Handbook of the author of the medical dissertation

Наркевич, А.Н.; Narkevich, A.N.; Виноградов, К. А.

doi:10.12737/textbook_5c0e0e5ef38722.83710895

Cited by 5 publications

(4 citation statements)

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“…Статистический анализ проводили с использованием программ StatTech 3.1.8 (ООО «Статтех», Россия) и Jamovi 1.6 2021 (Jamovi project, Австралия). Расчет 95 % ДИ медиан и их разницы для независимых выборок выполняли с использованием программного обеспечения «Довинт 1.0» (Россия) [24].…”

Section: статистический анализunclassified

Blood flow redistribution in the fetal umbilical-portal venous system in pregnancy complicated by diabetes mellitus

Kopteeva,

Shelaeva,

Alekseenkova

et al. 2024

Journal of obstetrics and women's diseases

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BACKGROUND: The fetal liver plays a central role in energy metabolism and is supplied mainly by the vessels of the umbilical-portal venous system. Redistribution of blood flow in this system is a key adaptive response of the fetus to environmental change. AIM: The aim of this study was to evaluate the hemodynamic redistribution in the fetal umbilical-portal venous system in pregnant women with pregestational diabetes mellitus, gestational diabetes mellitus and in healthy pregnant women. MATERIALS AND METHODS: This prospective cohort single-center study was conducted at the Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott, Saint Petersburg between February 2022 and September 2023. The study included 188 patients who made up the following comparison groups: pregestational diabetes mellitus (n = 86), gestational diabetes mellitus (n = 44), and control (n = 58). Patients underwent ultrasound from 30+0 to 41+3 weeks with assessment of venous hemodynamics in the vessels of the umbilical-portal venous system such as the umbilical vein, left portal vein, right portal vein, main portal vein, and ductus venosus. RESULTS: The umbilical vein volumetric blood flow in the I group exceeded that in the II group by 23.60 ml/min/kg and that in the control group by 30.35 ml/min/kg (p 0.001). The total liver volumetric blood flow in patients with pregestational diabetes mellitus (106.85 ml/min/kg) also exceeded that in the gestational diabetes mellitus group by 28.04 ml/min/kg and that in the control group by 33.73 ml/min/kg (p 0.001). The umbilical vein and total fetal liver blood flows increased to full-term pregnancy, but, when normalized by the estimated fetal weight, the both flows showed a downward trend at 37–41 weeks of gestation (p 0.001). No significant differences were revealed in the ductus venosus volumetric blood flow in the study groups. However, there was a significant decrease in the ductus venosus shunt fraction in patients with pregestational diabetes mellitus (16.83 %) by −8.34 % compared to the control group (24.56 %) and by −5.65 % compared to the II group (22.89 %). The downward trend persisted throughout the third trimester of pregnancy and reached its maximum at full-term (p 0.001). CONCLUSIONS: With pregestational diabetes mellitus, there is a priority redistribution of highly oxygenated blood from the umbilical vein to the right lobe of the fetal liver, accompanied by a decrease in the ductus venosus shunt fraction. This may underlie the pathogenesis of such complications as fetal macrosomia and diabetic fetopathy.

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Section: статистический анализunclassified

Blood flow redistribution in the fetal umbilical-portal venous system in pregnancy complicated by diabetes mellitus

Kopteeva,

Shelaeva,

Alekseenkova

et al. 2024

Journal of obstetrics and women's diseases

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“…Поскольку достаточный объем предварительных данных по исследуемой проблеме отсутствовал, минимальный объем выборки рассчитывался в соответствии с методом К.А. Отдельновой [20]. В качестве критического уровня статистической значимости было выбрано значение p<0,05.…”

Section: определение объема выборкиunclassified

Serum biomarkers associated with liver fibrosis in patients with type 2 diabetes

Krasner,

Romanov,

Fazullina

et al. 2024

Diabetes mellitus

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BACKGROUND: The diagnosis of liver fibrosis is an important task in the management of patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes. The currently used diagnostic methods have a number of disadvantages such as invasiveness and high cost, or insufficient sensitivity and specificity. Therefore, the search for new non-invasive markers of liver fibrosis remains an actual challenge.AIM: To assess a diagnostic value of serum growth differentiation factor-15 (GDF-15), microfibril-associated glycoprotein 4 (MFAP-4), collagen type IV alpha1 (COL4alpha1), Mac-2 binding protein (M2BPGI) and chitinase-3-like protein 1 (YKL-40) as markers of liver fibrosis in patients with type 2 diabetes and NAFLD.MATERIALS AND METHODS: A single center cross-sectional observational study was performed. The study included 74 patients, 23 men and 51 women, aged 18 to 74 years. Liver elastography was used as reference method for the fibrosis evaluation. APRI and fib-4, non-invasive fibrosis indices, were assessed. Serum concentrations of GDF-15, MFAP-4, COL4alpha1, M2BPGI, and YKL-40 were determined by ELISA. ROC analysis was used to evaluate the sensitivity and specificity of serum markers for the diagnosis of the liver fibrosis.RESULTS: Liver fibrosis stage 1 was verified in 16 subjects, stage 2 in 12, stage 3 in 7, and stage 4 in 19. Patients with advanced liver fibrosis (stages 3–4), compared with those without severe fibrosis (stages 0–2), had higher levels of GDF-15 (p=0.003), COL4alpha1 (p=0.007), and YKL-40 (p=0.04). Patients with stage 1-2 liver fibrosis had higher levels of COL4alpha compared to those without any signs of fibrosis (p=0.02). There were no significant differences in the level of MFAP-4 and M2BPGI between patients with different severity of fibrosis. According to the ROC analysis, GDF-15, COL4alpha1 and YKL-40 have diagnostic value in the detection of severe liver fibrosis comparable to that of the APRI and fib-4 indices.CONCLUSION: GDF-15, COL4alpha1 and YKL-40 could be considered as promising non-invasive markers of liver fibrosis in patients with type 2 diabetes and NAFLD.

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“…Минимальное количество наблюдений, достаточное для получения информации со значимостью 0,05, было определено по таблице К.А. Отдельновой [7] Взаимосвязь синдрома усталости и пола В нашем исследовании лица мужского пола составили 40%, женского -60%. При оценке зависимости суммарного балла по опроснику FAS от пола статистически значимых различий установлено не было (p = 0,965) (рис.…”

Section: материалы и методыunclassified

Fatigue syndrome after COVID-19 infection: results of personal observations

Kolesnikov,

Vizel,

Abashev

et al. 2024

Medicinskij sovet

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Introduction. The novel coronavirus disease (COVID-19) pandemic has presented challenges for health systems globally. However, as the number of COVID-19 survivors continue to increase, we get more and more evidence on the long-lasting symptoms after an acute infection. According to some studies, the total number of symptoms described can reach 200, but fatigue is considered the key presentation in such patients. The subjectivity of fatigue concept continues to be a significant obstacle to its study: the absence of validated assessment methods does not allow to adequately assess the prevalence and significance of fatigue in patients with lung injury induced by COVID-19.Aim. To assess the prevalence of fatigue syndrome in patients with lung injury induced by COVID-19 using a validated tool, the Fatigue Assessment Scale, and risk factors for the development of this condition.Materials and methods. Medical records of patients hospitalised for PCR-confirmed new coronavirus infection COVID-19 with lung lesions (n = 100), evaluated using the FAS scale, were retrospectively analysed. Statistical processing of the data was performed.Results. Objectively assessed fatigue was detected in 66% of patients. Statistically significant association between fatigue syndrome and obesity, severity of acute phase of infection, presence of comorbidities, Charlson comorbidity index was revealed.Conclusions. The use of objectification methods makes it possible to assess the prevalence and significance of fatigue syndrome in patients with COVID-19-induced lung lesions, to perform statistical analysis of possible risk factors for the development of this condition.

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Handbook of the author of the medical dissertation

Cited by 5 publications

References 0 publications

Blood flow redistribution in the fetal umbilical-portal venous system in pregnancy complicated by diabetes mellitus

Blood flow redistribution in the fetal umbilical-portal venous system in pregnancy complicated by diabetes mellitus

Serum biomarkers associated with liver fibrosis in patients with type 2 diabetes

Fatigue syndrome after COVID-19 infection: results of personal observations

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