Vol 24, No 5 (2018)

Articles

BINOCULAR IMPLANTATION OF NEW DIFFRACTIVE TRIFOCAL INTRAOCULAR LENS FOR PRESBYOPIA CORRECTION

Pershin K.B., Pashinova N.F., Tsygankov A.I., Miyovich O.P., Likh I.A., Gurmizov E.P.

Abstract

Aim. Evaluation of the visual and functional results of bilateral implantation of the diffractive trifocal intraocular lens (IOL), the incidence of adverse optical phenomena and the degree of patient satisfaction. Methods. A prospective, open-label study included 82 patients (164 eyes) with presbyopia who underwent cataract phacoemulsification (n = 128) or refractive lensectomy (n = 36) with bilateral implantation of a new multifocal IOL AT LISA tri 839MP. The mean age of the patients was 61.2 ± 11.8 (32-84) years. The period of observation of patients was from 6 to 36 (18.3 ± 3.9) months. Results. After 1 year of follow-up, the increase in UCNVA was observed from 0.19 ± 0.17 to 0.89 ± 0.21, UCIVA from 0.18 ± 0.20 to 0.78 ± 0.17, UCDVA from 0.26 ± 0, 23 to 0.9 ± 0.12 (p <0.05). The increase in BCNVA was from 0.49 ± 0.23 to 0.99 ± 0.07, BCIVA from 0.44 ± 0.27 before and 0.96 ± 0.11 and BCDVA from 0.58 ± 0.25 to 1.0 ± 0.04 (p <0.05). The greatest visual acuity (0.0 logMAR for OU) was noted with a defocus of 0, which corresponds to the point of clear vision in the distance. At -1.0 D (the point of clear vision at an average distance) and -2.5 D (the point of clear vision near), a high visual acuity (0.04 and 0.09 logMAR, respectively) was noted, which indicates a good vision correction in all investigated distances. The frequency of achieving SE in the range ± 0.5 D was 92.7%. The primary endpoint of the study (BCDVA = 1.0) in the long-term follow-up period was 95.1%. In all cases, high patient satisfaction and a low incidence of undesirable side effects were noted (glare, halo, difficulty in driving). Conclusion. Implantation of the trifocal IOL AT LISA tri 839MP leads to a good level of functional vision restoration at near, average and far distance after cataract surgery and clear lens removal.
Medical Journal of the Russian Federation. 2018;24(5):228-232
pages 228-232 views

EFFECTIVENESS OF GLUTEUS MAXIMUS FASCIA PLASTY FLAP FOR CLOSURE OF WOUND IN SURGICAL TREATMENT OF PILONIDAL DISEASE

Kitsenko Y.E., Shlyk D.D., Tulina I.A., Markaryan D.R., Tsarkov P.V.

Abstract

Aim: to compare short- and long-term results of primary midline closure and gluteus maximus fascia flap plasty after pilonidal sinus excision. Method: retrospective analysis included consecutive patients who had primary and recurrent pilonidal sinus excised. Patients with gluteus maximus fascia flap plasty formed 1st group, patients with primary midline closure formed 2nd group. Gluteus maximus fascia flap plasty technique: (i) separation in lateral directions of both gluteus maximus fascia from muscle and subcutaneous tissue; (ii) mobilised fascia flaps are brought together to midline and sutured; (iii) subcutaneous fat and skin sutured. Results: 60 patients operated in 2007-2016 were included: 28 in 1st group, 32 in 2nd group. Groups 1 and 2 didn’t differ in operation time (41.9±4.0 and 37.3±3.1 min, p=0.4), blood loss (6.9±0.5 and 8.3±1.6 ml, p=0.2), draining rate (7.1% and 12.5%, p=0.5), hospital stay (11.8±1.3 and 9.1±1.0 days, p=0.1), time to complete wound epithelialization (1.2±0.2 and 1.5±0.4 months, p=0.37). Mean follow-up was 20.7±3.2 and 53.8±6.5 months respectively. Recurrence rate was significantly lower in gluteus maximus fascia flap plasty group (3.6%) than in the 2nd group (21.9%, p=0.04). Conclusion: gluteus maximus fascia flap plasty after pilonidal sinus excision is feasible, doesn’t increase postoperative complications rate and leads to a lower recurrence rate compared to midline closure.
Medical Journal of the Russian Federation. 2018;24(5):233-236
pages 233-236 views

COURSE AND OUTCOME OF PREGNANCY, OBSTETRIC TACTICS BY PRETERM RUPTURE OF MEMBRANES AT THE TERM OF 24-32 WEEKS

Dudareva Y.A., Guryeva V.A., Filchakova O.N.

Abstract

The birth of premature children is the cause of the increase in morbidity and perinatal mortality in the country, that is why it is necessary to carry out not only prognosis of premature births but also to correctly determine the tactics of managing patients with premature rupture of membranes. The objective of the study was to evaluate the course of pregnancy, perinatal outcomes, depending on the chosen tactics of managing women with premature discharge of amniotic fluid in the period of 24-32 weeks of pregnancy. Materials and methods: 46 patients were included in this study, 26 of them were the main group with premature rupture of membranes at a gestation period of 24-32 weeks, long anhydrous period (more than 48 hours), and 20 patients were included into the control group. The main criterion for inclusion in the control group was a spontaneous active onset of labor at a gestation period of 24-32 weeks, with an anhydrous period of less than 12 hours. Results: Patients of both groups were comparable in age, frequency of extragenital and gynecological pathology, main characteristics of menstrual function, parity and outcomes of pregnancies. In the presence of certain conditions in the main group, it was possible to apply expectant management tactics, which, on average, prolonged the pregnancy by 12.0 ± 2.3 days, which in 30.8% of cases was accompanied by the development of chorionamnionitis (p = 0.020), without interrelation with duration of anhydrous period and frequency of postpartum purulent-septic complications. It was found that perinatal outcomes, weight and condition of newborns at birth were much better in women in the main group. Conclusion: The reasonably chosen expectant management strategy for women with premature rupture of membranes at the gestational period of 24-32 weeks, subject to certain conditions, will improve perinatal outcomes without significantly increasing the incidence of infectious and inflammatory processes in the mother and newborn.
Medical Journal of the Russian Federation. 2018;24(5):237-241
pages 237-241 views

CHANGING THE AMINO ACID IN THE URINE OF CHILDREN OF CHILDREN AND ADOLESCENTS UNDER THE INFLUENCE OF MILK «FORMULA ROSTA STANDART»

Mazanova N.N., Gorelova Y.Z., Bakanov M.I., Vasilyeva E.M., Letuchay T.A.

Abstract

Using the method of determining the amino acid spectrum in daily urine is important for conducting early diagnosis of many diseases and hereditary metabolic defects, reflecting the complete picture of the amino acid state in the patient's body. The study of 24-hour urine makes it possible to avoid difficulties with the transportation and storage of biomaterial. Evaluation of the results of the study made it possible to identify the lack of nutrition among schoolchildren, helped to adjust nutrition to weakened children and improve the physical and mental performance of schoolchildren. The examined weakened children did not suffer from this or that form of pathology of metabolism. The presented changes in the concentration of amino acids in the urine of schoolchildren before the reception of the dairy product "Formula Growth Standard" and after taking dairy products demonstrated the modern possibilities of personal selection of diet therapy and improving the quality of life of a teenager.
Medical Journal of the Russian Federation. 2018;24(5):242-248
pages 242-248 views

CHEMOTHERAPY OF RESPIRATORY TUBERCULOSIS IN CHILDERN AND ADOLESCENTS: SCIENTIFIC APPROACHES TO SOLVING THE PROBLEM

Ovsyankina E.S., Gubkina M.F., Panova L.V., Ergeshov A.E., Yukhimenko N.V., Khokhlova Y.Y.

Abstract

The article presents scientific approaches to the solution of actual problems of chemotherapy for children and adolescents tuberculosis with multiple pockets and extensively drug-resistant TB (MDR/XDR) pathogen to anti-TB drugs has the source of infection and the patient himself. The urgency of the problem determines: increase in the adult population of the M. tuberculosis with the specified allocation stability, the need for the drug susceptibility test of the source of infection to choose a starting chemotherapy regimen is determined by the negative M. tuberculosis status in the diagnostic material of the majority of children and adolescents. Patient-specific approach to chemotherapy is necessary subject to age limitations when choosing antituberculous drugs. Particular attention is paid to chemotherapy after surgical treatment. The results of scientific research carried out in accordance with WHO guidelines; indicate the possibility to shorten the duration of chemotherapy and to reduce the number of drugs in the treatment regimen without decreasing treatment efficacy.
Medical Journal of the Russian Federation. 2018;24(5):249-253
pages 249-253 views

PULMONARY TUBERCULOSIS WITH MULTIPLE DRAG-RESISTANT M. TUBERCULOSIS IN PATIENTS WITH DIABETES MELLITUS

Komissarova O.G., Abdullaev R.Y., Aleshina S.V., Romanov V.V.

Abstract

The aim of the study was to study the clinical manifestations and effectiveness of treatment of pulmonary tuberculosis with multidrug-resistant (MDR M. tuberculosis (MTB) in patients with different types of diabetes mellitus (DM). 66 patients with pulmonary tuberculosis combined with type 1 diabetes mellitus and 48 patients with pulmonary tuberculosis combined with type 2 diabetes were examined. It was found that in patients with type 1 DM, MDR tuberculosis was more often observed in men under 40 years of age, in the form of infiltrative pulmonary tuberculosis with the presence of destruction in lung tissue up to 2 cm in diameter with positive sputum and acute intoxication. In patients with type 2 DM, MDR tuberculosis was more often observed in men over the age of 40 in the form of fibrous-cavernous tuberculosis with the presence of destruction in lung tissue larger than 2 cm in diameter, with positive sputum and moderately severe intoxication. The effectiveness of treatment for negativation sputum in the compared groups did not differ significantly and amounted to 71,2% and 64,7%, respectively. However, to close the caverns in the lung, the treatment was more effective in patients with type 1 diabetes, which is probably due to the peculiarities of the tuberculosis process in this category of patients.
Medical Journal of the Russian Federation. 2018;24(5):254-257
pages 254-257 views

THE POSSIBILITY OF APPLICATIONS OF MODERN METHODS OF BRONCHODILATOR THERAPY IN PATIENTS WITH DIFFERENT FORMS OF PULMONARY TUBERCULOSIS

Kuklina G.M., Shmelev E.I.

Abstract

The paper presents the results of the possibility of applications of modern methods of bronchodilator therapy in patients with different forms of pulmonary tuberculosis, combined with COPD and asthma. On a large contingent of patients, the clinical efficacy of bronchodilator therapy has been demonstrated. In this case, the positive effect of bronchodilator therapy was distributed in three main areas: the general condition of patients, the course of tuberculosis and the course of COPD and asthma. In all three directions, positive results were obtained: the general condition of patients improved, the terms of bacilli were reduced and the rate of regression of the tuberculosis process increased, and the effectiveness of control of COPD and asthma increased. These data are a reliable indicator of the feasibility of cooperation between phthisiology and pulmonology.
Medical Journal of the Russian Federation. 2018;24(5):258-263
pages 258-263 views

CHOICE OF METHODS OF ANESTHESIA FOR SURGICAL OPERATIONS AND POSTOPERATIVE PAIN MANAGEMENT IN PATIENTS WITH SKIN AND SOFT TISSUE INFECTIONS

Rhalib S.M., Sviridov S.V., Vedenina I.V.

Abstract

The article presents a review of the literature highlighting to the choice of methods of anesthesia and treatment of postoperative pain syndrome in patients with skin and soft tissue infections (SSTI). Taking into account the particularity of patients with SSTI, who need multiple operations and long hospitalization, the choice of the method of anesthesia directly affects the quality of the patient’s postoperative management, contributes to the prevention of chronic pain, which facilitates the earlier activation of the patient.
Medical Journal of the Russian Federation. 2018;24(5):264-269
pages 264-269 views

DRAINING AUTO VALVE LIMBOSCLERECTOMY IN POSTTRAUMATIC GLAUCOMA TREATMENT

Lapochkin A.V., Lapochkin D.V., Zakharova D.A., Ovsyanko A.A., Spirin D.V.

Abstract

The aim of the current article is to report the case of a patient with posttraumatic glaucoma who underwent a successful a draining auto valve limbosclerectomy (DALS) 6 months ago. A 65-year-old patient admitted on April 2017 with history of blunt left eye trauma. The diagnosis of severe eye contusion, Ectopia lentis and ocular hypertension was made. A subtotal vitrectomy, lensectomy and iris fixation of posterior chamber intraocular lense were performed the next day. A laser trabeculoplasty was performed 10 days after surgery for lowering IOP. During a follow-up examination, the patient was found high IOP in the left eye despite maximum IOP-lowering topical treatment. A draining auto valve limbosclerectomy (DALS) was performed in the left eye. The reduction in IOP has subsequently been maintained over six months of follow-up. This patient’s experience is a single case, yet it contributes to the evidence that a draining auto valve limbosclerectomy (DALS) may be high efficient in posttraumatic glaucoma treatment.
Medical Journal of the Russian Federation. 2018;24(5):270-272
pages 270-272 views

ON THE 85TH ANNIVERSARY OF THE BIRTH OF VLADIMIR POTEMKIN

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Medical Journal of the Russian Federation. 2018;24(5):273-274
pages 273-274 views

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