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ORIGINAL RESEARCH
REVIEWS
PRACTICAL EXPERIENCE
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ORIGINAL RESEARCH
УДК: 616.37-003.7-073.7-073.756 DOI: 10.20969/VSKM.2025.18(6 ).7-15
Integration of ultrasonography, computed tomography, and magnetic resonance imaging in the diagnosis of Wirsung duct lithiasis: A multiparametric approach
Mirshavkat M. Akbarov1, Miraziz M.Mirolimov2, Nigora M. Djuraeva2, Ravshan A. Ibadov2, Khanum V. Abdukhalimova2
1 Tashkent State Medical University, 2 Farobiy Str., Tashkent 100109, Uzbekistan
2 Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V. Vakhidov, 10 Kichik Halqa Yo‘li Street, Tashkent 100115, Uzbekistan
Abstract. Introduction. Chronic pancreatitis often develops as a complication of acute destructive pancreatitis and is accompanied by pathologies, such as Wirsung duct lithiasis, ductal strictures, cysts, and fi stulas. These complications worsen the condition of patients and require accurate diagnosis. Modern methods, in particular magnetic resonance imaging with cholangiopancreatography, allow the timely detection of lesions and the choice of minimally invasive treatment, which reduces risks and improves the disease outcome. Aim. To compare the clinical efficacy of ultrasound, computed tomography, and magnetic resonance cholangiopancreatography in chronic pancreatitis complicated by Wirsung duct lithiasis. Materials and Methods. 35 patients with chronic pancreatitis complicated by Wirsung duct lithiasis were examined; ultrasound examination, computed tomography, and magnetic resonance tomography with cholangiopancreatography were performed. Results and Discussion. Ultrasonography detected large calcifi cations with a sensitivity of 42.9%. Computed tomography showed better sensitivity (80%) and accuracy (73.1%) for calcifi cations, but low specifi city (58.8%). Magnetic resonance imaging with cholangiopancreatography showed the highest sensitivity (97.1%), accuracy (84.6%), and diagnostic effi ciency (AUC 0.79), having visualized both calcified and soft tissue concretions and evaluated of ductal strictures. Conclusions. Magnetic resonance imaging with cholangiopancreatography is the most informative technique to diagnose Wirsung duct lithiasis. Optimal diagnosis requires the complex application of ultrasound, computed tomography, and magnetic resonance imaging, considering clinical data to choose an adequate therapy. Keywords: chronic pancreatitis, Wirsung duct lithiasis, pancreatic duct stricture, MRCP, CT, ultrasound, radiological diagnostics, complications, endoscopic treatment, multidisciplinary approach.
For citation: Akbarov, M.M.; Mirolimov, M.M.; Djuraeva, N.M.; et al. Integration of ultrasonography, computed tomography, and magnetic resonance imagin g in the diagnosis of Wirsung duct lithiasis: A multiparametric approach. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 7-15. DOI: 10.20969/VSKM.2025.18(6).7-15.
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УДК: 571.27 DOI: 10.20969/VSKM.2025.18(6).16-25
Occupational chronic obstructive pulmonary disease and arterial hypertension from the standpoint of immunopathogenesis
Sergey A. Babanov1, Leonid A. Strizhakov2, Alexander V. Zhestkov3, Marina Yu. Vostroknutova4, Vеrа.V. Kulagina3, Vasily D. Fedotov5, Irina N. Vasina4, Andrey S. Babanov1, Maria S. Artemyeva1
1Samara State Medical University, 89 Chapaevskaya str., 443099 Samara, Russia
2Scientific Research Institute of Occupational Medicine named after Academician N.F. Izmerov, 31 Budyonny Ave., 105275 Moscow, Russia
3Reaviz Medical University, 227 Chapaevskaya str., 443001 Samara, Russia
4Samara City Hospital No. 5, 56 Respublikanskaya str., 443051 Samara, Russia
5Volga Region Research Medical University, 10/1 Minin and Pozharsky Sq., 603950 Nizhny Novgorod, Russia
Abstract. Introduction. Understanding the clinical, functional, and immunopathogenetic characteristics of occupational chronic obstructive pulmonary disease (oCOPD), both in its isolated form and in comorbidity, offers new opportunities for evaluating its progression, predicting its course, and personalizing its pharmacotherapy. It also helps develop tailored primary and secondary prevention strategies. Aim. This study aimed to identify clinical, functional, and immunological risk markers of the development of occupational chronic obstructive pulmonary disease in individuals exposed to industrial aerosols of chemical and fi brogenic nature. Materials and Methods. The study included 235 individuals: 175 patients and 60 healthy controls. Dyspnea was assessed using the modifi ed British Medical Research Council (mMRC) questionnaire for dyspnea severity. All patients also underwent a 6-minute walk test (6MWT), and cough severity was assessed using a visual analog scale (VAS). Pulmonary function testing (spirometry) was performed using a “Care Fusion” computer spirometer from MicroLab UK (Great Britain). Serum levels of immunoglobulins A, M, and G were determined by the Mancini method (radial immunodiffusion). Serum cytokine and total IgE levels were measured by enzyme-linked immunosorbent assay (ELISA) using commercial kits and reagents (Proteinovyi Kontur LLC, Vector-Best, Diatex-E, DIA-plus, Pharmacia diagnostika). Vascular endothelial growth factor (VEGF) levels in serum were investigated using a sandwich-type enzyme-linked immunosorbent assay with reagents from eBioscience. Optical density results were calculated using a Dynatech MR 5000 multi-channel spectrophotometer (USA) at a wavelength of 450 nanometers. Spirometric and immunological data from the cohorts were analyzed using one-way ANOVA with intergroup comparisons by Dunnett’s test. Results and Discussion. Clinical, functional, and immunological manifestations of occupational chronic obstructive pulmonary disease (oCOPD) were fi rst established, both in its isolated course depending on severity and in combination with arterial hypertension. The study has regional (Samara region) and occupational (based on the detailed working conditions in the studied comparison cohorts) limitations. Conclusions. The identifi ed clinical, functional, and immunological features of oCOPD, both in its isolated form based on severity and in combination with arterial hypertension, can optimize approaches to early diagnosis, prognosis, pharmacotherapy, and prevention of occupational chronic obstructive pulmonary disease.
Keywords: occupational chronic obstructive pulmonary disease; arterial hypertension; comorbid course; spirometry; immunopathogenesis features; diagnosis; prognosis.
For citation: Babanov, S.A.; Strizhakov, L.A.; Zhestkov, A.V.; et al. Occupational chronic obstructive pulmonary disease and arterial hypertension from the standpoint of imm unopathogenesis. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 16-25. DOI: 10.20969/VSKM.2025.18(6).16-25.
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УДК: 616.33 DOI: 10.20969/VSKM.2025.18(6).26-32
Effects provided by biologically active probiotic supplements on the parameters of Helicobacter pylori eradication therapy
Anna V. Belkovets1,2, Margarita V. Kruchinina1,2, Liliya V. Scherbakova1, Polina A. Senshina1, Oleg V. Sorokin3, Aleksey V. Molokeev4, Mikhail A. Subotyalov5,6
1 Research Institute of Internal and Preventive Medicine – Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 175/1 Boris Bogatkov str., 630089 Novosibirsk, Russia
2 Novosibirsk State Medical University, 52 Krasny Prospekt, 630091 Novosibirsk, Russia
3 VedaGenetika LLC, 14 1st Parkhomenko Lane, 630108 Novosibirsk, Russia
4 JSC Vector-BiAlgam, Building 104, Scientific and Production Zone, 630559 Koltsovo, Novosibirsk Region, Russia
5 Novosibirsk State Pedagogical University, 28 Vilyuyskaya str., 630126 Novosibirsk, Russia
6 Novosibirsk State University, 1 Pirogov str., 630090 Novosibirsk, Russia
Abstract. Introduction. Using probiotics in H. pylori eradication regimens is a measure to increase the treatment efficacy and reduce side effects. Aim. To investigate the effect provided by adding biologically active probiotic supplements to H. pylori eradication regimens on certain microfl ora parameters, as well as on treatment tolerability and effectiveness in patients in Novosibirsk. Materials and Methods. The study included 60 patients indicated for H. pylori eradication: 35 women and 25 men, with a mean age of 51.6 ± 12.6 years. The analysis was conducted in two age- and gender-comparable groups, depending on the inclusion (Group 1) or non-inclusion (Group 2) of biologically active supplements (VedaBiotic, PhytolysateGastro, Novosibirsk, Russia) into the classical triple eradication regimen. The intestinal microfl ora condition was assessed using polymerase chain reaction with the COLONOFLOR-8 test (OOO Alphalab, St. Petersburg). In all statistical analysis procedures, the critical level of signifi cance for the null hypothesis (p) was taken as 0.05. Results and Discussion. No differences were found in the treatment effi cacy depending on the addition of biologically active supplements to the eradication regimen. Among the adverse events during therapy, diarrhea occurred less frequently in patients receiving biologically active supplements (36% vs. 65%, p=0.03). In Group 1, there was no decrease in total bacterial mass during eradication (27% vs. 23%, p=0.8), in contrast to Group 2 (30% vs. 67%, p=0.006). Proportion of patients with a normal amount of Bifi dobacterium halved in Group 2 (43% vs. 20%, p=0.05), with no difference for Group 1. Conclusions. Adding biologically active probiotic supplements to the eradication regimen did not affect t reatment effi cacy, but it allowed for a reduction in the incidence of diarrhea, preservation of the total bacterial mass after treatment, and maintenance of a normal level of Bifidobacterium.
Keywords: Helicobacter pylori, eradication, probiotics, metabiotics, symbiotics, total bacterial mass, Bifi dobacterium.
For citation: Belkovets,A.V.; Kruchinina,M.V.; Scherbakova, L.V.; et al. Effects provided by biologically active probiotic supplements on the parameters of Helicobacter pylori eradication therapy. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 26-32. DOI: 10.20969/VSKM.2025.18(6).26-32.
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УДК: 616.12-007.61 DOI: 10.20969/VSKM.2025.18(6 ).33-39
Prognostic role of microRNA-29a in the development of morphometric parameters according to echocardiographic data in patients with hypertrophic cardiomyopathy
Andrey V. Vysokikh1, Vera Yu. Kaplunova1, Elena V. Privalova1
1 I.M. Sechenov First Moscow State Medical University, 8-2 Trubetskaya str., 119991 Moscow, Russia
Abstract. Introduction. Hypertrophic cardiomyopathy is one of the most common inherited myocardial diseases, characterized by thickening of the interventricular septum, myocardial fi brosis, obstruction of the left ventricular outfl ow tract, and high clinical and genetic heterogeneity. Despite considerable progress in genetic diagnostics, pathogenic mutations are not found in all patients having a typical phenotype. Therefore, interest is growing in studying molecular biomarkers, in particular circulating microRNAs, which are regarded as promising tools for the diagnosis and prognosis of cardiovascular diseases. Special attention is paid to microRNA-29a being, according to clinical and experimental data, actively studied as a potential prognostic marker of myocardial hypertrophy and fi brosis in patients with hypertrophic cardiomyopathy. Aim. To determine the relationships between the circulating microRNA-29a expression levels and morphometric parameters by echocardiography in patients with hypertrophic cardiomyopathy. Materials and Methods. The study included 41 patients with diagnosed hypertrophic cardiomyopathy. All patients underwent echocardiography. MicroRNA-29a levels were measured in blood plasma by the quantitative real-time polymerase chain reaction (qRT-PCR). Statistical analysis was performed using SPSS 26. Data distribution was tested with the Shapiro–Wilk test. Correlation analysis was conducted using Spearman’s rank correlation coeffi cient (ρ), since most variables had a non-normal distribution. A p-value < 0.05 was considered statistically signifi cant. Results and Discussion. Positive correlations were found between microRNA-29a levels and echocardiographic parameters: A weak correlation with interventricular septal thickness (ρ = 0.33; p = 0.035) and a moderate correlation with the pressure gradient in the left ventricular outflow tract (ρ = 0.42; p = 0.006). No other echocardiographic parameters showed any signifi cant correlations. Conclusions. MicroRNA-29a may be considered a potential biomarker of myocardial hypertrophy in hypertrophic cardiomyopathy. The identifi ed correlations of microRNA-29a with key echocardiographic parameters indicate its probable diagnostic and prognostic significance.
Keywords: hypertrophic cardiomyopathy, diagnostics, epigenetic markers, echocardiography, prognostic role, microRNA.
For citation: Vysokikh, A.V.; Kaplunova, V.Yu.; Privalova, E.V.Prognostic role of microRNA-29a in the development of morphometric parameters according to echocardiographic data in patients with hypertrophic cardiomyopathy. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 33-39. DOI: 10.20969/VSKM.2025.18(6).33-39.
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УДК: 616.233-002.3-036.12: 616.233-007.64-037 DOI: 10.20969/VSKM.2025.18(6 ).40-46
Validation of a personalized algorithm for predicting the bronchiectasis formation in patients with chronic mucopurulent bronchitis
Artem V. Vyazovoy1, Tatiana V. Prokofieva1, Olga S. Polunina1, Ekaterina A. Polunina1
1Astrakhan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 121 Bakinskaya str., 414000 Astrakhan, Russia
Abstract. Introduction. Amidst widespread and increasing environmental challenges and social tension, there is a rise in chronic non-specifi c lung diseases, including chronic bronchitis. Searching for predictors of an unfavorable course of chronic bronchitis can be considered a tool for addressing this issue. A promising approach is to assess the levels of various biomarkers that are an integral link in the pathogenesis of chronic bronchitis progression. This is necessary for creating personalized algorithms to predict the course of chronic bronchitis. Aim. To validate the previously developed personalized algorithm for predicting the formation of bronchiectasis in patients with chronic mucopurulent bronchitis over a 12-month follow-up period, using a test cohort. Materials and Methods. The study involved the observation of 92 patients with chronic mucopurulent bronchitis and resulted in the creation of a prognostic algorithm. To assess the quality of our proposed algorithm, it was validated. The personalized algorithm developed was validated on a test cohort comprising 38 patients with chronic mucopurulent bronchitis who underwent a prospective 12-month follow-up. After 12 months, computed tomography (CT) of the chest was performed, identifying the presence or absence of bronchiectasis, based on the results. The data obtained were compared with the previously predicted outcomes. The model was considered valid, as the metrics in the primary and test cohorts were similar. Results and Discussion. To evaluate the effi cacy of the prognostic algorithm, we applied it to the test cohort. Based on the calculations performed using the algorithm, out of 38 (100%) patients in the test cohort, true positive results were obtained in 8 individuals (21.1%), and false negatives (predicted absence of bronchiectasis development, while it actually formed) in 2 individuals (5.3%). True negative results were obtained in 25 individuals (65.8%). False positive results (predicted bronchiectasis formation, while it did not actually form) were obtained in 3 individuals (7.9%). Thus, 33 out of 38 cases were identified correctly. Conclusions. A mathematical algorithm was validated aimed at predicting the development of bronchiectasis in patients with mucopurulent bronchitis over a 12-month observation period. Its prognostic effi cacy was identical to the results obtained in the primary cohort of patients hospitalized in the therapeutic department with an exacerbation of mucopurulent bronchitis, which indicates the validity of the algorithm proposed.
Keywords: chronic purulent bronchitis, validation, bronchiectasis, algorithm.
For citation: Vyazovoy, А.V.; Prokofi eva, T.V.; Polunina, O.S.; Polunina, E.A. Validation of a personalized algorithm for predicting the bronchiectasis formation in patients with chronic mucopurulent bronchitis. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 40-46. DOI: 10.20969/VSKM.2025.18(6).40-46.
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УДК: 616.34-06.6 DOI: 10.20969/VSKM.2025.18(6).47-53
Prognostic value of systemic inflammatory markers in colorectal cancer
Bulat I. Gataullin1,2, Rishat M. Dinov1, Yana A. Erpert1, Ilgiz G. Gataullin1
1Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
2Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia
Abstracts. Introduction. Cancer-related systemic infl ammatory response is one of possible tumor progression indicators. Systemic infl ammation markers in serum are reported in the scientifi c literature, which may be useful for predicting survival or assessing the risk of recurrence, such as neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), systemic infl ammation index (SII), C-reactive protein (CRP) concentration, systemic infl ammatory response index (SIRI), etc. Developing an optimal biomarker useful for predicting relapse or poor prognosis is clinically important for identifying patients who may benefi t from the combination and comprehensive treatment, including chemotherapy, chemoradiation therapy, and extended surgery. The point of these markers is their predictive role with regard to unfavorable prognosis in both oncologic diseases and other diseases, since in this case they will also depend on the patient’s comorbid background, and predict the patient’s risk of death considering their comorbid pathology. Aim. To evaluate the correlation between the colorectal cancer patients’ overall survival indices and infl ammatory markers. Materials and Methods. Data of 232 patients with histologically verified colorectal cancer were studied retrospectively according to the materials of the cancer register of the oncological dispensary of the Ministry of Health of the Republic of Tatarstan. Sampling was performed for 2017, for further study of 5- and 10-year survival of these patients. Inclusion criteria for the study were as follows: Patients with colorectal adenocarcinoma T 1-4, N any, M any. Exclusion criteria were the presence of acute infl ammatory processes, such as abscess or phlegmon, active bleeding within the last 6 months, and congenital/acquired immunodefi ciencies (including HIV/AIDS). Systemic inflammatory response indices were collected, counted, and evaluated. Further, the data obtained were intercompared. The research included collecting, computing, and assessing the patients’ systemic infl ammatory response indices. The data obtained were analyzed and intercompared to identify the statistically signifi cant relationships with overall survival rates. Statistical analysis was performed using the MedCalc v.20.104 software. Results and Discussion. The present study showed that changes in hematologic parameters refl ecting the severity of systemic immune infl ammation and systemic infl ammatory response in patients with colorectal cancer correlate with their disease prognosis. Conclusions. Despite the small number of patients, our study showed that the increased values of SII and NLR are potential predictors of disease outcome in patients with colorectal cancer.
Keywords: colorectal cancer, systemic inflammation index, survival rate, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, prognosis.
For сitation: Gataullin, B.I.; Dinov, R.M.; Erpert, Y.A.; Gataullin, I.G. Prognostic value of systemic infl ammation markers in colorectal cancer. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 47-53. DOI: 10.20969/VSKM.2025.18(6).47-53.
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УДК: 616.379-008.64-007.248:616.155.34 DOI: 10.20969/VSKM.2025.18(6).54-63
Identification of low-density neutrophils and features of forming neutrophil extracellular traps in patients with diabetic osteoarthropathy (Charcot foot)
Inna V. Druk1, Dmitry G. Novikov1, Alexander N. Zolotov1, Nikolay А. Kirichenko1, Elizaveta A. Kirkh1, Anton V. Indutny1, Vladimir V. Khodus2, Natalia L. Samuseva1, Elena A. Sorokina2, Natalia A. Romashova2
1Omsk State Medical University, 12 Lenin str., 644099 Omsk, Russian Federation
2Clinical Medical Unit No. 9, 73 5th Kordnaya str. 73, 644018 Omsk, Russian Federation
Abstract. Introduction. Charcot neuroarthropathy is a severe complication of diabetes mellitus. Although the clinical picture of Charcot neuroarthropathy is well-defi ned, the underlying immunological mechanisms have not been fully elucidated, thereby constraining the effi cacy of therapeutic approaches, particularly those aimed at osteoclast inhibition. An important research trend is the studies of abnormal neutrophil activation and their ability to form extracellular traps. Aim. To study the features of forming neutrophil extracellular traps by leukocytes isolated from venous blood in patients with type 1 and type 2 diabetes mellitus complicated by diabetic foot syndrome without and Charcot neuroarthropathy. Materials and Methods. Three groups were examined: “Control” (healthy volunteers, n=12), “Patients with diabetic foot syndrome” (n=7), “Charcot foot” (n=8). Cells were isolated by gradient centrifugation on Ficoll-Verografi n. Cell samples from the mononuclear and granulocyte fractions were examined using light microscopy (Romanowsky-Giemsa stain) and luminescence microscopy (neutrophil extracellular traps were stained with propidium iodide). Spontaneous and induced NETosis was assessed ex vivo. Results and Discussion. In the mononuclear fraction without stimulation, cloud-shaped and fi lamentous extracellular traps that had been absent in the “Control” group, were detected in both groups of patients, indicating spontaneous NETosis. Number of cloud-shaped neutrophil extracellular traps was higher in the “Charcot foot” group (p=0.0175), while fi lamentous traps were signifi cantly more frequent in both patient groups compared to the control (p=0.0379 and p=0.0006, respectively), with a predominance of fi lamentous forms in the “Charcot foot” group. In the granulocyte fraction, an increase in fi lamentous traps was noted in the “Patients with diabetic foot syndrome” group (p=0.0141). The “Charcot foot” group showed pronounced interindividual variability. Induced NETosis in the “Charcot foot” group in the granulocyte fraction was characterized by a predominance of fi lamentous neutrophil extracellular traps (p=0.0093). After exposure to an antigenic stimulator (probiotic), both patient groups showed a low ability of normal-density neutrophils to form extracellular traps, indicating a weakening of their antimicrobial activity implemented via this mechanism. Conclusions. Neutrophils of normal and low density were identified in the blood of patients with diabetes mellitus. In patients with diabetic foot syndrome and Charcot neuroarthropathy, low-density neutrophils and, possibly, monocytes are prone to spontaneously forming extracellular traps, which is more pronounced in the “Charcot foot” group. Induced NETosis was characterized by predominantly forming fi lamentous extracellular traps and especially intense in the “Charcot foot” group. Normal-density neutrophils in the patient groups are characterized by a reduced ability for induced NETosis in response to antigenic stimulation with a probiotic.
Keywords: diabetes mellitus, diabetic foot syndrome, diabetic neuroarthropathy, Charcot foot, low-density neutrophils, neutrophil extracellular traps.
For citation: Druk, I.V.; Novikov, D.G.; Zolotov, A.N.; et al. Identifi cation of low-density neutrophils and features of forming neutrophil extracellular traps in patients with diabetic osteoarthropathy (Charcot foot). The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 54-63. DOI: 10.20969/VSKM.2025.18(6).54-63.
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35. Патент № 2712179 C1 Российская Федерация, МПК G01N 33/48, G01N 33/49. Способ определения относительного количества этотически трансформированных фагоцитов: № 2019107008 : заявл. 13.03.2019 : опубл. 24.01.2020 / А.С. Гурьев, Д. В. Мосальская, А. Ю. Волков ; заявитель Общество с ограниченной ответственностью «Медтехнопарк» (ООО «Медтехнопарк»). Patent № 2712179 C1 Rossiyskaya Federatsiya, MPK G01N 33/48, G01N 33/49: Sposob opredeleniya otnositel’nogo kolichestva etoticheski transformirovannykh fagotsitov: № 2019107008: zayavleno 13.03.2019: opublikovano 24.01.2020 Gur’yev AS, Mosal’skaya DV, Volkov AYU; zayavitel’ Obshchestvo s ogranichennoy otvetstvennost’yu “Medtekhnopark” (OOO “Medtek-hnopark”) [applicant Limited Liability Company “Medtechnopark” (OOO “Medtechnopark”)]. [Patent No 2712179 C1 Russian Federation, IPC G01N 33/48, G01N 33/49: Method for determining the relative number of ethmically transformed phagocytes: No 2019107008: declared 13.03.2019: published 24.01.2020.]. 2020. (In Russ.).
УДК: 616.24-002.17 DOI: 10.20969/VSKM.2025.18(6 ).64-71
Efficacy of enhanced external counterpulsation in patients with post-COVID-19 interstitial lung damage and ventilation disorders
Nadezhda A. Nikolaeva1, Olga O. Voronkova1, Maria V. Kozhevnikova1, Alexey S. Lishuta1, Yuri N. Belenkov1
1I.M. Sechenov First Moscow State Medical University, 8-2 Trubetskaya str., 119991 Moscow, Russia
Abstract. Introduction. The COVID-19 pandemic has led to a signifi cant number of patients suffering from interstitial lung damage and ventilation disorders that persist long time after the acute infection. Enhanced external counterpulsation a non-invasive therapeutic approach originally developed for cardiovascular diseases, improves microcirculation and endothelial function, making it a potential treatment option for patients with post-COVID complications. Aim. To evaluate the effi cacy of enhanced external counterpulsation in improving lung volumes, diffusing capacity, and exercise tolerance in patients with persistent ventilatory dysfunction following COVID-19 pneumonia. Materials and Methods. The study included 30 patients with confi rmed COVID-19-associated pneumonia (median time since pneumonia onset: 15 months) and persistent ventilatory impairments. The study group (n=15) underwent a course of enhanced external counterpulsation (20 sessions, 60 minutes each, compression pressure 220-280 mmHg), while the control group (n=15) received standard treatment only. Spirometry, body plethysmography, diffusing capacity of the lungs for carbon monoxide, 6-minute walk test, and dyspnea severity (Borg scale) were assessed at baseline and after 1 month. Statistical analysis was performed using non-parametric tests (Mann-Whitney U, Wilcoxon signed-rank) in StatTech v. 4.8.5. Results and Discussion. The study group demonstrated signifi cant improvements in lung volumes, namely: Total lung capacity (65→76%, p<0.001), vital capacity (56.5→73%, p=0.006), forced expiratory volume in 1 second (65→82%, p=0.041), and functional residual capacity (70→81%, p=0.018), whereas no signifi cant changes were observed in controls. The distance in 6-minute walk test increased from 313 to 352 m (p=0.007), with reduced dyspnea severity (p=0.010). No signifi cant changes in diffusing capacity of the lungs were noted in either group. The benefi ts observed may be attributed to the enhanced perfusion of poorly ventilated alveolar and bronchiolar regions and the improved muscular metabolism, collectively reducing dyspnea and increasing exercise capacity. Conclusions. Enhanced external counterpulsation improves respiratory function and physical tolerance in patients with post-COVID ventilatory dysfunction, supporting its inclusion in comprehensive rehabilitation programs.
Keywords: COVID-19, interstitial lung damage, enhanced external counterpulsation, exercise tolerance, microcirculation.
For citation: Nikolaeva, N.A.; Voronkova, O.O.; Kozhevnikova, M.V.; et al. Effi cacy of enhanced external counterpulsation in patients with post-COVID-19 interstitial lung damage and ventilation disorders The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6),64-71. DOI: 10.20969/VSKM.2025.18(6).64-71.
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УДК: 618.19-006-079.4-073.43 DOI: 10.20969/VSKM.2025.18(6).72-77
Diagnostic efficiency of compression elastography and shear wave elastography in the differential diagnosis of breast lumps
Iroda Z. Pulatova 1, Veronika Ye. Gazhonova 2
1 Center for the Development of Professional Qualifications of Medical Workers, 51 Parkentskaya str., 100000, Tashkent, Uzbekistan
2 Central State Medical Academy, 21 MarshalTimoshenko str., 121359, Moscow, Russia
Abstract. Introduction. To date, breast cancer is the most common malignant tumor and the main cause of cancer mortality among the female population. Traditional ultrasound diagnostics in B-mode and elastography in combination with mammography are widely used at the stages of clinical screening of breast cancer, and they also are the methods of differential diagnostic assessment of benign and malignant mammary tumors. Aim. To determine the efficiency of an integrated approach to the differential diagnosis of breast lumps using compression elastography and shear wave elastography in a comparative aspect. Materials and Methods. A prospective comprehensive ultrasound examination of breast was performed on 134 women aged 26 to 72 years (the average age was 49±6.3) having complains of pain feelings, feeling of fullness, and the presence of palpable masses in the breast. The examinations were performed using the expert-class ultrasound scanner Logiq S8 HD Clear (GE Healthcare, Milwaukee, WI, USA) with linear sensor 9L-D, frequency range being 8-10 MHz. All tumors were examined using standard ultrasound diagnostics in B-mode and elastography; they were also logged using the Breast Imaging Reporting & Data System (BIRADS). Results and Discussion. In 134 patients, 219 focal breast masses of various morphological genesis were detected echographically. All focal masses identifi ed based on the fi ndings of morphological studies were divided into two groups: The first group consisted of 154 (70.3%) formations corresponding to malignant genesis; the second group consisted of 65 (29.7%) formations in which the tumor growth was benign. In the fi rst group, 16 (10.4%) formations had a type 2 elastogram, 27 (17.5%) formations – type 3, 36 (23.4%) – type 4, and 75 (48.7%) – type 5 in compression elastography. With compression elastography, the average stiffness index was 5.31±0.4 [3.6-16.2] for malignant tumors, while it was 1.76±0.14 [0.8-2.1; p<0.001] for benign tumors. During shear wave elastography in malignant tumors, the average stiffness value was 98.4±12.3 kPa, while it was 18.2±4.3 kPa (p<0.001) in benign tumors. Analyzing the findings of this study, the complex application of elastography in integration with the B-mode to the diagnosis of focal breast masses wa accurate in 98.6% of cases. The sensitivity and specifi city indices were 97.9% and 96.2%, respectively. Conclusions. An integrated approach to the application of these methods of echography with a B-mode has shown signifi cantly high efficiency of ultrasound diagnostics.
Keywords: ultrasound diagnostics, B-mode, elastography, breast tumor, breast lump.
For citation: Pulatova, I.Z.; Gazhonova, V.E. Diagnostic effi ciency of compression elastography and shear wave elastography in the differential diagnosis of breast lumps. The Bulletin of Contemp orary Clinical Medicine. 2025, 18 (6), 72-77. DOI: 10.20969/VSKM.2025.18(6).72-77.
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УДК: 616.71-089.844 DOI: 10.20969/VSKM.2025.18(6 ).78-83
Optimizing surgical treatment of patients with the chronic osteomyelitis of long bones
Eduard V. Khalimov1,2, Boris A. Lekomtsev1,2, Alexander Y. Mikhailov1,2, Andrey V. Syakterev2, Angelina E. Savelyeva1
1Izhevsk State Medical Academy, 281 Kommunarov str., 426056, Izhevsk, Russia
2City Clinical Hospital No. 6, 1 Truda str., 426067 Izhevsk, Russia
Abstract. Introduction. According to the World Health Organization, 5-7% of people suffer from chronic osteomyelitis of various etiologies and localizations. Osteomyelitis treatment remains a pressing problem in modern surgery, driven by the high incidence of this disease. Surgical management of osteomyelitis is based on performing osteonecrosis sequestrectomy and fi lling residual osteomyelitic cavities, employing a variety of methods. Aim. This study aimed to conduct a comparative analysis of surgical treatments and changes in the quality of life of patients with the chronic osteomyelitis of long tubular bones. Materials and Methods. Surgical treatment outcomes was studied based on 44 patients with the chronic osteomyelitis of long tubular bones from January, 2014 through November, 2024. All patients in this study underwent osteonecrosis sequestrectomy with plastic reconstruction of the residual bone cavity. All participants (n=44) were divided into two groups based on the type of plasty. Group A comprised 24 patients (54.5%) who received muscle fl ap plasty, while Group B comprised 20 patients (45.5%) who received bone “shavings” plasty using our own method. Data was processed using the MS Excel software, determining mean values (M), standard error of the mean (m), and statistical signifi cance (p) using Student’s t-test. Results and Discussion. Total number of complications in the early postoperative period was 8 (33.3%±9.8%) in Group A. In Group B, a twofold reduction in complications was recorded at 4 (20%±9.2%), which was statistically signifi cant (p=0.3). The average length of hospital stay was 24±1.2 days in Group A, while it was 16.5±1.7 days in Group B, which was statistically signifi cantly (p=0.2) lower than in Group A. Late postoperative recurrent complications were observed in 5 patients (20.8%±8.5%) in Group A and in 2 patients (10%±6.9%) in Group B, which was statistically signifi cantly (p=0.3) 2.5 times lower than in Group A. Quality of life parameters were optimized in Group B patients. Good outcomes in Group B constituted 71.4%±10.1%, compared to 47.4%±11.8% in Group A, which was statistically signifi cantly (p=0.1) lower than in Group B. Unsatisfactory outcomes were observed in 9.5%±6.6% of Group B patients and 26.3%±10.4% of Group A patients, which was statistically signifi cantly (p=0.1) higher than in Group B. Conclusions. The method proposed for fi lling the residual bone cavity using autogenous bone “shavings” allows for a reduction in the duration of hospital treatment, decreases the number of complications in the early postoperative period, lowers the recurrence rate of the disease, and improves the quality of life of patients in the long-term period after surgical treatment.
Keywords: long bones, chronic osteomyelitis, comparing techniques of residual bone cavity grafting, complications, setbacks, quality of life.
For citation: Khalimov, E.V.; Lekomtsev, B.A.; Mikhailov, A.Y.; et al. Optimi zing surgical treatment of patients with the chronic osteomyelitis of long bones. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 78-83. DOI: 10.20969/VSKM.2025.18(6).78-83.
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3. Юнусова Л.Р ., Икрамов Г.О., Халманов Б.А., Сувонов К.Ж. МСКТ диагностика остеомиелита верхней челюсти, у пациентов перенесших COVID-19 // Вестник современной клинической медицины. – 2022. – Т .15, вып.5. - С.81-85. Yunusova LR, Ikramov GO, Khalmanov BA, Suvonov KZh. MSKT diagnostika osteomielita verhnej chelyusti, u pacientov perenesshih COVID–19 [MSCT diagnosis of osteomyelitis of the upper jaw, in patients who underwent COVID–19]. Vestnik sovremennoj klinicheskoj mediciny [Bulletin of Contemporary Clinical Medicine.] 2022; (15) 5: 81–85. (In Russ.). DOI: 10.20969/VSKM.2022.15(5).81-85
4. Смирнова Г.О., Цкаев А.Ю., Денисов Е.Б., [и др.]. Комбинированная пластика при посттравматическом остеомиелите большеберцовой кости (клиническое наблюдение) // Раны и раневые инфекции. Журнал имени проф. Б.М. Костючёнка. – 2022. – Т . 9, № 4. – С. 24-31. Smirnova GO, Tsakaev AYu, Denisov EB, et al. Kombinirovannaya plastika pri posttravmaticheskom osteomielite bol’shebercovoj kosti (klinicheskoe nablyudenie) [Combined plastic surgery for post-traumatic osteomyelitis of the tibia (clinical observation)]. Rany i ranevye infekcii. Zhurnal imeni prof BM Kostyuchyonka [Wounds and wound infections. Journal named after prof BM Kostyuchenok]. 2022; 9 (4): 24-31. (In Russ.). DOI: 10.25199/2408-9613-2022.9(4).24-31
5. Mohd YusofN, Saleh AK, Abuomira IEAA, et al. Mono-Lateral External Fixation for Treatment of Femoral Osteomyelitis. Orthop Res Rev. 2022 Nov 22; 14: 437-443. DOI: 10.2147/ORR.S383863
6. Chudilova GA, Tarakanov VA, Chicherev EA, et al. Differentiated disorders of the immune system in acute hematogenic and acute posttraumatic osteomyelitis in children. Medical Immunology (Russia). 2023; 25 (4): 891-898. DOI: 10.15789/1563-0625-DDO-2759
7. Ergashev VA. Comparative analysis of pathogens of post-traumatic and hematogenous osteomyelitis. New Day in Medicine. 2021; 2 (34): 102-106.
8. Антропова Е.С., Мельцер Р.И., Стоянов А.И. Топографоанатомическое обоснование способа мышечной пластики при остеомиелите большеберцовой кости // Морфология. – 2020. – Т . 157, № 2-3. – С. 21. Antropova ES, Meltzer RI, Stoyanov AI. Topografoanatomicheskoe obosnovanie sposoba myshechnoj plastiki pri osteomielite bol’shebercovoj kosti [Topographic-anatomical substantiation of the method of muscle grafting for osteomyelitis of the tibia]. Morfologiya [Morphology]. 2020; 157 (2-3): 21. (In Russ.).
9. Булавкин В.П., Федянин С.Д., Матусевич Е.А., [и др.]. Лечение остеомиелита пяточной кости с применением аутомиело-фибринозно-тромбоцитарного сгустка // Вестник ВГМУ . – 2022. №3. – С. 102-107. Bulavkin VP, Fedyanin SD, Matusevich EA, et al. Lechenie osteomielita pyatochnoj kosti s primeneniem automielo-fi brinozno-trombocitarnogo sgustka [Тreatment of osteomyelitis of the calculus with the use of automyelo-fi brinous-thrombocyte clot]. Vestnik VGMU [Bulletin of VSMU]. 2022; (3): 102-107. (In Russ.).
10. Ruan W, Li M, Guo Q, Lin B. Gastrocnemius muscle fl ap with vancomycin/gentamicin-calcium sulfate and autogenous iliac bone graft for the phase I treatment of localized osteomyelitis after tibial plateau fracture surgery. J Orthop Surg Res. 2021 May 27; 16 (1): 341. DOI: 10.1186/s13018-021-02496-1
11. Steinhausen E, Lefering R, Glombitza M, et al. Bioactive glass S53P4 vs. autologous bone graft for fi lling defects in patients with chronic osteomyelitis and infected non-unions - a single center experience. J Bone Jt Infect. 2021 Jan 12; 6 (4): 73-83. DOI: 10.5194/jbji-6-73-2021
12. Гаврилов А.Н., Перова Е.В. Костная пластика при лечении хронического остеомиелита // Фундаментальные исследования. – 2005. – № 5. – С. 45-45. Gavrilov AN, Perova EV. Kostnaya plastika pri lechenii hronicheskogo osteomielita [Вone graft in the treatment of chronic osteomyelitis]. Fundamental’nye issledovaniya [Fundamental Research]. 2005; (5): 45-45. (In Russ.).
13. Кочоров О.T., Иманкулова А.С., Иманкулов М.А., [и др.]. Хирургическое лечение больных хроническим гематогенным остеомиелитом длинных костей с тотальным поражением // Раны и раневые инфекции. Журнал имени проф. Б.М. Костючёнка. – 2023. – Т . 10, № 3. – С. 40-45. Kochorov OT, Imankulova AS, Imankulov MA, et al. Hirurgicheskoe lechenie bol’nyh hronicheskim gematogennym osteomielitom dlinnyh kostej s total’nym porazheniem [Surgical treatment of patients with chronic hematogenous osteomyelitis of long bones with total damage]. Rany i ranevye infekcii. Zhurnal imeni prof. B.M. Kostyuchyonka [Wounds and wound infections. Journal named after prof. B.M. Kostyuchenok]. 2023; 10 (3): 40-45. (In Russ.). DOI: 10.25199/2408-9613-2023.10(3).40-45
14. Трушин П.В., Штофин С.Г. Новые подходы в пластике секвестральных полостей при хроническом остеомиелите // Вятский медицинский вестник. – 2019. – № 4(64). – С. 22-26. Trushin PV, Shtofi n SG. Novye podhody v plastike sekvestral’nyh polostej pri hronicheskom osteomielite [New approaches to plastic surgery of sequestral cavities in chronic osteomyelitis]. Vyatskij medicinskij vestnik [Vyatka Medical Bulletin]. 2019; (4) (64): 22-26. (In Russ.)
15. Головнев А.В., Есина О.В., Щеголев М.Б., [и др.]. Лечение больных хроническим остеомиелитом с использованием мелкогранулированного пористого никелида титана // Вестник Кыргызско-Российского Славянского университета. – 2009. – Т. 9, № 2. – С. 134-137. Golovnev AV, Esina OV, Shchegolev MB, et al. Lechenie bol’nyh hronicheskim osteomielitom s ispol’zovaniem melkogranulirovannogo poristogo nikelida titana [Тreatment of patients with chronic osteomyelitis using fine-granular porous titanium nickelide]. Vestnik Kyrgyzsko-Rossijskogo Slavyanskogo universiteta [Bulletin of the Kyrgyz-Russian Slavic University]. 2009: 9 (2): 134-137. (In Russ.).
16. Шамсиев А.М., Зайниев С.С. Оценка качества жизни пациентов, перенесших хронический рецидивирующий гематогенный остеомиелит // Вестник науки и образования. – 2020. – № 8-2(86). – С. 24-27. Shamsiev AM, Zayniev SS. Ocenka kachestva zhizni pacientov, perenesshih hronicheskij recidiviruyushchij gematogennyj osteomielit [Assessment of the quality of life of patients who have suffered chronic recurrent hematogenous osteomyelitis]. Vestnik nauki i obrazovaniya [Bulletin of Science and Education]. 2020; (8-2) (86): 24-27. (In Russ.).
17. Халимов Э.В., Михайлов А.Ю., Лекомцев Б.А., [и др.]. Метод пластики костной полости аутогенной костной стружкой при хроническом остеомиелите длинных трубчатых костей // Сборник научных трудов международной научно-практической конференции «Остеомиелит у детей и взрослых». – 20-21 октября 2022 г . – Москва – С. 109-111. Khalimov EV, Mikhailov AYu, Lekomtsev BA, et al. Metod plastiki kostnoj polosti autogennoj kostnoj struzhkoj pri hronicheskom osteomielite dlinnyh trubchatyh kostej [Method of bone cavity plastic surgery with autogenous bone chips in chronic osteomyelitis of long tubular bones]. Sbornik nauchnyh trudov mezhdunarodnoj nauchno-prakticheskoj konferencii «Osteomielit u detej i vzroslyh» [Collection of scientifi c papers of the international scientific and practical conference “Osteomyelitis in children and adults”]. Moscow. October 20-21, 2022; 109-111. (In Russ.).
УДК: 612.172.1; 616.379-008.64 DOI: 10.20969/VSKM.2025.18(6).84-90
Diabetes mellitus as a readmission risk factor after coronary artery bypass grafting
Dinara R. Khusnullina1, Albert S. Galyavich2, Rustem N. Khairullin1
1Interregional Clinical Diagnostic Center, 12а Karbyshev str., 420101 Kazan, Russia
2 Kazan State Medical University, 49 Butlerov str., Kazan, 420012 Russia
Abstract. Introduction. Coronary artery bypass grafting is one of the methods for myocardial revascularization in coronary heart disease. After surgical restoration of coronary blood fl ow, some patients experience recurrent angina necessitating readmission to fi nd out its causes. Type 2 diabetes mellitus is recognized as one of the factors contributing to the recurrence of angina after coronary artery bypass grafting. Aim. To clarify the role of type 2 diabetes mellitus in the development of angina after successful coronary artery bypass grafting. Materials and Methods. The study included 200 patients aged 39 to 81 years (155 men and 45 women) with and without type 2 diabetes mellitus. The parameters studied included age; sex; body mass index; laboratory and instrumental (imaging) parameters; presence/absence of type 2 diabetes mellitus; and the time interval between coronary artery bypass grafting and the onset of angina. The data obtained were analyzed statistically using the SPSS software with a package of standard statistical programs. The significance of differences between groups was determined using Fisher’s exact test. Results and Discussion. Two years after coronary artery bypass grafting, the recurrence of clinical angina was more frequently diagnosed in patients with type 2 diabetes mellitus (in 80.1% of cases). Conclusions. Type 2 diabetes mellitus is a readmission risk factor due to recurrent angina after coronary artery bypass grafting.
Keywords: diabetes mellitus, coronary heart disease, cardiovascular diseases.
For citation: Khusnullina, D.R.; Galyavich, A.S.; Khairullin, R.N. Diabetes mellitus as a re admission risk factor after coronary artery bypass grafting. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 84-90. DOI: 10.20969/VSKM.2025.18(6).84-90.
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8. Цыганкова О.В., Евдокимова Н.Е., Веретюк В.В., [и др.]. Инсулинорезистентность и хроническая сердечная недостаточность с сохраненной фракцией выброса. Патогенетические и терапевтические перекрестки // Сахарный диабет . – 2022. – Т. 25, №6. – С. 535-547. Tsygankova OV, Evdokimova NE, Veretyuk VV, et al. Insulin resistance and heart failure with preserved ejection fraction. Pathogenetic and therapeutic crossroads. Diabetes mellitus. 2022; 25(6): 535-547. (In Russ.) DOI: 10.14341/DM12916
УДК: 613.98: 615.03 DOI: 10.20969/VSKM. 2025.18(6).91-96
Pharmacotherapy of geriatric patients with cardiovascular diseases: Challenges in real-world clinical practice
Ainura T. Sharaeva1
1B.N. Yeltsin Kyrgyz-Russian Slavic University, 1 Ch. Aitmatov Ave., 720000 Bishkek, Kyrgyzstan
Abstract. Introduction. In recent decades, the global population has shown a rapid growth trend, projected to reach 9.7 billion people by 2050. Concurrently, the rapid aging of the global population has become a signifi cant concern. Geriatric patients suffer from a wide range of chronic diseases more frequently and take more medications than younger patients. Regular use of 5 or more medications is considered polypharmacy. Negative consequences of polypharmacy in the elderly include hospitalization, development of adverse drug reactions (ADRs), and use of potentially inappropriate medications. However, the relationship between polypharmacy and adverse drug reactions remains ambiguous. Aim. To assess the rationality of pharmacotherapy among hospitalized patients with cardiovascular diseases, aged 65 years and older. Materials and Methods. A retrospective analysis was conducted of prescription sheets from 113 medical records of elderly patients aged 65 years and older with cardiovascular diseases. The purpose was to evaluate pharmacotherapy in real-world clinical practice and identify associated problems that could become reasons for interventions or for the revisions of treatment regimens. Pearson’s correlation analysis (r) was used to assess the relationship between quantitative indicators. Fisher’s exact test was employed for the analysis of binary variables and to check the statistical signifi cance of differences between two categorical variables (presence/absence of polypharmacy and occurrence of adverse drug reactions). Results and Discussion. The study found that polypharmacy was used in 67 (59.3%) patients, while 46 (40.7%) patients did not have it. Incidence of adverse drug reactions (ADRs) was 32.8% (22 out of 67 patients) in the polypharmacy group, compared to 8.7% (4 out of 46 patients) in the non-polypharmacy group. The odds ratio (OR) calculated was 5.13 (95% CI 1.63–16.14), and the relative risk (RR) was 3.78 (95% CI 1.39–10.23). Association between polypharmacy and the development of ADRs was statistically signifi cant (p = 0.0029, Fisher’s exact test). Pearson’s correlation analysis also revealed strong and statistically signifi cant associations between age and the occurrence of ADRs (r = 0.99, p <0.001). A very strong positive correlation was found between polypharmacy and the development of ADRs (r = 0.99, p <0.001), and also between taking ≥8 medications and the development of ADRs (r = 0.97, p <0.001). Conclusions. Pharmacotherapy challenges, such as polypharmacy and the development of adverse drug reactions, remain relevant in real-world clinical practice.
Keywords: pharmacotherapy, geriatric patients, cardiovascular diseases, polypharmacy, adverse drug reactions.
For citation: Sharaeva, A.T. Pharmacotherapy of geriatric patients with cardiovascular diseases: Challenges in real-world clinical practice. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 91-96. DOI: 10.20969/VSKM.2025.18(6).91-96.
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УДК: 616.27-006-07-073.756.8 DOI: 10.20969/VSKM.2025.18(6).97-104
Multimodal imaging of mediastinal tumors: Advantages of integrating the finding of computed tomography and magnetic resonance imaging
Otabek D. Eshonhodjaev1, Nigora M. Djuraeva1, Ravshan A. Ibadov1, Sharif U. Rakhimiy2, Sardor Kh. Ibragimov1, Khanum V. Abdukhalimova1
1 Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V.Vakhidov,
10 Kichik Halqa Yo‘li str., 100115 Tashkent, Uzbekistan
2SURGEMED Clinic, 96A Al-Khwarizmi str., 220110 Urgench, Khorezm Region, Uzbekistan
Abstract. Introduction. Mediastinal tumors represent a clinical and radiological challenge due to their morphological polymorphism and potential malignancy. The present study aims to comprehensively evaluate the diagnostic value of computed tomographic angiography and magnetic resonance imaging with Diffusion-Weighted Imaging in the preoperative stratifi cation of mediastinal tumors. This aims to improve therapeutic algorithms and prognostic evaluation. Aim. The primary objective was to investigate the effi cacy of different diagnostic methods and approaches for mediastinal tumors to inform surgical treatment tactics and improve clinical outcomes. Materials and Methods. Based on the analysis of computed tomographic angiography data, the sensitivity and specifi city of the method in diagnosing malignant and benign mediastinal tumors were assessed. The overall sensitivity was found to be 79.5%, with maximum sensitivity for angiomas (100%) and minimum for Group C thymomas (68.7%). Receiver Operating Characteristic analysis confirmed the high accuracy of computed tomographic angiography in differentiating malignant and benign mediastinal tumors (Area Under the Curve=0.817 and Area Under the Curve=0.843; p<0.001). The diagnostic value of the method for benign tumors was 100% for cysts, neurinomas, teratomas, and lipomas. With respect to thymic carcinomas, the sensitivity and specifi city of computed tomographic angiography were 68.7% and 69.6%, respectively. Results and Discussion. The analysis showed that the use of computed tomography and magnetic resonance imaging with contrast allowed for accurate assessment of tumor size and the extent of invasion into adjacent structures. Minimally invasive methods demonstrated less trauma and reduced hospitalization time for patients. In 85% of cases, endoscopic interventions led to successful tumor removal with minimal complications. Open surgeries were primarily utilized for large and invasive tumors requiring extended resection. Conclusions. Computed tomographic angiography has demonstrated high diagnostic value in assessing mediastinal tumors, providing effective differentiation between benign and malignant lesions. The method further aids in identifying the degree of invasion and structural features, thereby guiding surgical intervention tactics.
Key words: computer tomography, magnetic resonance imaging, mediastinal tumors, VATS, thoracotomy.
For citation: Eshonhodjaev, O.D.; Djuraeva N.M.; IbadovR.A.; et al. Multimodality imaging of mediastinal tumors: advantages of integrating computed tomography and magnetic resonance imaging data. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 97-104. DOI: 10.20969/VSKM.2025.18(6).97-104.
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REVIEWS
УДК: 618.145 DOI: 10. 2096 9/VSKM.2025.18(6).105-114
Platelet-rich plasma therapy for thin endometrium
Zukhra A. Abusueva1, Kira L. Seydalievа1, Amina M. Biyarslanova1, Magomedsultan S. Surkhaev1, Patimat N. Aygumova1, Aslizhat G. Omarieva1, Khadizhat M. Bataalieva1, Abdulbasir R. Khalitov1
1Dagestan State Medical University, 1 Lenin Sq., 367005 Makhachkala, Russia
Abstract. Introduction. Thin endometrium presents a signifi cant challenge in reproductive medicine, as it is a key factor reducing the effectiveness of in vitro fertilization and embryo transfer programs. Its presence is often associated with low pregnancy rates. Current treatment methods demonstrate unstable effi cacy and require improvement. Aim. This review aims to provide a comprehensive assessment of the therapeutic potential of platelet-rich plasma as an innovative approach to increasing endometrial thickness and improving reproductive outcomes in patients with thin endometrium. Materials and Methods. Recent scientifi c literature was analyzed in a systemic manner, dealing with the use of platelet-rich plasma for thin endometrium. The methods of platelet-rich plasma preparation, its administration protocols, and reported clinical outcomes were studied. Furthermore, possible mechanisms of platelet-rich plasma effect provided on endometrial regeneration were considered, including the activation of angiogenesis and stimulation of cell growth through the release of growth factors. Results and Discussion. According to research data, intrauterine infusion of platelet-rich plasma may contribute to an increase in endometrial thickness, as well as improve implantation and pregnancy rates in patients with resistant forms of thin endometrium. However, the lack of unifi ed platelet-rich plasma preparation methods and differences in treatment protocols complicate the direct comparison of results between studies. Safety profile of platelet-rich plasma therapy is assessed as favorable, with a minimal number of reported adverse events. Conclusions. Platelet-rich plasma therapy is a promising method for endometrium restoration in cases of insufficient thickness. Implementing this approach into widespread clinical practice requires conducting randomized controlled trials and developing standardized protocols for the preparation and application of platelet-rich plasma.
Keywords: platelet-rich plasma, thin endometrium, in vitro fertilization, embryo transfer, growth factors.
For citation: Abusueva, Z.A.; Seidaliyeva, K.L.; B yarslanova, A.M.; et al. Platelet-rich plasma therapy for thin endometrium. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 105-114. DOI: 10.20969/VSKM.2025.18(6).105-114.
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УДК: 616.72-089.843 DOI: 10. 2096 9/VSKM.2025.18(6).115-122
Advanced laboratory techniques for diagnosing periprosthetic infections: Capabilities and constraints
Pavel V. Iliasov1, Olga V. Gribkova1, Elena A. Voronova2, Dmitry S. Kudashev1, Maria Yu. Sefedinova1, Viktoria A. Ulivanova1, Andrei V. Kozlov1, Artem V. Lyamin1
1 Samara State Medical University, 89 Chapayevskaya str., 443099 Samara, Russia
2 JSC Medical Company IDK, Mother-and-Child Group of Companies, 29 Entuziastov str., 443067 Samara, Russia
Abstract. Introduction. Periprosthetic infection is one of the most severe and expensive complications of arthroplasty, with an incidence ranging from 0.3% to 3.3% of cases in primary joint replacement and from 5.9% to 13.6% in revision surgeries. Despite the fact that periprosthetic infections are mostly caused by bacterial pathogens and the detection of microorganisms in clinical material is an important diagnostic criterion, microbiological research methods have some constraints, the most important one being the time factor. Thus, there is a need for fi nding the most optimal laboratory marker that can be used intraoperatively. Aim. To analyze the literature data on laboratory diagnostic techniques developed to detect periprosthetic infections. Materials and Methods. The review presents data from foreign and domestic studies published in the PubMed, Cyberleninka, and Google Scholar databases. The studies were selected among literary sources published before 2025. The following were subject to inclusion: Original studies, literature reviews, and meta-analyses, all dealing with the diagnosis of periprosthetic infection. Results and Discussion. The most common microorganisms causing periprosthetic infections are Staphylococcus aureus, coagulase-negative staphylococci, and Cutibacterium acnes. However, microbiological testing is time-consuming and depends on the laboratory’s capabilities and its staff’s experience. In this regard, it is optimal to use alpha-defensin and leukocyte esterase as the markers of periprosthetic infections. These tests are characterized by high sensitivity and specifi city, easy to perform, and provide results within a few minutes. Conclusions. Leukocyte esterase and alpha-defensin are optimal periprosthetic joint infection markers for intraoperative use, and multiplex polymerase chain reaction is the technique that can be effectively used along with classical bacteriological analysis to identify the pathogen in synovial fl uid and determine its drug resistance during postoperative examination.
Keywords: periprosthetic infection, synovial fl uid, biomarkers, leukocyte esterase, alpha-defensin
For citation: Iliasov, P.V.; Gribkova, O.V.; Voronova, E.A.; et al. Advanced laboratory techniques for diagnosing periprosthetic infections: Capabilities and constraints. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 115-122. DOI: 10.20969/VSKM.2025.18(6).115-122.
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PRACTICAL EXPERIENCE
УДК: 616.126-007.271-089 DOI: 10.20969/VSKM.2025.18(6).123-129
Surgical treatment of aortopulmonary septal defect: A case report and current review
Ruslan T. Alisherov1, Nurayim M. Nurdinova1, Samatbek O. Kadyraliev1,2, Kaldarbek A. Abdramanov1,2
1Southern Regional Scientific Center of Cardiovascular Surgery, Ministry of Health of the Kyrgyz Republic, 81 Mamyr Baatyr str., 720901 Jalal-Abad, Kyrgyzstan
2Jalal-Abad State University named after B. Osmonov, Ministry of Education and Science of the Kyrgyz Republic, 49 Ruzi Azimov str., 720907 Jalal-Abad, Kyrgyzstan
Abstract. Introduction. Aortopulmonary window is an abnormal communication between the ascending aorta and the pulmonary trunk in the presence of two independent aortic and pulmonary valves. This congenital defect results from a disturbance in the embryonic development of the aortopulmonary trunk and is typically located in the proximal ascending aorta on its medial wall. This article presents a clinical case of an aortopulmonary window with typical clinical symptoms, describes the specifi cs of its surgical treatment, and discusses the long-term outcomes of therapy. Current literature was reviewed to assess contemporary approaches to the diagnosis and treatment of this cardiac defect. Aim. To present a clinical case of an aortopulmonary window with characteristic symptoms, to demonstrate the peculiarities of surgical correction, and to analyze the long-term treatment outcomes. Materials and Methods. This article presents the clinical case of an eight-year-old boy with an aortopulmonary window, diagnosed from an early age. To accurately determine the location and size of the defect, and to assess valve function, physical examination, electrocardiogram, chest X-ray, echocardiography, and aortography were performed, aligning with the advanced recommendations in the literature. Surgical intervention was performed under cardiopulmonary bypass – a standard method ensuring the safety and successful correction of the defect, as supported by research data. Results and Discussion. The patient with an aortopulmonary window presented with the characteristic complaints of dyspnea and rapid fatigue, consistent with literature data on circulatory disturbances associated with this defect. Physical examination revealed typical signs: A loud second heart sound and a systolic murmur. Diagnosis using echocardiography and angiography allowed for precise determination of the defect’s location and size. Surgical correction under cardiopulmonary bypass was successful, showing positive dynamics in the patient’s clinical condition. The literature review confi rms the effi cacy and safety of the chosen method; however, continuous postoperative follow-up is necessary for timely detection of complications. Conclusions. Successful diagnosis and surgical correction of the aortopulmonary window signifi cantly improved the patient’s condition. The method is confi rmed by literature as effective and safe, with regular postoperative monitoring being essential.
Keywords: congenital heart disease, aortopulmonary septal defect, pulmonary hypertension, heart failure, artificial blood circulation.
For citation: Alisherov, R.T.; Nurdinova, N.M.; Kadyraliev, S.O.; Abdramanov, K.A. Surgical treatment of aortopulmonary septal defect: A case report and current review. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 123-129. DOI: 10.20969/VSKM.2025.18(6).123-129.
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УДК: 618.14-006.36 DOI: 10.20969/VSKM.2025.1 8(6).130-137
X-ray endovascular embolization in the treatment of a giant uterine fibroid: A case report
Bulat M. Sharafutdinov1,2,3, Sergey A. Ryzhkin1,2,4,5,8, Alevtina V. Akhmetzyanova2,3, Leysan Sh. Ibragimova3, Timur Kh. Khayrullin3, Diaz A. Galimyanov5,6,7
1Russian Medical Academy of Postgraduate Education, 2/1/1 Barrikadnaya str., 125993 Moscow, Russia
2Kazan State Medical Academy – Branch of the Russian Medical Academy of Postgraduate Education, 36 Butlerov str., 420012 Kazan, Russia
3Republican Clinical Oncological Dispensary named after Prof. M.Z. Sigal, 29 Sibirsky Trakt str., 420029 Kazan, Russia
4Kazan State Medical University, 49 Butlerov str., 420012 Kazan, Russia
5Institute of Biology and Fundamental Medicine, Kazan Federal University, 74 Karl Marx str., 420012 Kazan, Russia
6Dispatch Center, 88 Adel Kutuy str., 420073 Kazan, Russia
7Radiology Data Center, 138/2 Orenburgsky Trakt str., 420064 Kazan, Russia
8Academy of Sciences of the Ministry of Healthcare of the Republic of Tatarstan, 20 Bauman str., 420503 Kazan, Russia
Abstract. Introduction. In recent years, uterine artery embolization has become widely used as both a treatment of benign diseases of the female reproductive organs, such as uterine leiomyoma and nodular adenomyosis, and an efficient method of preventing and managing profuse uterine bleeding associated with the malignant neoplasms of the female reproductive system, abnormal placenta previa, cicatricial pregnancy, and postpartum hemorrhage, due to its high effi cacy, minimal invasion, and organ preservation. The total incidence of complications after uterine artery embolization varies between 0.1% and 37.3%, according to Russian and international literature. High variability in the number of complications depends on the experience of clinical physicians and of high-tech centers where uterine artery embolization is performed. One of extremely rare but serious postoperative complication is necrotic uterus destruction. According to international literature, only 21 cases of postembolization uterine necrosis have been reported worldwide. Aim. To demonstrate a clinical case of uterine necrosis development after X-ray endovascular embolization of the uterine arteries, performed for uterine fi broids. Materials and Methods. 45-year-old patient A. was routinely admitted with the diagnosis of a giant interstitial uterine fi broid to the gynecology department of the University Clinic of Kazan Federal University in 2022. Transarterial embolization was performed in the Department of X-ray Surgical Diagnostics and Treatment. According to ultrasound of the uterus and appendages on the 3rd day after the procedure, there was no blood fl ow in the fi broid node. The patient was discharged with clinical improvement on the 6th day after the intervention. Results and Discussion. Аfter uterine artery embolization for the uterine fi broid, the patient was admitted to the gynecology department of the oncology clinic, complaining of purulent-hemorrhagic vaginal discharge. Pelvic magnetic resonance imaging revealed a fl uid-fi lled tubular structure in the pelvic cavity (hydrosalpinx) with an abnormal luminal substrate (neoplastic process), and a uterine leiomyoma. Given the necrotic uterus destruction, a surgery was performed, including extirpation of the uterus and appendages, resection of the rectum, and transverse colostomy. Postoperative period was unremarkable. The patient was discharged in an improved clinical condition. Conclusions. The clinical case presented is intended to enhance the clinical specialists’ knowledge of the rare but possible complications of uterine artery embolization. To prevent these complications, during planning the surgery type and strategy, it is necessary to thoroughly study the anatomical parameters and possible blood supply to the fi broid, correctly select and administer embolic agents, as well as long-term postoperative monitoring to prevent the risk of developing possible complications after surgery.
Keywords: uterine artery embolization, uterine fibroid, myomectomy, uterine necrosis.
For citation: Sharafutdinov, B.M.; Ryzhkin, S.A.; Akhmetzyanova, A.V.; et al. X-ray endovascular embolization in the treatment of a giant uterine fi broid: A case report. The Bulletin of Contemporary Clinical Medicine. 2025, 18 (6), 130-137. DOI: 10.20969/VSKM.2025.18(6).130-137.
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