Modern concepts of anal sphincter insufficiency and its treatment

The international clinical analysis of the treatment of topical issues - failure of the anal sphincter, which has not only medical but also social value is presented. The comparative analysis of effectiveness of suggested above operating methods and modern approaches of different surgical methods of anal incontinence correction was conducted.Представлен мировой клинический анализ лечения актуальной проблемы – недостаточности анального сфинктера, которая имеет не только медицинское, но и социальное значение. Проведен сравнительный анализ эффективности как предлагавшихся ранее оперативных вмешательств, так и современные подходы различных хирургических методик коррекции анальной инконтиненции

The critical status of newborns and its influence on neurological status

To study and evaluate the psychomotor development of children from the neonatal period to one year, undergoing neonatal intensive care, 64 children born in asphyxia were examined : the I - group 36, full-term, II - 28 preterm group and the control group included 35 healthy term infants. In the result of the study, it was found that in children, who suffered hypoxic-ischemic lesion of the Central nervous system and neonatal intensive care, regardless of the time of birth, the inhibition of motor activity and muscle tone is observed, and there is a gap in the physical and psychomotor development in contrast to children in the control group.С целью изучения и оценки психомоторного развития детей от периода новорожденности до года, перенесших неонатальную реанимацию, было обследовано 64 детей рожденных в состоянии асфиксии: из них I - группа 36 доношенных, II- группа 28 недоношенных и контрольная группа - 35 относительно здоровых доношенных детей. В результате проведенного исследования установлено, что у детей, перенесших гипоксически-ишемическое поражение ЦНС и неонатальную реанимацию, независимо от срока рождения наблюдается угнетение двигательной активности и мышечного тонуса, а так же отмечается отставание в физическом и психомоторном развитии в отличие от детей контрольной группы

Сопоставление рентгенологической и патоморфологической картины легких у пациентов с COVID-19

Aim. Compare radiological patterns of COVID-19 pneumonia with pulmonary histology in deceased patients.Materials and methods. The analysis of recent lifetime CT studies of deceased patients was performed with the identification of all existing and leading CT symptoms, including “ground glass”, “crazy paving”, consolidation, as well as the symptom complex (pattern) of organizing pneumonia. Based on the CT symptoms, we selected the target points for taking the specimens by 3-D reconstructions. At the autopsy the lungs were entirely fixed into the front and then marked on CT sections cut from 1 to 3 pieces that were placed in paraffin and processed according to the standard technique, stained with hematoxylin and eosin and fuchsin-facelina. The specimens were analyzed by identifying all available histology changes and selecting the leading one.Results. 45 targeted pieces of lung tissue were obtained from 14 deceased COVID-19 patients (7 men/ 7 women), with an average age of 77.1 ± 12.9 (49–90 years). In deceased patients with the presence of the "ground glass" symptom, in most cases (57.1%) revealed an increase in intra-alveolar cellularity, hyaline membranes, desquamation of the alveolar epithelium and infiltration of the interalveolar septum by lymphocytes, which corresponds to the exudative phase of diffuse alveolar damage (DAP). Mosaic histological changes with alternation of filled alveoli (intraalveolar edema, clusters of red blood cells, macrophages, lymphocytes) and air alveoli were detected from the areas of “crazy paving” zones. Several cases demonstrated interstitial edema and lymphoid infiltration of interalveolar partitions of different severity without their thickening. Areas of consolidation were histologically represented by extensive intraalveolar hemorrhages and / or typical zones of hemorrhagic infarcts in 45.5% of cases. Perilobular consolidation, subpleural cords, symptoms of “halo” and “reverse halo”, which we considered as part of the symptom complex of organizing pneumonia in 43% of cases, morphologically corresponded to organizing pneumonia (the proliferative phase of DAP), as well as to distelectases.Conclusion. Comparison of CT patters and post-mortem pulmonary histology in COVID-19 deceased patients demonstrated that CT symptoms and patterns correspond to certain morphological changes of different phases of DAP.Цель исследования: сопоставить рентгенологические паттерны COVID-19 с гистологическими изменениями у умерших.Материал и методы. Проведен анализ последних прижизненных КТ-исследований умерших пациентов с выделением всех имеющихся и ведущего КТ-симптомов, включая “матовое стекло”, “булыжная мостовая”, консолидация, а также симптомокомплекс (паттерн) организующейся пневмонии. На основании выделенных КТ-симптомов были выбраны прицельные точки взятия материала при помощи построения трехмерных реконструкций. На аутопсии фиксированные целиком легкие разрезались фронтально, далее из обозначенных на компьютерной томограмме участков вырезали от 1 до 3 кусочков, которые заливались в парафин и обрабатывались по общепринятой методике с последующей окраской срезов толщи- ной 3–5 мкм гематоксилином и эозином, пикрофуксин-фукселином. Анализ материала проводили путем выявления всех имеющихся патоморфологических изменений с выделением ведущего из них.Результаты. Были получены 45 прицельно взятых кусочков ткани легкого от 14 умерших (7 мужчин/ 7 женщин), средний возраст 77,1 ± 12,9 (49–90) года. У умерших пациентов с наличием симптома “матово- го стекла” при КТ в большинстве случаев (57,1%) были выявлены увеличение числа клеток в просветах альвеол (внутриальвеолярная клеточность), гиалиновые мембраны, десквамация альвеолярного эпителия и инфильтрация лимфоцитами межальвеолярных перегородок, что может соответствовать признакам экссудативной фазы диффузного альвеолярного повреждения (ДАП). Из участков, обозначенных как зоны “булыжной мостовой”, были выявлены мозаичные гистологические изменения с чередованием заполненных альвеол (внутриальвеолярный отек, скопления эритроцитов, макрофагов, лимфоцитов) и воздушных альвеол, местами при наличии интерстициального отека и лимфоидной инфильтрации межальвеолярных перегородок разной степени выраженности без их утолщения. Участки консолидации гистологически были представлены обширными внутриальвеолярными кровоизлияниями и/или типичными зонами геморрагических инфарктов в 45,5% случаев. Перилобулярная консолидация, субплевральные тяжи, симптомы “ободка” и “обратного ободка”, которые мы расценивали в рамках симптомокомплекса организующейся пневмонии, на компьютерной томограмме в 43% случаев морфологически соответствовали организующейся пневмонии (пролиферативная фаза ДАП), а также дистелектазам.Заключение. При попытке рентгенопатоморфологического сопоставления у пациентов с COVID-19 с поражением легких нами было показано, что различные симптомы и паттерны при КТ соответствуют определенным морфологическим изменениям в различные фазы ДАП

Clinical features of post-COVID-19 period. Results of the international register “Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)”. Data from 6-month follow-up

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period

Evaluation of feijoa hybrid forms (Feijoa sellowiana Berg) according to productivity and fruit quality

The years of studying feijoa plants cultivated in the humid subtropics of the Krasnodar Territory have shown the necessity for selection of forms from seed populations with different maturity of fruits, high yields and high fruit quality. Seven promising forms have been evaluated primarily. After observation the growth dynamics of shoots B-13 for has been selected with an active growth. The average shoots length has reached 22,8 cm by the end of the growing season. Assessment of fruit cast have shown that the largest percentage of active ovaries is found in B-13 form and “Dagomysskaya” variety and (17%).Assessment of harvesting period has revealed early ripening forms (II-III decade of September – I decade of October), they include 4-10, 12-5, 13-11, IIIB-1 forms; mid-ripening forms (II-III decade of October – I decade of November) are 10-22, B-13 and late-ripening forms are 6-24, the fruits of which ripen from the 3rd decade of November till the 1st decade of December. Form B-13 has been selected as a high-yielding one: 19,2 kg / bush, and a large-fruited one – average fruits weigh 96,0 g. The forms of 4-10, B-13 have been selected according to sugar content, with 9,70 % and 8,12 % of sugar respectively. The forms of 6-24, 12-5 and B-13 are observed to contain more monosaccharides than sucrose. Two forms of 4-10 and B-13 have been selected as the best in taste with the highest percentage of monosaccharides, in particular, fructose, which gives the fruits the “sweet taste”.The fruits of form 12-5 are characterized by a highest content of vitamin “C” –75,68 mg%. Forms of 4-10 and 12-5 have the highest sugar-acid ratio which is 5,5 and 5,0, respectively, and the lowest ratio is observed in forms of 6-24 and 10-22 – 2,9 and 3,0, respectively

Diagnostic significance of additional instrumental methods of examination of patients with pelvic organ prolapse

In this work the diagnostic importance and indications to application of various methods of research (ultrasonography of the pelvic organs and the pelvic floor, a complex urodynamic study, dynamic magnetic resonance imaging (MRI) orgnes of pelvis and pelvic floor) at patients with simple and complicated forms of pelvic organ prolapse is defined