Nizhniy Novgorod, Russia
Nizhniy Novgorod, Russia

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Averyanov M.Y.,Kirov State Medical Academy | Gaar E.V.,Russian Railways | Gorokhov V.N.,City Clinical Hospital No39
Sovremennye Tehnologii v Medicine | Year: 2011

The aim of the study is to analyze the effectiveness of non-tension and traditional hernioplasty techniques in abdominal hernias of various localizations taking into account the postoperative period peculiarities, the frequency of postoperative complications and recurrences. Materials and methods. There have been analyzed the results of surgical treatment in 348 patients with hernias of various localization. In 268 of them there has been performed hernioplasty using meshed endoprosthesis (the main group), and in 80 of them - using traditional technique (control group). Conclusion. Non-tension hernioplasty techniques have a number of essential advantages compared to traditional ones. The advantages are the following: absence of a marked pain syndrome in postoperative period, lack of the necessity to administer narcotic preparations, the decrease of powerful analgesic administration, shortening of hospitalization period. In any hernia localization, atension plasty is less traumatic and can be performed under spinal or local anesthesia. It provides rapid rehabilitation and early return to work, significantly decreases the number of recurrences and complications.

Fraerman A.P.,Nizhny Novgorod regional neurosurgical center | Syrkina N.V.,City Clinical Hospital No39 | Zhelezin O.V.,City Clinical Hospital No39
Sovremennye Tehnologii v Medicine | Year: 2010

A classification and peculiarities of the combined craniocerebral trauma acute period clinical manifestation depending on localization of the intracranial damages (a damage of a facial skeleton, a spinal cord, a chest, the abdominal cavity organs) are presented in the first part of lecture. The organism general reactions at the different combinations of damages (a traumatic shock, hemorrhage, fat embolism) are demonstrated.

Yarikov A.V.,City Clinical Hospital No39 | Balyabin A.V.,39 Health | Yashin K.S.,Privolzhsky Federal Research Medical Center | Mukhin A.S.,Nizhny Novgorod State Medical Academy
Sovremennye Tehnologii v Medicine | Year: 2015

The review presents the comparative analysis of current surgical techniques to treat atherosclerotic carotid lesions: carotid stenting and carotid endarterectomy (classical and everting), and describes the advantages and disadvantages of these methods introducing indications and contraindications. Particular emphasis is given to the technique and time to complete carotid endarterectomy. The paper concerns the benefits of a patch over a primary suture, as well as presents the requirements for a patch used in carotid endarterectomy. The authors studied all current materials used for patches, and gave merits and demerits of each material described. The review assesses the feasibility and safety of the more invasive surgical approach for brain revascularization in an acute period of ischemic stroke in strict compliance with surgical indications. The authors have concluded that carotid endarterectomy has a positive effect on cognitive functions in patients in the form of neurological and neuropsychological status improvement. There has been also proved that all above mentioned techniques have no advantages, moreover, they can be mutually complementary and, actually, used in chronic cerebral ischemia treatment. © 2015, Nizhny Novgorod State Medical Academy. All rights reserved.

Fraerman A.P.,Nizhny Novgorod interregional neurosurgical center | Syrkina N.V.,City Clinical Hospital No39 | Zhelezin O.V.,City Clinical Hospital No39 | Gomozov G.I.,City Clinical Hospital No7
Sovremennye Tehnologii v Medicine | Year: 2010

An algorithm of the emergency measures at a combined craniocerebral trauma elaborated on a basis of the proper investigation results and literary modern data is presented in the second part. The basic principles of the combined trauma diagnosis and treatment are stated. The main statements, defining a surgical tactics at the brain damage different combinations (at the craniocephal and cranioverteral traumas, traumas of breast, abdomen, the extremity fractures and etc.), are regarded in detail.

Lobanov I.A.,City Clinical Hospital No39 | Shakhov B.E.,Nizhny Novgorod State Medical Academy | Medyanik I.A.,Nizhny Novgorod Research Institute of Traumatology and Orthopedics | Fraerman A.P.,City Clinical Hospital No39
Sovremennye Tehnologii v Medicine | Year: 2013

The aim of the investigation was to assess the informativity of proton magnetic resonance spectroscopy (PMRS) data in differentiation of brain tumors and nonneoplastic diseases with similar signal characteristics on standard MRI scans, as well as glioma grade determination. Materials and Methods. We examined 45 patients aged from 25 to 56 years with suspected expansive process of brain using proton magnetic resonance spectroscopy. The study was performed on MRI scanner "Magnetom Symphony 1.5 T" (Siemens, Germany) using software package Spectroscopy Evaluation. The examination included routine brain investigations (MRI), as well as diffusion weighted images with diffusion factors of b=0, b=500, b=1000 with the following ADC-mapping. To receive graphic spectra and parametrical maps, there was used SE impulse sequence. To assess the grade of gliomas and metabolic changes in peritumoral area we studied peak height of choline, creatine, N-acetyl aspartate and their ratio. Results. According to histologically confirmed PMRS, 18 from 30 patients with cerebral gliomas were found to have low-grade gliomas (grade II), 12 patients - high-grade gliomas (grade III-IV). The results of the examination indicated high informative value of proton MR spectrometry as an important diagnostic technique in neuro-oncology. The modality is the most valuable and informative in the differentiation of cerebral gliomas, metastatic lesions, lymphomas, as well as in tumor grade determination of gliomas.

Tikhomirov S.E.,City Clinical Hospital No39 | Tsybusov S.N.,Nizhny Novgorod State Medical Academy | Kravets L.Y.,Nizhny Novgorod neurosurgical center | Fraerman A.P.,Nizhny Novgorod SRI of traumatology and orthopedics | Balmasov A.A.,Nizhny Novgorod State Medical Academy
Sovremennye Tehnologii v Medicine | Year: 2010

The possibilities of the Reperen's polymer implant use for a plasty of the base of the skull and dura mater defects are investigated. It is established, that a material fully responses to modern requirements to implants: biocompatibility, plasticity, possibility of sterilization, compatibility with the neurovisualization methods, stability to mechanical loads, a low level of thermo- and electro-conduction, an available cost, a minimum risk of infectious complications. The implants from Reperen permit to close a defect of dura mater and the base of the skull in majority of cases, encountered in neurosurgical practice. The peculiarities of the cranioplasty operation methods and the dura mater plasty, the indications and contraindications to their use are presented. The CT-tomograms, demonstrating the proximate results, are demonstrated. The complications in postoperative period are described and analyzed. The recommendations on the inflammatory complication decrease are given.

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