Na Semashko Nizhny Novgorod Regional Clinical Hospital

Nizhniy Novgorod, Russia

Na Semashko Nizhny Novgorod Regional Clinical Hospital

Nizhniy Novgorod, Russia
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PubMed | Mordovian Republican Clinical Hospital, Saint Petersburg State University, National Research Center for Hematology, Volgograd Regional Clinical Oncology Dispensary One and 7 more.
Type: Journal Article | Journal: Terapevticheskii arkhiv | Year: 2016

to analyze well-known risk factors (RFs), such as age, immunophenotype, baseline leukocytosis, enhanced lactate dehydrogenase (LDH) activity, time to achieve complete remission, a risk group, and cytogenetic abnormalities) in patients with acute lymphoblastic leukemia (ALL) in the use of the ALL-2009 protocol.The protocol covered 298 patients (137 women (including 13 pregnant women) and 161 men) aged 15 to 55 years (median age 28 years) with Ph-negative ALL. The phenotype was unknown in 6 patients. Three (1%) were ascertained to have a biphenotypic variant. 182 (62.4%) patients were found to have B-cell ALL (early pre-B ALL (n=51); common ALL (n=92), and pre-B ALL (n=39); 107 (36.6%) patients had T-cell ALL (early T-ALL (n=56); thymic T-ALL (n=41), and mature T-ALL (n=10). According to the baseline clinical and laboratory parameters (leukocytosis of 30109/l and more for B-ALL; and that of 100109/l and more for T-ALL; phenotype -I for B-ALL, phenotype -I-II-IV for T-ALL; LDH activity was more than twice the normal values; the presence of translocation t(4;11)), the high-risk group included most patients with B-ALL (n=110 (72.8%)) and T-ALL (n=76 (76%)). Thirty-five patients with T-ALL underwent autologous bone marrow transplantation (BMT). Allogeneic BMT was performed in 18 (7%) of the 258 patients who had undergone an induction phase.Five-year overall survival for all the patients included in the investigation was 59%; relapse-free survival was 65%, which was significantly different in the patients with B-ALL and in those with T-ALL: the overall survival rates were 53.3 and 67.5% (p=0.1); the relapse-free survival was 56 and 79% (p=0.005), respectively. Multivariate analysis including the well-known RFs demonstrated that the latter for T-ALL were of no independent prognostic value and only the patients age was identified for B-ALL (p=0.013).A lower chemotherapeutic load and a small number of allogeneic BMTs did not affect total positive treatment results in adult patients with ALL, by complying with the principle achieving the continuity of cytostatic effects and by preserving the total cytostatic loading dose. The results of the Russian investigation casts some doubt on the necessity of using very intensive consolidation cycles and performing a large number of allogeneic BMTs in adult patients with ALL.


Ovchinnikov E.A.,Na Semashko Nizhny Novgorod Regional Clinical Hospital | Maksimova I.Y.,Na Semashko Nizhny Novgorod Regional Clinical Hospital | Agarkova D.I.,Nizhny Novgorod State Medical Academy | Barskov A.N.,Na Semashko Nizhny Novgorod Regional Clinical Hospital | Ovchinnikov V.A.,Nizhny Novgorod State Medical Academy
Sovremennye Tehnologii v Medicine | Year: 2014

The aim of the investigation was to study clinical and instrumental manifestations of the compression of carotid arteries and internal jugular veins in nodular goiter, and estimate thyroidectomy as a decompression technique.Materials and Methods. We examined and operated on 13 patients with bilateral nodular euthyroid goiter, III–IV–V degree.The patients aged from 28 to 58 years. Thyroidectomy was indicated by the compression of trachea in 11 patients and the compression of trachea and esophagus — in 2 patients.In addition to conventional pre- and postoperative studies the patients underwent duplex scanning of carotid arteries and internal jugular veins, fundoscopy, and contrast multidetector computed tomography (MDCT) of cervical vessels.Results: All patients in the thyroid above nodules were found to have phlebectasia of one or both internal jugular veins with reduced linear blood flow velocity, while at the level of the nodules and beneath linear velocity increased. Three patients appeared to have common carotid arteries extended and compressed to the outside, and MDCT in one patient revealed total contrast absence of a part of the carotid artery at nodular level and no contrast of the internal jugular vein on the same side. Fundoscopy showed the presence of wide straight veins and narrow arteries. After nodular goiter resection, phlebectasia of internal jugular veins disappeared, linear blood flow velocity normalizing, and dislocated carotid arteries being straightened.Conclusion: In addition to tracheal and esophageal compression, the compression of great cervical vessels in nodular goiter is no less important indication for thyroidectomy. © 2014, Nizhny Novgorod State Medical Academy. All rights reserved.


Vdovin A.K.,Diagnostic Ultrasound Unit | Akulenko S.V.,Na Semashko Nizhny Novgorod Regional Clinical Hospital | Safonov D.V.,Nizhny Novgorod State Medical Academy
Sovremennye Tehnologii v Medicine | Year: 2013

We developed methods to improve ultrasound-guided percutaneous renal puncture core biopsy in diffuse diseases. The use of semiautomatic needles True-Cut, caliber 14G, with harpoon-type mandrin, which enables to obtain high-quality tissue samples, up to 2 cm in length and up to 1.2 mm in thickness that makes it possible to perform a single tissue retrieval (2-3 - in exceptional cases). 40 patients underwent "free hand" biopsy using semi-automatic needles. The peculiarity of the suggested technique of biopsy needle visualization improvement is in the creation of induced anechoic space in paranephral cellular tissue by means of tissue infiltration by 0.25% novocaine solution. It helps to localize the tip of a mandrin immediately close to the renal surface and enables its controlled introduction into the selected biopsy area. To avoid the calices-pelvis system or vessel damage, the approach is along the line going obliquely superiorly down through parenchyma of the middle third of the kidney towards the lower pole at sufficient distance from the renal sinus echostructures. Informative material for histological study was obtained without complications in all cases. The optimized biopsy technique permits early activization of patients and their reduced (up to one day) stay in hospital.


Tishkova S.K.,Na Semashko Nizhny Novgorod Regional Clinical Hospital | Protopov S.B.,Nizhny Novgorod State Medical Academy
Sovremennye Tehnologii v Medicine | Year: 2011

There is presented a case of successful surgical treatment of severe brain injury (comminuted fractures with displaced fragments of the anterior wall of maxillary sinus on the right, right maxilla, cribriform bone, nose bones, medial wall of the left orbit with impaction of a fractured fragment into orbital cavity with optic nerve compression). As a result, a foreign object non-identified in history taking was removed from periorbital area.


Lobanova N.A.,Na Semashko Nizhny Novgorod Regional Clinical Hospital
Sovremennye Tehnologii v Medicine | Year: 2011

The objective of the investigation is to study the relations of the main parameters of phosphoric and calcium metabolism and anemia in patients with an end-stage chronic renal failure (CRF). Materialssandmethods. andmethods.anddmethods. methods.methods. There have been analyzed the characteristics of peripheral blood and the parameters of phosphoric and calcium metabolism in 108 patients with end-stage CRF. Results. In patients with end-stage chronic renal failure before the hemodialysis treatment, the severity of anemia correlates predominantly with the state of phosphoric and calcium metabolism. Anemia before the dialysis is to be treated not only by the preparations stimulating erythropoesis and iron preparations but also by the remedies correcting phosphoric and calcium metabolism abnormality, preferably without using calcium preparations.


Kuznetsova I.A.,Na Semashko Nizhny Novgorod Regional Clinical Hospital
Sovremennye Tehnologii v Medicine | Year: 2011

The aim of the study is to substantiate the use expediency of the new algorithm of the neck of the uterus neoplasia diagnosis and to evaluate the approach effectiveness. An optical coherent tomography (OCT) has been used in this research. Materials and methods. 380 patients with all the spectrum of the neck of the uterus states have been examined. Under the investigation there have been cytological investigation, and a HPV-test, a colposcopic examination, an OCT, a morphological investigation. Results. An OCT is capable of visualizing the neck of the uterus mucous membrane at the layers level and intratissue elements. A method sensibility in recognition of a mucous membrane neoplasia is 82%, a specificity is 78%, the errors - 19.2% (κ=0.65). An OCT-investigation is compatible with colposcopy in real clinical conditions. It is capable of differentiating the colposcopic signs according to a possible malignization risk based on optical picture types. An OCT as a diagnostic algorithm allows to reveal the neck of the uterus pathology and to decrease the biopsy volume by 34%. Conclusion. A complementary use of colposcopy and OCT makes it possible to avoid not only random biopsies, but significantly decrease a number of wrong manipulations (more than by 30%). An OCT method is certain to be included into the algorithm of the neck of the uterus examination at a stage of the indication detection and a biopsy site selection carrying out colposcopic investigation. This is sure to increase effectiveness of the precancer and cancer early diagnosis.


Larin R.A.,Na Semashko Nizhny Novgorod Regional Clinical Hospital | Kuzmin A.V.,Na Semashko Nizhny Novgorod Regional Clinical Hospital | Rylkin U.A.,Nizhny Novgorod State Medical Academy
Sovremennye Tehnologii v Medicine | Year: 2013

We described a case of laterally situated impacted wisdom tooth extraction in maxillary sinus using an endoscopic endonasal approach. The technique was shown to be an adequate alternative to a traumatic transmaxillary approach earlier applied in such cases.


Krupin V.N.,Nizhny Novgorod State Medical Academy | Mamonov M.V.,Na Semashko Nizhny Novgorod Regional Clinical Hospital | Artifeksova A.A.,Nizhny Novgorod State Medical Academy
Sovremennye Tehnologii v Medicine | Year: 2013

The aim of the investigation was to develop the technique of effective and pathologically reasonable management of infertility in male patients with varicocele. Materials and Methods. The research was based on the results of clinical observations of 865 patients with varicocele aged 18-39 years, classified into two groups depending on the presence or absence of spermatogenesis disturbances. The pattern of changes in hemodynamic indices in different periods after varicocele surgical treatment was studied in 135 patients. Ejaculate was examined in accordance with WHO laboratory manual for the examination and processing of human semen (1987). Hemodynamic condition in scrotal organs was assessed by ultrasound on "Aloka SSD-3500" and "Aloka SSD-4000" (Japan) using linear probe 7.5 MHz. The spermatogenesis condition in infertility was evaluated by morphological examination of the material obtained by testicular biopsy. Results. The analysis of the surgical treatment results of 135 patients showed the improvement of arterial testicular blood supply in 97 patients (71.8%). The rest 38 patients (28.2%) had no changes in arterial blood supply, but in some cases (9 patients) there was insignificant increase of arterial testicular blood supply within the first month after the surgery. The developed operational procedure for varicocele included the superior testicular vein ligation, which was followed by the ligation of a. hypogastrica inferior in 93 patients. The findings suggest great efficiency of the technique. The recovery of ejaculate parameters takes far less time compared to standard varicocelectomy.


Larin R.A.,Na Semashko Nizhny Novgorod Regional Clinical Hospital | Pisarev E.N.,Nizhny Novgorod State Medical Academy
Sovremennye Tehnologii v Medicine | Year: 2013

There has been considered a case of spontaneous nasal liquorrhea in a patient with lateral sinus wall defect and a sinus mass of nonneoplastic origin (pseudomeningovele) not associated with the operation on hypophysis and skull base structures; and shown the possibilities of an advanced endoscopic approach as an alternative to an intracranial technique. The details of surgical management and defect closure technique have been represented.


Trofimov A.O.,Nizhny Novgorod State Medical Academy | Kalentiev G.V.,Na Semashko Nizhny Novgorod Regional Clinical Hospital | Voennov O.V.,Na Semashko Nizhny Novgorod Regional Clinical Hospital
Sovremennye Tehnologii v Medicine | Year: 2014

There have been presented up-to-date data on cerebral infrared oximetry application in intracranial hemorrhage. The principles of the technique enabling to perform noninvasive monitoring of cerebral tissue oxygenation have been given. There has been shown the comparability of cerebral oximetry and invasive assessment techniques of cerebral tissue saturation, jugular oximetry and cerebral microcirculation. Some systems for oxygen status determination have been presented. Special attention has been paid to the use of coefficients and indices of cerebral infrared oximetry to assess functional state of cerebral microvasculature and cerebral autoregulation. There have been described prospects for further development of cerebral oximetry as a part of many-component monitoring in craniocerebral injury and hemorrhagic strokes.

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