Интегральный способ прогнозирования риска панкреатита после эндоскопической ретроградной холангиопанкреатографии

The objective: development of a method for determining the individual risk of post-ERCP pancreatitis (PEP) before endoscopic intervention.Subjects and Methods. A prospective observational study of the results of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) was performed in 1,210 patients. The primary end point was the development of PEP. Multiple regression logistic analysis was used to determine the risk of developing PEP.Results. A model of independent variables was determined, which significantly (p = 0.0001) affected the risk of developing PEP. Based on the results of the logistic analysis, regression coefficients were calculated for all significant patient-dependent factors (gender, age, preoperative level of amylasemia and bilirubinemia, and nature of the underlying disease). The risk of PEP decreased in men (by 47.5%), with an increase in the age of patients (for 1 year by 2.3%) and bilirubin (with an increase of 1 μmol/l by 0.3%) but increased with an increase in amylase activity blood serum (by 0.7% for each 1 U/l). A formula has been developed to assess the individual risk of PEP at the stage of preparing a patient for therapeutic ERCP.Conclusion. Analysis of patient-dependent factors makes it possible to reliably determine the risk of developing PEP. It was determined that a female gender, young age (under 40 years old), sphincter of Oddi dysfunction increased the risk of PEP, while a male sex, stenting of the main pancreatic duct, and jaundice reduced this risk. The use of the proposed formula will help predict a significant (p = 0.0001) degree of risk of PEP before performing primary therapeutic ERCP in a particular patient.Цель: разработка способа определения индивидуального риска развития пост-ЭРХПГ-панкреатита (ПЭП) до выполнения эндоскопического вмешательства.Материал и методы. Проведено проспективное наблюдательное исследование результатов лечебной эндоскопической ретроградной холан- гиопанкреатографии (ЭРХПГ) у 1 210 пациентов. Первичной конечной точкой считали развитие ПЭП. Для определения риска развития ПЭП применяли множественный логистический регрессионный анализ.Результаты. Определена модель независимых переменных, которая достоверно (p = 0,0001) влияет на риск развития ПЭП. По результатам логистического анализа вычислены регрессионные коэффициенты для всех значимых пациент-зависимых факторов (пол, возраст, предоперационный уровень амилаземии и билирубинемии, характер основного заболевания). Риск ПЭП снижался у мужчин (на 47,5%), при увеличении возраста пациентов (за 1 год на 2,3%) и уровня билирубина (при увеличении на 1 мкмоль/л на 0,3%), но повышался при увеличении активности амилазы сыворотки крови (на 0,7% на каждую 1 Ед/л). Разработана формула, позволяющая оценить индивидуальный риск ПЭП на этапе подготовки пациента к выполнению лечебной ЭРХПГ.Вывод. Анализ пациент-зависимых факторов позволяет достоверно определить риск развития ПЭП. Определено, что женский пол, молодой возраст (до 40 лет), дисфункция сфинктера Одди увеличивали, а мужской пол, стентирование главного панкреатического протока, наличие желтухи снижали риск развития ПЭП. Использование предложенной формулы поможет прогнозировать достоверную (p = 0,0001) степень риска ПЭП до выполнения первичной лечебной ЭРХПГ у конкретного пациента

НЕИНВАЗИВНАЯ ДИАГНОСТИКА РАКА МОЧЕВОГО ПУЗЫРЯ МЕТОДОМ КРОСС-ПОЛЯРИЗАЦИОННОЙ ОПТИЧЕСКОЙ КОГЕРЕНТНОЙ ТОМОГРАФИИ (СЛЕПОЕ СТАТИСТИЧЕСКОЕ ИССЛЕДОВАНИЕ)

Whether cross-polarization (CP) optical coherence tomography (OCT) could be used to detect early bladder cancer was ascertained; it was compared with traditional OCT within the framework of blind (closed) clinical statistical studies. One hundred and sixteen patients with local nonexophytic (flat) pathological processes of the bladder were examined; 360 CP OCT images were obtained and analyzed. The study used an OCT 1300-U CP optical coherence tomographer. CP OCT showed a high (94%) sensitivity and a high (84%) specificity in the identification of suspected nonexophytic areas in the urinary bladder.Оценена возможность кросс-поляризационной (КП) оптической когерентной томографии (ОКТ) в выявлении раннего рака мочевого пузыря (РМП), выполнено сравнение ее с традиционной ОКТ в рамках клинических слепых (закрытых) статистических исследований. Исследованы данные 116 пациентов с локальными неэкзофитными («плоскими») патологическими процессами мочевого пузыря, получено и проанализировано 360 КП ОКТ-изображений. В работе использован КП оптический когерентный томограф «ОКТ 1300-У». КП ОКТ показала высокую чувствительность (94 %) и специфичность (84 %) в идентификации неэкзофитных подозрительных зон в мочевом пузыре

Production of {\pi}+ and K+ mesons in argon-nucleus interactions at 3.2 AGeV

First physics results of the BM@N experiment at the Nuclotron/NICA complex are presented on {\pi}+ and K+ meson production in interactions of an argon beam with fixed targets of C, Al, Cu, Sn and Pb at 3.2 AGeV. Transverse momentum distributions, rapidity spectra and multiplicities of {\pi}+ and K+ mesons are measured. The results are compared with predictions of theoretical models and with other measurements at lower energies.Comment: 29 pages, 20 figure

Изменения ультраструктуры и микроциркуляции стенки мочевого пузыря у пациентов с неинвазивными формами рака

Bladder cancer relapses are associated with diffuse pattern of neoplastic changes in the mucous layer of the bladder; treatment efficacy depends on the degree of structural alterations in the bladder wall.Materials and methods: for evaluation of microcirculation characteristics and structural alterations of mucous layer of the bladder we have used laser analyzer of capillary blood circulation («ЛАКК-01» produced by НПП «ЛАЗМА», Russia) and compact mobile optic tomograph (ИПФ РАН, Russia).Results: conducted researches have shown alterations affecting both epithelial and submucous layers with their microcirculatory bed in perifocal to bladder tumor tissues.Conclusions: complimentary application of laser Doppler flowmeter and compact mobile optic tomograph allows defining the type and extent of pathologic process in the bladder wall in superficial tumors and choosing optimal method of correction.

Endoscopic optic coherent tomography in diagnosis of early bladder cancer

Our goal was statistical assessment of the in vivo cystoscopic optical coherence tomography (OCT) ability to detect early neoplasia in human urinary bladder. We analyzed major reasons of false positive and false negative image recognition results. Optical coherence tomography was performed to image the bladder during cystoscopy. The study enrolled 114 zones with suspicion for bladder cancer. The diagnosis was established by histopathology examination of a biopsied tissue. Each biopsy site was examined by OCT. Two physicians blinded to all clinical data participated in the recognition (malignant, suspicion or benign) of the OCT images. 82% sensitivity and 85% specificity for the OCT recognition of dysplastic/malignant versus benign/reactive conditions of the bladder were demonstrated. The interobserver agreement multi-rater kappa coefficient is 0.56. Good sensitivity and specificity of the OCT method in the diagnostics of bladder neoplasia makes OCT a promising complementary cystoscopic technique for non-invasive evaluation of zones suspicious for early cancer

DIROFILARIASIS OF THE PENIS

This article presented a rare clinical case in Urology - Dirofilariasis of the penis. Filaria are biohelminths, which are most common in tropical countries. Dirofilariasis is the only human filariasis, found in the territory of the Russian Federation. Mosquitoes are carriers of the disease. Changing climate conditions in the direction of warming, the availability of international travel, non-compliance with preventive measures lead to an increase in the number of cases of infection by helminths, including rare species