MRI) of heart with gadolinium contrasting for diagnosis of rare cardiac pathology - isolated myocardial infarction of the right ventricle. Materials and methods: The study of patient A. 46 years old, transferred to the intensive care unit of the Institute of Clinical Cardiology from the city hospital where he has hospitalized with a diagnosis - acute pneumonia. The following studies were carried such MSCT-pulmonography, MRI of the heart contrast enhancement, MSCT coronary angiography. Results: Using MRI of the heart with contrast enhancement, an isolated myocardial infarction of the right ventricle has detected. The conclusion: MRI of the heart with contrast enhancement is the method of choice in diagnosis for suspected myocardial infarction of the right ventricle.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Presentation of diagnostic possibilities of volume computed tomography (VCT) of a heart combined with pharmacological vasodilation agent adenosine triphosphate (ATP) test in estimation of myocardial perfusion and detection of left ventricle myocardial ischemia diagnosis with non-obstructive coronary arteries. Materials and methods: VCT combined with ATP test was performed at female 53-year-old patient with non-obstructive coronary arteries verified by coronary angiography. The VCT «Aqulion ONE 640 Vision Edition» (Toshiba, Japan) was used. The non-ionic iodinecontaining contrast agent Ultravist-370 (Bayer, Germany) was infused in a quantity of 60 ml at rest and during ATP test. The clinical and instrumental data were also performed. Conclusion: The presented clinical case shows the possibilities in myocardial ischemia of the left ventricle in non-obstructive coronary arteries diagnostics by a volume CT combined with ATP pharmacological test.

© 2018 Russian Electronic Journal of Radiology.All right reserved. This article presents the clinical case of an extragastric large gastrointestinal stromal tumor combined with osteomyelofibrosis. It made great differential diagnostic difficulties with regard to the tumor location. Modern radiology methods are described, which allow to reveal and establish the organogenesis of the tumor as well as its histological characteristics.