Статьи журнала - Saratov Medical Journal
Все статьи: 102
Instances of folliculogenesis in rat thyroid: The norm vs. the experiment
Статья научная
Objective: identification and characterization of the stages of new follicle formation, along with measuring the frequency of folliculogenesis in various parts of the thyroid in normal and experimental conditions. Materials and Methods. The experiment was performed on 36 mature white rats distributed among three groups: the control (Group I), 60-day exposure to sodium benzoate at a dose of 1,000 mg/kg (Group II), and administration of Mexidol at a dose of 50 mg/kg against the background of a 60-day exposure to sodium benzoate (Group III). The stages of folliculogenesis were studied using light microscopy followed by statistical analysis of its frequency. Results. The formation of a new follicle begins with the proliferation of thyrocytes on the cell wall of the mature follicle, after which a cavity is formed between the cells into which they secrete colloid. As the follicle grows, the height of the thyrocytes declines, and the size of their cavity and the amount of colloid increase. In Group II vs. Group I, on days 3 and 24 of the experiment, signs of folliculogenesis were detected 1.7 and 1.4 timesless frequently in the thyroid center, and 2 and 1.2 times less often in the thyroid periphery; while in Group III vs. Group II, these were observed1.3 and 1.6 timesmore often in the center of the organ, and 1.3 and 1.3 times more frequently in the thyroid periphery. Conclusion. During folliculogenesis in the thyroid, focal proliferation of thyrocytes develops in the cell wall of one of the follicles with further formation of the cavity of the newly formed follicle and its growth. Normally, the formationfrequency of new follicles is higher in the organcenter vs. the periphery and lower in both thyroid zones in the group of rats exposed to sodium benzoate. However, in the group of rats where sodium benzoate administration waspharmaceuticallycorrected by Mexidol, the frequency of the young follicleformation increased, albeitit did not reach the control values.
Бесплатно
Статья научная
Objective: to conduct a comparative analysis of the features of intracellular metabolism in polymorphonuclear leukocytes (PMN) in the peripheral blood of rats with inherited stress-induced arterial hypertension (ISIAH) vs. normotensive animals (NTA). Materials and Methods. In the leukocytes of rat blood (15ISIAH rats and 20 NTA), the indicators of carbohydrate and lipid metabolisms, the activity of a number of key enzymes reflecting the state of redox processes, and PMN functional activity level were determined using histochemical methods. Results. The study established that a stable increase in blood pressure was accompanied by hypertrophy of the left ventricle, degenerative changes in cardiomyocytes and a decrease in the density of the microvasculature. At the same time, the amount of intracellular glycogen in leukocytes decreased by 23% while the amount of intracellular lipids remained unchanged. The levels of activity of intracellular ATPase and myeloperoxidase decreased by 22% with a slight increase in the activity of succinate dehydrogenase (by 13%). The number of PMN with a positive hematocrit (НСТ) test was higher by 35% in ISIAH rats.Conclusion. Analysis of the studied PMN metabolism indicators revealeddisorders in the energysupplying and enzymatic processes of leukocytes in arterial hypertension.
Бесплатно
Статья научная
Objective: to assess the proportion of leukocytes (CD45+ cells) and T-lymphocytes (CD3+ cells) in the liver during physical exertion of varying intensity with and without the use of meldonium. Materials and Methods. The experiments were conducted on male Wistar rats performing physical exercise of varying intensity. Meldonium was added to the feed of the experimental animals at a rate of 100–120 mg/kg of body weight during water-based exercise. After the experiment, liver samples were taken, sections were prepared and stained with hematoxylin and eosin, and immunohistochemical reactions were performed for CD45+ and CD3+ cell markers. Results. Under heavy physical exertion, the proportions of CD45+ and CD3+ cells in the liver parenchyma increased 3.2- and 2.9-fold, while perivascularly they increased threefold and 6.3-fold (p=0.001), respectively, vs. the intact group. After the administration of meldonium during heavy physical exertion, the percentage of CD45+ cells decreased in the liver parenchyma and perivascularly by 1.8 times (p=0.008), the proportion of CD3+ cells declined by 1.7 times in the liver parenchyma (p=0.001) and by 2.3 times around the blood vessels (p=0.004) vs. intact animals. Histologically, inflammation and degenerative changes in the liver tissue decreased. Conclusion. The use of meldonium during heavy physical exertion led to a decrease in the percentage of CD45+ and CD3+ cells due to a reduction in the degree of inflammatory infiltration of the liver tissue and the severity of the destructive process.
Бесплатно
Malnutrition in hospitalized children
Статья научная
Objective: Our study aimed to determine the prevalence and grade of malnutrition in patients hospitalized for various indications and to examine its relationship with comorbidities and socio-demographic factors. Materials and Methods: This study enrolled children aged 1 month to 15 years old with a median age (Q25; Q75) of 1.8 (1.27–3.47) years, admitted to our hospital with various diagnoses between 1 January 2019 and 31 December 2019. Our study included 498 patients, 286 (57.4%) of which were male and 212 (42.6%) were female. Results: Of all patients, 40 (19.7%) with a median age of 2.25 (1.27–3.48) years had a weight z-score of less than –2SD. Of our patients, 47.2% (n=235) had malnutrition sensu the Waterlow classification. There were significant differences between the groups in socioeconomic level and C-reactive protein (CRP) content. Conclusion: Malnutrition is associated with a low socioeconomic status. It plays an important role in hospitalizations with various diagnoses.
Бесплатно
Статья научная
Objective: based on the Russian Federation multicenter registry data, to assess the comprehensiveness of medicamentous therapy in patients with stable coronary artery disease (CAD) from the perspective of 2018 European Society of Cardiology (ESC-2018) recommendations for myocardial revascularization and 2017 American Appropriate Use Criteria (AUC-2017) for the expediency of revascularization. Materials and methods. Anamnestic data of 1531 patients with stable CAD (average age: 61.7 ± 9.8 years; 76% men) were studied. The data source was the Russian Federation multicenter registry of patients with arterial hypertension, CAD, and chronic heart failure. We identified the prescription of optimal medical therapy (OMT) sensu ESC-2018, maximal anti-ischemic therapy (MAT) sensu AUC-2017, and compliance of drug therapy with ESC-2018 and AUC-2017 simultaneously. OMT included at least one anti-ischemic medication + antiplatelet agent + statin + short-acting nitrate + blocker of the renin-angiotensin system in the presence of hypertension, diabetes mellitus, or heart failure. MAT included at least two anti-ischemic pharmaceutical drugs. Compliance with these criteria was determined in the groups of patients who underwent, or did not undergo, myocardial revascularization, as well as among those, for whom invasive treatment was indicated as the first priority, as the second priority, or was not indicated at all, according to ESC-2018 and AUC-2017. Results. Among patients who received solely medicamentous therapy (n=924), OMT was prescribed in 18%, while in the revascularization group (n= 07), in 9% of cases (p <0.001). MAT was also prescribed more often in the conservative therapy group (34%) than in the revascularization group (24%): p = 0.001. OMT sensu ESC-2018 and AUC-2017 in the groups with, or without, intervention was prescribed in 3% vs. 7% of cases, respectively (p <0.001). Conclusion. According to the Russian Federation multicenter registry, medicamentous therapy of stable CAD complies with the provisions of European and American clinical guidelines for myocardial revascularization in a small proportion of patients, regardless of the chosen treatment tactics.
Бесплатно
Methodology of designing specialized medical information registries
Статья научная
The objective. Developing information exchange methodology by means of specialized registries among the core healthcare partakers in the course of provisioning medical assistance to traumatology and orthopedic patients. Materials and Methods. We conducted the analysis and systematization of functionality for 31 registers of traumatology- and orthopedics-related medical information from the databases of the Federal Institute of Industrial Property, European Patent Office and developers’ websites. The search depth has been set at 1979 and defined by the date of the earliest discovered information source. Results. The analysis of specialized registries revealed that majority of those (70.9%) were mono-nosologic, hence containing information about the diagnosis and treatment procedures provided at the level of a specific medical institution. We developed the methodology for evaluating the functionality of specialized medical information registries, containing the data on used medical devices, medications, medical technologies, rehabilitation programs, and assessment of medical treatment effectiveness. Such methodology was designed to operate on data from the information systems of major healthcare partakers. Conclusion. The proposed information exchange methodology defined the necessity of integrated, target-oriented registry development. Its implementation would allow increasing the quality of management decisions proposed by healthcare participants.
Бесплатно
Microbiological aspects of acute odontogenic osteomyelitis in children
Статья научная
Objective: to identify the species composition of pathogens causing acute odontogenic inflammatory process in the children’s jaws; to examine the sensitivity and resistance of the isolated microflora to antibiotics of various groups; and to determine the dependence of the disease clinical course on the type of dominant pathogen. Materials and Methods.The results of a microbiological study of exudate from purulent odontogenic foci of 900 children regarding periostitis and osteomyelitis of the jaws were analyzed. Results. In 65.6% of cases, the causative agent was Streptococcus pyogenes known as group A beta-hemolytic streptococcus (GABHS) possessing a high sensitivity to vancomycin (99%), fluoroquinolones (98%), beta-lactam antibiotics (91%), and the highest resistance to macrolides (41%). We have also isolated Streptococcus viridans (6.1%), Streptococcus pneumoniae (4.3%) andmixed microflora (14.3%). The syndrome of endogenous intoxication of the body was manifested by high fever in 56% of cases, by leukocytosis in 38% of patents, and by acceleration of the erythrocyte sedimentation rate in 57.4% of study subjects. There was no statistically significant difference in the degree of endogenous intoxication between groups with different types of streptococci. Conclusion. The cause of the inflammatory process in the jaws was GABHS (65.6% of cases) with a high sensitivity to vancomycin (99%), fluoroquinolones (98%), and beta-lactam antibiotics (91%).
Бесплатно
Статья научная
Objective: to evaluate the dynamics of gastrointestinal wall perfusion in acute adhesive intestinal obstruction and to determine the critical period of reversibility of ischemic changes. Materials and Methods: The study was conducted on 50 rats in an acute experimental setting. Chronic adhesive disease was induced 30 days prior to the main experiment. Animals were divided into a control group (laparotomy without adhesions) and four experimental groups with adhesive disease: sham group (without obstruction), group A (strangulation for 1 hour), group B (strangulation for 24 hours), and group C (strangulation for 48 hours). Microcirculation was measured using non-contact laser Doppler flowmetry with vibration noise suppression; the M1 parameter (first spectral moment reflecting blood flow intensity, TPU) was evaluated. Statistical analysis was performed using STATISTICA 10.0 with parametric and non-parametric tests. Results: Peritoneal adhesions were found to reduce basal perfusion by 10.5% (0.95±0.05 vs 0.85±0.06 TPU; p=0.0256). The initiation of strangulation resulted in a sharp, approximately three-fold decrease in M1 within the first 10 minutes (to 0.34±0.09 TPU). Perfusion recovery after obstruction resolution depended on the duration of ischemia: after 1 hour, 68% of the baseline level was recovered; after 24 hours, 24%; and after 48 hours, no recovery was observed (p=0.567), indicating the development of the irreversible "no-reflow" phenomenon. Conclusion: Following strangulation, perfusion levels progressively decreased until the development of "biological zero" of microcirculation. The critical period of ischemia reversibility in adhesive strangulation is in the range of 24–48 hours.
Бесплатно
Morphological aspects of orbital defect reconstruction in rats with elastin-based biomaterial
Статья научная
The objective of the study was to identify morphological aspects of replacement of xenogeneic decellularized elastin matrix (ХDEM) transplanted into a bone defect of the upper orbital wall in rats. Materials and methods. The experiment was performed on 60 Wistar rats with artificially created 7×4 mm defect in the upper edge of their orbit. In the experimental group (n=30), DХEM was placed in the defect area. Its size matched the size of the defect, and it was attached with a suture material (50 μm silk). Soft tissues were sutured layer by layer in the control group (n=30). Tissue excision was performed after 1, 3 and 12 months. Histological, immunohistochemical and electron microscopic methods were employed. Results. We were gradually replacing DХEM with bone tissue against the background of a pronounced reaction of CD68+/MMP-9+ macrophages, which implied its resorption and lysis. Osteogenesis occurred via intramembranous ossification and endochondral ossification, which was preceded by centripetal migration of endothelial kidneys with subsequent differentiation into capillaries and overgrowth of loose fibrous connective tissue containing progenitor cells. The microenvironment, represented by reticulin fibers, TGF-β1, and sulfated glycosaminoglycans, could contribute to the differentiation of progenitor cells in the osteogenic direction and to osteogenesis per se. In the control group, the defect remained open throughout the experiment. Conclusion. Decellularized biomaterial, based on elastin matrix, has osteoconductive and osteoinductive properties and can serve an adequate biomimetic for reconstruction of the bone defects.
Бесплатно
Morphometric indicators of the thymus mass in fetuses and early neonates
Статья научная
Objective: to identify reference values of thymus mass in fetuses and early neonates depending on their body mass. Materials and Methods. We analyzed 922 autopsy reports for fetuses of 18-42 weeks of gestation and neonates of the first 7 days of their life: Group I included those who died of infectious diseases (n=67); Group II comprised those who died of noncommunicable diseases (n=855). We examined the thymus mass and body mass, calculated the thymic index (TI). Spearman’s R was employed to evaluate the correlation. A polynomial regression model was constructed using the spline approximation method. Results. The data on the thymus mass are presented in the range of fetal and neonate body mass values from 300 g to 5,500 g. The thymus mass varied from 1.1 g to 1.48 g (for fetal mass of 300-500 g) to 12.36 g-15.09 g (for neonate body mass of 400-5,500 g). The organ mass increased with increasing gestational age, decreasing by day 3 of the newborn’s life. The median values of the thymic index for groups I and II 0.32 and 0.28 (p=0.2). Regardless of the pathology type, gestational age and life expectancy, the thymus mass correlated with the body mass (R=0.88; p<0.001). The dynamics of changes in the thymus mass (y) depending on the values of the decimal logarithm of the body mass (x) is described by the following polynomial regression equations: y=13.937x2-75.662x+104.47 for children of Group I and y=16.65x2-93.487x+133.56 for Group II. Conclusion. Reference values of the thymus mass in fetuses and neonates are presented depending on their body mass: we revealed that there is a strong direct correlation between the thymus mass and the body mass.
Бесплатно
Nutrition education for expectant mothers: Nourishing the future
Статья научная
Background: This review explores the importance of preconception education, examining its impact on maternal health, fetal development, and long-term well-being. The effectiveness of appropriate nutritional interventions, along with the role of different nutrients and their influence on epigenetics in the preconception period, are discussed with reference to the current scientific literature. Objective: Women should enter pregnancy in the healthiest possible condition. Nutrition is increasingly recognized as important for reproductive health. Preconception nutrition education for women not only influences the immediate health of the mother and her offspring but also has the potential for transgenerational impact. It is of paramount importance for mothers to receive evidence-based nutrition education. Results: Nutrients that influence healthy reproduction and lifelong health include vitamin B complex, in particular B1, B6, folate, B13, and B12; antioxidants (vitamins C and E); minerals such as iron, zinc, magnesium, selenium, iodine, and copper; and essential fatty acids. Recent studies have shown that a healthy diet, minimal consumption of fast food and foods with a high glycemic load, can normalize the course of pregnancy. These beneficial nutrients also reduce the risk of neural tube defects, autism, dyslexia, Down syndrome, childhood cancer, obesity, and fetal cell membrane defects associated with maternal diabetes. Research on paternal diet and its impact on health is limited. A woman's metabolism is seriously influenced by activity and affection. Modern foods are often processed beyond cellular recognition, which can lead to neurological and physical illnesses and mortality. A history of starvation or deprivation in early life can be passed from grandmothers to grandchildren through epigenetic inheritance across generations.
Бесплатно
Open-heart surgery in elderly patients: short-term vs. long-term effects
Статья научная
The objective of the study was to analyze in-hospital mortality and long-term survival of elderly patients who underwent open-heart surgery and met the criterion of frailty. Materials and Methods. The study involved 266 patients over 75 years old complying with the frailty criterion (F-index ≤5). A total of 155 operations of coronary artery bypass grafting (CABG), 47 surgeries of aortic valve replacement (AVR), and 64 procedures of CABG in combination with AVR were performed. Study subjects were distributed among the groups depending on the surgery type. Postoperative complications were evaluated, and short-term and long-term outcomes were compared. Results. In-hospital mortality was 5.3% in general group, 9.4% in CABG+AVR group, 3.9% in CABG group, and 4.2% in AVR group. There was no significant difference among the rates of in-hospital mortality between the groups (р>0.05). Long-term survival rates in general group were as follows: 98.3% for 1-year survival, 94.6% for 3-year survival, and 82.1% for 5-year survival. Type of surgery had no significant impact on the outcome (р>0.05). Conclusion. Short- and long-term effects of CABG, AVR, and combination of CABG with AVR in the group of elderly patients who meet the criterion of frailty were characterized by low mortality and low incidence of non-fatal complications. The type of cardiac surgery and old age did not affect significantly the outcome of a surgical treatment.
Бесплатно
Статья научная
Objective: analysis of opinion dynamics in young people on prevention and treatment of sexually transmitted infections (STIs) against the background of COVID-19 pandemic vs. the pre-pandemic period. Materials and Methods. Our research was based on a comparison of data from a sociological survey of 400 respondents 16-21 years of age in 2021 and an analysis of 838 questionnaires from participants of the same age in a similar study in 2017. The research employed the methodology of sociological questionnaire. The original questionnaire was used, consisting of 46 questions, combined into five thematic blocks: assessment of the STI problem relevance, likelihood of infection risk, readiness to undergo preventive screening examinations, preferred directions for seeking medical help in the event of STI, and consent to examination and treatment in conjunction with a sexual partner. By gender, the distribution of study subjects was as follows: 51% of women (n=427) in 2017 vs. 52% (n=208) in 2021; 49% of men (n=411) in 2017 vs. 48% (n=192) in 2021. In processing and presenting the data, extensive indicators were used, compared with the assessment of the significance of differences sensu Student’s t-test. Results. In 2021, we observed an increase in the interest of young people in undergoing screening examinations (79.5% vs. 63% in 2017, p=0.006) and seeking medical help (93.5% vs. 89.5%, p=0.007); on the other hand, in 2021, young people were more likely to conceal their health status from a partner (32.2% vs. 8.3%, p=0.003). Conclusion. The study revealed a change in the opinions of respondents regarding STIs during the pandemic, specifically, an increase in understanding the need for regular examinations and seeking medical help in the event of STI symptoms, but at the same time, there was a reduced responsibility for the sexual health of their partner.
Бесплатно
Optimizing the process of developing human blood vessel models
Статья научная
Objective: to optimize the process of blood vessel biomechanical modeling via developing models of cerebral arterial circle. Materials and methods. Biomechanical modeling requires development of a patient-oriented three-dimensional (3D) solid-state geometric model of the object under study. This task can be resolved by computed tomography (CT) or magnetic resonance imaging (MRI). We developed the program that implements the construction of blood vessel contours from separate slices of MRI in a semi-automatic mode. These contours are exported as saved curves in a specific format to SolidWorks, where they are used to create 3D models of blood vessels. The models obtained this way take into account individual characteristics of the vascular system structure of a particular patient, and can be used in the process of biomechanical modeling. Results. The results of the program implementation of the recursive frontal growth method for processing 2D slices of tomograms are presented. Conclusion. The developed software allows semi-automatic loading of DICOM images and obtaining flat cross-sections (MRI slices) of vessels on their basis, as well as transferring them for further processing into computer-aided design systems.
Бесплатно
Pathomorphological characteristics of the wound bed prior to skin autografting
Статья научная
Objective: to conduct a comparative pathomorphological analysis of wounds of various origins requiring full-thickness skin autografting. Materials and Methods. Histomorphological comparison of the wound bed prior to plastic surgery with full-thickness skin autografts was performed in three groups of patients: (1) during excision of scar tissue in elective surgery; (2) in case of traumatic skin detachments with autografting sensu Krasovitov; (3) when excising the granulation tissue to the fibrous layer. The object of the study included biopsy specimens from patients of three study groups. Results. The histological picture of wounds after removal of scars was characterized by well-developed dense fibrocellular connective tissue and had signs of chronic inflammation. In contrast to the cicatricial wound, acute lesions were characterized by granulation and mature dense fibrous connective tissues with pronounced inflammatory changes, each of which had its own characteristics. Conclusion. The results of the comparative analysis revealed the features of the morphological picture of wounds depending on the type of damage. In the group of acute injuries, traumatic and burn wounds, the most pronounced tissue damage was revealed. Given the obtained data, it should be assumed that full-thickness skin autografting will yield the best result in the group of patients after the planned excision of scar tissue.
Бесплатно
Pentraxin 3: possibilities and prospects for using a biomarker in patients with COVID-19
Статья научная
Objective: to determine the potential predictive value of serum biomarkers for adverse cardiovascular events in post-COVID-19 patients. Materials and Methods. The prospective study included 114 patients hospitalized with confirmed COVID-19. In addition to standard examinations, blood samples were collected on the day of admission to determine levels of serum cardiovascular biomarkers, including pentraxin 3 (PTX3). Patients were monitored for 366 [365; 380] days after discharge from the COVID-19 hospital with registration of all major adverse cardiovascular events (MACE) that developed. Results. During follow-up, we observed MACE in 19 patients (16.7%), including 2 deaths (1.8%) from cardiovascular causes. The incidence of MACE was higher in patients with higher concentrations of PTX3 (OR 1.28, 95% CI 1.13-1.45; p<0.001), interleukin 6 (OR 1.01, 95 % CI 1.0-1.02; p=0.048), D-dimer (OR 2.05, 95% CI 1.16-3.6; p=0.019), lactate dehydrogenase (OR 1.08, 95% CI 1.03-1.13; p<0.001), and MB fraction of creatine kinase (OR 1.19, 95% CI 1.02-1.39; p=0.001). PTX3˃3.1 ng/mL predicted the development of MACE with a sensitivity of 94.0% and specificity of 82.1% (AUC 0.885; p<0.001). Conclusion. Serum biomarkers, in particular PTX3, can be used to predict the development of MACE in the long-term follow-up of post-COVID-19 patients.
Бесплатно
Статья научная
Objective: development and efficacy assessment of the tactic of actions in reverse shoulder arthroplasty in bone mass defects and deficiency of the scapular glenoid fossa. Materials and Methods. At the Division of Adult Orthopedics, N.N. Priorov National Medical Research Center of Traumatology and Orthopedics, Ministry of Healthcare of the Russian Federation, 6 patients with glenoid bone mass deficiency were subjected to the reverse shoulder arthroplasty: 4 of those received the replacement of marginal bone defects, whereas 2 subjects underwent the replacement of extensive bone defects. Results. During the follow-up period of the operated patients, which lasted 6-24 months, good clinical, radiological and functional results were obtained. There were no intraoperative or postoperative complications. Conclusion. The proposed replacement method of glenoid defects in reverse arthroplasty exhibited high efficacy.
Бесплатно
Perimortem and postmortem caesarean section: a systematic review
Статья научная
Rationale: Perimortem caesarean section (PMCS) is an emergency procedure performed in pregnant women over 20 weeks of gestation with cardiac arrest, in order to save the mother and the foetus, or only one of them. The objective of the review was to present clinical traits and evaluate survival of mothers and newborns as well as the complications following PMCS. Materials and methods: A systematic review between March and May 2021 was performed using the PRISMA method with the terms "perimortem caesarean section" "postmortem caesarean section", "maternal cardiac arrest", "perimortem caesarean section "AND "case report" "postmortem caesarean section" AND "case report". Results: 23 papers from 12 countries with 39 cases were counted. Of the total sample, 17.94% of the mothers survived and of these, 42.85% had neurological complications. Of 39 newborns counted, 69.23% survived, 28.20% died and in 2.56% the information was missing. 30.76% of the cases followed the five-minute rule and 56.41% required 6 or more minutes, 12.82% did not specify time. Conclusion: The results of this analysis demonstrated higher mortality in women who had a cardiac arrest during pregnancy related to the neonates who survived. The possibility of performing PMCS should neither be ruled out even if the established five-minute time frame has passed, nor should time be invested in verifying foetal viability.
Бесплатно
Polymorphisms of hemostasis and folate cycle genes as predictors of COVID-19 severity
Статья научная
Objective: to identify the frequency of single nucleotide polymorphisms (SNPs) of hemostasis and folate cycle genes in patients with stable coronary artery disease (CAD) depending on the severity of COVID-19 in the acute period. Materials and methods. Our study included 416 patients with CAD who had COVID-19 more than 12 weeks ago with documented severity course. All patients were distributed among two groups. Group 1 included patients with mild severity (n=203), while Group 2 comprised patients with moderate severity (n=213) of COVID-19. All study subjects were examined for polymorphisms of hemostasis and folate cycle genes. We performed an assessment of the following genetic variants: 20210 G>A of the F2 gene, 1691 G>A of the F5 gene, 807 C>T of the ITGA2 gene, 10976 G>A of the F7 gene, 1298A>C of the MTHFR gene, 66 A>G of the MTRR gene, 2756 A>G of the MTR gene, 677 C>T of the MTHFR gene, 455 G>A of the FGB gene, 103 G>T of the F13A1 gene, 675 5G>4G of the SERPINE1 (PAI-1) gene, and 1565 T>C of the ITGB3 gene. These polymorphisms are likely to contribute to a more severe course of COVID-19 in patients with CAD. Results. Predisposing factors for the development of a more severe course of COVID-19 among patients with CAD may be the presence of heterozygous polymorphism (455 G>A) of the FGB gene and 1565 T>C polymorphism (CC genotype) of the ITGB3 gene. Contrariwise, the 807 C>T polymorphism (CC genotype) of the ITGA2 gene in the analyzed sample was associated with a mild course of COVID-19. Conclusion. SNPs 455 G>A of the FGB gene and 1565 T>C (rs5918) of the ITGB3 gene are potential markers for identifying and predicting a more severe course of COVID-19 in patients with CAD
Бесплатно
Статья научная
Objective: assessment of the anatomical and topographical parameters of the wound channel formed in the course of the posterolateral musculofascial approach with the purpose of identifying the possibility of its clinical use in decompressive and stabilizing surgical interventions. Materials and Methods: a posterolateral musculofascial approach to the lumbar spine was modeled using material from 20 male and female cadavers 54 – 76 years of age (median 67.5 years) who died from diseases not associated with the pathology of the spine. The study examined wound length, depth, wound depth index, and wound access zone, as well as the angle of intersection of the wound edges with the surface of surgical instruments. Results: the mean length of the surgical wound when performing the lateral musculofascial approach was 149.75±6.35 mm. The mean depth of the wound was 116.75±8.85 mm. The mean value of the surgical wound depth index with interfascial approach was 77.96±5.04. The mean area of the intervertebral disc available for removal was 71.2±2.8%. The length of the aperture in the annulus fibrosus was on average 15.8±0.78 mm. The mean angle of the intersection of the wound edge by the trajectory of transpedicular screw implantation was 3.15±1.25°. Conclusion:the assessment of the anatomical and topographical parameters of the wound channel formed during the posterolateral musculofascial approach allowed concluding that such surgical approach could be used to improve the functional outcomes of decompressive and stabilizing interventions on the lumbar spine.
Бесплатно
