OPERATION BENTALL DE BONO AGAINST THE BACKGROUND OF BILATERAL POLYSEGMENTAL VIRAL PNEUMONIA (COVID-19) CASE FROM PRACTICE
S. Ahmed, I.Kh. Bebezov, M.K. Dzhundubaev, A.A. Rakimbaev, A.K. Turgunov, D.B. Toktosunova, I.A. Akhmedova, R.S. Kalieva, E.D. Seytakhunova
Coronavirus-2 Severe Acute Respiratory Syndrome (SARS-CoV-2) was first described in early December 2019 and has rapidly spread globally, causing significant disruptions in the provision of healthcare services in many countries. The volume of cardiac surgery has also undergone significant changes due to the redistribution of bed resources. Although the measures applied have been beneficial for the treatment of patients with coronavirus infection (COVID-19), the implications of postponing cardiac surgery for patients with cardiovascular disease need to be considered. It can be assumed that these patients will have progression of the underlying disease, which will lead to an increase in the number of patients in need of emergency cardiac surgery. The article describes a case of emergency surgery in a patient with dissecting aneurysm of the aortic root on the background of bilateral polysegmental viral pneumonia (COVID-19).
Key words: Covid-19, viral pneumonia, aortic aneurysm, multislice computed tomography (MSCT).
ASPECTS OF THE INFLUENCE OF CAVITATION PHENOMENA OF ULTRASONIC WAVES ON BIOLOGICAL OBJECTS AT DIFFERENT LEVELS OF TISSUE ORGANIZATION (LITERATURE REVIEW)
H.Z. Ahmedov, B.I. Nurdinov, A.V. Lysenko, A.T. Alymkulov
Ultrasound is the most common diagnostic technique for many diseases with morphological substrates and pathological processes. Lack of control over the activities of ultrasound rooms, lack of knowledge about the physical properties of sound waves by the personnel, is a support for the development of remote consequences from a complex of factors associated with an ultrasound wave.
The article reflects the literature data and the likely influence of the effect of cavitation bubbles on the structural components of tissue cells. The blame is given to oncological processes and possible indirect effects on them.
Key words: cavitation, ultrasound, oncology, side effects.
CHARACTERISTICS OF OPPORTUNISTIC INFECTIONS IN THE BLOOD OF PREGNANT WOMEN AND NEWBORNS
G.U. Asymbekova, A.O. Atykanov, O.Zh. Uzakov, Ya.V. Ten
The article presents data from a survey of 166 pregnant women and 67 newborns at the "Clinic of Professor G.U. Asymbekova" for the period 2019-2020, for the presence of opportunistic infections in the blood serum. 1340 studies were carried out to determine rubella, toxoplasma, cytomegalovirus (CMV), herpes simplex virus (HSV) types 1 and 2, chlamydia - trachomatis, mycoplasma - hominis, ureaplasma - urealyticum, trichomonas - vaginalis by enzyme immunoassay (ELISA) (enzyme immunoassay) Ig) of class G, M, A by diagnostic test systems of "VEKTOR" company (Russia).
It was found that in pregnant women, infection occurred before pregnancy, and during pregnancy, there was no acute phase of infection. Positive titers of IgG antibodies and the absence of IgM antibodies in newborn babies indicate the transmission of IgG antibodies during pregnancy from the mother, as well as the absence of acute infection.
Keywords: Pregnant women, newborn children, opportunistic infections, immunoglobulins, antibodies.
ESTIMATION OF MORTALITY FROM BREAST CANCER IN KYRGYZSTAN
A.L. Chokoev, N.S. Igisinov
According to the International Agency for Research on Cancer, about 3 million new cases of breast cancer (BC) are predicted in 2040, while it is expected that about 1 million women will die from this pathology.
Purpose of the research: to estimate mortality rates from breast cancer (BC) in Kyrgyz Republic (KR) for 2003-2017.
Material and research methods. The material was the data of the National Statistical Committee of the Kyrgyz Republic concerning deaths from breast cancer (ICD 10 - C50). The main method used was a retrospective study (2003-2017) using descriptive and analytical methods of biomedical statistics.
Results and discussion. From 2003-2017 3 502 death cases of BC were registered in KR and the average age of the dead is 58,7±0,4 (95% ДИ=58,0-59,4). The average annual mortality rate from BC was 8,4±0,20/0000 (95% ДИ=8,0-8,8) and the standardized indicator – 11,0±0,40/0000 (95% ДИ=10,3-11,7), and their trends were decreasing Тdecline=−0,7% и Тdecline=−1,9%. Age-specific mortality rates indicate unimodal growth, with a peak in the older age group – 70 years and elder – 50,5±2,40/0000 (95% ДИ=45,9-55,2). Age trends were different.
Conclusions. The results of the analysis of mortality rates must be taken into account for monitoring and evaluating anti-cancer measures in the republic.
Keywords: breast cancer, mortality, trends, Kyrgyzstan.
IMMUNOLOGICAL ASPECTS OF CYTOMEGALOVIRAL INFECTIONS AFTER PEDIATRIC LIVER TRANSPLANTATION
N.Zh. Erimova, Sh.K. Batyrkhanov, B.K. Shirtaev, B.B. Baimakhanov, A.T. Chormanov, S.D. Akilbekov, A.G. Akhbetova
The article reflects the role of antiviral prophylaxis with valganciclovir or ganciclovir after pediatric liver transplantation. The study was conducted on the basis of data from thirty operations, in children from 6 months to 8 years. All patients of our center with cytomegalovirus infection (CMV) received antiviral therapy for a month. In patients with active CMV, the viral load was reduced. Six months later, the quantitative polymerase chain reaction (PCR) for CMV became negative in all patients. After nine (9) months, viral load increased in 1 (3.3%) patient with inactive CMV. After 12 (twelve) months, viremia was diagnosed in 6 (20%) patients and they were prescribed antiviral therapy for 3-6 months with valganciclovir. A decrease in the total number of T-lymphocytes and T-helpers was noted against the background of phylactic suppressive therapy and viremia (8 patients).
Purpose : The purpose of this work is to assess the role of CMV infection in transplant immunology in children and the effect of CMV on the outcome of liver transplantation.
Materials and methods .
Place of research: JSC “NSCH named after A.N. Syzganov”.
Subject of research: Pediatric patients with liver cirrhosis.
Study duration: from March 2016 to the present day.
Study design: Randomized controlled trial.
Research protocol: Since March 2016, 30 (30) surgical operations for liver transplantation have been performed in children using materials taken from living donor relatives. Patient age: from 6 months to 8 years, of which: 23 (76.6%) patients - biliary atresia; 2 (6.9%) patients - liver cirrhosis as a result of autoimmune hepatitis; 1 (3.3%) patient - primary hyperoxaluria; 1 (3.3%) patient - cholangiocarcinoma; 1 (3.3%) patient - inoperable hepatoblastoma; 1 (3.3%) Liver cirrhosis in the outcome of viral hepatitis "C" against the background of histiocytosis of Langerhans cells. The number of female newborns - 17 (56.7%) patients, male babies - 13 (43.3%) patients.
All patients with positive quantitative PCR before surgery took cytomegalovirus immunoglobulin for 3-5 days. The left lateral sector was transplanted to 23 (76.6%) patients with biliary atresia from their CMV seropositive relative (D + / R +) and 4 (23.3%) patients from their CMV seronegative donors (D - / R +).
Clinical laboratory and instrumental research methods: In order to assess the immunological status of children, the results of immunograms, hemograms with leukoformula were used. By electrochemiluminescent immunoassay from venous and capillary blood, IgM, IgG antibodies, and the avidity of antibodies to cytomegalovirus were determined.
Methods stat. Analysis: Statistical processing of digital values was carried out using standard methods of statistical analysis used in biomedical research, using a software package for personal computers: Microsoft Office Excel, StatisticaStatSoft. All pediatric liver transplants from March 2016 to the present day have been counted.
Ethical issues: The study was conducted in accordance with the current version of the Declaration of Helsinki, in accordance with the Standard of Good Clinical Practice (GCP) (Appendix 2 to the order of the Acting Minister of Health of the Republic of Kazakhstan dated February 4, 2021 No. ҚР DSM-15) .
Results. The total number of seropositive donors (D + / R +) is 26 (86.6%). The total number of seronegative donors (D- / R +) is 4 (13.4%). One concurrent liver and kidney transplant was performed in one infant patient. All patients with biliary atresia had CMV infection (CMVI). Eight (8) patients had active disease. Follow-up period: 14 days - 3 years after liver transplantation.
Key words: liver transplantation, cytomegalovirus infection, pediatric transplantation.
TRENDS IN THE INCIDENCE AND MORTALITY OF CERVICAL CANCER IN THE KYRGYZ REPUBLIC
S.A. Vaninov, S.M. Akhunbaev, D.D. Ibraimova, N.M. Nasirova, O.A. Bolbachan
Cervical cancer is one of the most important medical and social problems that cause enormous social and economic damage to society. The activities of medical institutions providing cancer care should be aimed at cancer prevention, timely detection, and treatment of cancer patients. The study used statistical data from the Health care Center, the National Center for Oncology and Hematology of the Kyrgyz Republic from 2012 to 2017. The study was conducted using a systematic approach, which consists of assessing the dynamics of the prevalence, structure, and dynamics of mortality from cervical cancer by age and region of the Kyrgyz Republic. The object of the study was women with a diagnosis of cervical cancer. The subject of study: appealability, the prevalence of incidence and mortality in women with this disease. Research method: statistical (intensive, extensive indicator, credibility, time series indicators, reliability criterion).
In the Kyrgyz Republic, there has been a significant increase in the prevalence of incidence from 97.5 ± 1.8 in 2012 to 105.3 ± 1.8 in 2017, p <0.001. Most often, patients of the I-II stage are found in all regions of the republic. The main age groups with a high proportion of cervical cancer were patients from 35 to 65 years of age and older. Also, there were patients from 20 to 35 years of age. Single cases were also observed at 0-6 years of age in 2013 and 7-14 years of age in 2017. Chui, Osh, and Jalal-Abad regions, as well as Bishkek, are regions with a high proportion of patients with cervical cancer.
The tendency of a sharp increase in mortality from cervical cancer was observed in fairly young age groups (25-29, 30-34, 40-44 years of age). It should be noted that the growth rate of the mortality rate prevailed in 2013, 2015. One case of mortality at the age of 0-4 years was detected in 2014.
To identify trends in women's health, identify the importance of cervical cancer and causes of mortality, the negative impact of the disease, premature deaths on society, the indicator of lost years of potential life, and economic losses are calculated. In the republic in 2017, the years of potential life lost amounted to 13.47 years in total, the economic losses from premature mortality from cervical cancer amounted to 940.2 million soms.
Thus, the leading place in the structure of oncological incidence and mortality in women takes cervical cancer, while providing significant economic damage.
Keywords: incidence, malignant neoplasms, mortality, prevalence, cervical cancer, years of potential life lost, economic damage.
OPHTHALMOLOGIC EXAMINATION AND STUDY OF VISUAL CONSEQUENCES IN CHILDREN WITH PRIMARY BRAIN TUMORS
K.B. Yrysov, B.A. Beknazarova, Alik kyzy E., N.A. Mamaziyaeva
Purpose of the work: To study the visual consequences of children with primary brain tumors who were sent for ophthalmological examination without a standard protocol.
Material and Methods: Medical records of all children (0-18 years old) with primary brain tumors were analyzed. In our institution, all children referred for ophthalmological examination were examined by pediatricians and / or neuro-ophthalmologists. For each patient, the following clinical data were collected: age at the time of tumor diagnosis, gender, pathologic diagnosis, major problems at initial presentation (including visual problems), tumor location, classification of surgical resection, treatment methods, and survival.
Humphrey visual field testing, optical coherence tomography (OCT) of the retinal nerve fiber layer (RNFL), and fundus color photographs were obtained from collaborating patients.
Results. A total of 141 patients (73 [52%] men; mean age [range 0-18] years) with primary brain tumors were included. There were 100 people who were recently diagnosed and 41 people who were examined for follow-up examination (brain tumor was diagnosed before enrollment in the study). The most common type of tumor was glioma, while other types of tumors (eg, ependymoma and atypical teratoid rhabdoid tumors) were less common. There were more patients with tumors of the parenchyma and fewer with tumors of the optic nerve and chiasm.
A decrease in visual acuity was observed in 37 patients (54%) in 1 or both eyes, of which 26 out of 68 (38%) had progressed amblyopia. Causes included deprivation (ptosis, keratopathy, and / or cataract) in 15 patients (58%), strabismus in 11 patients (42%), and refractive errors in 11 patients (42%). Exposure keratopathy due to palsy of the seventh cranial nerve was found in 10 patients (15%), of which 3 (30%) required aggressive treatment (tarsorrhaphy or corneal transplant).
Conclusion. The time has come for an interdisciplinary, integrated approach to the diagnosis and treatment of visual impairment in children with brain tumors. Given the significant advances in technology, OCT analysis of the retinal nerve fiber layer and ganglion cell complex in children under 3 years of age usually complements a thorough pediatric and / or neuro-ophthalmic assessment.
Key words : primary brain tumors, ophthalmological examination, decreased visual acuity, visual fields.