Способ хирургического лечения острого флотирующего тромбоза илеофеморального сегмента глубоких вен нижних конечностей у пациентов ортопедического профиля

Introduction. The incidence rate of vein thrombosis stands at 180 cases per 100 thousand per year and reaches 200 cases per 100 thousand in older age population.This study aims to assess the efficacy and safety of the proposed method of retrograde vacuum aspiration performed under the conditions of increased intra-abdominal pressure in patients with iliofemoral deep vein thrombosis.Materials and methods. The analysis of surgical treatment of acute floating iliofemoral deep vein thrombosis in 52 orthopedic surgery patients following hip and knee arthroplasty. Acute floating iliofemoral deep vein thrombosis was identified in the postoperative period where the length of the floating part exceeded 4 cm. Patients received emergency treatment in the form of either the surgical prophylaxis of pulmonary embolism (study group n = 18) or a vena cava filter implantation in the infrarenal segment of the vein (control group n = 34).Results and discussion. Patency of the iliofemoral segment was completely restored after the surgery in all the 18 patients in the study group. In the control group, however,, all the 34 patients (px2 < 0.001) retained thrombotic masses in the iliofemoral segment even at the time of discharge from hospital . The length of hospital stay was also different between the comparison groups, amounting to 7 ± 0.74 days for the study group and the patients without thromboembolic complications, and to 21 ± 1.5 days (pm u — 0.0124) for the control.Conclusions 1. The new surgical method proposed for the treatment of acute floating iliofemoral deep vein thrombosis makes it possible to highly effectively restore the full patency of the vein in the shortest possible timeframe. This method is safe and more cost-effective than the classic surgical approach to the treatment of this pathology. 2. Further research into the efficacy and safety of the method proposed is needed as well as a longer term follow up on a larger number of patients.Введение. Эпидемиология тромбозов венозной системы достигает 180 случаев на 100 тыс. населения в год и увеличивается у возрастных пациентов до 200 случаев на 100 тыс. населения.Цель — изучить эффективность и безопасность предложенной методики ретроградной вакуум-аспирации в условиях повышенного внутрибрюшного давления при тромбозе илеофеморального сегмента глубоких вен нижних конечностей.Материалы и методы. Проведен анализ хирургического лечения острого флотирующего тромбоза илеофеморального сегмента глубоких вен нижних конечностей у 52 пациентов ортопедического профиля после эндопротезирования тазобедренных и коленных суставов. В послеоперационном периоде был выявлен острый флотирующий тромбоз илеофеморального сегмента глубоких вен с длиной флотирующей части более 4 см. В срочном порядке пациентам выполнена хирургическая профилактика ТЭЛА, (группа исследования n = 18) и имплантация кава-фильтра в инфраренальный отдел нижней полой вены (контрольная группа n = 34).Результаты и обсуждение. У всех 18 пациентов исследуемой группы после операции наблюдалась полная проходимость илеофеморального сегмента, в то время как в группе сравнения даже к моменту выписки тромботические массы в илеофеморальном сегменте сохранялись у всех 34 пациентов (рх2 < 0,001). Сроки госпитализации пациентов также отличались в группах сравнения: в исследуемой группе — 7 ± 0,74 дня, так же как у пациентов без тромбоэмболических осложнений, а у пациентов группы сравнения составили 21 ± 1,5 дня (pm u — 0,0124).Выводы. 1. Предложенный способ хирургического лечения острого флотирующего тромбоза илеофеморального сегмента глубоких вен нижних конечностей позволяет в кратчайшие сроки с высокой эффективностью полностью восстановить проходимость просвета вен, является безопасным и экономически выгодным по сравнению с классическим подходом хирургического лечения данной патологии. 2. Необходимо продолжить исследование эффективности, безопасности и отдаленных результатов предложенной методики с вовлечением большего количества пациентов

Mechanisms of illegal aggressive behavior of women suffering from schizophrenia

Aim. To establish comparative clinical and psychopathological and social factors leading to realization of intrafamilial and extrafamilial aggressive actions of females suffering from schizophrenia when comparing the mechanisms of illegal actions. Methods. The article presents the results of the study of 91 female patients diagnosed with schizophrenia according to the International Classification of Diseases, 10th revision, (F20.0) of continuous and episodic with progressive deficit type of course, who committed aggressive socially dangerous acts and are admitted for involuntary treatment to Kazan psychiatric hospital of specialized type with intensive supervision. Two groups were identified: group 1 included 57 patients committed aggressive criminal acts in the family, and group 2 included 34 patients committed criminal acts against persons outside the family. A comparison was performed between two basic scientific concepts regarding the reasons and conditions of illegal acts committed by mentally ill persons. Statistical significance of the differences between the compared data was determined (using Fisher's angular transformation criterion and Mann-Whitney test). Results. Comparative study of the analysis concepts of illegal behavior in females suffering from schizophrenia demonstrated that the results turned out to be more detailed when using the concept of psychopathological mechanisms. So, in the productive psychotic mechanism imperative hallucinations and automatisms were noted predominantly in women from group 1 - in 59.5% (p

A New Surgical Method for the Treatment of Acute Floating Iliofemoral Deep Vein Thrombosis in Orthopedic Patients

Introduction. The incidence rate of vein thrombosis stands at 180 cases per 100 thousand per year and reaches 200 cases per 100 thousand in older age population.This study aims to assess the efficacy and safety of the proposed method of retrograde vacuum aspiration performed under the conditions of increased intra-abdominal pressure in patients with iliofemoral deep vein thrombosis.Materials and methods. The analysis of surgical treatment of acute floating iliofemoral deep vein thrombosis in 52 orthopedic surgery patients following hip and knee arthroplasty. Acute floating iliofemoral deep vein thrombosis was identified in the postoperative period where the length of the floating part exceeded 4 cm. Patients received emergency treatment in the form of either the surgical prophylaxis of pulmonary embolism (study group n = 18) or a vena cava filter implantation in the infrarenal segment of the vein (control group n = 34).Results and discussion. Patency of the iliofemoral segment was completely restored after the surgery in all the 18 patients in the study group. In the control group, however,, all the 34 patients (px2 < 0.001) retained thrombotic masses in the iliofemoral segment even at the time of discharge from hospital . The length of hospital stay was also different between the comparison groups, amounting to 7 ± 0.74 days for the study group and the patients without thromboembolic complications, and to 21 ± 1.5 days (pm u — 0.0124) for the control.Conclusions 1. The new surgical method proposed for the treatment of acute floating iliofemoral deep vein thrombosis makes it possible to highly effectively restore the full patency of the vein in the shortest possible timeframe. This method is safe and more cost-effective than the classic surgical approach to the treatment of this pathology. 2. Further research into the efficacy and safety of the method proposed is needed as well as a longer term follow up on a larger number of patients

The role of IGF-1 signaling in skeletal muscle atrophy

Insulin-like growth factor 1 (IGF-1) is a key anabolic growth factor stimulating phosphatidylinositol 3-kinase (PI3K)/Akt signaling which is well known for regulating muscle hypertrophy. However, the role of IGF-1 in muscle atrophy is less clear. This review provides an overview of the mechanisms via which IGF-1 signaling is implicated in several conditions of muscle atrophy and via which mechanisms protein turnover is altered. IGF-1/PI3K/Akt signaling stimulates the rate of protein synthesis via p70S6Kinase and p90 ribosomal S6 kinase and negatively regulates protein degradation, predominantly by its inhibiting effect on proteasomal and lysosomal protein degradation. Caspase-dependent protein degradation is also attenuated by IGF/PI3K/Akt signaling, whereas evidence for an effect on calpain-dependent protein degradation is inconclusive. IGF-1/PI3K/Akt signaling reduces during denervation-, unloading-, and joint immobilization-induced muscle atrophy, whereas IGF-1/PI3K/Akt signaling seems unaltered during aging-associated muscle atrophy. During denervation and aging, IGF-1 overexpression or injection counteracts denervation- and aging-associated muscle atrophy, despite enhanced anabolic resistance with regard to IGF-1 signaling with aging. It remains unclear whether pharmacological stimulation of IGF-1/PI3K/Akt signaling attenuates immobilization- or unloading-induced muscle atrophy. Exploration of the possibilities to interfere with IGF-1/PI3K/Akt signaling reveals that microRNAs targeting IGF-1 signaling components are promising targets to counterbalance muscle atrophy. Overall, the findings summarized in this review show that in disuse conditions, but not with aging, IGF-1/PI3K/Akt signaling is attenuated and that in some conditions stimulation of this pathway may alleviate skeletal muscle atrophy