Aim The aim of this study was to determine the impact of CYP2C19 and ABCB1 gene polymorphisms and CYP3A4 isoenzyme activity on stent implantation complications among patients with an acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). Patients and methods Seventy-six patients (median age 63, range 37–91 years) with an ACS who underwent PCI were screened for CYP2C19 and ABCB1 gene polymorphisms with real-time polymerase chain reaction: CYP2C19*2, CYP2C19*17, and ABCB1 3435. CYP3A4 isoenzyme activity was determined by urine cortisol and 6-beta-hydroxycortisol levels. Stent implantation complications such as stent thrombosis (n=2) and restenosis (n=1) were observed among drug-eluting stent recipients. Results Low mean 6-beta-hydroxycortisol/cortisol ratio is indicative of impaired CYP3A4 activity and was associated with higher risk of thrombosis (b coefficient=0.022, SE 0.009, p=0.021 in the linear regression model). The increase in the length of the implanted stent was associated with higher risk of restenosis (b coefficient=0.006, SE=0.002, p=0.001 in the linear regression model). The presence of the CYP2C19*2 polymorphism did not affect the incidence of stent thrombosis (b coefficient=−1.626, SE=1.449, p=0.262 in the logistic regression model), nor did the CYP2C19*17 (b coefficient=−0.907, SE=1.438, p=0.528 in the logistic regression model) and ABCB1 3435 polymorphisms (b coefficient=1.270, SE=1.442, p=0.378 in the logistic regression model). Conclusion We did not find evidence that the presence of CYP2C19*2, CYP2C19*17, and ABCB1 3435 polymorphisms may jeopardize the safety of stent implantation in patients with an ACS. Patients with low CYP3A4 isoenzyme activity may have increased risk of stent thrombosis.

The purpose of the study is to analyze and systematize main causes of secondary spine deformations forming in patients who had operations due to thoracic and lumbar spine damages. Material and Methods. The analysis of poor surgical results of 155 patients previously operated due to various thoracic and lumbar spine damages has been conducted. All patients had complications associated with secondary spinal column deformations at various time after the intervention. Standard investigation included the analysis of patients' complaints, their previous history, somatic, neurological and orthopedic status. Results. The intensity of spinal column deformation was defined due to the character and level of primary trauma structurally characterized predominantly by unstable damages. However as it has been found in this research the main cause of this complicated pathology lied in the number of tactical and technical pitfalls of primary surgical treatment. Conclusion. Surgical operations due to secondary post-traumatic deformations in most cases are laborious and are accompanied by significant surgical trauma therefore systematization and analysis of the main causes of poor results of primary spine surgery may contribute to the preventive treatment of this type of pathology.
Shulga А.Е., Zaretskov V.V., Ostrovsky V.V., Arsenievich V.B., Smolkin A.A., Norkin I.A. Towards the causes of secondary post-traumatic deformations of thoracic and lumbar spine // Saratov Journal of Medical Scientific Research, Vol. 11, Issue 4, 2015, pp. 570-575

Marjolin’s ulcer is an uncommon malignant condition related to non-healing wounds, more often of burn injuries. Our aim is increase the suspicion index of primary care workers about the risk of squamous cell carcinoma in skin chronic ulcers or scar tissue, mainly in extremities. We report a Marjolin’s ulcer associated with traumatic chronic ulcer in the leg of a 73-year-old white female. Histological diagnosis was poorly differentiated squamous cell carcinoma. The tumor evolved unsuspected on the border of the ulcer in a region of venous insufficiency and lymph edema. In the majority of cases, Marjolin’s ulcer represents a highly aggressive squamous cell carcinoma. Adequate managing of risk factors constitutes the best tool for prevention of this malignancy, diagnosis is challenging, and it can be overlooked or under reported. As late diagnosis favors poor outcome, even single case reports might enhance the suspicion of primary care workers about this preventable condition.
Vitorino Modesto dos Santos, Anna Gabriela Oliveira Camilo, Leonardo Aquino de Souza, Lucas Maciel Rodrigues Monteiro, Christiane Silveira Marinho, Diogo Wagner da Silva de Souza Marjolin’s ulcer: a challenging complication of non-healing wounds // Russian Open Medical Journal, Vol. 4, Issue 3, 2015, pp. 0-0

Objective. The purpose of the study is to analyze the errors, complications and outcomes of the operative treatment of patients with femoral neck fracture in the 1st group with application of wires bundle and fixation in the llizarov frame (64 cases) and in the 2nd group with application of developed monolateral wire- and half-pin device (23 cases). Material and Methods. The observation of 87 patients with fractures of the femoral neck. Operations performed using spokes kit for transosseous osteosynthesis by GA llizarov and develop devices for the treatment of patients with fractures of the proximal femur. Two groups of patients were studied: duration of surgery, duration of osteosynthesis, complications, and outcomes (in terms of one year after the dismantling clips) using the modified scale Luboshyce — Mattis — Schwartzberg. Results. Fracture repair was achieved in 40 patients (62,5%) of the 1st group. The following complications were observed in this group: non-union and pseudarthrosis — in 21 (32,8%) case; aseptic necrosis of the femoral head in 3 (4,7%) cases; hip ankyloses — in one (1,6%) case, breakage and migration of wires into the joint cavity and smaller pelvis — 3 (4,7%) patients and cutting out of wires from the femoral head was observed in 3 (4,7%) cases. Totally 61 complication were revealed. In the second group of the patients non-union was found in one patient (64 years old). Complications were observed in 6 patients of this group — pint-tract infection, moderate secondary displacement of the fragments (the patient fell down on the operated limb) and wire breakage. Conclusion. The efficiency of the femoral neck osteosynthesis with application of elaborated monolateral wire- and half-pin fixator made up 95,7% of the positive outcomes (in osteosynthesis using bunch of wires with llizarov frame fixation the same 60,9% of the positive outcomes).
Allakhverdiev A.S., Soldatov Y.P. Comparative analysis of treatment outcomes in patients with femoral neck fracture using monolateral wire and half-pin fixator of the authors' design and transosseous fixation wires // Saratov Journal of Medical Scientific Research, Vol. 10, Issue 4, 2014, pp. 627-635

The analysis of the treatment results of 319 patients with complicated forms of gastroduodenal ulcer disease has been carried out. The group is formed by the 223 patients over 60 years old and 96 young and middle-aged patients. The description ofpreoperative and postoperative treatmentwith application of the controlled sympathetic medication denervation of the elderly and aged people with complicated forms of gastroduodenal ulcer disease in the preoperative period and the exposure of the abdominal nerve plexus to alternative magnetic field of “Magniter" device have been provided. . The treatment algorithm of elderly and aged people with such pathology has been introduced. The results of the research have revealed reliable decrease in postoperative complications development incidence, postoperative complication development relief, earlier improvement of the clinical, laboratory and instrumental indices in elderly and aged patients with complicated forms of gastroduodenal ulcer disease, and also postoperative mortality decrease and cuts of the patients' stay period in hospital.
V.I. Midlenko, A.V.Smolkina, S.I. Barbashin CURATIVE AND DIAGNOSTIC TACTICS IN COMPLICATED FORMS OF GASTRODUODENAL ULCER DISEASE IN PATIENTS OVER 60 // Saratov Journal of Medical Scientific Research, Vol. 4, Issue 2, 2008, pp. 115-119