Publications by authors named "T Gogokhia"

8 Publications

[TELOMERASE ACTIVITY AS A POTENTIAL BIOMARKER FOR PREOPERATIVE DIFFERENTIAL DIAGNOSIS OF CYSTIC NEOPLASMS OF THE LIVER].

Georgian Med News 2021 Mar(312):31-36

I.M. Sechenov First State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation.

The goal of the study was to find ways to improve the quality of preoperative diagnosis of mucinous cystic liver neoplasms using such tumor markers as CA 19-9 and telomerase activity. We conducted a retrospective analysis and a prospective study that included the results of treatment of 80 patients with cystic neoplasm of the liver (31 with MCNL, 36 with multichamber non-parasitic cysts (NPC), 13 with stage II (WHO classification) echinococcus liver cysts. Our study showed the presence of telomerase activity in 29 (93.5%) patents with MCNL (in case of IMCNL, the TA was high both in the tumor itself and the CNL content).16 patients demonstrated high TA (+++) both in the tumor itself and the CNL content; 11 and 2 patients had moderate (++) and low (+) TA, respectively. 12 (38.7%) patients with MCNL had the CA 19-9 level above 1000 U/L, 14 (45.1%) - above 10,000 U/L, and 3 (9.6%) - above 100,000 U/L, while only 1 (6.5%) patient had the CA 19-9 level <1000 U/L. The analysis of data showed the absence of TA in the CNL content in 33 of 36 patients with NPC. However, three patients demonstrated a low activity of telomerase. CA 19-9 levels were below 1000 U/L in 27 (75%) of 36 patients with NPC. It was established that the determination of TA and the level CA 19-9 in the contents of the CNL is a valuable method, which makes it possible to carry out a preoperative differential diagnosis of CNL with a high probability.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2021

[NON-SURGICAL ASPECTS OF THYROID SURGERY].

Georgian Med News 2021 Mar(312):14-22

1I.M. Sechenov First Moscow State Medical University (Sechenov University), Department of Faculty Surgery N2, Russian Federation.

The level of calcium in the blood serum, voice function, thyroid status and quality of life of patients up to 1 year after removal of the thyroid gland were studied. Thyroidectomy is an operation associated with a high risk of postoperative hypocalcemia with clinical manifestations (19.6%), which is transient in 15.5%, and permanent in 4.1%. After thyroidectomy transient voice disorders are observed that are not associated with paresis of the laryngeal nerves. These voice disorders spontaneously resolve in the period from 2 to 6 months after the operation. The effectiveness and safety of therapy for postoperative hypothyroidism, the correct selection of the dose of L-thyroxine depends not only on the level of TSH, but also on the genetic characteristics of the patient. Pharmacogenetic testing allows predicting the effectiveness of hypothyroidism correction. The quality of life after thyroidectomy is generally worse than after organ-preserving operations. To a large extent, it is determined by hypothyroidism. In the long term, the quality of life after thyroidectomy approaches the estimates of patients after organ-preserving operations. For an adequate assessment of the results of the operation, it is necessary to analyze the results no earlier than 1 year later.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2021

[COMPLEX TREATMENT OF PATIENTS WITH VENOUS TROPHIC ULCER IN THE CONDITIONS OF COVID-19 HOSPITAL].

Georgian Med News 2021 Mar(312):7-14

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of the Russian Federation.

The aim of the study was to study the effectiveness of complex treatment of decompensated chronic venous insufficiency (CVI) using innovative techniques and proteolysis inhibitors with a wide spectrum of activity in patients with SARS-CoV-2 (COVID-19) in COVID hospital. This study was performed in the surgical department of COVID hospital on the basis of the Clinical Hospital No. 4 of the First Moscow State Medical University named I.M. Sechenov (Sechenov University). During the period from April 2020 to February 2021, 32 patients with confirmed SARS-CoV-2 (COVID-19) and the presence of venous trophic ulcers (VTU) of the lower extremities were treated. All patients underwent complex therapy for viral pneumonia in accordance with the order of the Ministry of Health of the Russian Federation. The protease inhibitor Aprotinin (Gordox ™) was used to improve microcirculation and prevent the development of a "cytokine storm". To accelerate the cleansing and epithelialization of venous trophic ulcers, the surface of the trophic ulcer was treated with an air plasma flow of NO and injections into the trophic ulcer of autoplasma. Against the background of complex treatment, all patients showed positive dynamics of the clinical picture: relief of hyperthermia, increase or stabilization of SpO2 values from 95% and above, significant decrease in CRP, LDH, D-dimer indices, increase in the number of lymphocytes, decrease in the VTU area by 1.5 times, active granulation and marginal epithelialization of the ulcer. In 14 patients (43.8%), complete epithelialization of the VTU defect was noted by the end of the third week. According to the CIVIQ-20 questionnaire, all 32 patients participating in the study showed positive dynamics. There were no lethal outcomes. Multicomponent therapy of decompensated forms of CVI of the lower extremities in the COVID hospital in patients with moderate severity of coronavirus infection with the use of proteolysis inhibitors leads to a rapid relief of symptoms of intoxication, prevents the progression of lung tissue and parenchymal organ damage and contributes to the positive dynamics of healing of ulcerative defects in the vast majority of patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2021

[SUBACUTE THYROIDITIS AND COVID-19 (REVIEW)].

Georgian Med News 2021 Feb(311):98-103

2I.M. Sechenov First Moscow State Medical University (Sechenov University), Russian Federation, Department of Faculty Surgery N2, Russian Federation.

The COVID-19 pandemia has shown that there is not enough knowledge today to fully control it. Along with severe respiratory syndrome, attention has recently been paid to extrapulmonary lesions, including endocrinopathies. The aim of the study was to summarize the current literature data about the effects of the SARS-CoV-2 coronavirus on the thyroid gland. One of the most striking manifestations of viral aggression is de Quervain's subacute thyroiditis. The analysis of works from the most authoritative international abstract bibliographic databases was carried out using methods of analysis and processing of scientific resources. Based on the analysis, it was concluded that subacute thyroiditis can be both a clinical manifestation and a complication of COVID-19. The SARS-CoV-2 coronavirus can also trigger other thyroid diseases. The causes of subacute thyroiditis are considered to be the direct effect of the SARS-CoV-2 coronavirus on thyroid cells due to the use of ACE2 receptors, the subsequent inflammatory reaction and apoptosis, as well as central hypothalamus-pituitary mechanisms. The clinical variants of subacute thyroiditis in COVID-19 are diverse and have not been fully evaluated. In this regard, it can be concluded that the true incidence of subacute thyroiditis in COVID-19 is much greater, since it is masked by severe lesions of other organs.
View Article and Find Full Text PDF

Download full-text PDF

Source
February 2021

[EXPERIENCE OF TREATMENT OF THE SEPTIC PHLEGMONS OF THE LOWER LIMBS AFTER THE COMBINED PHLEBECTOMY].

Georgian Med News 2020 Feb(299):7-12

First Moscow State Medical University. I.M. Sechenov (Sechenov's University), Department of Faculty Surgery No. 2, Russia.

The aim of the study - to identify the causes and develop methods of treatment and prevention of septic phlegmons of the lower extremities after combined phlebectomy. The article presents the experience of treating 6 patients between the ages of 21 and 69 years with severe pyo-inflammatory complications (septic phlegmons) of the lower extremities after combined phlebectomy between 2012 and 2019. All patients had signs of a expressed systemic inflammatory response (SIRS3 and SIRS4) when they received admission. Against the background of intensive detoxification therapy in intensive care department, all patients were operated on emergency indications. Under anesthesia, they were performed an opening the subcutaneous phlegmons of the lower extremities using wide stripes incisions. Comprehensive therapy included the prescribing of antibiotics, anti-inflammatory drugs, stage necrectomy, the treatment of purulent wounds with various variants of surgical energy (plasma flows and NO-therapy) in various modes. The results of the treatment were estimated in the near and distant periods. Timely diagnosis, surgical treatment with the opening of purulent cavities with a wide excision of necrotized subcutaneous fat and fascia, as well as the subsequent plasmadynamic stage wound purification in therapeutic mode allowed in all cases to stop systemic inflammatory syndrome, to achieve rapid cleansing and healing of wounds. All patients were discharged for outpatient treatment. There were no fatalities. The long-term results of treatment were found to be satisfactory, and no patients were found to be disabled. The careful compliance to the main stages of the combined phlebectomy, especially the quality control of postoperative hemostasis, can minimize the development of septic complications. The comprehensive treatment with active surgical tactics and the use of air-plasma technologies allow to achieve a rapid cleansing of wounds and a speedy recovery of patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
February 2020