Sechenov Medical Journal

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No 2 (2014)
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5-15 31

Radiofrequency ablation is a minimally invasive treatment for local destruction, widely used in the combined treatment of kidney cancer. Application of radiofrequency ablation allowed to expand the indications for more radical treatment of kidney tumors in patients who may not perform traditional nephrectomy or partial nephrectomy due to extremely burdened somatic status. Efficacy and safety of RFA greatly increased when it is combined with presuperselective occlusion of blood vessels that feed the tumor. We have experience in the use of superselective embolization in combination with RFA when a kidney tumor is in two patients. In both observations obtained good results of combined treatment. In some patients, this combination (CCE + RFA) may be an alternative to open surgery, thus expanding the range of modern minimally invasive treatments for kidney tumors.

16-22 40

The paper analyzes the current approaches to the study of plastic reconstructive surgery of the urogenital area.


32-37 40

Excess visceral obesity is considered the hallmark of the metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD), which in the modern view is regarded as one of the criteria for MS. Epicardial fat (PE) is involved in the pathogenesis of atherosclerosis in coronary vessels. The purpose of this study is evaluation of patients with MS and NAFLD epicardial fat thickness values by echocardiography and their association with 1) the clinical and metabolic changes, 2) the initial manifestation of atherosclerotic lesions of the vascular bed, according to the thickness of the intima-media complex. In our study patients with MS and NAFLD had higher values of the thickness of the epicardial fat than the control group. Increase in the layer of epicardial fat was associated with insulin resistance and manifestations of remodeling of the vascular wall, endothelial dysfunction, dyslipidemia, impaired left ventricular diastolic function.

38-41 36

Background: chronic heart failure (CHF) is known to profoundly aff ect health related quality of life (HRQoL). Methods: 68 patients aged 43-80 years (mean duration of disease 8,63±4,52 years) were included. HRQoL was measured with the Minnesota Living With Heart Failure Questionnaire; depression — using Beck Depression Inventory. Results: depression was diagnosed in 54,4% patients with CHF. Depressive symptoms correlated with such measures of HRQoL as physical activity, social activity and psychoemotional status. Conclusion: patients with CHF suff er from severe limitations of HRQoL. Depression was the most important correlate of HRQoL.

42-48 46

The present study is based on a working assumption that personality disorders (somatoperceptive accentuation) and cardiovascular diseases (coronary heart disease, arterial hypertension) are initially independent dimensions and interact throughout the cardiac pathology (as opposed to the opinion that personality disorder is a predisposition factor for cardiovascular diseases). Objective: to study the interaction of different types of personality disorders (somatoperceptive accentuation) with cardiovascular diseases (on the model of arterial hypertension and coronary heart disease), taking into account the course of heart disease and therapy adherence. Methods: patients with arterial hypertension and coronary heart disease from the department of cardiology underwent cardiological examination using standart techniques, clinical interview with psychiatrist. Criteria for assessing prognosis of cardiovascular disease were developed. Results: 3 specific psychosomatic\cardiopersonified syndromes, formed by interaction of personality disorders and somatic illness, were obtained: the first — with a favorable course of cardiovascular disease, congruent somatoperceptive accentuation (somatotony/neuropathy) of personality disorder; second — with adverse course of cardiovascular disease, provoked by somatopercepive personality disorder (body image aloof); third — with unfavorable course of cardiovascular disease, comorbid neuropathic accentuation of personality disorder. Conclusion: favorable course of cardiovascular disease in condition of congruent somatoperceptive accentuation: personality disorder helps to improve the prognosis of the disease (prevention of complications, high therapy adherence). Unfavorable course in condition of body image aloof\neuropathy: personality disorder is associated with worsening of the prognosis (complications, low therapy adherence).


49-53 80

The article considers the problems of treatment of the children with obstructive bronchitis and prolonged cough with physiotherapy methods.

54-58 26

The article deals with local therapy in the practice of pediatric rheumatologist. Separately considered the possibility of using nonsteroidal anti-inflammatory drugs. Particular attention is paid to the effectiveness and safety of pharmacological treatment of pain and inflammatory syndromes in rheumatic diseases.

59-64 58


The goal of this article is to provide an overview and comparison of published data on PsA with information obtained in the survey. A survey was conducted of 24 patients with PsA. Identified terms of formation of articular and cutaneous syndromes in PsA in children, as well as options for debut and height of the disease are presented. The brief characteristic of therapy is given. The data obtained svidedelstvuyut that for PsA in children was different: the debut changed the structure and height of the disease, the timing of the formation of cutaneous and articular syndrome, and this disease was more likely to suffer for young children.


65-71 47

The article is devoted to operational forecasting and decision-making features in elective surgery. The paper presents the original formula predictive of death based on the study of operational outcomes described five types of predictions. It is shown that only a combination of normative and descriptive hiking allows you to build evidence based decision making. Only the application of the scientific approach will allow the person making the decision, more objectively assess a problem situation, to take into account the available resources and constraints to formulate and analyze solutions, choose from them acceptable. In the article the problem of operational forecasting and rational theory of decision making in general and oncology considered and developed as an integrated, interdisciplinary, involving philosophy, mathematics, statistics and psychology.

72-77 39

Urgency of the problem is due to the prevalence of genital prolapse, early onset, high rates of relapse. In this regard, this study before the goal was set: to increase the effectiveness of surgical treatment of patients with prolapse of the internal reproductive organs by developing and implementing a new method of surgical treatment and prevention of recurrent prolapse. We examined 74 women with prolapse of the internal reproductive organs in combination with other gynecological pathology: I group consisted of 38 patients who underwent surgical treatment of descent and prolapse of internal genitals by a modifi ed procedure based on the method of fixing the sacro-uterine ligaments ≪reinforced≫ aponeurotic flap; Group II — 36 patients who underwent the original two-stage combined operation of fixing the sacro-uterine ligaments aponeurotic flap method of V.I. Krasnopolsky. Studies have shown that the proposed modification is physiologically sound and technically easy to perform, almost does not extend the time of surgery (compared with the original analogue), allows to some extent to preserve reproductive function, restore the anatomy and function of the pelvic organs. Its application is not accompanied by severe postoperative complications, reduces the number of relapses, improve quality of life.


78-83 47

The purpose of the study is to investigate the clinical significance of determination of serum FGF-23 and Klotho in patients with different stages of chronic kidney disease (CKD). Materials and Methods: The study included 70 patients with CKD stages 1–5D (30 men and 40 women, mean age 41,0–6,7 years), in whom the serum levels of FGF-23 and Klotho, as well as work Ca х P and the content of intact parathyroid hormone (iPTH). Results: the progression of CKD from stage 1 to 5D serum concentration of FGF-23 was increased, and the concentration of Klotho decreased. Glomerular filtration rate (GFR) was directly correlated with the serum concentration of FGF-23 (r=0,693, p <0,01) and back — with a protein concentration of Klotho (r=-0,799, p <0,01). Increased levels of FGF- 23 as GFR decline began in CKD stage 3 and outpaced the increase in serum levels of phosphorus and iPTH, which increased in CKD stage 4–5. In 49 patients with CKD and hypertension increase the degree of BP directly correlated with the serum concentration of FGF-23 (r=0,452; p <0,01) and back — with the serum concentration of Klotho (r=-0,687; p <0,01). In addition, changes in the levels found a link of FGF-23 and Klotho with increasing thickness of the posterior wall of the left ventricle, the frequency of detection of calcifications in the heart and major arteries and anemia. Conclusion: These results suggest the possibility of practical application of Klotho and FGF-23 levels as an early diagnostic marker of kidney damage for prognosis and improve cardio-renoprotective strategies.

84-88 37

A blood plasma detoxitycation efficiency by a barbotage method (gas bubbling through a liquid medium) is investigated. It is established that the efficiency of removal of carbon tetrachloride out of the plasma and its mixtures with plasma substitutes is determined by the speed of gas bubbling and foam characteristics such as fluid-time foam formation and concentration of foaming agent.


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ISSN 2218-7332 (Print)
ISSN 2658-3348 (Online)