Vitebsk State Medical University
Vitebsk, Belarus
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Osmolovsky A.N.,Vitebsk State Medical University
Novosti Khirurgii | Year: 2017

Objectives. To work out the effective and safe technique of the subclavian vein puncture without damaging dome of the pleura and pneumothorax. Methods. The subclavian vein puncture by the own original methodology was carried out in 34 patients aging from 19 to 88 years (the main group). Control group consisted of 50 cases of the subclavian vein catheterization in the manner of Aubaniac. 50 case histories of patients were selected by the continuous sampling method. The incidence of major complications after the subclavian vein puncture was analyzed in patients of the main and control groups including unsuccessful puncture on the selected side (failed puncture); damage of the subclavian artery; subcutaneous hematoma; pneumothorax; damage of the internal thoracic duct, trachea; thrombotic complications. The data which is given in the literature on the puncture-related complications of central veins were taken for the standard. Results. All major complications of the subclavian vein puncture were registered in the control group, except for the damage of the thoracic duct and the trachea. The incidence of major complications in the control group was in the digital range of literature data that indicates the independent nature of the complications in using the same methodology under different conditions. Only two kinds of complications, unsuccessful puncture (6%) and subcutaneous bruise (6%) were registered in the main group. The incidence of these complications was comparable with the results of the control group and literature data. At the same time this group had no serious complications such as pneumothorax, subclavian artery damage and thromboembolic complications. Conclusion. The designed technique of the subclavian vein puncture permits to avoid the subclavian artery injury, damaging the dome of the pleura and pneumothorax and is considered to be more effective and safer than the existing methods.

Moiseev D.V.,Vitebsk State Medical University | Buzuk G.N.,Vitebsk State Medical University
Pharmaceutical Chemistry Journal | Year: 2011

The HPLC capacity factors of 27 flavonoids were determined using the following chromatographic conditions: Zorbax SB 250∈×∈4.6 mm analytical columns containing C-18, C-8, and CN sorbents with particle size 5 μm, mobile phase consisting of 0.01 M potassium dihydrogen phosphate pH 3.0 and acetonitrile at a ratio of 80:20 (v/v), column temperature 30°C; absorption spectra were recorded over the range 190 - 400 nm. This chromatography system can be used for preliminary identification of flavonoids in plant materials. © 2011 Springer Science+Business Media, Inc.

Studies of potential biomarkers in periodontology are focused on analysis of oral liquid which revealed a number of potential salivary periodontitis biomarkers. The biomarkers should be simple to perform, with easily interpretable results providing relevant information from initial stages of disease, to measure its activity, thus reflecting the disease evolution (e.g., from gingivitis to periodontitis). However there are some more scientific, clinical and technological tasks to develop successful clinical salivary diagnostics for periodontitis treatment. The purpose of our study was to assess interrelations of IFNγ and neopterine in oral fluid of the patients with chronic generalized periodontitis (CGP), aiming for more complete understanding of periodontal disorders and at patients with an intolerance of stomatologic materials. It is shown that the average levels of neopterine in exacerbated moderate-stage CGP patients was raised before treatment to 11.6 [8.0; 15.4] ng/ml, as compared with post-treatment level of 5,5 [4,1; 7,1] ng/ml (P < 0.05) Average amount of IFNγ in oral fluid from these patients group was 6.7 [5.0; 8.7] pg/ml before treatment, as compared to 5.5 [3.5; 7.1] pg/ml after treatment (no significant difference). Neopterine level in patients with exacerbated severe CGP before treatment was even higher than in patients of moderate/severe group, with an average of 8.2 [6.0; 9.9] ng/ml thus sufficiently exceeding post-treatment levels, i.e., 5.5 [4.1; 7.1] ng/ml (P < 0.05). A course of periodontal therapy in this group was associated with sufficient changes of IFNγ levels in oral fluid: appropriate levels before and after treatment were, respectively, 8.6 [7.3; 11.2] pg/ml, and 5.4 [4.3; 6.7] pg/ml. We have revealed that the OHI-S and SBI indexes characterizing conditions of oral cavity are interconnected with local neopterine and IFNγ levels. It is shown that an increased neopterine concentration in oral fluid and its correlation with SBI index in CGP patients is an independent biomarker of therapeutic effect. The patients with a CGP exhibited a highly significant correlation between initial levels of IFNγ and neopterine in oral fluid (R = 0.82; p = 0.0001), and after treatment (R = 0.78; p = 0.0001) in both groups of the patients. Level of a neopterin and IFNγ at patients with complaints to intolerance of dentoprosthetic materials before removal of artificial limbs and after removal of orthopedic designs authentically didn't change. © 2017, SPb RAACI.

Boer-Auer A.,Dermatologikum Hamburg | Jones M.,Charles Nicolle Hospital | Lyasnichaya O.V.,Vitebsk State Medical University
Journal of Cutaneous Pathology | Year: 2012

Background: The histopathologic pattern of clonal seborrheic keratosis (SK) is quite similar to the nested pattern of pagetoid Bowen's disease [squamous cell carcinoma in situ (SCCIS)], and differentiation between the two can be challenging, especially when only small pieces are available for interpretation. Methods: Eleven examples of clonal SK and 13 examples of pagetoid SCCIS were examined histopathologically (tabulating necrotic keratinocytes, suprabasal mitoses, infiltrate, parakeratosis housing plump nuclei, crowding of nuclei) and immunohistochemically (using Ki-67, bcl-2, cytokeratin 7 and cytokeratin 10). Sensitivity, specificity, p-values (Fisher's exact test, two-tailed) and positive/negative likelihood ratios (+LR/-LR) were calculated. Results: Significant differences were seen with regard to crowding (p = 0.0009) and mitoses (p = 0.0006); however, only complete absence of necrotic keratinocytes or of crowding appeared to be diagnostically convincing for a diagnosis of clonal SK (-LR > 0.01). Significant differences were also seen with bcl-2 (p = 0.0005) and cytokeratin 10 antibodies (p < 0.00001). Both markers displayed a typical nested pattern in clonal SK, nests being bcl-2-positive and cytokeratin 10-negative. Cytokeratin 10-negative nests were the most convincing criterion for differentiation between clonal SK and pagetoid SCCIS (+LR > 10, -LR < 0.01). Conclusions: The most reliable marker to distinguish clonal SK from pagetoid SCCIS is cytokeratin 10 when it spares nests. Other criteria that assist in the differential diagnosis are bcl-2 expression, absence of crowding and of mitoses. Copyright © 2012 John Wiley & Sons A/S.

Konorev M.R.,Vitebsk State Medical University
Terapevticheskii Arkhiv | Year: 2012

Aim. To evaluate the efficiency of first-line Helicobacter pylori eradication therapy with glucosaminylmuramyldipeptide (Licopid JSC «Peptek», Russia). Subjects and methods. Eradication therapy was performed in 128 patients (84 men and 34 women; mean age 44.1 ±13.5 years) with duodenal bulb ulcer associated with H. pylori. The latter was detected in the gastroduodenal mucosa by a morphological study and rapid urease test before and 6-8 weeks after treatment and discontinuation of all drugs. Gastric metaplasia areas in the duodenum were revealed by periodic acid-Schiff and Alcian blue staining. The patients were divided into 4 groups according to the treatment protocol: 1) omeprazole (O) 0.04 g/day, clarithromycin (C) 1 g/day, amoxicillin (A) 2 g/day for 7 days (OCA7; n=33); 2) the above drugs for 14 days (OCA14; n=34); 3) O 0.04 g/day, C1 g/day, A 2.0 g/day for 7 days, and glucosaminylmuramyldipeptide (Licopid) (L) 0.001 g/day for a day (OCA7L1 ; n=34) and 4) the above drugs and L 0.01 g/day for 10 (OCA7L10; n=27). Results. According to trie data of intention-to-treat analysis and per protocol, the H. pylori eradication rate was 81.8 and 87.1% for OCA7; 82.4 and 93.3% for OCA14; 88.2 and 93.8% for OCA7L1; 88.9 and 96% for OCA7L10 after PT and RRT, respectively. The rate of side effects was as follows: 6.1% for OCA7; 17.6% for OCA14 (5.9% stopped treatment); 5.9% for OCA7L1; 7.4% for OCA7L10. The cost of the treatment protocols was $ 32 for OCA7; $ 64 for OCA14; $ 40 for OCA7L1; $ 67 for OCA7L10. The intake of glucosaminylmuramyldipeptide (licopid) 0.001 g/day during 7-day triple anti-Helicobacter pylori therapy increased eradication by 6.4% (ITT) and 6.7% (PP), without raising the rate of side effects. Conclusion. H. pylori-positive patients with duodenal bulb ulcer should be given glucosaminylmuramyldipeptide (Licopid) 0.001 g/day during 7-day first-line eradication therapy as alternative to the 14-day treatment regimen.

Ziankou A.,Vitebsk State Medical University
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery | Year: 2015

OBJECTIVE: To carry out the comparative analysis of early and midterm results of no-touch aorta multivessel small thoracotomy coronary artery bypass grafting (MVST CABG), conventional off-pump (OPCABG) and on-pump CABG (ONCABG). METHODS: From 2007 to 2014, 537 consecutive patients underwent CABG by the same surgeon. Propensity score computer matching was performed, and a total of 453 patients were successfully matched in 3 groups of 151 patients. RESULTS: Significant differences were found in the intraoperative blood loss: 220 (180; 300) mL in MVST CABG versus 400 (300; 550) mL in OPCABG vs 350 (250; 435) mL in ONCABG group; first 24-hour postoperative blood loss: 170 (100; 280), 320 (200; 470), and 380 (200; 500) mL, respectively; operation time: 352.4 ± 74.4, 289.3 ± 55.0, and 280.4 ± 56.4 minutes, respectively; median time to return to full physical activity: 14, 56, and 56 days, respectively (P < 0.05); rate of deep wound infection: 0.0%, 2.0%, and 2.0%, respectively; and postoperative length of stay (surgical department): 4.5, 7.0, and 7.5 days, respectively (P < 0.1). No significant differences were observed in rates of severe in-hospital events (P > 0.05), cumulative midterm survival, and freedom from major adverse cardiac and cerebrovascular events (P > 0.05). CONCLUSIONS: The MVST CABG seems as safe as OPCABG and ONCABG and is associated with less wound infections, perioperative blood loss, shorter hospital length of stay and time to return to full physical activity. Multivessel small thoracotomy CABG can be applied to most patients with coronary heart disease saving the effectiveness during midterm follow-up. The MVST CABG can be introduced avoiding a prolonged learning curve. ©2015 by the International Society for Minimally Invasive Cardiothoracic Surgery.

Kupchenko A.M.,Vitebsk State Medical University
Novosti Khirurgii | Year: 2014

Objectives. To study the etiological structure and sensitivity of aerobic microorganisms of peritoneal exudate to antibacterial preparations in patients with generalized purulent peritonitis in regards to the current condition.Methods. At Vitebsk Emergency Hospital the peritoneal exudate in 92 patients with generalized purulent peritonitis has been studied by the developed test systems "ID - ENT", "AB - ENTER", "AB - GRAM (-)", "AB - STAF", "AB - PSEUD". Pathogenetic significance of enterobacteria and Gram Negative Aerobic microorganisms as well as their specious composition and sensitivity to antibacterial preparations has been defined.Results. In the majority (73%) cases the conducted microbiological examination has manifested the generalized purulent peritonitis caused by mixed aerobic and anaerobic flora (only by anaerobes - in 14%, only aerobes - in 13%). The representatives of the genus Enterobacteriaceae have dominated among the isolated 80 strains of aerobic and facultative - Anaerobic microorganisms. The aerobic microflora of peritoneal exudate components was represented by E. coli - 53,75%, Enterococcus spp.- 10%, Streptococcus spp. - 8,75%, Klebsiella spp. - 10%, Proteus spp. - 5%, Staphylococcus spp. - 6,25%, Pseudomonas aeruginosa - 6,25%. In studying the sensitivity of main aerobic pathogens of generalized purulent peritonitis to antimicrobial agents the existence in the vast majority of strains of multiple drug resistance has been established. Carbapenems (meropenem - 94,4% of the sensitive microorganisms, imipenem - 88,7%), the third-generation aminoglycosides (amikacin - 87,3%), fluoroquinolones (moxifloxacin - 87,3%, ciprofloxacin - 84,5%, norfloxacin - 83,1%), the fourth generation cephalosporins (cefepime - 80,3%) exhibit maximal antibacterial effect on the aerobic component.Conclusion. The obtained data concerning the etiological structure of aerobic microflora of peritoneal exudate in patients with generalized purulent peritonitis will assist in creating of new effective antibiotic therapy schemes available to reduce mortality rate and improve pharmacoeconomic treatment results of given morbility.

Plotnikov P.V.,Vitebsk State Medical University
Novosti Khirurgii | Year: 2014

Objectives. To determine the effectiveness of the miltimodal treatment of pyogenic wounds depending on the ability of the isolated pathogen to form biofilm.Methods. During the research, the comprehensive examination and treatment of 48 patients with pyogenicinflammatory processes of soft tissues have been conducted in the Republican Scientific and Practical Center "Infection in Surgery" on the basis of the pyogenic surgery department of ME "Vitebsk Regional Clinical Hospital" during the period of 2012-2014. The control group patients (n=31) were subjected to a standard treatment, the main group patients (n=17) received the suggested integrated treatment of the pyogenic wounds taking into account the ability of pathogens to form biofilm based on the application of the vacuum-instillation therapy with the dimeksid solution as a rinsing liquid. There were no reliable differences in age, sex as well as in nosologic forms of diseases in the investigated groups.Results. Antiseptics widely used in clinical practice have been studied. Dimeksid, inol, isopropyl alcohol destroied the biofilm most intensively. These antiseptics are considered to be recommended for treatment of wounds, associated with pathogens capable to form biofilm. Statistically significant reduction term of the clearance wound, the appearance of granulation tissue, the marginal epithelialization beginning and the length of treatment in the patients underwent the miltimodal treatment of the pyogenic wounds according to the worked out method have been revealed.Conclusion. The performed research has proved the efficacy of the suggested method of pyogenic wounds treatment taking into account the ability of some pathogens to form biofilm. The application of proposed method can reduce treatment terms of patients with pyogenic wounds by 6 days (p=0,03).

Ovsianik D.M.,Vitebsk State Medical University
Novosti Khirurgii | Year: 2014

Objectives. To study the indicators of endothelial dysfunction in acute pancreatitis and assess their potential for differential diagnosis of infected and sterile pancreatic necrosis.Methods. A prospective investigation of indicators of endothelial dysfunction - the number of circulating endothelial cells and concentration of stable degradation products of nitric oxide in the blood of patients (n=92) with various forms of acute pancreatitis has been carried out. The results of a study of healthy volunteers (n=15) were used as a control. For diagnostic test evaluation of sensitivity/specificity for forecast verification and diagnosis of infected pancreatic necrosis the Receiver Operating Characteristic (ROC) analysis has been applied.Results. In case of the edematous form of acute pancreatitis a statistically significant increase of circulating endothelial cells number and the level of nitrate/nitrite in the blood by 1.5-folds compared to healthy persons (=0,0051; =0,0206) have been observed. An expressive clinical manifestation of endothelial dysfunction has been occurred in pancreatic necrosis, as for its sterile course the tendency to regress have been appeared. In the infected pancreatic necrosis the negative dynamics demonstrating this disease usually was found in increase of the number of circulating endothelial cells in the blood. Within the first week of hospitalization the level of nitrate/nitrite - >36 uM/L (sensitivity - 81,8%, specificity - 60,3%, AUC=0,7; =0,0323) may be used in prediction of infected pancreatic necrosis. The presence of 39 and more circulating endothelial cells in 100 ul. plasma (sensitivity - 84 %, specificity - 86%, AUC = 0,834; p <0,001) happen to be one of diagnostic signs of infection of pancreatic necrosis in the second phase of disease.Conclusions. The received results testify to expediency of the research of endothelial dysfunction by determination of the number of circulating endothelial cells in the blood of patients with acute pancreatitis as a method should be applied for early detection of infection of pancreatic necrosis.

Kozlov A.I.,Vitebsk State Medical University
22nd International Congress on Sound and Vibration, ICSV 2015 | Year: 2015

Some different equations derived as second-order approximations to complete system of equations of nonlinear acoustics of Newtonian media such as Lighthill-Westerwelt equation, Kuznetsov one, et cetera are usually solved numerically or at least approximately. A general exact analytical method of solution of such problems based on a short chain of changes of variables is presented in the work. Three types of possible solutions were found depending on parameters of each initial equation: a so-called Taylor shock (or diffusive soliton), a monotonously decaying solution as well as a periodic one.

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