HERALD of North-Western State Medical University named after I.I. Mechnikov
type: channel
description: ISSN (print): 2618-7116, ISSN (online): 2618-9704 Founders: Eco-Vector LLC, I.I. Mechnikov North-Western State Medical University Editor-in-Chief: Mazurov Vadim Ivanovich, Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor Frequency / Access: 4 issues per year / Subscription Included in: White List (4th level), Higher Attestation Commission List, RISC
publisher: Eco-Vector
language: ru-RU
publication name: HERALD of North-Western State Medical University named after I.I. Mechnikov
issn: 2618-7116
copyright: Authors who publish with this journal agree to the following terms: Authors retain copyright and grant the journal exclusive license to first publication. Authors are able to distribute the manuscript and/or the article in accordance with Self-Archiving policy of the journal (see details). The manuscript can be accepted for publication only by decision of the Editor-in-Chief and the Editorial board of the journal in accordance with the Manuscript stelection policy of the journal (see details). Published Article will be distributed in print and electronic version an will be available under subscription with Delayed Open Access or in Immediate Open Access under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). The access model depends on the publisher's decision or is determined by a separate Open Access publishing agreement with the authors. An exclusive license for publication granted by authors allows the publisher to use the article in the following ways: Reproduction of the Article or its sections or parts, as well as the metadata of the Article in any languages, in any material form, including on paper and electronic media, as a separate work in the journal and/or databases (local or in the Internet) of the publisher and/or other persons, at the discretion of the publisher; Distribution of the Article or its sections or parts, as well as the metadata of the Article in any languages, on any medium as part of the journal and/or databases of the publisher or other persons, at the discretion of the publisher, or as an independent work around the world whether on Open-Access terms or for a fee without remuneration to the Author; Making the Article or any of its sections or parts, as well as the Article’s metadata in any languages, publicly available in such a way that any person can access the Article from any place, including via the Internet, and at any time of their own choosing; Granting permission/s for the…
items: Role of myocardial bridges in arterial remodeling and atherosclerosis development
items: Cardiotoxicity and cardiac arrhythmias in cancer therapy: a review of current evidence
items: Cardio-rheumatology: present and future. Part II
items: Diagnosis and management of cerebral venous and sinus thrombosis in patients recovering from COVID-19
items: Cognitive status and anxiety levels in female patients during the preoperative period
items: The importance of gas chromatography-mass spectrometry steroid profiling in selecting surgical strategy for large adrenal tumors
items: Effectiveness of caries prevention in patients with high mineralization level of permanent teeth
items: Functional changes in the spine as predictors of comorbidities in patients with ankylosing spondylitis
items: Biofilm-forming activity of Enterococcus faecalis on basic materials of removable dental prosthetic bases
items: Analysis of genetic polymorphism associations with cardiometabolic risk factors and phenotypic age in individuals without significant pathology
items: Successful treatment of victims with closed abdominal trauma with damage to the duodenum (clinical observations)
items: Metachronous development of Hodgkin’s lymphoma and nodal marginal zone lymphoma in a patient with Sjögren’s syndrome: a case report

Role of myocardial bridges in arterial remodeling and atherosclerosis development
type: item
description: Myocardial bridges represent segments of coronary arteries partially covered by myocardial muscle fibers. Although myocardial bridges were previously thought to be rare, recent studies indicate an increase in their prevalence, which has been associated with acute coronary syndromes, arrhythmias, myocardial infarction, and even sudden cardiac death. Some authors suggest that myocardial bridges may contribute to the formation of atherosclerotic plaques in the proximal part of the coronary arteries. Autopsy findings also demonstrate increased atherosclerotic plaque formation at sites of arterial obliteration, suggesting a shared pathogenic mechanism in the intima-media layer. This review summarizes current knowledge regarding the role of myocardial bridges in vascular remodeling and atherosclerosis progression, while identifying gaps requiring further investigation. The authors conducted a search of publications in the electronic databases PubMed, Google Scholar, and eLibrary using the following keywords: “atherosclerosis and myocardial bridges”, “myocardial bridges and cardiovascular diseases”, “pathophysiology of myocardial bridges”, “visualization of the cardiovascular system”, “myocardial bridges”. All works published between 1951 and 2024 were included. The obstructive mechanism involves compression of the intramural segment of the coronary artery by myocardial tissue during systole. Hemodynamic conditions created by myocardial bridges typically feature elevated wall shear stress due to the narrowing of the arterial lumen during systole, thereby minimizing plaque formation within the bridge itself. However, proximal to the myocardial bridges, wall shear stress decreases, creating favorable conditions for atherosclerotic plaque development. Myocardial bridges influence the thickness of the intima and the area of the arterial lumen, as well as the segments located proximally and distally. The location, thickness, and length of myocardial bridges directly affect the …
creator: Artem A. Shakhariants
creator: Zarina N. Guileva
creator: Bai-Ali M. Murtazov
creator: Aminat S. Tukhigova
creator: Aminat S. Rasueva
creator: Isa S. Kurbanov
creator: Gapur Z. Bokov
creator: Velena V. Zagidullina
creator: Arina R. Krotova
creator: Ekaterina V. Litvinova
creator: Sataney A. Sizhazheva
creator: Khutmat Kh. Musaeva
creator: Ilnara I. Garipova
creator: Anastasiia A. Dzhabarova
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 5
ending page: 16
doi: 10.17816/mechnikov646478

Cardiotoxicity and cardiac arrhythmias in cancer therapy: a review of current evidence
type: item
description: Cardiac arrhythmias are among the most frequent and clinically significant manifestations of anticancer therapy-induced cardiotoxicity. Despite substantial progress in oncology and the increasing availability of targeted and immunological treatments, the incidence of cardiovascular complications, including rhythm disturbances, continues to rise. This article provides a comprehensive review of current evidence on the association between various types of anticancer therapies — including traditional cytotoxic chemotherapy, targeted therapies, immune checkpoint inhibitors, Chimeric antigen receptor T-cell therapy, and Bispecific T-cell engager therapy — and the development of arrhythmias. Special attention is given to pathophysiological mechanisms, including direct cardiomyocyte toxicity, electrophysiological disturbances due to ion channel blockade, ischemic myocardial injury, and inflammatory changes. The review outlines the clinical manifestations of common arrhythmias such as atrial fibrillation, ventricular tachycardia and atrioventricular block caused by different classes of anticancer drugs. Additionally, it discusses modern approaches to the diagnosis, screening, and prevention of arrhythmic complications in patients with cancer. A key emphasis is placed on the importance of a multidisciplinary approach involving close collaboration among cardiologists, oncologists, and clinical pharmacists to optimize treatment safety and efficacy while preventing potentially life-threatening conditions. Finally, the article highlights the need for further research into molecular mechanisms and the development of standardized monitoring algorithms in patients undergoing anticancer therapy, including the application of digital health technologies and artificial intelligence.
creator: Valeria A. Kolomyitseva
creator: Liana A. Zaripova
creator: Darina A. Bazhina
creator: Aiganat P. Aidemirova
creator: Murat S. Gumerov
creator: Maryam A. Uyanaeva
creator: Pavel N. Furs
creator: Venera M. Gadeeva
creator: Timur A. Salyakhov
creator: Liana R. Gazislamova
creator: Artem V. Vasilyev
creator: Diana A. Koksheneva
creator: Tagir R. Osmanov
creator: Victoria V. Fedorenko
creator: Askar R. Gareev
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 17
ending page: 30
doi: 10.17816/mechnikov677295

Cardio-rheumatology: present and future. Part II
type: item
description: Patients with rheumatic diseases exhibit a markedly increased risk of developing and accelerating cardiovascular pathology, which is largely attributed to the significant role of chronic inflammation as one of the etiological factors in both atherogenesis and heart failure. Achieving sustained clinical and laboratory remission of the Immune-mediated inflammatory disease has been shown to reduce the risk of cardiovascular complications. Given the direct association between persistent inflammation and a wide range of comorbid conditions, this factor must be carefully considered when planning and implementing rational pharmacotherapy in multimorbid patients. It is well established that pharmacological agents used in rheumatology exert diverse effects on the cardiovascular system. Over the past decade, growing research interest has been directed toward the potential application of anti-inflammatory agents with different mechanisms of action for both the prevention and treatment of atherosclerosis and ischemic heart disease. Particular attention has been paid to the modulation of the “NLRP3 inflammasome – interleukin-1 – interleukin-6 – C-reactive protein” signaling pathway. According to several studies, inhibition of this cascade may contribute to reduced likelihood of cardiovascular events. This review summarizes current data on the effects of various classes of antirheumatic drugs on the cardiovascular system, including both their beneficial and adverse effects.
creator: Yi Ma
creator: Zhuo Wang
creator: Vadim I. Mazurov
creator: Evgeniy A. Trofimov
creator: Roman A. Bashkinov
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 31
ending page: 42
doi: 10.17816/mechnikov637317

Diagnosis and management of cerebral venous and sinus thrombosis in patients recovering from COVID-19
type: item
description: BACKGROUND: Cerebral venous thrombosis is a multifactorial and difficult-to-diagnose disease, complicated by venous stroke, intracerebral hemorrhage, progressive cerebral edema, dislocation syndrome, and even death. The broad variability of clinical symptoms and lack of pathognomonic manifestations complicate timely diagnosis of cerebral venous thrombosis. AIM: To identify significant risk factors for cerebral venous thrombosis and to evaluate the dynamics of neuroimaging findings at 1, 3, and 6 months after cerebral venous thrombosis onset in young and middle-aged patients with a history of COVID-19, comparing outcomes between those treated with direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs). METHODS: Young and middle-aged patients with a history of novel coronavirus infection (COVID-19) were examined and divided into two groups depending on the presence or absence of cerebral venous thrombosis. The main risk factors, structural features of the major arteries and cerebral venous sinuses, as well as the course of cerebral venous and sinus thrombosis during anticoagulant therapy (with direct oral anticoagulants and vitamin K antagonists) at 1, 3, and 6 months after the development of cerebral venous thrombosis were analyzed. RESULTS: We examined 120 young and middle-aged patients with COVID-19 divided into 2 groups: Group I – 70 patients who developed cerebral venous thrombosis during COVID-19 – 21 (30%) men and 49 (70%) women; Group II – 50 patients who had COVID-19 without cerebral venous thrombosis development – 27 (54%) men and 23 (46%) women. The main risk factor for developing cerebral venous thrombosis among women in the first group (with cerebral venous thrombosis during COVID-19) compared to the second group (patients who had COVID-19 without developing cerebral venous thrombosis) was the use of combined oral contraceptives: 22.9% and 4.0%, respectively (р = 0.001). Among group I patients, 32 (45.7%) cases of cerebral venous thrombosis w…
creator: Elena G. Klocheva
creator: Farahnoz Z. Olimova
creator: Mariya Viktorova Zhukova
creator: Inga V. Chistova
creator: Vitalii V. Goldobin
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 43
ending page: 51
doi: 10.17816/mechnikov632951

Cognitive status and anxiety levels in female patients during the preoperative period
type: item
description: BACKGROUND: Postoperative complications remain the primary cause of prolonged treatment duration, decompensation of existing comorbidities, and unfavorable clinical outcomes. One of the key concerns in surgery and anesthesiology is postoperative cognitive dysfunction, induced by the combined effects of surgical trauma and anesthetic agents. AIM: To assess the prevalence of cognitive impairment and anxiety among female patients admitted for elective surgical treatment. METHODS: A single-center, cross-sectional study was performed, enrolling female patients scheduled for surgical intervention on reproductive organs. During enrollment, a standard preoperative examination was conducted, along with testing using the Montreal Cognitive Assessment (MoCA) and the State-Trait Anxiety Inventory (STAI) by C.D. Spielberger (adapted by Yu.L. Khanin). RESULTS: Assessment of the main domains of cognitive status using the MoCA questionnaire revealed that female patients initially presented with varying cognitive statuses. Based on this test, two study groups were identified: Group A included 22 female patients without cognitive impairment (mean MoCA score: 28.4 ± 1.4 points; mean age: 37.2 ± 11.9 years), while Group B comprised 10 female patients with cognitive impairment (mean MoCA score: 22.9 ± 2.1 points; mean age: 49.1 ± 19.9 years). No statistically significant differences in age were found between the groups (p = 0.06), but significant differences were observed on the MoCA test (p < 0.001). Anxiety assessment with the Spielberger–Khanin scale revealed a high level of trait anxiety in both groups: mean scores were 45.9 ± 8.3 in Group A and 45.6 ± 4.2 in Group B (p = 0.722). For state anxiety, mean scores were 44.5 ± 8.4 and 43.6 ± 6.7, respectively (p = 0.436), indicating a moderate level. CONCLUSION: Among female patients admitted for surgical treatment of reproductive system diseases, 31.3% exhibited newly diagnosed cognitive dysfunction, as well as state and trait anxiety a…
creator: Svetlana A. Perepelitsa
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 52
ending page: 59
doi: 10.17816/mechnikov634070

The importance of gas chromatography-mass spectrometry steroid profiling in selecting surgical strategy for large adrenal tumors
type: item
description: BACKGROUND: The selection of surgical strategies for large adrenal tumors remains clinically critical. For determining eligibility for endoscopic video-assisted surgery, the absence of malignancy features is essential. Steroid metabolome analysis by gas chromatography-mass spectrometry (GC-MS) provides the highest diagnostic yield for detecting early signs of malignancy during preoperative evaluation and, according to multiple studies, exceeds the accuracy of radiologic imaging techniques. AIM: To evaluate the clinical utility of urine steroid profiling by GC-MS for preoperative diagnosis and surgical decision-making in large malignant adrenocortical neoplasms. METHODS: Patients with adrenal tumors larger than 50 mm and without clinical or laboratory signs of hypercortisolism were examined. Based on histological analysis, the following diagnoses were established: adrenocortical carcinoma, adrenocortical adenoma (with malignancy grade assessed using the Weiss scoring system), and rare adrenal diseases (schwannoma, ganglioneuroma, myelolipoma, etc.). Patients with adrenocortical adenomas smaller than 50 mm served as the control group. Urinary steroid profiles were analyzed by gas chromatography-mass spectrometry in all patients before surgical treatment. The Mann-Whitney U test was used for comparison of urinary steroid excretion. RESULTS: According to gas chromatography-mass spectrometry (GC-MS), 23 patients (33.8%) with adrenal tumors >50 mm exhibited biochemical features of adrenocortical carcinoma (ACC) prior to surgery, which was later confirmed histologically. In patients with adrenocortical adenoma and a malignancy score of 2 on the Weiss scale (n = 16, 23.5%), urinary excretion of tetrahydro-11-deoxycortisol, androgens, progestogens, and mineralocorticoids was significantly higher than in patients with adrenocortical adenoma lacking malignant features (n = 14) and the control group (n = 30). No statistically significant differences were observed in the urinary…
creator: Aleksandr A. Lisitsyn
creator: Ludmila I. Velikanova
creator: Natalia V. Vorokhobina
creator: Zulfiya R. Shafigullina
creator: Ekaterina V. Malevanaya
creator: Elena G. Strelnikova
creator: Vadim I. Mazurov
creator: Inna E. Kotkas
creator: Peter А. Kushnir
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 60
ending page: 67
doi: 10.17816/mechnikov640865

Effectiveness of caries prevention in patients with high mineralization level of permanent teeth
type: item
description: BACKGROUND: Dental caries is one of the most common diseases, present in about 95%–98% of the world’s population, which represents a serious public health problem. Since the 1980s of the 20th century, many studies have shown that caries resistance depends on the mineralization of tooth enamel during tooth eruption. An important stage in the formation of a child’s dental status is the process of enamel maturation, the period when dental caries is most likely to occur. Some studies suggest that tooth development is independent of external factors and is controlled mainly by genetics, while others suggest that development is also influenced by external factors. Interventions for the prevention of tooth decay have been studied many times, but the data on remedies for the prevention of tooth decay in teeth with high mineralization are inconsistent. AIM: To identify the clinical and morphological criteria of highly mineralized teeth and to evaluate the efficacy of caries prevention measures in patients with highly mineralized permanent teeth. METHODS: The first stage consisted of determining the clinical and morphological parameters of teeth extracted for orthodontic indications in children aged 9 to 15 years. Next, patients were followed for one year, divided into groups based on their use of calcium- and phosphorus-containing preparations, hydroxyapatite, or no supplementation. The following examinations were performed: assessment of the DMFT (decay, missing, filled teeth) index, enamel resistance testing, and quantitative light-induced fluorescence (QLF) measurements. RESULTS: 86 people took part in the study. As a result of the study, the clinical and morphological criteria of highly mineralised teeth were clarified. Clinical criteria: fissure enamel is dense, smooth, and shiny; fissures are of open type, grooved; the enamel surface is dense and smooth in the maxillary, lingual, and approximal areas; absence of enamel defects in the form of stains or pigmentation; tee…
creator: Alisa P. Limina
creator: Elena A. Satygo
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 68
ending page: 74
doi: 10.17816/mechnikov635585

Functional changes in the spine as predictors of comorbidities in patients with ankylosing spondylitis
type: item
description: BACKGROUND: Advanced ankylosing spondylitis can be characterized by the formation of disabling spinal deformities. However, the effect of cervicothoracic kyphosis on the cardiovascular system is poorly understood. In routine rheumatology practice, the occiput-to-wall distance is used as a reliable method to confirm the presence of kyphosis in patients. AIM: To assess the association between kyphosis (measured by occiput-to-wall distance, the occiput-to-wall distance) and the development of comorbidities in patients with late-stage ankylosing spondylitis. METHODS: The study included men with advanced-stage ankylosing spondylitis. As part of the standard assessment of the primary disease, clinical and laboratory examinations were performed, including additional measurement of myostatin levels. Cardiovascular status was also evaluated using echocardiography and ultrasound examination of the brachiocephalic arteries. RESULTS: Forty men (33 to 67 years old) with advanced ankylosing spondylitis participated in the study. All patients were divided into 2 groups: 1) with the occiput-to-wall distance < 10 cm (n = 45%), 2) with the occiput-to-wall distance ≥ 10 cm (n = 55%). The analysis of cardiovascular system status showed that all patients in the occiput-to-wall distance ≥ 10 cm group had hypertension (100% vs 66.7%, p = 0.005) with predominance of grade 2 arterial hypertension (45.5% vs 27.8%, p = 0.010) in contrast to the occiput-to-wall distance ≥ 10 cm group. Echocardiography revealed statistically significant reductions in left ventricular function values in the occiput-to-wall distance ≥ 10 cm group compared to the occiput-to-wall distance < 10 cm group. Notably, the occiput-to-wall distance ≥ 10 cm group was more frequently overweight (86.23 ± 14.03 vs. 74.83 ± 14.44, p = 0.016) with a predominance of class I–II obesity (45.5% vs. 11.1%, p < 0.001). Also in our patients we found a correlation between serum myostatin level and the occiput-to-wall distance (r = 0.404…
creator: Elena V. Zonova
creator: Elena S. Yushina
creator: Elena B. Luksha
creator: Viktor V. Rerikh
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 75
ending page: 88
doi: 10.17816/mechnikov642481

Biofilm-forming activity of Enterococcus faecalis on basic materials of removable dental prosthetic bases
type: item
description: BACKGROUND: According to a number of authors, Enterococcus faecalis is characterised by low biofilm-forming ability on polymeric plastics. Such a feature of enterococci allows them to be considered marker strains in determining the resistance of plastics used in dentistry to microbial colonisation. This determines the need to study the aspects of interaction between clinical strains of Enterococcus faecalis and the main structural polymeric materials used for the manufacture of the bases of removable dental prostheses. AIM: To study the biofilm-forming activity of Enterococcus faecalis strains isolated from the oral cavity on the basic materials of bases of removable dental prosthetic structures. METHODS: The study included individuals with dental defects (code K08.1 according to the International Classification of Diseases). In order to assess the oral microbiota, isolate clinical strains of Enterococcus faecalis, and cultivate the on the following materials: hot-curing acrylic material Etacryl-02, thermoinjection polymer Deflex Acrynel, and thermoplastic monomer-free material Perflex T-Crystal, biomaterial was collected from patients of the observation groups from the central apex area of dental defects using swab probes. Statistical analysis was performed using the Shapiro–Wilk test, Student’s t-test, and χ²-test. RESULTS: Bacterial film formation was most pronounced on the acrylic material hot curing acrylic material (coefficient of biofilm-forming activity ranged from 16.7 to 30.6). The same index was in the range of 4.6–10.1 when studied on thermoplastic monomer-free material, and for thermoinjection polymer — 1.2–2.7. It was found that 12.5% of Enterococcus faecalis strains formed an intensive biofilm on thermoplastic monomer-free material and hot curing acrylic material simultaneously, 25% — on thermoinjection polymer and hot curing acrylic material. A quarter of strains practically did not form biofilm on thermoplastic monomer-free material and thermoinject…
creator: Oksana A. Shuliatnikova
creator: Mikhail V. Yakovlev
creator: Anatoliy P. Godovalov
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 89
ending page: 96
doi: 10.17816/mechnikov634363

Analysis of genetic polymorphism associations with cardiometabolic risk factors and phenotypic age in individuals without significant pathology
type: item
description: BACKGROUND: Against the background of significant achievements in the treatment and prevention of various diseases, the direction of “medicine for the healthy” currently does not adequately meet the public demand for active longevity. Developing age assessment systems (epigenetic, biochemical and other “clocks”) allow us to get closer to the assessment of biological age, which is an important step towards finding technologies that can slow down aging. AIM: To identify the relationship between clinical characteristics, phenotypic age and genetic factors in a cohort of people without clinically significant pathology who lead a healthy lifestyle. METHODS: A single-center, cross-sectional study was conducted. A retrospective analysis of clinical, laboratory and instrumental examination results of participants in wellness programs at the “First Line” preventive medicine resort was performed. Genetic polymorphism was determined using commercially developed biochip technology. Gene polymorphisms (222 single nucleotide variants) potentially associated with cardiometabolic risks according to published scientific data were analyzed. RESULTS: In a cohort of 29 patients aged 27 to 68 years, 14 single nucleotide variants were identified, associated with changes in systolic (rs6920220 of the TNFAIP3 gene, rs1137101 of the LEPR gene) and diastolic (rs1137101 of the LEPR gene, rs7903146 of the TCF7L2 gene, rs12255372 of the TCF7L2 gene) blood pressure, dyslipidemia (rs266729 of the ADIPOQ gene, rs1045642 of the ABCB1 gene, rs1815739 of the ACTN3 gene), increased body weight (rs4961 of the ADD1 gene), as well as with decreased phenotypic age (rs17553719 of the AQP3 gene, rs1801197 of the CALCR gene, rs2470152 of the CYP19A1 gene, rs1800955 of the DRD4 gene, rs17782313 of the MC4R gene). Most of these associations have not been previously studied or have been reported in only a few publications. CONCLUSION: The assessment of the influence of a wide range of genetic polymorphisms seem…
creator: Yaroslav I. Ashikhmin
creator: Natalia V. Samburova
creator: Elena V. Zyatenkova
creator: Evgeniy A. Trofimov
creator: Artem V. Tishkov
creator: Anna K. Ratnikova
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 97
ending page: 106
doi: 10.17816/mechnikov687046

Successful treatment of victims with closed abdominal trauma with damage to the duodenum (clinical observations)
type: item
description: This article presents two clinical observations of successful treatment of victims with closed abdominal trauma complicated by duodenal injury, with an emphasis on key aspects of treatment and prevention of complications. Injuries to internal organs in closed abdominal trauma pose a serious threat to the lives of victims, especially in cases of damage to the duodenum. Despite the fact that duodenum injuries constitute a relatively small proportion of all abdominal injuries, they are accompanied by a high mortality rate, reaching 30% in isolated injuries and up to 80% in combined injuries. Diagnosis of such injuries is a particular problem. The absence of pathognomonic symptoms, as well as the frequent combination with other injuries (e.g., pancreas, retroperitoneal hematomas, or pelvic fractures) complicates the timely detection of these injuries. In addition, inadequate surgical tactics can lead to severe postoperative complications, including duodenal fistula (2%–16%), intra-abdominal abscess (15%), and pancreatitis (0.5%). The high incidence of severe complications and significant mortality emphasizes the importance of studying effective diagnostic methods, surgical tactics, and postoperative management of patients with duodenal injury. According to the literature, the incidence of duodenal injury in closed abdominal trauma ranges from 0.6 to 5% of all abdominal injuries. The most common injuries are to the retroperitoneal part of the intestine; the horizontal part is injured in 30%–40% of cases, the descending part in 20%–30%, and the upper part in 15%–22%. A significant problem is the recognition of retroperitoneal ruptures in combination with pancreatic injury and the presence of retroperitoneal hematomas caused by kidney injury or pelvic bone fracture. There are no pathognomonic symptoms of duodenal injury.
creator: Andrey E. Demko
creator: Vladimir G. Verbitsky
creator: Anton O. Parfenov
creator: Evgenii A. Kolchanov
creator: Aleksei V. Kosachev
creator: Egor V. Yurkevich
creator: Grigory A. Mamedov
creator: Dmitrii V. Nagornov
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 107
ending page: 113
doi: 10.17816/mechnikov636986

Metachronous development of Hodgkin’s lymphoma and nodal marginal zone lymphoma in a patient with Sjögren’s syndrome: a case report
type: item
description: According to various population-based studies, lymphoproliferative disorders develop 2–10 times more frequently in individuals with autoimmune pathology compared to the general population. Patients with Sjögren's disease/syndrome exhibit 10–44 times increased risk of lymphoma development compared to the general population. This predisposition is primarily driven by chronic B-cell stimulation from autoantigens produced by exocrine glands and other organs. However, no clear therapeutic guidelines for the management of these patients have been published. This report presents a unique case of metachronous development of Hodgkin's lymphoma and nodal marginal zone lymphoma in a patient with Sjögren’s syndrome. The diagnostic workup is described in detail, including histopathological and immunohistochemical findings as well as imaging studies, along with the therapeutic approaches employed. The main difficulty in treatment was the alternation of recurrent course of lymphomas amid immunological dysregulation and autoaggression aggravated by checkpoint inhibitors, especially immune damage to the liver. The issue of the formation of an optimal therapeutic approach in this category of patients is raised in this article. The article examines the relationship between autoimmune pathology and lymphoproliferative disorders, addressing fundamental questions about the primacy of pathological processes and the development of optimal diagnostic and therapeutic approaches for this patient category.
creator: Mariia N. Diakonova
creator: Elena S. Pavlyuchenko
creator: Aleksandr A. Mirsaitov
creator: Roman Ya. Byrsan
creator: Elena E. Leenman
creator: Irina A. Bekhtereva
creator: Ekaterina A. Liz
creator: Vadim I. Mazurov
rights: Copyright (c) 2025 Eco-Vector
date: 2025-07-30
publication date: 2025-07-30
volume: 17
number: 2
starting page: 114
ending page: 121
doi: 10.17816/mechnikov636448