Modern Methods Of Diagnosis Research Articles

РЕЗУЛЬТАТЫ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ОПУХОЛЕЙ СПИННОГО МОЗГА И ПОЗВОНОЧНИКА С КОМПРЕССИЕЙ НЕВРАЛЬНЫХ СТРУКТУР

Spinal cord tumors, differing in their histostructure, the nature of growth and the ratio to the diameter of the spinal cord, continue to be a difficult problem, both in terms of choosing the optimal treatment tactics and results. We present the results of surgical treatment of the most common spinal chord neoplasms in 2022, conducted in the Alexandro-Mariinskaya Regional Clinical Hospita. The purpose of the study – to present the results of surgical treat-ment of spinal cord and spine tumors with secondary compression of neural structures that differ in histostructure, de-gree of malignancy and level of lesion. In 2022, 19 patients were operated on by various methods in the Alexandro-Mariinskaya Regional Clinical Hospita. 3 clinical cases with different histostructure and topographic-anatomical level of lesion are presented. Surgical treatment of spinal cord tumors was performed in 19 patients with different histostruc-ture and topographic and anatomical lesion levels. Using the example of three clinical cases, the choice of various sur-gical treatment tactics that are most optimal for maintaining the patient's quality of life is demonstrated. The analysis of the surgical manual, its relationship with the prognostic trend, which affect the overall survival of patients with tu-mors of the spinal cord and spine. The dependence of a number of factors was revealed: the histological structure, the degree of “aggressiveness” of the oncological process, the possible spread of metastatic foci in the body. This, in turn, is interconnected with modern methods of diagnosis, surgical and adjuvant treatment, neurological and somatic compen-sation of the patient, which will allow to determine and transfer the aggressiveness of the indicated treatment method. The available modern equipment, accumulated surgical experience and the chosen active tactics for the maximum total removal of the lesion justified themselves, allowing to achieve a good functional result in 18 of the 19 operated patients.

НЕСОСТОЯТЕЛЬНОСТЬ РУБЦА МАТКИ ПОСЛЕ КЕСАРЕВА СЕЧЕНИЯ: СОВРЕМЕННЫЕ МЕТОДЫ ЛЕЧЕНИЯ (ОБЗОР ЛИТЕРАТУРЫ)

In modern gynecology, doctors are faced with the problem of uterine scar failure after cesarean section. The topic is difficult and debatable both during pregnancy and outside of pregnancy. The article summarizes information from the English and Russian-language literature on modern methods of diagnosis and correction of an untenable uterine scar after cesarean section, which allow to preserve reproductive health and improve the quality of life of patients.

Modern methods of diagnosis and treatment of inflammatory bowel diseases

The treatment of patients with inflammatory bowel disease is an ever-evolving field of medicine. However, doctors often face difficulties in managing such patients. In this interview, E.A. Belousova shares her expert opinion on modern methods of diagnosis and treatment of inflammatory bowel disease, paying special attention to a multidisciplinary approach to the management of concomitant diseases and the prevention of complications caused by drug therapy.

Endocrine disorders and their impact on reproductive health: modern aspects of diagnosis and treatment

This work is a comprehensive review of modern aspects of the diagnosis and treatment of endocrine disorders and their impact on reproductive health. The basic principles of the functioning of the human endocrine system are highlighted, including the role of hormonal balance in maintaining the health and functioning of the reproductive system. Various types of endocrine disorders and their effects on reproductive health are also being investigated. In particular, conditions such as hypothyroidism, hyperthyroidism, polycystic ovary syndrome (PCOS), hyperprolactinemia and diabetes, their symptoms, diagnosis and treatment are highlighted. Special attention is paid to the relationship between endocrine disorders and infertility, as well as methods of correcting hormonal imbalances to restore reproductive function. In addition, modern methods of diagnosis and treatment of endocrine disorders are discussed, including laboratory and instrumental methods, molecular genetic studies, as well as advanced approaches in pharmacological therapy, surgical interventions and alternative methods such as active surveillance and lifestyle changes.

Pasteurella multocida and Mannheimia haemolytica; virulence factors, diseases, and notably increasing antibiotic resistance rate among their isolates: a comprehensive review

TThe current review on Pasteurella multocida and Mannheimia haemolytica tried to shed light on these two organisms due to their medical and economic importance as well as to their elevating antibiotic resistance rate among the isolates from animals basically cattle, sheep, and goats. In this comprehensive review, we screened both old and recently published works that are available electronically on authorized scientific sites. Here we provide the latest data on those organisms their structure, suitable growth conditions, virulence factors, pathogenesis, their associated diseases, and their distribution along with antibiotic resistance emergence and the possibility of more new emergences of resistant isolates among species of both organisms. Lastly, we reviewed all the old and modern methods for diagnosis, controlling, and preventing the occurrence of diseases caused by these organisms besides studying and reviewing the effective ways to manage antibiotic resistance issues. Our review concluded that more specific research is needed to shed light on phenotype and genotype differences among those organisms, some issues should be subjected to intensive investigations and research focus such as emerging and re-emerging infectious diseases caused by these organisms and antigenic variants between agents. Evaluation of innate and adaptive immunity after infections or vaccinations is important for producing more specific drugs or vaccines in the future.

CLINICAL AND IMMUNOLOGICAL FEATURES OF REACTIVATION OF CHRONIC LYME BORRELIOSIS AFTER A PREVIOUS INFECTION OF COVID-19

A clinical case of reactivation of chronic Lyme borreliosis after a COVID-19 infection has been described. The purpose of the study is to use the example of a clinical case of reactivation of chronic Lyme borreliosis to demonstrate the peculiarities of its course, and modern methods of diagnosis and treatment, as well as to confirm the potential impact of coronavirus disease on the possibility of reactivation of chronic infectious pathology, even with a mild course of the COVID-19 infection. Materials and Methods. A diagnosis of borreliosis polyarthritis and Lyme myocarditis has been established. Since the specific lesions occurred for no apparent reason, and the symptoms appeared in winter, this ruled out the possibility of re-infection with Lyme borreliosis. During the further search for a potential causative agent that led to the detected changes, the patient was tested for the detection of antibodies to Borrelia burgdorferi by immunoenzymatic analysis. Results and discussion. The obtained positive result in the detection of specific antibodies (IgM – 46.64 units/ml, IgG – 87.31 units/ml) indicated the reactivation of Lyme borreliosis. At the same time, the immunological changes were significantly deeper than during the initial episode of infection. Treatment was prescribed: doxycycline 100 mg twice a day for 28 days, anti-inflammatory therapy. After completion of the course of etiotropic therapy, there was clinical remission, as well as negative results of specific IgM after 3, 6, and 12 months. Even 3 months after achieving clinical remission, the patient had residual immunological changes. Conclusion. So, the clinical case shows the difficulties of establishing a diagnosis of reactivation of Lyme borreliosis, and the need for clinical vigilance of practical healthcare specialists regarding similar cases, even with a mild course of the COVID-19 infection, is emphasized.

Epidemiological data, etiology, pathogenesis, risk factors, clinical manifestations, modern methods of diagnosis and treatment, prediction of the course of multiple myeloma (literature review)

Background. Multiple myeloma (MM) is a neoplastic disease with a multistage course characterized by uncontrolled, multifocal proliferation of monoclonal plasma cells in the bone marrow, which produce monoclonal immunoglobulin or only its fragments, which lead to destruction of bone tissue and organ damage. Quite high rates of both morbidity and mortality from MM require more careful attention and deeper scientific research of this problem. Objective of the article is to investigate the epidemiology, etiology, pathogenesis, risk factors, clinical manifestations, modern methods of diagnosis and treatment, and also prediction of the course of MM. Methods. The following research methods were used: search, extraction and processing of information; assessment of the quality of sources; systematic literature review; content analysis. Research materials are thematic publications of ukrainian and foreign scientists. Results. MM accounts for ~1% of all malignant neoplasms and ~14% of hematological neoplasms worldwide. Etiological factors of MM: genetic predisposition, bacterial or viral infections, ionizing radiation, carcinogenic toxins. The clinical syndrome of MM is characterized by hypergammaglobulinemia, hypercalcemia, susceptibility to infections, and pathological fractures. Diagnosis of MM includes: general analysis of peripheral blood; diagnosis of serum and urine proteins; aspiration biopsy and trepanobiopsy of bone marrow; cytogenetic and molecular diagnostics; other laboratory diagnostics; radiography, CT, MRT and PET-CT. The main methods of treatment of MM: radiation therapy, chemotherapy, combined CT with the inclusion of new drugs, HDCT + autologous THSC. Prediction of the course of MM depends on the R-ISS stage, LDH level and high-risk cytogenetics. Conclusion. During the last years of modern oncohematology, we observe scientific achievements in the diagnosis and treatment of MM. A thorough study of the epidemiology, etiology and pathogenesis, risk factors and clinical manifestations of MM contribute to effective diagnosis and selection of the optimal treatment strategy and tactics, as well as determining the prognosis of the course of MM.

Modern Approach to Fabry Disease Diagnosis and Management in Children

Fabry disease (FD), or Andersen-Fabry disease, is a rare hereditary lysosomal disease (sphingolipids storage disease) characterized by progressive multisystem involvement. The major symptoms among children are neuropathic pain / acroparesthesia, angiokeratomas, hypo- or anhidrosis, vortex keratopathy. Biochemical tests, molecular genetic testing, and family screening play crucial role in the diagnosis of the disease. Specific pathogenetic treatment of FD includes enzyme replacement therapy (ERT) with recombinant medications of the lysosomal enzyme -galactosidase A. ERT initiation before the development of severe organs and systems’ damage contributes to its higher efficacy. This article covers various aspects of pathogenesis, clinical picture features in childhood, modern methods of diagnosis and management of FD according to literature data.

Modern methods of diagnosis and treatment of lacrimal stenosis. Literature review

This analysis is based on the study of Russian and foreign literature sources devoted to both high-tech and routine methods of studying the lacrimal drainage system, as well as the description of modern methods of conservative and surgical treatment of lacrimal stenosis. This article gives information about advantages and disadvantages of each of the methods of diagnosis and treatment of obliteration of the lacrimal tract, highlights the questions of their usage in dacryology.

EFFECTIVENESS OF CONSERVATIVE THERAPY IN THE TREATMENT OF KITTENS WITH NEUROLOGICAL DEFICIENCY OF THE THIRD DEGREE CAUSED BY A SPINE FRACTURE ALONG THE LOWER MOTOR NEURON OF THE PELVIC LIMB

The article discusses the practice of conservative treatment of changes in the body that kittens suffer from these various neurological disorders, consisting in a complete restriction of cell activity during the period of body fusion. Modern methods of diagnosis and surgical treatment of compression fractures in different parts of the spine have changed towards less invasive, have become more selective and take into account the needs of patients. The purpose of this study was to determine the effectiveness of conservative therapy on the process of spinal fusion and the dynamics of neurological deficits in cases where surgical treatment is not possible. Neurological deficit of the third degree in the pelvic limbs was determined by non-ambulatory paresis, which was accompanied by paraparesis, hyporeflexia of the pelvic limbs, preservation of deep pain sensitivity, pronounced proprioceptive deficit with partial preservation of gait. Analysis of the considered clinical cases allows us to assert that in conditions where it is not possible to carry out surgical treatment of spinal fractures in kittens with pathology up to the third degree of neurological deficit, conservative therapy is effective and applicable, consisting of a complete restriction of activity for the period of fusion of the spine, as well as the use of analgesia. The study does not exclude surgical stabilization of spinal fractures.

Modern methods of diagnosis and monitoring of keratoconus

The article presents data on modern methods of diagnosis and monitoring of keratoconus. The main pathognomonic signs are described according to routine research methods: biomicroscopy, viso-, autoref- and keratometry, as well as special research methods such as keratotopography, keratotomography, optical coherence tomography, aberrometry, confocal microscopy and the study of biomechanical properties of the cornea. The “gold standard” in the diagnosis of subclinical keratoconus, today, is scanning keratotomography on a Scheimpfl ug camera with the Belin-Ambrósio enhanced ectasia protocol embedded in the device

Primary disability caused by glaucoma in the Krasnoyarsk region

PURPOSE. Assessment of the state of primary disability (PD) caused by glaucoma in the adult population of the Krasnoyarsk Region over time in the period from 2017 to 2021.METHODS. The information from the reporting documentation of the Bureaus of Medical and Social Expertise (MSE) of Russia and the Krasnoyarsk Region for 2017–2021 was analyzed. The analysis of primary disability indicators was carried out for two age groups of the adult population: individuals of working age (men aged 18–59; women aged 18–54) and individuals of retirement age (men aged 60 and older; women aged 55 and older). The obtained results were processed using the Statistica 10.0 software (StatSoft, USA).RESULTS. During 2017–2021 in the Krasnoyarsk Region, 1930 adults were recognized for the first time as disabled due to an ocular pathology. Glaucoma occupied the first ranking place — 31.0% (599) of cases in the structure of primary disability. Individuals of retirement age became disabled in 86.8% (520) of cases. Residents of the cities of the region became disabled in 69.1% (414) of cases. Males dominated among those who were recognized as disabled for the first time (RDF) due to glaucoma — 60.4% (362) of cases. The level of PD for glaucoma among the adult population of the region in 2017 was 0.52, in 2018 — 0.52, in 2019 — 0.59, in 2020 — 0.44, in 2021 — 0.57 per 10 thousand adult population. For five years, there was an increase in the level of PD due to glaucoma by 50% among the able-bodied urban population of the region, by 45.6% among senior citizens, by 110% among the able-bodied village population. In persons of retirement age living in rural areas of the region, the prevalence of PD decreased by 21.1%. The maximum values of the intensive indicator of PD were determined for men of retirement age: in 2017 — 3.6 per 10 thousand, in 2021 — 3.8 per 10 thousand of the corresponding population of the region. Formation of the contingent of disabled people occurred mainly due to the RDF of I and II disability groups. The proportion of group I disability was the largest — 40.4% (242/599) of cases. People with group I disability were more often treated with local antihypertensive drugs, were operated on at stage 3 of glaucoma.CONCLUSION. To reduce primary disability for glaucoma it is necessary to increase preventive efforts, timely use modern methods of diagnosis and treatment, including surgery, and ensure sufficient availability of ophthalmological personnel and high-tech equipment.

Adult Moyamoya Disease and Syndrome: Current Perspectives and Future Directions: A Scientific Statement From the American Heart Association/American Stroke Association.

Adult moyamoya disease and syndrome are rare disorders with significant morbidity and mortality. A writing group of experts was selected to conduct a literature search, summarize the current knowledge on the topic, and provide a road map for future investigation. The document presents an update in the definitions of moyamoya disease and syndrome, modern methods for diagnosis, and updated information on pathophysiology, epidemiology, and both medical and surgical treatment. Despite recent advancements, there are still many unresolved questions about moyamoya disease and syndrome, including lack of unified diagnostic criteria, reliable biomarkers, better understanding of the underlying pathophysiology, and stronger evidence for treatment guidelines. To advance progress in this area, it is crucial to acknowledge the limitations and weaknesses of current studies and explore new approaches, which are outlined in this scientific statement for future research strategies.

Multiple organ failure in patients with combined breast injury: diagnosis and treatment

Relevance. Modern methods of diagnosis and treatment of victims with severe combined trauma, the fulfillment of the conditions of the "golden hour" do not solve the problem of a favorable outcome, sepsis and multiple organ failure (PON) remain the main cause of death.The purpose of the study. To study the possibilities of complex diagnostics and treatment using combined methods of extracorporeal hemocorrection in patients with PON after severe combined breast injury.Object and methods. The results of diagnosis and treatment of 20 victims with combined chest injury were analyzed. The criteria for inclusion in the study were as follows: age over 18 years; severe combined closed chest injury: AIS > 2 on the background of combined injuries, ISS 28–34 points, severity of the condition on the ARASNE II scale over 20 points, the use of extracorporeal hemocorrection (MEG) methods.The results of the study. In patients with severe combined breast injury, the severity of the course of multiple organ failure is shown and the effectiveness of combined methods of extracorporeal hemocorrection (MEG), the features of manifestations of PON and the dynamics of changes in indicators against the background of complex treatment is determined. The main method of diagnosis of PON was a clinical and laboratory picture, taking into account coagulological, biochemical disorders, biomarkers of inflammation and instrumental assessment of CT of the lungs and ultrasound picture of the state of parenchymal organs of the chest and abdomen.Сonclusions. An integrated approach to the management of victims with PON, including early MEG, helps to reduce intoxication, stabilize the condition and increases life expectancy.

Prospects for diagnostics and treatment of neurofibromatosis type 1 in Russia

Purpose of the study. Analysis of available data on modern methods of diagnosis and treatment of neurofibromatosis type 1 (NF1) and their application in the Russian Federation. Material and Methods. The search for relevant sources was carried out in the Scopus, Web of Science, PubMed, Elibrary systems, including publications from February 1992 to December 2022. Of the 1873 scientific articles found, 48 were used to write a systematic review. Results. Neurofibromatosis type 1 (NF1) is caused by germline heterozygous mutations in the NF1 gene, which encodes the neurofibromin protein, which suppresses mitogen-activated signaling pathways necessary for cell proliferation. Clinical manifestations of NF1 are similar to Peutz–Jeghers, Laugier–Hunziker, Rusalkab–Muret–Smith, Bannayan–Zonnana, LEOPARD syndromes, neurofibromatosis type 2 and lipomatosis; therefore, to confirm the diagnosis, the most important criterion is the detection of a gene mutation by sequencing, since there are no mutagenesis hotspots in the NF1 gene. To detect 17q11.2 locus microdeletions, MLPA method is used. In Russia, such methods of molecular genetic identification of NF1 were carried out in Moscow and in the Republic of Bashkortostan. Surgical interventions using a neodymium laser and therapy with mitogen-activated protein kinase inhibitors are the most effective for the treatment of tumor syndrome. Scientific results of the use of a surgical laser in the treatment of plexiform neurofibromas and extramedullary tumors of the spinal cord have been published in Russia. Treatment of NF1 with selumetinib in Russia was announced by the interregional public organization for assistance to patients with neurofibromatosis “22/17”, which provides the drug to children with inoperable neurofibromas free of charge. Conclusion. In modern medicine, it is necessary to widely use methods for identifying mutations in the NF1 gene by creating universal panels of targeted sequencing. This will allow not only the differential diagnosis of NF1, but also the identification of the cause of chemoresistance of sporadic malignant neoplasms for the introduction of mitogen-activated protein kinase inhibitors in their treatment. Combination of this method with surgical excision of neurofibromas using a neodymium laser is optimal.

Modern methods of diagnosis and treatment of patients with COVID and post-COVID anosmia

Since 2019, the interest in coronavirus infection has increased worldwide due to the emergence of several pandemic outbreaks associated with this group of pathogens. In total, 3 outbreaks of pandemics were registered in the 21st century, caused by new strains of coronaviruses: MERS-CoV, SARS-CoV and SARS-CoV-2. Among them the leader in prevalence, occurrence of severe respiratory complications and mortality is SARS-CoV-2. SARS-CoV-2 is the causative agent of the coronavirus disease of 2019. COVID-19 is a disease characterized by acute respiratory viral syndrome, transmitted by airborne droplets. The clinical course of COVID-19 varies significantly from patient to patient and can range from asymptomatic to severe forms. One of the common symptoms of the manifestation of COVID-19 is a smell disorder. The pathogenesis and clinical course of coronavirus infection caused by SARS-CoV-2 were examined to identify the causes leading to olfactory disorders in the manuscript. The analysis of existing methods for the diagnosis of olfactory disorders and their treatment was also carried out. The content of the article includes current hypotheses of the pathogenesis of viral anosmia in COVID-19 and a new look at the relevance of this problem among the population around the world. The article analyzes scientific data on the problem of anosmia in coronavirus infection caused by SARS-CoV-2, investigates modern diagnostic methods, highlights the principles of treatment of patients with post-COVID anosmia and presents prospects for further research on this problem.

Tonsillitis in the practice of a nurse

The problem of acute and chronic tonsillitis remains relevant from year to year both in medical and general medical terms. Tonsillitis is still one of the most frequent manifestations of upper respiratory tract diseases. The article reflects the issues of epidemiology, etiopathogenesis, and classification of various tonsillitis forms. Modern methods of diagnosis and differentiation of viral and bacterial forms of the disease are considered. Modern recommendations in the tactics of treatment of these patients are taken into account.

The role of isthmic-cervical insufficiency in miscarriage

Cervical insufficiency (CI) is one of the main pathological conditions that leads to pregnancy loss, in particular, recurrence miscarriages and premature births, which account for up to 5 % of all obstetric cases. Recurrence pregnancy losses caused by CI lead to serious psychological trauma for both the woman and her family members, as well as significant economic losses for the society. However, many women in some regions of the world still do not know about this pathology, and clinicians do not always diagnose this condition in time.At the same time, etiology of CI remains uncertain, and there are still ambiguous points regarding the diagnosis of this pathology and its treatment. The diagnosis of CI should be established by analyzing the medical history, clinical manifestations and results of ultrasound examination. Treatment of CI mainly includes surgical and conservative methods. Surgical treatment is performed with cervical cerclage, while conservative techniques mainly include the use of vaginal progesterone and insertion of various types cervical pessaries. This article summarizes the potential risk factors associated with cervical insufficiency that are of great attention and may be useful for future researches. Also, the review of the literature considers modern methods of diagnosis and treatment of CI to understand this pathology of the cervix better. From a modern standpoint, a consensus and problematic issues are presented in accordance with the recently updated recommendations, which are of practical importance, and are also important for further deeper research on this topical issue of modern obstetrics.

Benign neoplasms of the colon: problems and solutions

Benign neoplasms of the colon, rectum, anus and anal canal are true neoplasia of the colon mucosa and are associated with a high risk of colorectal cancer (CC). The literature review analyzes epidemiology, risk factors, and modern methods of diagnosis and treatment, and describes priority minimally invasive interventions for benign colorectal tumors.

Multidisciplinary Approach to Recurrent Upper Respiratory Tract Diseases in Children. Intermediate Study Results

The issue of recurrent upper respiratory tract diseases in children is common and relevant. Commonly this pathology is associated with other diseases that lead to the prolonged, complicated, or chronic course of the inflammatory process in the upper respiratory tract. Objective. The aim of the study is to improve management principles for children with recurrent upper respiratory tract diseases according to the developed multidisciplinary and personalized approach (modern methods of diagnosis and health monitoring) for achieving long-term remission. Methods. The study included 65 children aged from 3 to 17 years 11 months with recurrent upper respiratory tract diseases. Examination: nasal, nasopharynx and larynx endoscopy, abdominal ultrasound with aqueous-siphon test, tympanometry, and laboratory tests (complete blood count, evaluation of total and specific IgE levels, antistreptolysin O, nasopharynx and oropharynx microbiological study, enzyme-linked immunosorbent fecal analysis for Helicobacter pylori). Results. 88% of examined children showed allergic pathology according to our study results. Clinical signs of gastroesophageal reflux disease (GERD) were revealed in 30% of children with chronic oropharynx inflammation. GERD signs were revealed both via abdominal ultrasound with aqueous-siphon test and via fiberoptic laryngoscopy and later confirmed by esophagogastroscopy in 8.7% of patients. Obtained data indicates high prevalence of allergic and gastroenterological pathology in children with recurrent upper respiratory tract diseases. Conclusion. Obtained results allow us to establish scientifically multidisciplinary and personalized approach for the management of children with recurrent upper respiratory tract disease. This approach shall include key diagnostic methods required for improvement of comorbid conditions revealing, and achieving and maintaining control over the disease symptoms. The study is currently ongoing.