ЭПИДЕМИОЛОГИЧЕСКАЯ ХАРАКТЕРИСТИКА НОВООБРАЗОВАНИЙ ЩИТОВИДНОЙ ЖЕЛЕЗЫ В РАЗВИТОМ ПРОМЫШЛЕННОМ РЕГИОНЕ

The purpose of the study was to assess thyroid cancer epidemiology in the Udmurt Republic during 2008–18 and to estimate thyroid cancer raetes until 2023.Material and Methods. The incidence of thyroid cancer in the Udmurt Republic was studied over a 10-year period (2008–18) according to state statistical accounting and reporting documentation.Results. The age-standardized incidence rate of thyroid cancer in the Udmurt Republic for both sexes increased from 2.57 ± 0.36 per 100,000 population in 2008 to 6.60 ± 0.61 per 100,000 population in 2018, with an average annual percentage change of 9.9 %. The mortality rate from thyroid cancer decreased from 0.39 ± 0.12 per 100,000 population in 2008 to 0.36 ± 0.14 per 100,000 population in 2018.The incidence of thyroid cancer in the Udmurt Republic in 2023 was estimated to be 10.24 per 100,000 population.Conclusion. In the Udmurt Republic, the increase in the incidence of thyroid cancer is significantly higher than in the Volga Federal District and Russia. The obtained estimates of thyroid cancer incidence until 2023 can be used in developing programs for early detection and prevention of this disease. Цель исследования – оценить эпидемиологическую ситуацию по новообразованиям щитовидной железы в Удмуртской Республике за 2008–18 гг. и дать оценку прогноза заболеваемости до 2023 г.Материал и методы. Изучена эпидемиология рака щитовидной железы в Удмуртской Республике за последние 10 лет (2008–18 гг.) с использованием данных государственной статистической учетно-отчетной документации.Результаты. Стандартизованный показатель заболеваемости раком щитовидной железы (РЩЖ) в Удмуртской Республике на оба пола вырос с 2,57 ± 0,36 на 100 тыс. населения в 2008 г. до 6,60 ± 0,61 случая на 100 тыс. населения в 2018 г. Прирост заболеваемости за исследованный период составил 156,8 %, среднегодовой прирост составил 9,9 %. Показатель смертности от рака щитовидной железы снизился с 0,39 ± 0,12 на 100 тыс. населения в 2008 г. до 0,36 ± 0,14 на 100 тыс. населения в 2018 г., не уступая показателям по РФ. По прогнозу заболеваемость РЩЖ в Удмуртской Республике в 2023 г. может составить 10,24 на 100 тыс. населения.Заключение. В Удмуртской Республике прирост заболеваемости злокачественной патологией щитовидной железы значительно выше, чем в Приволжском федеральном округе и России. Полученные оценки прогноза заболеваемости раком щитовидной железы населения региона до 2023 г. могут быть использованы при разработке программ по ранней диагностике и профилактике.

Acute phlegmonous appendicitis in rare variant of appendix diverticulum (case report)

Background. Appendicitis-like diverticulitis is considered a rare disease and is usually the subject of clinical reports. Clinical manifestations of this pathology is similar to those of appendicitis, which is why a preoperative diagnosis is made quite rarely. When carrying out the study, we considered a clinical case of acute phlegmonous appendicitis with a rare variant of the appendix wall diverticulum.Material and methods. To assess clinical cases, a retrospective analysis of medical documentation (medical records of patients with diverticulitis in particular) was used. The assessment of clinical symptoms was accompanied by using general clinical, histological and microbiological methods.Results. Patient I., 62 years old, was diagnosed with acute appendicitis. An urgent appendectomy was carried out, during which the vermiform process was removed. It was located retrocecally, in the adhesive process and loose infiltrate. The length of the process is 7–8 cm, its diameter is 1–1,5 cm. 6 diverticula up to 0,7 cm in size are visible. When the process is cut, the pyoid contents protrudes from its lumen. In addition, the appendix removed during appendectomy was sent for pathological study. A standard histopathological study was carried out with the step-like sectioning and hematoxylin and eosin staining.Conclusion. From the results of a pathological study, it was found that the layers of the vermiform process wall with diverticula are diffusely infiltrated by polymorphonuclear leukocytes. The mucous membrane is anesthetized and had ulcerative defects. The patient was diagnosed with phlegmonous appendicitis, periappendicitis, diverticulitis.Vermiform process diverticulitis is not a common pathology, however a timely diagnosis can cause quite severe complications

Оценка качества жизни пациентов с диффузным токсическим зобом после проведенной тиреоидэктомии

Introduction. Graves’ disease is a disorder associated with thyroid gland producing excessive amounts of hormones which causes changes in the functional status of various organs and systems. Among thyroid disorders it takes the second place (after endemic goitre) in prevalence. Until now, there is no consensus on a single strategy for the treatment of disorders of the thyroid gland. This is why this paper aims to assess the impact of surgical treatment of Graves’ disease on patients’ quality of life and whether it would be possible to improve it by following the surgery with hormone replacement therapy.Materials and methods. This paper presents a retrospective analysis of 70 case histories of patients who received surgical treatment for diffuse toxic goitre at the BIH UR “First Republican Teaching Hospital” MH UR,Izhevsk, in the period from 2008 to 2014. Percentages of the disease by stage were as follows: stage II — 20%, stage III — 70%, stage 4 — 10%. One lobe resection was performed in 3% of patients, two lobe resection — in 1%, hemithyroidectomy — in 18±4.6%, subtotal resection — in 8%, thyroidectomy — in 70±5.5%.Results. Percentages of patients with various degrees of severity of postoperative hypothyroidism were as follows: severe — 66%, medium — 29%, light — 5%; there were no Graves’ disease recurrences. Patients’ complaints following thyroidectomy included body weight gain — 79.1±4.8%, cold in extremities — 83.3±4.4%, cardiac arrhythmia — 85.2±4.2%, oedemas — 84.3±4.3%, drowsiness, atonia — 67.1±5.6%, changes in appetite — 21±4.8%, skin pallor — 47.6±5.9%, brittle nails, hair loss — 51.2±5.9%, joint pain — 31.2±5.53%.Conclusion. Hypothyroidism always follows thyroidectomy and requires ongoing hormone replacement therapy with L-thyroxine. Th quality of life does not have to suffer if an individual dosage is established and followed on a permanent basis.Диффузный токсический зоб — заболевание, сопровождающееся гиперпродукцией гормонов щитовидной железы и изменением в связи с этим функционального состояния различных органов и систем. По распространенности среди заболеваний щитовидной железы занимает второе место после эндемического зоба. До настоящего времени нет общего мнения по поводу единой тактики лечения заболеваний щитовидной железы. В этой связи основной целью настоящего исследования является оценка влияния оперативного лечения диффузного токсического зоба на качество жизни пациентов и возможность его улучшения путем сочетания хирургического лечения с послеоперационной заместительной гормональной терапией.Материалы иметоды. Проведен ретроспективный анализ 70 историй болезни оперированных пациентов с диффузным токсическим зобом в БУЗ УР «Первая Республиканская клиническая больница» МЗ УР, г. Ижевск, за период с 2008 по2014 г. Стадии заболевания: 2-я стадия — 20 %, 3-я стадия — 70 %, 4-я стадия — 10 %. Им были произведены резекция доли — 3 %, резекция обеих долей — 1 %, гемитиреоидэктомия — 18 ± 4,6 %, субтотальная резекция — 8 %, тиреоидэктомия — 70 ± 5,5 %.Результаты. Процент заболевших послеоперационным гипотиреозом: тяжелая степень — 66 %, средняя степень — 29 %, легкая степень — 5 %, рецидивов ДТЗ не было. Жалобы после тиреоидэктомии: прибавка веса — 79,1 % ± 4,8, зябкость конечностей — 83,3 ± 4,4 %, перебои в работе сердца — 85,2 ± 4,2 %, отеки — 84,3 ± 4,3 %, сонливость, вялость — 67,1 ± 5,6 %, нарушение аппетита — 21 ± 4,8 %, бледность кожных покровов — 47,6 ± 5,9 %, ломкость ногтей, выпадение волос — 51,2 ± 5,9 %, боли в суставах — 31,2 ± 5,53 %.Заключение. В результате проведенной тиреоидэктомии всегда возникает гипотиреоз, который требует постоянной заместительной гормональной терапии препаратами L-тироксина. В случае постоянного приема препаратов, индивидуально подобранной дозировки качество жизни не страдает

Occupational disease and characterization of gigienic environment factors in the manufacture of superphosphates

Average dust concentrations exceed the permissible values in the workplace all the professions studied from 1.3 to 7.9 times with the exception of job machinist scraper, where dust concentrations are within the limit value. Analysis of the dust concentration in air of working zone, depending on the time of the year shows that during the cold season dustiness of air higher than the warm period, which is associated with a reduction of air exchanges in the winter due to fi ne fraction and a high humidity in the premisesСредние концентрации пыли превышают допустимые значения на рабочих местах всех исследуемых профессий от 1,3 до 7,9 раза за исключением рабочего места машиниста скрепера, где концентрации пыли находятся в рамках предельно допустимых значений. Анализ концентраций пыли в воздухе рабочей зоны в зависимости от периода года показывает, что в холодный период года запыленность воздушной среды выше по сравнению с теплым периодом, что связано с уменьшением кратности воздухообмена зимой за счет мелкодисперсной фракции и более высокой влажностью в производственных помещениях

Comparison of quality of life in patients with primary postoperative and autoimmune hypothyreosis

Background. Achieving a high level of quality of life is one of the priorities in the treatment of chronic diseases. Focusing on the quality of life, it is possible to optimally adjust the treatment plan for patients, influencing the link that suffers most in this pathology. Hypothyroidism is mainly formed as a result of surgery on the thyroid gland, or autoimmune thyroiditis, and at the same time is one of the most common endocrine diseases, is of great social importance due to the potentially adverse effect on most organs and systems, resulting in a decrease in quality of life.The aim. To analyze the impact of primary hypothyroidism (postoperative hypothyroidism and autoimmune thyroiditis) on the quality of life of patients.Materials and methods. During the study, a clinical, laboratory and psychological study of 78 women with uncompensated primary hypothyroidism was carried out: 40 women aged 32–76 years with postoperative hypothyroidism (main group) and 38 women aged 36–60 years with autoimmune thyroiditis (comparison group). The quality of life was judged by the indicators of the MOS SF-36 questionnaire.Conclusion. In the examined patients with primary hypothyroidism, an association between an increase in TSH levels and a decrease in all indicators of the quality of life was revealed. First, indicators of physical functioning, general health, role and emotional functioning worsened. The dependence of indicators on the MOS SF-36 scales with the age of patients, the duration of hypothyroidism, and the level of TSH was revealed. The quality of life in patients with postoperative hypothyroidism was significantly reduced compared to patients who had hypothyroidism due to autoimmune thyroiditis

The first TIPS surgery performed in the Udmurt Republic in a young patient with secondary biliary cirrhosis

Treatment of patients with iatrogenic injuries of the biliary tract is the most difficult and important section in hepatobiliary surgery. When analyzing the causes, it was found that in 70–94 % of cases this type of injury is observed during cholecystectomy. We present a rare clinical case of the development of secondary biliary cirrhosis due to iatrogenic trauma of the biliary tract. This injury caused long-term suffering for the patient due to the further development of complications of cirrhosis, specifically of portal hypertension. The latter caused repeated recurrent profuse bleeding from varicose veins of the esophagus. The use of a minimally invasive transjugular intrahepatic portosystemic shunt procedure for the first time in the Udmurt Republic was of particular relevance in solving this problem. This procedure has become a key one in solving the abovementioned problems and will become the preventive measure for the cirrhosis progression in the future. It is also important to focus on prophylactic measures aimed at preventing iatrogenic injuries of the biliary tract, as this problem can cause irreversible complications. Prevention should include adequate examination and visualization of the bile ducts and gallbladder before surgery, their careful mobilization, compliance with the rules of operation with electrosurgical instruments, as well as the use of additional minimally invasive techniques such as choledoscopy, cholangiography and intraoperative ultrasound. Besides that, all manipulations should be carried out under strict control and clear visualization of instruments and anatomical structures of organs. The article provides a detailed description of the technique of transjugular intrahepatic portosystemic shunt surgery, as well as presents X-ray images obtained during this operation

The results of individual training in obese women

The aim of the study - to evaluate the effectiveness of the set of training in women with obesityЦель исследования - оценить эффективность составленного комплекса тренировок у женщин с ожирением

Криомассаж грудной клетки и сильвинитовая спелеотерапия в комплексной медицинской реабилитации больных бронхиальной астмой

Summary. The study was conducted to evaluate therapeutic and preventive effect of chest cryomassage and sylvinite speleotherapy in addition to the standard drug therapy in patients with mild to moderate persistent partially controlled bronchial asthma. Effects of a comprehensive rehabilitation programme were confirmed by a distinct reduction in eosinophilic and neutrophilic inflammation, significant improvements in systemic immunity, lung function, cardiorespitatory hemodynamics, exercise tolerance, and psychological adaptation.Резюме. Изучено лечебно-профилактическое действие криомассажа грудной клетки и сильвинитовой спелеотерапии на фоне стандартного медикаментозного лечения у больных легкой и среднетяжелой персистирующей бронхиальной астмой с частично контролируемым течением. Отчетливый регресс эозинофильного и нейтрофильного воспаления, выраженное улучшение показателей системного иммунитета, внешнего дыхания, легочной кардиогемодинамики, физической толерантности, психологической адаптации позволил констатировать преимущество комплексного применения реабилитационных методов

Assessment of readiness for revaccination against covid19

The aim of the study - to identify factors influencing readiness for revaccination against COVID-19Цель исследования - выявление факторов, влияющих на готовность к ревакцинации против НКВ

Information sources in the educational activities of students of a medical university

The article presents the results of a study devoted to the study of information sources that students use during the period of distance learning due to the covid-19 pandemic. During the study, it was shown that 5th year students are aware of the existence of most authoritative sources of information, however, their application in the educational process is limited. It was also shown that 56% of students participate in additional educational activities 1-2 times a year or less, which requires the development of corrective measuresВ статье приведены результаты исследования, посвященного изучению информационных источников, к которым прибегают студенты в период дистанционного обучения, обусловленного пандемией «ковид-19». В ходе исследования было показано, что студенты 5 курса осведомлены о существовании большинства авторитетных источников информации, однако применение их в учебном процессе ограничено. Также было показано, что 56% студентов участвуют в дополнительных образовательных мероприятиях 1-2 раза в год и реже, что требует разработки корректирующих мероприятий