1
|
Kakotkin VV, Semina EV, Zadorkina TG, Agapov MA. Prevention Strategies and Early Diagnosis of Cervical Cancer: Current State and Prospects. Diagnostics (Basel) 2023; 13:diagnostics13040610. [PMID: 36832098 PMCID: PMC9955852 DOI: 10.3390/diagnostics13040610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
Cervical cancer ranks third among all new cancer cases and causes of cancer deaths in females. The paper provides an overview of cervical cancer prevention strategies employed in different regions, with incidence and mortality rates ranging from high to low. It assesses the effectiveness of approaches proposed by national healthcare systems by analysing data published in the National Library of Medicine (Pubmed) since 2018 featuring the following keywords: "cervical cancer prevention", "cervical cancer screening", "barriers to cervical cancer prevention", "premalignant cervical lesions" and "current strategies". WHO's 90-70-90 global strategy for cervical cancer prevention and early screening has proven effective in different countries in both mathematical models and clinical practice. The data analysis carried out within this study identified promising approaches to cervical cancer screening and prevention, which can further enhance the effectiveness of the existing WHO strategy and national healthcare systems. One such approach is the application of AI technologies for detecting precancerous cervical lesions and choosing treatment strategies. As such studies show, the use of AI can not only increase detection accuracy but also ease the burden on primary care.
Collapse
Affiliation(s)
- Viktor V. Kakotkin
- Scientific and Educational Cluster MEDBIO, Immanuel Kant Baltic Federal University, A. Nevskogo St., 14, 236041 Kaliningrad, Russia
| | - Ekaterina V. Semina
- Scientific and Educational Cluster MEDBIO, Immanuel Kant Baltic Federal University, A. Nevskogo St., 14, 236041 Kaliningrad, Russia
| | - Tatiana G. Zadorkina
- Kaliningrad Regional Centre for Specialised Medical Care, Barnaulskaia Street, 6, 236006 Kaliningrad, Russia
| | - Mikhail A. Agapov
- Scientific and Educational Cluster MEDBIO, Immanuel Kant Baltic Federal University, A. Nevskogo St., 14, 236041 Kaliningrad, Russia
- Correspondence: ; Tel.: +7-(4012)-59-55-95
| |
Collapse
|
2
|
Markaryan DR, Lukyanov AM, Garmanova TN, Agapov MA, Kubyshkin VA. [Postpartum fecal incontinence. State of the problem]. Khirurgiia (Mosk) 2022:127-132. [PMID: 35658144 DOI: 10.17116/hirurgia2022061127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A review of the current national and foreign literature is devoted to epidemiology, risk factors, causes, diagnosis and modern treatment approaches for fecal incontinence (FI). Incidence of FI in early and delayed period after childbirth is 30% or more. At the same time, up to 87% of postpartum injuries of anal sphincter remain undiagnosed. Importantly, routine caesarean section does not reduce the risk of incontinence. In addition to typical complaints of spontaneous gas and stool, diagnosis of FI after childbirth includes transrectal ultrasound, MRI, anorectal manometry and pudendal nerve terminal motor latency testing. Survey of proctologists from different regions of Russia revealed a high demand from medical community for educational programs devoted to diagnosis, treatment and rehabilitation of patients with postpartum perineal injuries.
Collapse
Affiliation(s)
| | - A M Lukyanov
- Lomonosov Moscow State University, Moscow, Russia
| | | | - M A Agapov
- Lomonosov Moscow State University, Moscow, Russia
| | | |
Collapse
|
3
|
Agapov MA, Kakotkin VV, Gallyamov EA, Kubyshkin VA. [Pain and quality of life after laparoscopic transabdominal preperitoneal hernioplasty with different ways of fixing the peritoneum. Results of early completion randomized clinical trial]. Khirurgiia (Mosk) 2022:14-20. [PMID: 36073578 DOI: 10.17116/hirurgia202209114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To compare and statistically evaluate the severity of pain syndrome and quality of life depending on the method of fixation of the parietal peritoneum during laparoscopic hernia repair (suture fixation or the use of tack fixation). METHODS A randomized clinical trial was conducted from May to June 2021 at the Lomonosov Moscow State University Medical Center. It was planned to observe patients for a year. In the first group, the fixation of the parietal peritoneum was performed using suture fixation, in the second group, the peritoneal flap was fixed using a fixation device. In the course of statistical data processing, it was planned to study the dependence of the duration of the operation, the severity of the pain syndrome in the early postoperative period, the frequency of complications, the quality of life of patients in the postoperative period on the chosen method of the fixation of the parietal peritoneum. RESULTS At the initial stage of the study, 8 patients with inguinal hernias were selected in the first group during randomization, and 6 patients were selected in the second group. Each patient of the second group in the early postoperative period had a more pronounced local pain, protective muscle tension in the projection of fixation of the parietal peritoneum with tacks, which was accompanied by negative psychoemotional reactions, an increase in the dose of analgesic drugs. Due to the revealed features of the early postoperative period in patients of second group, it was considered unethical and inappropriate to continue the study within the protocol. CONCLUSION The results obtained do not allow us to draw statistically supported conclusions. The solution of the problem of the peritoneal flap fixation method is possible in two ways: abandoning stapler fixation in favor of suture or conducting additional clinical studies with an analysis of the impact of the choice of peritoneal fixation technique not only on acute and chronic postoperative pain, but on quality of life in the early and delayed postoperative periods.
Collapse
Affiliation(s)
- M A Agapov
- Lomonosov Moscow State University, Moscow, Russian Federation
| | - V V Kakotkin
- Lomonosov Moscow State University, Moscow, Russian Federation
| | - E A Gallyamov
- Lomonosov Moscow State University, Moscow, Russian Federation
- Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - V A Kubyshkin
- Lomonosov Moscow State University, Moscow, Russian Federation
| |
Collapse
|
4
|
Sanzharov AE, Gallyamov EA, Sergeev VP, Biktimirov RG, Aminova LN, Kochkin AD, Meshchankin IV, Agapov MA, Gololobov GY. [Results of laparoscopic pelvic exenterations]. Khirurgiia (Mosk) 2022:45-57. [PMID: 35775844 DOI: 10.17116/hirurgia202207145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To analyze clinical outcomes after pelvic exenteration for advanced primary or recurrent pelvic cancer. MATERIAL AND METHODS We analyzed the outcomes in 35 patients after pelvic exenteration for advanced primary or recurrent pelvic cancer (gynecological cancer, urologic cancers, colon cancer). There were 3 (8.57%) men and 32 (91.43%) women. Mean BMI was 26 kg/m2. RESULTS Total exenteration was performed in 10 (28.57%) patients, anterior exenteration - 18 (51.43%) patients, posterior exenteration - 7 (20.0%) patients. Intraoperative complications (damage to the common iliac vessels) occurred in 1 (2.86%) patient. Mean surgery time was 280 minutes (range 180-600), mean intraoperative blood loss - 400 ml (range 100-2000). Mean postoperative ICU-stay was 24 hours. Major postoperative complications Clavien-Dindo grade 3-4 were detected in 3 (8.57%) patients. One (2.86%) patient died in 84 days after surgery from multiple organ failure due to progression of disease (Clavien-Dindo grade 5). There were 4 (11.43%) patients with complications Clavien-Dindo grade ≥3. Negative resection margin (R0) was achieved in 32 (91.43%) cases. The follow-up period ranged from 2 to 70 months (median 16.5 months). Overall survival was assessed in 25 patients. Other 10 patients or their relatives did not get in touch and therefore did not participate in assessment of survival. Overall 2-year survival assessed in 6 patients with cervical cancer was 24%. Overall 2-year survival estimated in 8 patients with bladder cancer was 100%. A patient with colon cancer lived for 23 months. Among 2 patients with vulvar cancer, 1 patient died in 25 months after surgery, the second one was followed-up for 11 months. Patients with primary multiple tumors were followed-up for 10-21 months. Overall 1-year survival was 100%. One patient died after 21 months. CONCLUSION Analyzing own findings and world literature data, we can conclude that laparoscopic technique ensures better intra- and postoperative results compared to standard laparotomy. However, there are insufficient data to confirm superiority of laparoscopic approach regarding oncological results.
Collapse
Affiliation(s)
- A E Sanzharov
- Federal Scientific and Clinical Center for Specialized Methods of Medical Care and Medical Technologies, Moscow, Russia
| | - E A Gallyamov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - V P Sergeev
- State Research Center of the Russian Federation - Burnazyan Federal Medical Biophysical Center, Moscow, Russia
| | - R G Biktimirov
- Federal Clinical Center of High Medical Technologies of the Federal Medical and Biological Agency, Moscow, Russia
| | | | - A D Kochkin
- Road Clinical Hospital, Nizhny Novgorod, Russia
| | - I V Meshchankin
- MEDSI Clinical Hospital on Pyatnitskoe highway, Moscow, Russia
| | - M A Agapov
- Lomonosov Moscow State University, Moscow, Russia
| | - G Yu Gololobov
- Sechenov First Moscow State Medical University, Moscow, Russia
| |
Collapse
|
5
|
Mareev VY, Orlova YA, Plisyk AG, Pavlikova EP, Akopyan ZA, Matskeplishvili ST, Malakhov PS, Krasnova TN, Seredenina EM, Potapenko AV, Agapov MA, Asratyan DA, Dyachuk LI, Samokhodskaya LM, Mershina ЕА, Sinitsyn VE, Pakhomov PV, Zhdanova EA, Mareev YV, Begrambekova YL, Kamalov АА. Proactive anti-inflammatory therapy with colchicine in the treatment of advanced stages of new coronavirus infection. The first results of the COLORIT study. ACTA ACUST UNITED AC 2021; 61:15-27. [PMID: 33734043 DOI: 10.18087/cardio.2021.2.n1560] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/16/2021] [Indexed: 02/06/2023]
Abstract
Actuality The course of the novel coronavirus disease (COVID-19) is unpredictable. It manifests in some cases as increasing inflammation to even the onset of a cytokine storm and irreversible progression of acute respiratory syndrome, which is associated with the risk of death in patients. Thus, proactive anti-inflammatory therapy remains an open serious question in patients with COVID-19 and pneumonia, who still have signs of inflammation on days 7-9 of the disease: elevated C-reactive protein (CRP)>60 mg/dL and at least two of the four clinical signs: fever >37.5°C; persistent cough; dyspnea (RR >20 brpm) and/or reduced oxygen blood saturation <94% when breathing atmospheric air. We designed the randomized trial: COLchicine versus Ruxolitinib and Secukinumab in Open-label Prospective Randomized Trial in Patients with COVID-19 (COLORIT). We present here data comparing patients who received colchicine with those who did not receive specific anti-inflammatory therapy. Results of the comparison of colchicine, ruxolitinib, and secukinumab will be presented later.Objective Compare efficacy and safety of colchicine compared to the management of patients with COVID-19 without specific anti-inflammatory therapy.Material and Methods Initially, 20 people were expected to be randomized in the control group. However, enrollment to the control group was discontinued subsequently after the inclusion of 5 patients due to the risk of severe deterioration in the absence of anti-inflammatory treatment. Therefore, 17 patients, who had not received anti-inflammatory therapy when treated in the MSU Medical Research and Educational Center before the study, were also included in the control group. The effects were assessed on day 12 after the inclusion or at discharge if it occurred earlier than on day 12. The primary endpoint was the changes in the SHOCS-COVID score, which includes the assessment of the patient's clinical condition, CT score of the lung tissue damage, the severity of systemic inflammation (CRP changes), and the risk of thrombotic complications (D-dimer) [1].Results The median SHOCS score decreased from 8 to 2 (p = 0.017), i.e., from moderate to mild degree, in the colchicine group. The change in the SHOCS-COVID score was minimal and statistically insignificant in the control group. In patients with COVID-19 treated with colchicine, the CRP levels decreased rapidly and normalized (from 99.4 to 4.2 mg/dL, p<0.001). In the control group, the CRP levels decreased moderately and statistically insignificantly and achieved 22.8 mg/dL by the end of the follow-up period, which was still more than four times higher than normal. The most informative criterion for inflammation lymphocyte-to-C-reactive protein ratio (LCR) increased in the colchicine group by 393 versus 54 in the control group (p = 0.003). After treatment, it was 60.8 in the control group, which was less than 100 considered safe in terms of systemic inflammation progression. The difference from 427 in the colchicine group was highly significant (p = 0.003).The marked and rapid decrease in the inflammation factors was accompanied in the colchicine group by the reduced need for oxygen support from 14 (66.7%) to 2 (9.5%). In the control group, the number of patients without anti-inflammatory therapy requiring oxygen support remained unchanged at 50%. There was a trend to shorter hospital stays in the group of specific anti-inflammatory therapy up to 13 days compared to 17.5 days in the control group (p = 0.079). Moreover, two patients died in the control group, and there were no fatal cases in the colchicine group. In the colchicine group, one patient had deep vein thrombosis with D-dimer elevated to 5.99 µg/mL, which resolved before discharge.Conclusions Colchicine 1 mg for 1-3 days followed by 0.5 mg/day for 14 days is effective as a proactive anti-inflammatory therapy in hospitalized patients with COVID-19 and viral pneumonia. The management of such patients without proactive anti-inflammatory therapy is likely to be unreasonable and may worsen the course of COVID-19. However, the findings should be treated with caution, given the small size of the trial.
Collapse
Affiliation(s)
- V Yu Mareev
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - Ya A Orlova
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - A G Plisyk
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - E P Pavlikova
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - Z A Akopyan
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - S T Matskeplishvili
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia
| | - P S Malakhov
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia
| | - T N Krasnova
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - E M Seredenina
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - A V Potapenko
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - M A Agapov
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - D A Asratyan
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia
| | - L I Dyachuk
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - L M Samokhodskaya
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - Е А Mershina
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - V E Sinitsyn
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - P V Pakhomov
- Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - E A Zhdanova
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - Yu V Mareev
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia Robertson Centre for Biostatistics, Glasgow, Great Britain
| | - Yu L Begrambekova
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - А А Kamalov
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| |
Collapse
|
6
|
Gallyamov EA, Agapov MA, Busyrev YB, Kakotkin VV, Kubyshkin VA, Donchenko KA, Gadlevskiy GS, Wu Z. [Outcomes of various techniques of mesh prosthesis fixation in laparoscopic hernia repair]. Khirurgiia (Mosk) 2021:34-41. [PMID: 33395510 DOI: 10.17116/hirurgia202101134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare early and long-term results of various mesh prosthesis fixation methods in laparoscopic inguinal hernia repair. MATERIAL AND METHODS It is a prospective clinical non-randomized trial. The study included 212 patients. Conventional stapler fixation (112 patients), self-gripping mesh implants (48 patients) and n-butyl cyanoacrylate adhesive fixation (52 patients) were compared. We estimated surgery time, pain syndrome severity in early and long-term postoperative period, postoperative morbidity and recurrence rate were evaluated. RESULTS Early postoperative morbidity, activation of patients and hospital-stay were similar in all groups. Pain syndrome within 6 postoperative hours in the first group exceeded the same parameter in the second group by 1.23 times (95% CI 1.15-1.31, p<0.05) and by 1.19 times in the third group (95% CI 1.12-1.26, p<0.05). Within 12 hours, pain syndrome in the first group was 1.27 times more severe compared to the third group (95% CI 1.20-1.34, p<0.05). Pain syndrome in long-term period was similar in all groups. In the first group, one recurrence was detected (0.9%). CONCLUSION There were no significant between-group differences. However, we found the correlation of postoperative pain syndrome with mesh implant fixation technique.
Collapse
Affiliation(s)
- E A Gallyamov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - M A Agapov
- Lomonosov Moscow State University, Moscow, Russia
| | - Yu B Busyrev
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - V V Kakotkin
- Lomonosov Moscow State University, Moscow, Russia
| | | | | | - G S Gadlevskiy
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Z Wu
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| |
Collapse
|
7
|
Mareev VY, Orlova YA, Plisyk AG, Pavlikova EP, Matskeplishvili ST, Akopyan ZA, Seredenina EM, Potapenko AV, Agapov MA, Asratyan DA, Dyachuk LI, Samokhodskaya LM, Mershina ЕА, Sinitsyn VE, Pakhomov PV, Bulanova MM, Fuks AA, Mareev YV, Begrambekova YL, Kamalov АА. [Results of Open-Label non-Randomized Comparative Clinical Trial: "BromhexIne and Spironolactone for CoronаvirUs Infection requiring hospiTalization (BISCUIT)]. ACTA ACUST UNITED AC 2020; 60:4-15. [PMID: 33487145 DOI: 10.18087/cardio.2020.11.n1440] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 11/12/2020] [Indexed: 11/18/2022]
Abstract
Introduction The aim of this study was to assess the efficacy and safety of a combination of bromhexine at a dose of 8 mg 4 times a day and spironolactone 50 mg per day in patients with mild and moderate COVID 19.Material and methods It was an open, prospective comparative non-randomized study. 103 patients were included (33 in the bromhexine and spironolactone group and 70 in the control group). All patients had a confirmed 2019 novel coronavirus infection (COVID 19) based on a positive polymerase chain reaction (PCR) for SARS-CoV-2 virus RNA and/or a typical pattern of viral pneumonia on multispiral computed tomography. The severity of lung damage was limited to stage I-II, the level of CRP should not exceed 60 mg / dL and SO2 in the air within 92-98%. The duration of treatment is 10 days.Results The decrease in scores on the SHOKS-COVID scale, which, in addition to assessing the clinical status, the dynamics of CRP (a marker of inflammation), D-dimer (a marker of thrombus formation), and the degree of lung damage on CT (primary endpoint) was statistically significant in both groups and differences between them was not identified. Analysis for the group as a whole revealed a statistically significant reduction in hospitalization time from 10.4 to 9.0 days (by 1.5 days, p=0.033) and fever time from 6.5 to 3.9 days (by 2.5 days, p<0.001). Given the incomplete balance of the groups, the main analysis included 66 patients who were match with using propensity score matching. In matched patients, temperature normalization in the bromhexine/spironolactone group occurred 2 days faster than in the control group (p=0.008). Virus elimination by the 10th day was recorded in all patients in the bromhexine/spironolactone group; the control group viremia continued in 23.3% (p=0.077). The number of patients who had a positive PCR to the SARS-CoV-2 virus on the 10th day of hospitalization or longer (≥10 days) hospitalization in the control group was 20/21 (95.2%), and in the group with bromhexine /spironolactone -14/24 (58.3%), p=0.012. The odds ratio of having a positive PCR or more than ten days of hospitalization was 0.07 (95% CI: 0.008 - 0.61, p=0.0161) with bromhexine and spironolactone versus controls. No side effects were reported in the study group.Conclusion The combination of bromhexine with spironolactone appeared effective in treating a new coronavirus infection by achieving a faster normalization of the clinical condition, lowering the temperature one and a half times faster, and reducing explanatory combine endpoint the viral load or long duration of hospitalization (≥ 10 days).
Collapse
Affiliation(s)
- V Yu Mareev
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - Ya A Orlova
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - A G Plisyk
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - E P Pavlikova
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - S T Matskeplishvili
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia
| | - Z A Akopyan
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - E M Seredenina
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - A V Potapenko
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - M A Agapov
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - D A Asratyan
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia
| | - L I Dyachuk
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - L M Samokhodskaya
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - Е А Mershina
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - V E Sinitsyn
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - P V Pakhomov
- Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - M M Bulanova
- Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - A A Fuks
- Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - Yu V Mareev
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia Robertson Centre for Biostatistics, Glasgow, Great Britain
| | - Yu L Begrambekova
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - А А Kamalov
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| |
Collapse
|
8
|
Gallyamov EA, Agapov MA, Donchenko KA, Gallyamov EE, Kakotkin VV. [Comparison of efficiency and safety of laparoscopic manual esophagoenterostomy and esophagoenterostomy with mechanical anastomotic devices after laparoscopic gastrectomy for stomach cancer]. Khirurgiia (Mosk) 2020:11-17. [PMID: 32352662 DOI: 10.17116/hirurgia202004111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To compare laparoscopic manual esophagoenterostomy and esophagoenterostomy with mechanical stapling anastomotic devices after laparoscopic gastrectomy for stomach cancer. MATERIAL AND METHODS There were 34 patients who underwent laparoscopic gastrectomy for stomach in 2015-2018. Roux-en-Y esophagoenterostomy was used to reconstruct the gastrointestinal tract. Manual anastomoses were performed in 18 patients (group 1), stapled anastomoses (endogia 45 mm, covidien, mansfield, ma, usa) - in 16 patients (group 2). There was no randomization. Surgery duration, length of icu-stay, terms of enteral nutrition initiation, postoperative complications, hospital-stay were analyzed. RESULTS Mean duration of surgery in the first group was 217 (184-302) min, in the second group - 201 (162-311) min. Duration of surgery in the first group was 1.08-fold higher than in the second group (95% CI 1.03-1.13, p=0.05). Mean blood loss was 145 ml in both groups. Mean icu-stay was 20.2 (17-42) hours in the first group and 21.1 (16.2-46) hours in the second group (ratio 0.96, 95% CI 0.92-1.01, p=0.06). Total enteral feeding (sipping) was initiated on the third day in both groups. Mean postoperative hospital-stay was 9.21 (6-13) days in the first group and 9.23 (6-12 days) days in the second group (ratio 0.99, 95% CI 0,95-1.02, p=0.06). Postoperative morbidity was 5.5% in the first group and 6.25% in the second group. CONCLUSION Laparoscopic manual esophagoenterostomy proposed by our surgical team does not have disadvantages in comparison with stapling anastomotic devices and these methods may be alternative to each other.
Collapse
Affiliation(s)
- E A Gallyamov
- Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University), Moscow, Russia
| | - M A Agapov
- Lomonosov Moscow State University, Faculty of Fundamental Medicine, Moscow, Russia
| | - K A Donchenko
- Lomonosov Moscow State University, Faculty of Fundamental Medicine, Moscow, Russia
| | - E E Gallyamov
- Federal Medical and Biological Agency of Russia, Moscow, Russia
| | - V V Kakotkin
- Lomonosov Moscow State University, Faculty of Fundamental Medicine, Moscow, Russia
| |
Collapse
|
9
|
Abstract
Ventral hernia is still one of the most common reason for scheduled and emergency surgery. The review is designed to reveal relationships between metabolism in extracellular matrix of connective tissue and pathogenesis of ventral hernias. These data will be valuable to develop a personalized approach to the treatment of these patients.
Collapse
Affiliation(s)
| | - M A Agapov
- Lomonosov Moscow State University, Moscow, Russia
| | | | - V V Kakotkin
- Lomonosov Moscow State University, Moscow, Russia
| |
Collapse
|
10
|
Gallyamov EA, Agapov MA, Busyrev YB, Gallyamov EE, Kakotkin VV, Allakhverdieva AR. [Comparison of minimal invasive technologies for treatment of infected pancreatic necrosis]. Khirurgiia (Mosk) 2020:22-28. [PMID: 32271733 DOI: 10.17116/hirurgia202003122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
AIM the assessment of the role of minimally invasive interventional procedures in the treatment of patients with infected pancreatic necrosis and their safety, as well as comparison of the results of the most common modern minimally invasive techniques among themselves. METHODS The results of treatment of 310 patients are presented with infected destructive pancreatitis from 2013 to 2018 on the basis of the city clinical hospital named after I.V. Davydovsky. The patients were divided into three groups: in the first one (n=170) patients underwent puncture followed by drainage of necrotic foci under ultrasound and CT control, in the second (n=98) patients underwent sanation of foci completely by laparoscopic access, in the third (n=42) a series of retroperitoneoscopy was used for the same purpose. RESULTS In 114 (67.1%) cases, patients from the first group did not require further surgical intervention. The results of percutaneous drainage were successful. The average length of hospital stay in the first group was 27 days, in the second and third groups - 31 days (the ratio in the 2nd and 3rd groups was 1.03 (95% CI 0.97-1.08; p<0.05)). In the course of treatment, complications were identified in 35 (35.7%) patients in the 2nd and 17 (40.4%) patients in the 3rd group (ratio 0.88 (95% CI 0.82-0.94)). There were 22 (7.1%) deaths. The causes of death were: 1 (0.3%) of the patient had arrosive bleeding, 2 (0.7%) had duodenal fistulas, 19 (6.1%) multiple organ failure against the background of widespread retroperitoneal phlegmon. CONCLUSION The efficacy of treatment of infected pancreatic necrosis depends on the possibility of full drainage of the necrotic focus, regardless of approach. Minimally invasive techniques can reduce intraoperative trauma by reducing the wound surface, which contribute to develop systemic inflammatory response syndrome.
Collapse
Affiliation(s)
- E A Gallyamov
- Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Moscow, Russia
| | - M A Agapov
- Lomonosov Moscow State University, Faculty of Fundamental Medicine, Moscow, Russia
| | - Yu B Busyrev
- Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Moscow, Russia
| | - E E Gallyamov
- Federal Medical and Biological Agency of Russia, Moscow, Russia
| | - V V Kakotkin
- Lomonosov Moscow State University, Faculty of Fundamental Medicine, Moscow, Russia
| | - A R Allakhverdieva
- Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Moscow, Russia
| |
Collapse
|
11
|
Gallyamov EA, Agapov MA, Lutsevich OE, Kubyshkin VA, Kakotkin VV, Tolstykh MP. [Early ileostomy closure in patients with rectal cancer. Primary results of the randomized controlled multicenter trial]. Khirurgiia (Mosk) 2019:35-40. [PMID: 31317939 DOI: 10.17116/hirurgia201906135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIM To evaluate safety of early closure of ileostomy in patients with rectal cancer after primary surgery. MATERIAL AND METHODS The trial included patients from several medical centers without signs of anastomotic leakage. CT-proctography or rectoscopy were performed in 8 days after primary surgery to confirm integrity of the anastomoses. Exclusion criteria were factors affecting normal tissue regeneration (diabetes mellitus, steroid drugs prescription, etc.). Patients with intact anastomoses and no exclusion criteria were randomized into 2 groups: group 1 (n=31) with early closure of ileostomy (in 8-13 days after surgery) and group 2 (n=34) with delayed closure (after 12 weeks). All data were analyzed. RESULTS Postoperative morbidity was similar in both groups (6.45% vs. 5.88%, p=0.08). However, less duration of reconstructive surgery was noted in group 1 (50 (27-126) min vs. 71 min (31-134). This value was 1.42 times less in the main group (95% CI 1.30-1.52; p=0.02). CONCLUSION Early closure of ileostomy in patients after surgery for rectal cancer is feasible and does not result increased postoperative morbidity. This approach may be considered as an alternative to delayed closure. However, further researches devoted to analysis of ileostomy-associated complications and quality of life are necessary.
Collapse
Affiliation(s)
- E A Gallyamov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - M A Agapov
- Faculty of Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - O E Lutsevich
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - V A Kubyshkin
- Faculty of Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - V V Kakotkin
- Faculty of Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - M P Tolstykh
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| |
Collapse
|
12
|
Gallyamov EA, Lutsevich OE, Kubyshkin VA, Erin SA, Agapov MA, Presnov KS, Busyrev YB, Gallyamov EE, Gololobov GY, Zryanin AM, Starkov GA, Tolstykh MP. [Redo laparoscopic surgery for recurrent gastroesophageal reflux disease and hiatal hernia]. Khirurgiia (Mosk) 2019:26-31. [PMID: 30855587 DOI: 10.17116/hirurgia201902126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To assess mechanisms of recurrent gastroesophageal reflux disease and the ability to perform adequate surgical correction after previous surgery. MATERIAL AND METHODS The authors from various surgical centers have operated 2678 patients with gastroesophageal reflux disease and hiatal hernia for the period 1993-2018. 127 (4.74%) patients underwent redo surgery for recurrent disease, 46 of them were previously operated in other clinics. RESULTS Median follow-up after redo surgery was 63 months (12-139). Satisfactory functional result was achieved in 76.4% of patients.
Collapse
Affiliation(s)
- E A Gallyamov
- Sechenov First Moscow State Medical University of Healthcare Ministry of the Russia, Moscow, Russia; Central Clinical Hospital of Civil Aviation, Moscow, Russia
| | - O E Lutsevich
- Evdokimov Moscow State University of Medicine and Dentistry of Healthcare Ministry of the Russia Russia, Moscow, Russia
| | - V A Kubyshkin
- University's Clinic of Lomonosov Moscow State University, Moscow, Russia
| | - S A Erin
- Spasokukotsky Municipal Clinical Hospital, Russia, Moscow, Russia
| | - M A Agapov
- University's Clinic of Lomonosov Moscow State University, Moscow, Russia
| | - K S Presnov
- Central Clinical Hospital of Civil Aviation, Moscow, Russia
| | - Yu B Busyrev
- Sechenov First Moscow State Medical University of Healthcare Ministry of the Russia, Moscow, Russia
| | - E E Gallyamov
- Sechenov First Moscow State Medical University of Healthcare Ministry of the Russia, Moscow, Russia
| | - G Yu Gololobov
- Sechenov First Moscow State Medical University of Healthcare Ministry of the Russia, Moscow, Russia
| | - A M Zryanin
- University's Clinic of Lomonosov Moscow State University, Moscow, Russia
| | - G A Starkov
- Central Clinical Hospital of Civil Aviation, Moscow, Russia
| | - M P Tolstykh
- Evdokimov Moscow State University of Medicine and Dentistry of Healthcare Ministry of the Russia Russia, Moscow, Russia
| |
Collapse
|
13
|
Greyasov VI, Chuguevsky VM, Sivokon NI, Agapov MA, Abubakarov RS. [Non-functioning gallbladder as a risk factor for bile ducts injury during laparoscopic cholecystectomy]. Khirurgiia (Mosk) 2018:52-56. [PMID: 29460879 DOI: 10.17116/hirurgia2018252-56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM To analyze the effect of gallbladder's morpho-functional changes as a risk factor for injury of extrahepatic bile ducts during cholecystectomy. MATERIAL AND METHODS Laparoscopic cholecystectomy was performed in 20 564 patients. There were 147 64 (71.8%) patients with chronic gallbladder inflammation and 5800 (28.2%) - with acute process. It was performed a retrospective analysis of the incidence and causes of intraoperative trauma of extrahepatic bile ducts and bile outflow. Two groups of comparison were distinguished: acute calculous cholecystitis and chronic inflammation. RESULTS There were 93 (0.04%) complications followed by bile outflow (55 (0.94%) in the 1st group and 38 (0.25%) in the 2nd group). Marginal injury of the ducts was interoperatively detected in 5 patients of group 1 and 3 patients of 2 groups. In postoperative period it was found in 6 patients of the 1st group due to electric trauma of common bile duct. Complete transection of common bile duct occurred in 10 (8.8%) cases, while chronic calculous cholecystitis was observed in 8 of them. At the same time, in 6 patients these were surgical interventions in scleroatrophic gallbladder. As a results, we determined the forms of non-functioning gallbladder with morphofunctional changes which promote trauma of extrahepatic bile ducts. CONCLUSION Long-term non-functioning gallbladder leads to cicatricial and adhesive processes in its wall and surrounding tissues that significantly complicates cholecystectomy and increases the risk of bile ducts trauma. Scleroatrophic gallbladder is the most dangerous which occurs in 4.1% of patients with chronic calculous cholecystitis. Further trials are advisable to develop optimal therapeutic and diagnostic tactics for various forms of long-term non-functioning gallbladder.
Collapse
Affiliation(s)
- V I Greyasov
- Department of Surgery and Endosurgery with a course of vascular surgery and angiology, Stavropol State Medical University, Stavropol, Russia; Yessentuki Municipal Hospital, Yessentuki, Russia
| | | | - N I Sivokon
- Yessentuki Municipal Hospital, Yessentuki, Russia
| | - M A Agapov
- Yessentuki Municipal Hospital, Yessentuki, Russia
| | | |
Collapse
|
14
|
Gallyamov EA, Agapov MA, Kubyshkin VA, Biktimirov RG, Malakhov PS, Zryanin AM, Kamalov AA, Lutsevich OE. [Multiple primary neoplasia of kidney, prostate and colon]. Khirurgiia (Mosk) 2018:98-100. [PMID: 29697693 DOI: 10.17116/hirurgia2018498-100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- E A Gallyamov
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - M A Agapov
- Medical Research and Education Center, Lomonosov Moscow State University, Russia
| | - V A Kubyshkin
- Medical Research and Education Center, Lomonosov Moscow State University, Russia
| | - R G Biktimirov
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - P S Malakhov
- Medical Research and Education Center, Lomonosov Moscow State University, Russia
| | - A M Zryanin
- Medical Research and Education Center, Lomonosov Moscow State University, Russia
| | - A A Kamalov
- Medical Research and Education Center, Lomonosov Moscow State University, Russia
| | - O E Lutsevich
- Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| |
Collapse
|
15
|
Danilova NV, Popov PV, Oleynikova NA, Malkov PG, Kharlova OA, Yusupova KI, Agapov MA. [Gastric adenocarcinoma arising in giant hyperplastic polyp]. Arkh Patol 2017; 79:43-52. [PMID: 29265077 DOI: 10.17116/patol201779643-52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Gastric hyperplastic polyps are usually solitary, their development is supposed to be associated with excessive proliferation of foveolar cells. It is essential to differentiate hyperplastic polyps from other sporadic polyps (adenomatous and fundic gland polyps) and lesions, included in familial polyposis syndromes. The frequency of adenocarcinoma in large gastric hyperplastic polyps (more than 1-2 cm in size) is about 2,1%. This article includes case report of gastric adenocarcinoma arised in large hyperplastic polyp in a 56-year-old patient. On histological examination a well-differentiated adenocarcinoma without invasion in the peduncle was identified. Immunohistochemically cells of adenocarcinoma showed elevated expression of claudin-3, CDX2, p53 and Ki67 compared to hyperplastic glands and dysplastic areas of the polyp. Also focal expression of MUC2 was revealed in adenocarcinoma. Expression of MUC5AC, CD44 and cyclin D1 was less prominent in cancer areas compared to hyperplastic and dysplastic glands. Levels of expression of claudin-1, claudin-4 and β-catenin were equal in adenocarcinoma and hyperplastic structures. Control endoscopic examination with following morphologic examination was performed three months after surgical operation. No signs of tumor growth were identified.
Collapse
Affiliation(s)
- N V Danilova
- M.V. Lomonosov Moscow State University, Moscow, Russia
| | - P V Popov
- M.V. Lomonosov Moscow State University, Moscow, Russia
| | | | - P G Malkov
- M.V. Lomonosov Moscow State University, Moscow, Russia
| | - O A Kharlova
- M.V. Lomonosov Moscow State University, Moscow, Russia
| | - Kh I Yusupova
- M.V. Lomonosov Moscow State University, Moscow, Russia
| | - M A Agapov
- M.V. Lomonosov Moscow State University, Moscow, Russia
| |
Collapse
|
16
|
Abstract
UNLABELLED The aim of this study was to define the possibility of using a collagen substance CollGARA as a protective barrier between the polypropylene mesh implant and abdominal organs. The drug is a sterile bioabsorbable membrane consisting of refolded equine collagen. Indications--use as barrier separating adjoining tissues and organs in the areas of the abdominal cavity, where the formation of adhesions. MATERIALS AND METHODS Were performed 10 operations in patients with ventral hernias with different localization. 8 patients had postoperative hernia in 2--linea alba hernia. 8 patients were operated open, 2--laparoscopically. After intra-abdominal hernia repair was performed plastic mesh implant, delimiting it from the abdominal cavity membrane CollGARA. Serious complications from the abdominal cavity and the surgical wound wasnt observed. RESULTS The first experience with intra-abdominal plastic polypropylene mesh implant coated with collagen plate indicates the possibility of applying this method in the future.
Collapse
Affiliation(s)
- V A Gorskij
- Chair of Surgery, Medical-Biological Faculty of the N.I. Pirogov Russian National Research Medical University, Russian Health Ministry, Moscow
| | - A S Sivkov
- Central Clinical Hospital, Lytkarino, Moscow Region
| | - M A Agapov
- Chair of Surgery, Medical-Biological Faculty of the N.I. Pirogov Russian National Research Medical University, Russian Health Ministry, Moscow
| | - B E Titkov
- Central Clinical Hospital, Lytkarino, Moscow Region
| | - S O Schadskij
- Chair of Surgery, Medical-Biological Faculty of the N.I. Pirogov Russian National Research Medical University, Russian Health Ministry, Moscow
| |
Collapse
|
17
|
Stupin VA, Basarbolieva ZV, Agapov MA, Laipanov BK, Khokonov MA, Klimiashvili AD, Rodoman GV. [Treatment of hepatic insufficiency in benign mechanical jaundice]. Klin Med (Mosk) 2013; 91:53-56. [PMID: 25696967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of this work was to estimate hepatic dysfunction and improve treatment of benign mechanical jaundice using an injection hepatoprotector. The study included 124 patients of whom 74 were given remaxol. 50 control subjects received basal therapy. The patients were randomized by the random sampling method. Severity of cholestasis was evaluated from the total and fractional bilirubin content and γ-glutamyl transpeptidase (GGT) level; AST and ALT activities were used to detect cytolysis. Liver synthetic function was estimated from prothrombin index (PTI) and coagulation function from fibrinogen level, PTI and APTT. Endogenous intoxication during biliary tract decompression was assessed by calculating the leukocyte intoxication index from the Kalf-Kalif formula. It was shown that remaxol suppresses cytolysis, reduces total and fractional bilirubin levels, improves bilirubin excretion in bile and decreases activity of hepatocyte excretory enzymes.
Collapse
|
18
|
Gorskiĭ VA, Agapov MA, Protasov AV, Iskhakov RR. [The use of fibrin-collagen substance in case of spleen injuries]. Khirurgiia (Mosk) 2013:73-77. [PMID: 24362297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Spleen damage is one of the most common injuries of the abdomen. Thus, splenectomy is one of the most common embodiments of the surgical procedure. Justified by the desire of surgeons to perform organ save surgery, which was made possible by the emergence of new hemostatic agents. In this paper, an experimental and clinical study of the effectiveness of fibrin-collagen substance (FCC) "Tachocomb" to hemostasis of spleen injuries was submitted.
Collapse
|
19
|
Gorskiĭ VA, Agapov MA, Titkov BE, Sologubov VV. [The use antibiotics' enreached glue substance for the abdominal surgery]. Khirurgiia (Mosk) 2012:48-54. [PMID: 22810345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
20
|
Gorskiĭ VA, Agapov MA, Sologubov VV. [Application of a glue substance in operations on the colon]. Vestn Khir Im I I Grek 2012; 171:78-81. [PMID: 23227750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The incompetent intestinal suture in the colon is one of the most frequent complications in emergency surgery. A great number of studies have found that the main way to improve the immediate postoperative result is to create optimal conditions for healing the intestinal wall. The results of clinical and experimental research of the drug "Tachocomb" for strengthening the intestinal anastomosis are described. It was shown that this technique allowed the mechanical strength of the anastomosis to be increased by stimulation of reparative processes in the intestinal suture and the microbial contamination to be reduced.
Collapse
|
21
|
Stupin VA, Basarbolieva ZV, Agapov MA, Laĭpanov BK, Khokonov MA, Tronin RI, Klimiashvili AD, Rodoman GV. [Treatment of the benign obstructive jaundice]. Khirurgiia (Mosk) 2012:75-79. [PMID: 22968509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
22
|
Titov VI, Ivanova AV, Agapov MA, Petrov VA. [The content of nitrite and N-nitroso compounds of plasma as a diagnostic test of nonspecific inflammation]. Klin Lab Diagn 2011:13-19. [PMID: 22312909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The authors' enzymatic sensor was applied to identify the content of nitrite and nitroso compounds of blood plasma in normal condition and under various inflammatory diseases. It is established that in normal conditions blood plasma contains nitrite, N-nitroso compounds (RNNO) and S-nitroso compounds (RSNO) in concentrations less than 100 nm. The plasma pool of nitroso compounds includes basically thiolferous nitrosate ferrum complex in concentration 3-20 microm. The concentration of nitrite in plasma is from 10 to 150 microm. The concentration (nitrite+RNNO) increases dramatically under inflammatory diseases. This indicator was 0.3-1.0 microm in examined patients with acute and chronic pancreatitis, cholecystitis, ENT diseases of inflammatory character and ARD. In the case of acute appendicitis the indicator reached 10 micro. In case of successful treatment the content (nitrite+RNNO) decreased to the concentration lower than 100 nm. The content of other nitrite and N-nitroso compounds had no reliable variations. Because of this, largely implemented evaluation of intensity of nitric oxide production by the aggregate indicator of nitrites content (NO(x)) in blood seems ambiguous. The reason is that in normal conditions nitrite is presented in trace amount and considerable quantity of nitrate can enter the organism in an exogenous way. Besides that the content of nitrite can depend on kidneys filterability. At the same time, based on the obtained data, the content (nitrite+RNNO) in plasma in concentrations higher than 150 nm are definitely to be considered as pathology.
Collapse
|
23
|
Agapov MA, Khoreva MV, Gorskiĭ VA. [The systemic inflammatory response syndrome correction in acute destructive pancreatitis]. Eksp Klin Gastroenterol 2011:18-23. [PMID: 22363994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Acute pancreatitis is a disease of variable severity. In which some patients experience mild, self-limited attacks while others manifest a severe, highly morbid, and frequently lethal attack. The exact mechanisms by which diverse etiological factors induce an attack are still unclear. Recent studies have established the role played by inflammatory mediators in the pathogenesis of acute pancreatitis. In our research we have estimated influence of not steroid anti-inflammatory preparation on synthesis pro-and anti-inflammatory Cytokines at healthy donors and at patients with Acute pancreatitis.
Collapse
MESH Headings
- Adult
- Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Cell Culture Techniques
- Cells, Cultured
- Cytokines/blood
- Cytokines/immunology
- Dose-Response Relationship, Drug
- Drug Therapy, Combination
- Humans
- Injections, Intravenous
- Leukocytes, Mononuclear/drug effects
- Leukocytes, Mononuclear/immunology
- Ligands
- Pancreatitis, Acute Necrotizing/blood
- Pancreatitis, Acute Necrotizing/complications
- Pancreatitis, Acute Necrotizing/drug therapy
- Pancreatitis, Acute Necrotizing/immunology
- Piroxicam/administration & dosage
- Piroxicam/analogs & derivatives
- Piroxicam/therapeutic use
- Systemic Inflammatory Response Syndrome/blood
- Systemic Inflammatory Response Syndrome/etiology
- Systemic Inflammatory Response Syndrome/immunology
- Systemic Inflammatory Response Syndrome/prevention & control
- Toll-Like Receptor 1/immunology
- Toll-Like Receptor 2/immunology
- Toll-Like Receptor 4/immunology
- Young Adult
Collapse
|
24
|
Koval'chuk LV, Khoreva MV, Nikonova AS, Grechenko VV, Agapov MA, Indarokov VA, Leonenko IV, Gorskiĭ VA, Gracheva LA. [Corrective effect of cyclooxygenase inhibitor on functional status of mononuclear cells expressing Toll-like receptors]. Zh Mikrobiol Epidemiol Immunobiol 2010:45-50. [PMID: 20218345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM To study the influence of the COX inhibitor--lornoxicam (LX)--on Toll-like receptor (TLR)-mediated production of proinflammatory and anti-inflammatory cytokines by peripheral blood mononuclear cells (PBMC) from healthy subjects and patients with acute pancreatitis (AP) in vitro. MATERIALS AND METHODS Cytokine production by PBMC of healthy donors was stimulated by TLR1/2 ligand peptidoglycan (PG) and TLR4 ligand lypopolysaccharide (LPS) in presence of LX. Levels of cyotokines (IL-1beta, IL-6, IL-8, IL-10, IL-12, and TNFalpha) were measured by ELISA. Group of patients with acute pancreatitis of toxic etiology included 11 subjects: patients from main group received combined therapy supplemented with NSAID from the oxicam class--LX; patients who received only standard basic treatment formed comparison group. RESULTS It was found that in vitro LX inhibits production of both proinflammatory and anti-inflammatory cytokines by PBMC of healthy subjects mediated by ligands of TLR1/2 and TLR4. Maximal inhibitory effect of LX was observed when cytokine production was induced through TLR1/2. Patients with AP demonstrated increased production of TNFalpha induced by TLR1/2 and TLR4 ligands. CONCLUSION LX inhibits TLR-mediated production of both proinflammatory (IL-1, IL-6, IL-8, IL-12, TNFalpha) and anti-inflammatory (IL-10) cytokinesby PBMC of healthy subjects in vitro. Treatment with LX in patients with AP results in diminished effector function of TLR1/2 and TLR4 already during 1st day of the illness and normalization of these indices by 6th day.
Collapse
|
25
|
Gorskiĭ VA, Koval'chuk LV, Agapov MA, Khoreva MV, Ovanesian ER, Nikonova AS, Grechenko VV. [Antimediatory therapy in the complex treatment of acute destructive pancreatitis]. Khirurgiia (Mosk) 2010:54-61. [PMID: 20524238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
|
26
|
Gorskiĭ VA, Faller AP, Ovanesian ER, Agapov MA. [Causes of the formation of hernias after laparoscopic cholecystectomy]. Vestn Khir Im I I Grek 2008; 167:81-84. [PMID: 18942444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The authors made an analysis of postoperative hernias in 32 patients. General and local causes are considered. The proposed technical methods used for exclusion of local causes allowed the frequency of postoperative hernias to be reduced from 1.9% to 0.5%.
Collapse
|