Abstract

Aim: was to study features of the clinical course, instrumental and biochemical parameters of patients with atherosclerotic aneurysmal expansion of the abdominal aorta on the base of retrospective analysis and prospective observation to determine indications for timely surgical correction.

Materials and methods: patients with the maximum diameter of the infra-renal abdominal aorta from 26 to 50mm (n=60) without primary indications for surgical treatment (endovascular abdominal aortic aneurysm repair) were selected for the prospective follow-up group. For the period of 2 years, all patients from prospective group underwent duplex scanning of the abdominal aorta every 6 months and multislice computed tomography (MSCT) of the aorta – once a year. The retrospective analysis included results of preoperative clinical-instrumental and laboratory examination of patients (n=55) who underwent endovascular aneurysm repair (EVAR) of the abdominal aorta with a maximum diameter of the infra-renal abdominal aorta more than 50mm.

Results: when comparing clinical, instrumental and biochemical parameters in patients with abdominal aortic aneurysm (AAA) before surgery and atherosclerotic aneurysmal abdominal aortic expansion of different degrees, not requiring surgical correction at the time of inclusion, it was shown that patients with AAA, statistically significantly differed from patients with AAA in clinical symptoms (pulsation and abdominal pain), burdened heredity, the number of smokers. There were no statistically significant differences in the severity of coronary and peripheral atherosclerosis. When comparing results of ultrasound duplex scanning and MSCT to estimate linear dimensions of the abdominal aorta in the group of patients with aneurysmal dilation and in the group of patients with abdominal aortic aneurysm, the comparability of results has been revealed. Prospective observation of patients with abdominal aortic aneurysmal dilation revealed predictors of disease progression: age less than 65 years, diameter of the upper third of the abdominal aorta more than 23mm, maximum diameter of the abdominal aorta more than 43mm, length of aneurismal dilation more than 52mm.

Conclusion: obtained results allowed to determine most informative indicators and criteria for the progression of atherosclerotic aneurysm expansion of the abdominal aorta, to determine further tactics of treatment, including the need for surgical correction of this pathology.

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Abstract:

Aim: was to assess the accuracy of the diagnosis of malformations of the fetus at early stages of pregnancy

Materials and methods: 26,404 pregnant women who came to the Republican Center for Screening Mothers and Children on a routine basis in terms of 11 to 20 weeks of pregnancy were examined. Among them, 25,956(98,3%) women were pregnant with a physiological course of pregnancy, 269(1,0%) pregnant women with fetal malformations and 179(0,7%) with pathological pregnancy

Prenatal diagnostics included ultrasound, biochemical, invasive and cytogenetic research methods. Initially, a primary ultrasound study of pregnant women was conducted, with the purpose of measuring fetometric, biometric and dopplerometric parameters. In case of deviation of above mentioned parameters from the norm, a second stage-biochemical screening was carried out. When biochemical parameters changed from normative values, the third stage was carried out - invasive and cytogenetic diagnostics.

Results: based on results of studies, all women were divided into 3 groups. The first group included women with a physiological course of pregnancy - 25,956(98,3%). In the second group of patients (n=269) with single fetal malformations, there were 230(85,5%), with multiple - 39 (14,5%). In the third group of women (n=179), in most cases, a non-developing pregnancy was registered - 99(55,31%), females with uterine fetal death were 69(38,5%), with bladder drift - 11 (6,2%).

Conclusions: every pregnant woman should be examined individually, regardless of age. When carrying out prenatal diagnosis of malformations of the fetus, doctors should use a single algorithm for performing an ultrasound examination. Practitioners should not rely on the age of the pregnant woman; regardless of the age of the pregnant woman, to conduct a more detailed examination for fetal malformations, both 35 years of age and older and younger than 35 years. In order to avoid undeveloped pregnancy, and intrauterine fetal death, as well as early detection of fetal malformations, there is a need for screening in the first trimester of pregnancy Inclusion of the first trimester in the screening program in a timely manner will create risk groups for the birth of children with malformations of the fetus, timely resolve the issue of further introduction of pregnancy, thereby reducing obstetric complications, and also reduce maternal and infant mortality.

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Abstract:

Breast cancer is the most frequent malignant disease in women in the Russian Federation. To reduce the mortality from breast cancer, various measures were used, of which mammographic screening proved its effectiveness. In recent decades, the active process of informatization of health care system in the Russian Federation has predetermined the need to introduce various information systems, including in the screening processes. Thus, on the basis of Research Institute of Clinical and Experimental Radiology of the federal state budget institution «National Research Center of Oncology N.N.Blokhin» the Ministry of Health of the Russian Federation it was developed a system SDRR-MS (System Description, Recommendations and Reporting of Mammography Screening), which can be used both in screening and in diagnostic processes. The system focused on educational process and standardization of a routine practice of radiologists and X-ray technicians in the breast examination. The system allows to unite an unlimited number of hospitals, while standardization processes are realized by means of a formalized description protocol, elaborated on the basis of the existing international standard BI-RADS. This article is focused on one of system component, intended for the description of x-ray breast examination. 

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