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Published By Eco-Vector

2220-3095

2021 ◽  
Author(s):  
Liudmila Baiushkina

Background:chronic migraine (СM) is a highly disabling neurological disease that is difficult to treat. The success of therapeutic management depends, in part, on psychosocial and personal factors. Aims:we have evaluated the clinical characteristics of patients suffering from СM, depending on the prevailing coping strategy of the individual. Methods:104 people with an established diagnosis of СM were examined, all of them underwent clinical and neurological examination and questionnaire testing. Results:in our group of patients, active behavioral coping strategies (a strategy for solving the problem and seeking social support) prevailed, passive coping was much less common. Patients with active coping strategies had the lowest level of comorbid psychoemotional disorders. Patients with passive coping strategies had a shorter history, the least severity of the effect of migraine, but were comparable in frequency of headaches and time lost due to headaches with patients with active coping strategies. Key words:chronic migraine, coping strategies, comorid disorders, anxiety, depression.


2021 ◽  
Author(s):  
Dmitry Fedorovich Pokrovskiy

This review presents the main pros and cons of Immediately Sequential Bilateral Cataract Surgery (ISBCS) versus Delayed Sequential Bilateral Cataract Surgery (DSBCS). The main arguments against ISBCS versus DSBCS are the likelihood of postoperative bilateral endophthalmitis and refractive errors. At the same time, careful selection of patients, the implementation of safety recommendations and the use of intracameral antibiotics, combined with the improvement of formulas for calculating intraocular lenses, provide the advantages of ISBCS associated with the rapid rehabilitation of patients after surgery and economic reasons.


2021 ◽  
Author(s):  
Aleksandr V. Bocharov ◽  
Leonid V. Popov ◽  
Astan K Mittsiev ◽  
Magomet D Lagkuev

the article highlights the historical aspects of the development of the concept of diagnosis and treatment of post-infarct left ventricular aneurysms, the possibilities of the main diagnostic methods, and also offers a new classification of post-infarct left ventricular aneurysms, taking into account the type of blood supply and the nature of the coronary lesion, which allows determining the optimal treatment strategy


2021 ◽  
Vol 12 (4) ◽  
pp. 80-85
Author(s):  
Aleksander I. Berishvili ◽  
Yuri V. Ivanov ◽  
Dmitry P. Lebedev ◽  
Fedor G. Zabozlaev ◽  
Edward V. Kravchenko ◽  
...  

Background: Giant tumors of the abdominal cavity, as a rule, occur in elderly patients with characteristic features and represent a serious problem in terms of choosing a radical method of therapy. Of particular difficulty are cases of giant serous endometrial cancer, requiring a differential diagnosis with ovarian cancer. Clinical case description: A clinical case of giant serous endometrial cancer mimicking ovarian cancer in a 55-year-old woman is presented. The patient came to the oncology department with complaints of abdominal enlargement, difficulty breathing and bloody discharge from the genital tract. The examination revealed the following: a giant formation (4065 cm), occupying the entire pelvic and the entire abdominal cavities, ascites, lesions of the retroperitoneal lymph nodes, and the greater omentum, an umbilical hernia. A chest CT showed multiple contrast-accumulating circular shadows of 313 mm (metastases). By the decision of the council, after the preliminary chemoembolization of both the uterine and ovarian arteries, a supravaginal amputation of the uterus with appendages was performed, along with the resection of the greater omentum, removal of the umbilical hernia with positioning a plastic mesh implant and excision of an excess skin flap. The histological examination of the intraoperative material made it possible to verify the diagnosis of a serous endometrial carcinoma with subtotal tumor necrosis, the myometrium invasion of more than a half of its thickness, with the egress to the perimetrium, metastatic lesions of both ovaries, the greater omentum, anterior abdominal wall. Stage T3b (FIGO IIIB). In the postoperative period, 6 courses of Paclitaxel / Carboplatin (AUC4-5) chemotherapy were carried out with a pronounced clinical effect. The patient was discharged in a satisfactory condition. The control PET-CT scan after the 6th chemotherapy course showed no pathology in the thoracic cavity, and no process progress in the abdominal cavity. Currently, the remission of the disease is 9 months. Conclusion: An algorithm for the diagnostic measures aimed at making the correct diagnosis is presented, and the tactics of treating a patient with giant serous endometrial cancer is described.


2021 ◽  
Author(s):  
Elizaveta Dedukh ◽  
Elena Alexandrovna Artyukhina

Abstract: A clinical case of interventional treatment of a patient with atypical atrial flutter who has not previously undergone surgical or interventional heart surgery. This clinical observation demonstrates the role of common zones of low-amplitude activity on the mechanism and treatment of atrial arrhythmias. Widespread areas of low-amplitude activity in the left atrium can create barriers to the propagation of excitation, which can cause atypical atrial flutter. High density mapping will help visualize the mechanism of this arrhythmia. Understanding the mechanism of atypical atrial flutter will help minimize RF exposure during treatment. Key words: high density mapping; atypical atrial flutter; atrial fibrosis; radiofrequency ablation.


2021 ◽  
Vol 12 (4) ◽  
pp. 66-74
Author(s):  
Aleksandr S. Zotov ◽  
Emil R. Sakharov ◽  
Sergey V. Korolev ◽  
Olga V. Drakina ◽  
Robert I. Khabazov ◽  
...  

Atrial fibrillation is one of the most common types of cardiac arrhythmia observed in clinical practice. Despite advances in the diagnosis and treatment, atrial fibrillation remains one of the leading causes of cardiovascular mortality and morbidity. In addition, atrial fibrillation is quite often combined with other pathologies of the cardiovascular system and is a marker of an unfavorable outcome. Several previous studies have demonstrated reduced survival in patients with coronary artery disease and atrial fibrillation who have not undergone surgery for arrhythmia. According to other data, the presence of preoperative atrial fibrillation among patients undergoing isolated coronary artery bypass grafting was associated with significantly higher rates of major postoperative complications. Nowadays, no one doubts the fact that atrial fibrillation during a coronary artery bypass surgery is a risk factor for increased hospital mortality, postoperative morbidity and leads to a decrease in the long-term survival. The studies confirm the necessity of surgical ablation for atrial fibrillation during coronary revascularization to reduce both short-term and long-term postoperative mortality and late complications.


2021 ◽  
Vol 12 (4) ◽  
pp. 44-50
Author(s):  
Alla V. Sidorova ◽  
Anna V. Starostina ◽  
Mariia A. Pecherskaia ◽  
Margarita R. Khabazova ◽  
Alexey A. Arisov

Background: Neovascular glaucoma (NVG) is a highly refractory form, it is characterized by fast development and a high level of the intraocular pressure (IOP). Aims: To evaluate the effectiveness of micropulse transscleral cyclophotocoagulation (mCPC) in the combined treatment of patients with secondary neovascular glaucoma. Methods: The study included 32 patients (32 eyes) with secondary NVG as an outcome of diabetes mellitus and (or) thrombosis of the central retinal vein or its branches. The preoperative IOP averaged 38.88.8 mm Hg with the most intense hypotensive therapy. All the patients underwent mCPC. In the postoperative period, the patients were examined on the first day after the operation, then in 1 week, 1, 3, 6 months, 1 year after the operation. Results: All the operations were performed without complications. Pain syndrome in all cases was stopped on the first day after surgery. Six patients had reactive hypertension on the first day, therefore, the hypotensive therapy was intensified. The IOP 1 week after mCPC was 20.97.9 mm Hg, after 1 month of observation 23.76.0 mm Hg with the hypotensive therapy. 34 weeks post-surgery, six patients with the preserved visual function experienced a repeated IOP increase, and the Ahmed valve was implanted. 6 months after mCPC, the IOP level averaged 22.87.7 mm Hg with the hypotensive therapy. Against the background of the IOP compensation, anti-VEGF drugs were injected in 4 cases, followed by laser coagulation of the retina. Conclusion: Application of mCPC in NVG glaucoma patients showed only a small number of postoperative complications. This method of laser treatment can be used in combination with panretinal laser coagulation before or after the surgery, including administration of anti-VEGF drugs before or after the surgery. In case of the IOP increase, mCPC may be repeated.


2021 ◽  
Author(s):  
Sergei A. Andreichenko ◽  
Mikhail V. Bychinin ◽  
Irina A. Mandel’ ◽  
Tatiana V. Klypa

Rationale: Mortality in patients with severe COVID-19 remains high. Finding therapies that can improve the outcome in these patients is an urgent function. Objective: To evaluate the clinical efficacy of dexmedetomidine in the results of complex treatment with a severe course of COVID-19. Materials and Methods: The retrospective study included 50 adult patients with severe COVID-19 admitted to the intensive care unit (ICU). The primary outcome of the study was the incidence of delirium. The secondary results of the study were dynamics of gas exchange indicators (PaO2 and PaCO2) and inflammatory markers (C-reactive protein (CRP), procalcitonin, lymphocyte count and neutrophil-lymphocyte ratio (NLR)) for 3 and 5 days of treatment, as well as the duration of mechanical ventilation (MV), length of stay (LOS) in the ICU and hospital and mortality. Results: The incidence of delirium did not differ between the dexmedetomidine group and the control group (41% and 48%, respectively; p = 0,661). The LOS in the ICU and the hospital, as well as the duration of MV, was comparable between the groups. However, hospital mortality in the dexmedetomidine treatment group was lower than in the control group (10,3% and 42,9%, respectively; p = 0,008). The addition of dexmedetomidine to the complex of therapy did not affect the change in blood gas, but contributed to an increase in the number of lymphocytes (p = 0,006) and a decrease in NLS (p = 0,002) by the fifth day of treatment. At the same time, no significant changes in CRP and procalcitonin levels were observed. Conclusion: Therapy with dexmedetomidine was not accompanied by a decrease in the frequency of delirium, LOS in the ICU and the hospital, and the duration of MV in patients with severe COVID-19. Prospective randomized trials are needed to confirm the beneficial effects of dexmedetomidine on the immune system and mortality.


2021 ◽  
Author(s):  
Margarita Shpilyuk ◽  
Liubov Krechetova ◽  
Dmitry Nechipurenko ◽  
Olga Beznoshchenko ◽  
Evgeniya Beresneva ◽  
...  

Background: At the moment, an urgent and unresolved problem is the search for a diagnostic method for disorders of the hemostasis system in patients against the background of the course of a new coronavirus infection. Presumably, integral tests, in particular, the thrombodynamics test, will make it possible to monitor changes in blood clotting, predict the course of the disease in patients with COVID-19. Aims: to comparative assessment of plasma hemostasis parameters and thrombodynamics test in patients with COVID-19 viral infection of varying severity. Methods: The study included 96 patients with a confirmed diagnosis of COVID-19, hospitalized in an infectious diseases hospital on the basis of National Medical Research Center for Obstetrics, Gynecology and Perinatology named after V.I. Kulakov in the period from 04.23.2020 to 06.20.2020 and discharged at the end of treatment. SARS-CoV-2 was identified by PCR. Patients were stratified by severity into 3 groups: mild course (n = 25), moderate course (n = 54), severe course (n = 17). Diagnostics and treatment of patients was carried out in accordance with the Temporary Methodological Recommendations of the Ministry of Health of the Russian Federation for the prevention, diagnosis and treatment of new coronavirus infection, versions 5, 6, 7. In the dynamics of treatment, patients were assessed APTT, prothrombin %, prothrombin time and thrombin time, fibrinogen, D-dimer, platelet count and thrombodynamic test (V / Vi / Vst, Tlag, Cs, D). Results: It was found that significant differences before admission and a week after the start of hospital treatment were observed for the thrombin time, D-dimer, platelet count, and thrombodynamic parameters: V / Vst, Cs, D. PT, APTT, TD (Tlag, D)) with the duration of hospital stay. There was a positive relationship between the content of fibrinogen and D (r = 0.6307, p 0.0001) and a strong positive relationship between PT and Tlag (r = 0.7499, p 0.0001). Conclusions: The thrombodynamics test can be recommended as a potential tool for a personalized approach to monitoring the hemostasis system and treating patients with COVID-19.


2021 ◽  
Author(s):  
Vitaliy E. Potapov ◽  
Vladimir Alekseevich Sorokovikov ◽  
Sergey Nikolaevich Larionov ◽  
Aleksandr Petrovich Zhivotenko

The problem of the pathology of the facet joints of the lumbar spine remains significant and is medical and social due to persistent pain syndrome, high incidence of morbidity and frequent disability outcomes. The complex anatomical and topographic relationships of the facet joints, intervertebral discs and radicular nerves force clinicians to pay attention to the pathology of facet syndrome. A pair of facet joints and an intervertebral disc constitute a functional unit - a "three-component complex" and are interconnected with each other. The article examines the anatomical and morphological features and radiological classifications of degenerative changes in the facet joints, which are currently used in clinical practice. Facet joint pathologies are the most common nosological form of degenerative-dystrophic process (spondyloarthrosis) and a potential source of pain with the formation of instability of the spinal motion segment and the formation of chronic pain syndrome. The features of facet syndrome diagnostics are presented on a clinical example of surgical treatment by means of laser dereception of facet joints.


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