Vol 8, No 3 (2023)

Human Anatomy

Specific features of human placenta anatomy in pregnancy achieved by in vitro fertilization

Mitrofanova I.V., Lutsai E.D., Sirik E.N.


Aim – to evaluate the qualitative and quantitative morphological characteristics of placentas of pregnant women after in vitro fertilization (IVF) registered in the prenatal period and after birth.

Material and methods. The retrospective study of medical records of pregnant and puerperia women focused on the chorion and placenta parameters registered by ultrasound examinations in the I, II, III trimesters. The patients' inclusion criteria were singleton pregnancy and birth at 37-41 weeks' gestation. The types of assisted reproductive technologies and delivery were not specified in this study. The patients were divided into 2 groups according to their age: 1 Group – I period of adulthood, 2 Group – II period of adulthood. The postpartum placenta morphometry included registration of shape, diameter, weight, thickness of the placenta, the place of attachment and length of the umbilical cord, the type of vessels branching.

Results. 1. The ultrasound characteristics of the placenta anatomy during pregnancy achieved by IVF are generally normal and do not have specific features.

  1. The pathological location of the chorion in the uterine cavity in the first trimester of pregnancy is characterized by a risk factor – the older age group.
  2. The weight of the placenta during full-term pregnancy after in vitro fertilization is higher than normal, its average area is larger due to a decrease in thickness.
  3. A large proportion of pathological (sheath) attachment of the umbilical cord can lead to more frequent complications of pregnancy – acute placental insufficiency.
Science and Innovations in Medicine. 2023;8(3):148-153
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Morphological features of the rat’s thyroid gland after application of defect in the tibiae

Morozov V.N.


Aim – to study the morphological features of the rat’s thyroid gland after application of a defect in their tibiae.

Material and methods. Sixty white mature male rats were divided into two groups. Group I – intact animals, Group II – rats subjected to a through defect in the proximal metaphysis of the tibiae. The experiment time-line was: 3, 10, 15, 24, and 45 days. The qualitative features of the thyroid gland structure were studied using light and electron microscopy; the quantitative features – with histomorphometry.

Results. The large follicles lined with simple squamous epithelium on the periphery of the gland as well as large and medium-sized follicles lined with low simple cuboidal, less often squamous epithelium in the center were observed in rats of Group II on days 3, 10, 15 of the experiment. The colloid filled completely or most of the follicle; there were desquamated epitheliocytes and cells with signs of apoptosis. The height of the follicular epithelium of the thyroid gland was smaller than the values of the Group I by 8.44%, 5.52%, 3.86% and 5.53%, 3.70%, 3.25% from 3rd to 15th days; the area of nuclei of follicular cells – by 5.22%, 4.93% from 3rd to 10th days and by 5.31% on 3rd day; nucleo-cytoplasmic ratio – by 3.11%, 2.29%, 2.28% from 3rd to 15th days and by 4.63%, 3.01% from 3rd to 10th days in the central and peripheral parts of the gland respectively. On the 3rd day, electron-microscopically, thyrocytes were low cuboidal or flat shape, the nucleus had tortuous contours and accumulations of heterochromatin under the karyolemma and in the karyoplasm. The cisternae of the rough endoplasmic reticulum were collapsed or had small slit-like spaces. Single lysosomes and secretory granules in the apical part of the cells and short microvilli were visualized.

Conclusion. The application of a defect in the tibiae of rats is accompanied by morphological changes in the thyroid gland from the 3rd to 15th days and then organ adapts to the trauma by the 24th and 45th days.

Science and Innovations in Medicine. 2023;8(3):154-158
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Analysis of hemodynamic changes in vertebral arteries and veins during functional tests with ultrasound monitoring

Nikolenko V.N., Moshkin A.S., Khalilov M.A.


Aim – to evaluate the correlation between the course of vertebral arteries and veins and the results of calculations of hemodynamic parameters during ultrasound with functional tests.

Material and methods. In the observation, 252 volunteers were examined using Samsung SonoAce R7 and GE Logiq F6 equipment. The hemodynamics was studied at the level of the second segment of the vertebral arteries and veins at rest, when turning, tilting and lifting the head. The results were processed using Microsoft Excel 2007 with subsequent statistical analysis.

Results. 504 vascular complexes were analyzed without taking into account the visualization side. When assessing the arteries, the highest maximum blood flow velocity was registered when lifting the head in women with a rectilinear course of the vessels. In the group of men with non-rectilinear course of vessels, the lowest average blood flow velocity was registered when tilting the head. The highest volume flow was recorded in case of non-rectilinear vascular course in women when lifting the head.

For vertebral veins, the highest indicators of maximum and minimum venous blood flow rates were observed in men with a rectilinear course of vessels when lifting the head. The highest values of the average flow velocity and volume flow were noted in men who had a rectilinear course of the vessels.

The maximum values of the calculated venous volume flow were registered in groups with rectilinear vascular course: in men up to 19.42±14.85 ml/min. (Me – 12.45 ml/min.), in women – 18.52± 15.30 ml/min. (Me – 10.50 ml/min.).

Conclusion. The data obtained by the study contributes to improving the software and analysis of individual changes during patient examination, helps to evaluate the effectiveness of treatment and rehabilitation, as well as to analyze multifactorial models.

Science and Innovations in Medicine. 2023;8(3):159-164
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Human levator ani muscular tissue ultrastructural organization

Chemidronov S.N., Kolsanov A.V., Suvorova G.N.


Aim – an electron microscopic study of the muscle tissue of levator ani muscle in human.

Material and methods. The paper describes the muscle tissue of levator ani muscle. The data was obtained by light-optical and electron microscopic examination of muscle tissue.

Results. The study of the ultrastructural organization of the muscle tissue of levator ani muscle in human shows that it corresponds to the structure of skeletal muscle tissue – it consists of muscle fibers that are cellular-symplastic structures. The main volume of the myosimplast is occupied by myofibrils located along its longitudinal axis, having a distinct sarcomeric organization – sarcomeres are separated by Z-lines, a dark disс is located on both sides of the centrally located M-line, light disсs are located on both sides of the Z-lines.

Conclusion. Levator ani muscle in human belongs to the striated skeletal muscle tissue of the locomotor type.

Science and Innovations in Medicine. 2023;8(3):165-168
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Gerontology and geriatrics

Dependence in instrumental activities of daily living and its associations with other geriatric syndromes in people over 65 years of age: data from the Russian epidemiological study EUCALYPT

Sharashkina N.V., Vorobyeva N.M., Permikina I.V., Selezneva E.V., Ovcharova L.N., Popov E.E., Kotovskaya Y.V., Tkacheva O.N.


Aim – to assess the frequency of disability in instrumental activities of daily living (IADLs) and to analyze its associations with other geriatric syndromes in persons aged ≥65 years.

Material and methods. The study involved 4,308 people (30% male) living in 11 regions of the Russian Federation, aged 65 to 107 years (average age 78 ± 8 years). The majority (60%) of participants were examined in a polyclinic, every fifth – in a hospital (20%) or at home (19%), 1% – in nursing homes. All patients underwent a comprehensive geriatric assessment, including an assessment of instrumental activities of daily living on the Lawton scale.

Results. Among the elderly, a high (54%) prevalence of dependence in IADLs was revealed, and with increasing age, this indicator increased significantly, reaching 82% in people over 85 years old. In patients with disability in IADLs, the frequency of all geriatric syndromes, except orthostatic hypotension, was higher, of which the most common were chronic pain syndrome (90%), frailty (80%), dependence in basic activities of daily living (ADLs) (78%), cognitive impairment (75%), probable depression (63%) and urinary incontinence (54%). One-factor regression analysis showed that the presence of disability in IADLs increases the chances of detecting other geriatric syndromes by 1.6–5.9 times.

Conclusion. The results of the EUCALYPT epidemiological study demonstrate a high prevalence of dependence in IADLs among the Russian population. The study also gives an idea of the relationship of dependence in IADLs with various geriatric syndromes.

Science and Innovations in Medicine. 2023;8(3):169-175
pages 169-175 views

Infectious diseases

Pathogenetic significance of CD3+CD56+ T-lymphocytes in hemorrhagic fever with renal syndrome

Ivanov M.F., Konstantinov D.Y., Balmasova I.P., Ulitina A.Y.


Aim – to evaluate the pathogenetic role of T-lymphocytes carrying the natural killer marker CD56 in hemorrhagic fever with renal syndrome (HFRS).

Material and methods. The study group included 65 patients with HFRS receiving the inpatient treatment in the Clinics of SamSMU, and 15 healthy people were chosen for the control group. The following examinations were scheduled for all patients in the different stages of the disease: a clinical blood test, flow cytometry with a given set of monoclonal antibodies, enzyme-linked immunosorbent assay of blood serum to determine the cytokine profile. For statistical analysis we used the SPSS v.23 software.

Results. The percentage of CD3+ CD56+ NKT blood content in comparison with those for cells of innate immunity (neutrophil granulocytes, monocytes, natural killers) and lymphocytes of adaptive immune response, as well as the level of cytokines in the blood serum showed that in polyuric and convalescent periods, the number of these cells significantly increases and remains closely embedded in correlations with other components of the immune system.

Conclusion. A new hypothesis has been proposed to interpret the role of NKT in the development of the immune response in HFRS.

Science and Innovations in Medicine. 2023;8(3):176-180
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A prognostic model for ischemic stroke outcome

Repina L.A., Romanova T.V., Poverennova I.E., Murtazina A.K.


Aim – to develop a mathematical model for the prognosis of ischemic stroke outcome in the acute period of the disease.

Material and methods. The study included 103 patients with ischemic stroke in the carotid basin with existing hemiparesis. The comprehensive examination comprised clinical and anamnestic data, state assessment using clinical scales, brain computed tomography, ultrasound, transcranial magnetic stimulation, evoked potential tests, laboratory blood tests. The patients were examined at admission, at discharge and in 12-24 months after leaving hospital. According to the motor function recovery, the patients were divided into two groups – with favorable and unfavorable outcome. Statistical methods identified the significantly different results in the two groups.

Results. The most significant indicators affecting the prognosis of ischemic stroke were identified.The developed criteria served the basis for a mathematical model using the results of transcranial magnetic stimulation.

Conclusion. The obtained mathematical model can be used to determine the outcome of ischemic stroke in the acute period. Transcranial magnetic stimulation is a method that allows for prognosis of the outcome in early period of stroke.

Science and Innovations in Medicine. 2023;8(3):181-188
pages 181-188 views

Public health, organization and sociology of health

Technologies for calculating and visualizing statistics on prevalence and incidence on the example of information about polypous rhinosinusitis in the Samara region

Palevskaya S.A., Gushchin A.V., Blashentsev M.K.


Aim – to statistically determine the distribution of chronic diseases in the chronology of observations; to show the specifics of methods for testing hypotheses in the quantitative and probabilistic prediction of the prevalence of polypous rhinosinusitis.

Material and methods. The outpatient data for the period of 2017–2021 and quantitative information about the cases with polypous rhinosinusitis as main or concomitant diagnosis registered by medical organizations of 25 districts of the Samara region were used in the study.

Results. The synthesis of the initial data statistics, which amounted to the volume of the numerical expansion of primary indicators in the following ratio: categories 15.8%, counting data 26.3%; quantitative values 21.1%; 26.7% – relative incidence and prevalence data. The rest of the data is the descriptive statistics and indicators in the form of tables of correlation coefficients. For extensions of the synthesized data, distributions were evaluated and hypotheses tested using statistical criteria.

Conclusion. The count of the number of chronic diseases is approximated by the density of atypical distributions. Approximately 58% of samples for diagnoses are not confirmed as obeying the law of distribution. In such a situation, when preparing a forecast for the transition to a time series, it is necessary to solve the problem of obtaining sequences with stationary characteristics. In machine learning, data in predictive calculations must be checked for probabilistic confirmation of the coincidence of related sample parameter distributions. The results of the forecast should be taken as a probabilistic conclusion at the level of an unrejected hypothesis.

Science and Innovations in Medicine. 2023;8(3):189-197
pages 189-197 views

Oncology and radiotherapy

Active surveillance of patients with low and intermediate risk prostate cancer

Andreeva R.D., Nizamova R.S., Vozdvizhenskii M.O., Zhurkina O.V., Isargapov R.M.


Aim – to analyze the survival of patients with localized low and intermediate risk prostate cancer receiving various types of treatment and active surveillance in the Samara region.

Material and methods. The study included 1474 patients with newly diagnosed localized prostate cancer in the Samara region for the period 2010-2016.

Results. In the Samara region, the radical prostatectomy proved to be the most effective treatment method. At the same time, the active surveillance was comparable to other treatment methods in men older than 75 years.

Conclusion. The active surveillance can improve the managing of prostate cancer patients by reducing overtreatment of its clinically insignificant forms, reducing treatment costs and reducing the number of side effects of radical treatment. At the same time, the possibility of radical treatment remains in case of malignant neoplasm progression.

Science and Innovations in Medicine. 2023;8(3):198-204
pages 198-204 views

Raman spectroscopy in noninvasive optical diagnostics of skin neoplasms

Kaganov O.I., Loginova Y.G., Moryatov A.A., Kozlov S.V.


Aim – to propose a schematic design of a new prototype having a potential for mass production and use in medical institutions for routine diagnostics of skin neoplasms.

Material and methods. The study included more than 600 patients with various skin neoplasms. We studied the samples of various skin neoplasms obtained after surgical treatment in the departments of the Samara Regional Clinical Oncology Center. For this purpose, we used the proposed original experimental device for Raman laser spectroscopy. The received signal was processed with a designed algorithm using artificial intelligence.

Results. The proposed diagnostic method reached the 89% sensitivity and 93% specificity proving to be effective. As a result, we have substantiated the technological possibility of creating a portable cost-saving spectroscopic technique with a neural network classifier. The device allows to perform preliminary diagnostics without the involvement of a specialist doctor and is devoid of subjective analysis criteria.

Science and Innovations in Medicine. 2023;8(3):205-209
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The effect of dry extract of white mistletoe leaves on the change of vasodilation function of the cerebral vascular endothelium in rats with chronic alcohol intoxication

Pozdnyakov D.I., Vihor' A.A., Adjiakhmetova S.L.


Aim – to evaluate the effect of dry extract of mistletoe leafs on the change of vascular endothelium vasodilation function in rats under conditions of chronic alcohol intoxication.

Material and methods. The chronic alcohol intoxication was modeled in female Wistar rats by course of oral administration of ethanol at the rate of 3g/kg/day. The tested extract and the reference drug – ethylmethylhydroxypyridine succinate were administered per os at a dose of 100 mg/kg. The vasodilation function of the vascular endothelium was assessed by the change in the rate of cerebral blood flow during modification of the endogenous nitric oxide synthesis. The concentration of active forms of endothelial and inducible nitric oxide synthase isofrom was determined by enzyme immunoassay.

Results. The course of the tested extract and the reference drug resulted in an increase in the rate of cerebral blood flow in relation to untreated animals by 48.1% (p<0.05) and 40.2% (p<0.05), respectively. The restoration of endothelium-dependent vasodilation of cerebral vessels was also noted with the administration of the studied extract of white mistletoe and the reference drug. The analysis of changes in the NO-synthase system showed that, when using the tested extract, the concentration of eNOS increased by 76.3% (p<0.05), and iNOS, on the contrary, decreased by 22.1% (p<0.05), which was comparable with the indicators of the group of animals receiving the reference drug.

Conclusion. The use of mistletoe leaf dry extract leads to the restoration of endothelium-dependent vasodilation of cerebral vessels in rats with chronic alcohol intoxication, probably due to the improvement of eNOS-dependent mechanisms of nitric oxide synthesis.

Science and Innovations in Medicine. 2023;8(3):210-214
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An integrated treatment approach including an obligatory component of psychological support to patients with tuberculosis in the anti-tuberculosis medical organizations of the Samara region

Krasnenkova N.S., Baryshnikovа L.A., Kabaeva M.N., Petrov M.B., Voekova N.A.


Aim – to implement a comprehensive approach to treatment of patients with tuberculosis in anti-tuberculosis medical organizations.

Material and methods. Fifty-two patients and fourteen employees took part in the study. For psychodiagnostics, we used the "TOBOL" questionnaire, the diagnostics of professional "burnout" by K. Maslach, S. Jackson, the Wheel of Life concept by Paul J. Meyer. The data was analyzed using Mann – Whitney U-test, Wilcoxon signed rank test.

Results. The older patients had a tendency for excessive vigilance and aggressiveness in their attitude to the disease. The harmonious and anosognostic types of attitude to the disease were prevalent in patients with permanent employment. The medical workers demonstrated a high level of emotional burnout. The training aimed at prevention of burnout was the part of the study. After the training, the registered values of emotional exhaustion were reduced by 7 points, the depersonalization score shifted from high to average, the reduction of personal achievements score raised by 5 points.

Conclusion. The age and social status can influence the type of attitude towards tuberculosis. Patients under 40 years of age with permanent employment have a more favorable prognosis of adherence to treatment and persistent clinical cure of tuberculosis. The introduction of an integrated approach to the provision of medical care with the mandatory presence of psychological support is relevant and necessary. This study substantiates the expediency of creating a psychological assistance office in a medical organization.

Science and Innovations in Medicine. 2023;8(3):215-219
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A method for eliminating a chest wall defect after the sternoclavicular joint resection

Medvedchikov-Ardiya M.A., Korymasov E.A., Benyan A.S., Rodin S.D.


Purulent arthritis of the sternoclavicular joint requires surgical treatment. The volume of the intervention depends on the degree of the joint's transformation and patient's general condition. The resulting defect of the chest wall tissues requires surgical closure at the reconstructive stage. In case of an extensive defect area with a skin deficiency, it is most advisable to use full-thickness flaps of the latissimus dorsi or pectoralis major muscles.

The article presents a clinical case of a patient operated for purulent arthritis of the sternoclavicular joint. The surgical treatment was planned in two stages. During the first stage, the use of vacuum-assisted dressings demonstrated its effectiveness. The second, reconstructive stage, included plastic surgery for the chest wall defect using a full-thickness flap of the pectoralis major on the thoracic branch of the thoracoacromial artery. The progress of the patient's surgical and general treatment was described in detail.

Science and Innovations in Medicine. 2023;8(3):220-224
pages 220-224 views

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