bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and blood gasometric parameters during Vaquejada competition
Authors: Arruda Silvana S.B. , Huaixan Lucio N. , Barreto-Vianna André R.C. , Godoy Roberta F. , Lima Eduardo M.M.
Published: December 2015

ABSTRACT: Clinical and complementary analysis are good alternatives to evaluate physiological demand in performance horses. The aim of this study was to assess whether the physical effort variation of the three-day Vaquejada competition (a Brazilian form of bullfighting) reflected in clinical and blood gasometric changes. During the competition eight sprints have been performed on the first day (D1), eight on the second (D2) and three on the last one (D3). Ten horses were evaluated by checking heart and respiratory rates and collecting blood samples for use in portable chemistry analyzer. Through that, it was assessed potential of hydrogen ion (pH), carbon dioxide pressure (pCO2), bicarbonate (HCO3-) and titratable base concentration (cBase). Evaluations were carried with resting of at least twenty hours, before physical activity (D0), as control parameter, and up to thirty minutes after each sprint. Clinical parameters have increased on D1, D2 and D3, when compared to D0, which demonstrated the increased demand for substrate and oxygen to the cells.. Blood gasometric trial showed reductions of all variables, most marked between D1 and D2. It was verified less alteration of all clinical and blood gasometric parameters in D3 against D0. We concluded that the change effort between days of competition influenced the clinical and blood gas parameters, demonstrating appropriate physiological response. The data were presented as mean and standard error of the mean (mean ± SEM) obtained in different days. Normality was confirmed by the Kolmogorov-Sminov test and data were compared by one-way ANOVA, followed by post-test Holm-Sidak (GraphPad Prism 2.6 for Windows, GraphPad Software, San Diego, CA, USA). P≤0.05 was considered as statistically significant.
Carcinoma hepatocelular metastático em Jaguatirica (Leopardus pardalis )
Authors: Miranda Dayane F.H. , Souza Francisco de A.L. , Fonseca Luciano S. , Almeida Hatawa M. de , Braga Juliana F.V. , Costa Francisco A.L. , Silva Silvana M.M. de S.
Published: December 2015

RESUMO: O carcinoma hepatocelular (CHC) é uma neoplasia rara nos animais domésticos e em espécies selvagens foi relatado somente em antílopes, veado, cães da pradaria e furões, mas não existem relatos em Leopardus pardalis (jaguatirica). Este trabalho descreve um caso de carcinoma hepatocelular metastático em uma fêmea felina de aproximadamente 18 anos de idade, da espécie Leopardus pardalis, proveniente do Parque Zoobotânico de Teresina-PI, com histórico de anorexia, apatia e evolução ao óbito que foi encaminhada ao Setor de Patologia Animal da Universidade Federal do Piauí para exame anatomopatológico. À necropsia foram observadas duas nodulações de aproximadamente 8,0cm de diâmetro no fígado, de coloração variando da brancacenta ao vermelhado claro, amarelada a vermelho escuro, subdivididas em lóbulos por tecido conjuntivo. No pâncreas foram observadas múltiplas nodulações de aproximadamente 1,0 cm de diâmetro, com superfície lisa, consistência firme, coloração vermelho-amarelada. A superfície de corte dos rins também apresentava várias nodulações milimétricas de distribuição multifocal, na região córtico-medular, consistência firme, coloração branco-acinzentada ou amarelada, sugerindo metástase. Os fragmentos das lesões de fígado foram coletados e no exame microscópico observaram-se proliferação de hepatócitos em cordões bem diferenciados, formando trabéculas com espessura de três ou mais células. Os hepatócitos apresentavam-se volumosos, pleomórficos, com citoplasma eosinofílico. Na coloração com PAS constataram-se, regularmente, acúmulo de glicogênio nos hepatócitos neoplásicos. A confirmação foi feita pela técnica de imunoistoquímica, utilizando-se anticorpo monoclonal (Hepatocyte Specific Antigen). Os achados anatomohistopatológicos, e o auxilio da imunoistoquímica permitiram concluir pelo diagnóstico de hepatocarcinoma trabecular metastático em Leopardus pardalis criado em cativeiro.
Características do sêmen a fresco e descongelado de garanhões da raça Nordestina
Authors: Santos Maria Alice M. , Gradela Adriana , Moraes Elenice A. , Souza Wildelfrancys L. , Alves Nadja G. , Costa Jonathan M. Silva , Matos Wasley C.G.
Published: December 2015

RESUMO: Este estudo descreveu as características seminais, da membrana plasmática e do acrossoma de espermatozoide congelado/descongelado de 19 ejaculados de garanhões da raça Nordestina. Os aspectos analisados incluíram os parâmetros físicos do sêmen fresco; a motilidade e a longevidade do sêmen diluído e descongelado; a morfologia espermática, integridade funcional e estrutural da membrana plasmática do espermatozoide e a habilidade de ligação do espermatozoide à membrana perivitelina da gema do ovo de galinha do sêmen descongelado. As variáveis foram avaliadas pela ANOVA com post hoc teste de Student Newman-Keuls (P<0,05). A MT e a MP foram maiores (P<0,05) no sêmen diluído do que no descongelado. A percentagem média de defeitos maiores, menores e totais foi muito inferior ao limite recomendado pelo CBRA. A porcentagem de reativos ao HOST foi de 14,21±1,12% e a porcentagem média de membranas íntegras detectadas pelo teste supravital de 62,22±9,06% e pela sonda SYBR-14 de 81,47±26,90. O número médio de espermatozoides ligados à MPV após a descongelação do sêmen foi de 230,39±57,09. A MT e MP no tempo 0 min do TTR foi superior (P<0,05) em relação a 150 min, não diferindo nos tempos 10 min e 30 min. Os resultados demonstram que a utilização dos testes laboratoriais adicionais ajudam no processo de avaliação das amostras, possibilitando a obtenção de informações mais confiáveis e precisas. Embora a criopreservação tenha provocado queda na motilidade seminal, o uso de diluidor contendo amidas minimizou os danos osmóticos nas células espermáticas e manteve a integridade morfológica, funcional e estrutural da membrana plasmática do espermatozoide. Estes resultados são um referencial em estudos futuros uma vez que, inexistem dados comparativos nesta raça.
Ensino superior e desenvolvimento regional: o Norte de Minas Gerais na década de 1960
Authors: ROTA JÚNIOR CÉSAR , IDE MARIA HELENA DE SOUZA
Published: December 2015

RESUMO O processo de implantação do ensino superior na região norte do estado de Minas Gerais, na década de 1960, ocorreu duas ou três décadas depois de sua efetivação em outros pontos do estado. Nesse período, os discursos sobre a região oscilavam entre seu grande potencial de desenvolvimento e uma marca de atraso econômico e social. Assim, por meio de pesquisa, buscou-se investigar os condicionantes históricos, com base em documentos oficiais e da imprensa escrita, que contribuíram para a concretização do ensino superior no Norte de Minas. Pode-se concluir que o desencadeamento do processo de desenvolvimento econômico regional, impulsionado por ações do Estado, veio a exigir maior investimento em educação, a fim de formar cidadãos que pudessem dar sua contribuição ao processo de industrialização e adaptados à consequente urbanização, culminando no estabelecimento dos primeiros cursos superiores, todos de formação de professores.
Estudos comparados como método de pesquisa: a escrita de uma história curricular por documentos curriculares
Authors: SILVA FABIANY DE CÁSSIA TAVARES
Published: December 2015

RESUMO O artigo apresenta uma pesquisa concluída, inscrita no campo da história da educação, com foco na reflexão sobre as condições teóricas e metodológicas que se colocam à utilização dos procedimentos do estudo comparado. A pesquisa objetivou a escrita de uma história curricular particular, por meio do estudo de documentos curriculares. A metodologia empregada nesta investigação está orientada pela explicitação dos fundamentos teóricos, das áreas de comparação e dos procedimentos investigativos que sustentam a eleição do estudo comparado como método de pesquisa. Ao elegermos os fundamentos, as áreas e os procedimentos, tratamos de analisar as diferenças e as semelhanças, de explorá-las ao máximo para descobrir como se expressam, de rastrear os conteúdos das informações no contexto em que estão apresentadas, de contextualizá-las, isto é, de estabelecer relações com as distintas situações em que foi/é produzida uma história curricular.
Impact of telemedicine in hospital culture and its consequences on quality of care and safety
Authors: Steinman Milton , Morbeck Renata Albaladejo , Pires Philippe Vieira , Abreu Filho Carlos Alberto Cordeiro , Andrade Ana Helena Vicente , Terra Jose Claudio Cyrineu , Teixeira Junior José Carlos , Kanamura Alberto Hideki
Published: December 2015

ABSTRACT Objective To describe the impact of the telemedicine application on the clinical process of care and its different effects on hospital culture and healthcare practice. Methods The concept of telemedicine through real time audio-visual coverage was implemented at two different hospitals in São Paulo: a secondary and public hospital, Hospital Municipal Dr. Moysés Deutsch, and a tertiary and private hospital, Hospital Israelita Albert Einstein. Results Data were obtained from 257 teleconsultations records over a 12-month period and were compared to a similar period before telemedicine implementation. For 18 patients (7.1%) telemedicine consultation influenced in diagnosis conclusion, and for 239 patients (92.9%), the consultation contributed to clinical management. After telemedicine implementation, stroke thrombolysis protocol was applied in 11% of ischemic stroke patients. Telemedicine approach reduced the need to transfer the patient to another hospital in 25.9% regarding neurological evaluation. Sepsis protocol were adopted and lead to a 30.4% reduction mortality regarding severe sepsis. Conclusion The application is associated with differences in the use of health services: emergency transfers, mortality, implementation of protocols and patient management decisions, especially regarding thrombolysis. These results highlight the role of telemedicine as a vector for transformation of hospital culture impacting on the safety and quality of care.
Structure and biodiversity of zooplankton communities in freshwater habitats of a Vereda Wetland Region, Minas Gerais, Brazil
Authors: Pinese Olívia Penatti , Pinese José Fernando , Del Claro Kleber
Published: December 2015

Abstract Aims: Vereda wetlands are among the most important aquatic habitats in Brazilian savannah (Cerrado) because of their association with river springs and its relevancy for biodiversity conservation. This study aimed to determine and compare the biodiversity of zooplankton in vereda lakes, differentiated by the presence or absence of aquatic macrophytes at an environmental reserve in Uberlândia, Minas Geais, Southeastern Brazil. Zooplanctonic abundance patterns and their relation with environmental parameters were also discussed and presented through multivariate statistics. Methods Twelve samples were taken at water surface, at 15-day intervals in 2006. It was observed a total richness of 75 species, including 12 genera, 29 species and one sub-species as new records for Minas Gerais State. Results Rotifers were the predominant group and Lecanidae was the most diverse family. Among cladocerans, Chydoridae showed the greatest richness and Bosminidae the highest abundance. Few adult copepods were sampled in this study, but nauplii were very frequent. Cyclopidae was the most common family among copepods and there was no record of Calanoida. Conclusions The difference in composition among the studied lakes was remarkable. The lake with macrophytes showed the greatest richness but the lowest density, and the opposite situation occurred in the other lake. This can be explained by the fact that aquatic macrophytes, as primary producers, exert a bottom-up effect on zooplankton community, sustaining a high local diversity in contrast with a low numeric abundance of these microorganisms. Therefore, this pattern may have been created by the surround heterogeneity and, at the same time, by the reduction of available minerals of the system caused by macrophyte matter fixation. Many studies on zooplankton need to be developed in palm swamp communities in order to better comprehend the biological diversity and the energy balance in different habitats for the conservation of aquatic ecosystems.
Chemical and morphological characterization of Agave angustifolia bagasse fibers
Authors: Hidalgo-Reyes Martin , Caballero-Caballero Magdaleno , Hernández-Gómez Luis Héctor , Urriolagoitia-Calderón Guillermo
Published: December 2015

The main aim of this study was to characterize cooked bagasse fibers from Agave angustifolia Haw. The fibers were characterized using scanning electron microscopy, differential scanning calorimetry, thermogravimetric analysis, X-ray Diffraction and chemical analysis. The tensile strength was also tested using fibers with a uniform length (30 mm). The fibers were light brown in color, with a mean diameter and length of 501 ?m and 144 mm, respectively. Scanning electron microscopy images revealed elliptically shaped cells with varying lumen size. Holocellulose content was approximately 82.12 %, and total lignin content was approximately 20.69 %. Due to the crystallinity and lignin content, the fibers proved to be thermo-stable until 220 °C. The mean values of tensile strength, Young’s modulus, % strain (?), and ultimate tensile strength were determined via mechanical tests. The results are comparable to those of other common lignocellulosic fibers, confirming their potential use as a reinforcing element in a polymer matrix to form a new biodegradable composite.
Experimental rationale for autologous modification of dental implants based on nonwoven titanium material with through porosity
Authors: Shcherbovskikh A E
Published: December 2015

Aim. To provide the experimental rationale for technology of autologous modification of dental implants based on non-woven titanium material with a through porosity considering the indicators of peg-spacer primary stability.
Methods. Randomised study included 20 preparations of mandible of pigs aged form 9 to 13 months. Periotest method was used for comparative assessment of stability indicators of dental implants models based on non-tissue titanium material with a through porosity that were installed using the conventional technology and by autologous modification using pin spacer diameters of 1.8, 2.0 and 2.3 mm.
Results. Increasing the pin spacer diameter from 2.0 to 2.2 mm increases the indicators of stability by 13.33 PT in models of dental implants with sleeve of nonwoven titanium material with a through porosity, by 2.7 PT - with sleeve of nonwoven titanium material modified by autologous bone. Modification of nonwoven titanium material with a through porosity by autologous bone increases implant stability by 13.49 PT with pin spacer diameter of 2.0 mm, by 2.86 PT - with pin spacer diameter of 2.3 mm.
Conclusion. The stability of the dental implant model depends on the pin spacer diameter of the intraosseous part and the density of nonwoven titanium material with a through porosity, which is regulated by autologous bone modification. Study results suggest using the technology of autologous modification of dental implants based on nonwoven titanium material with a through porosity widely in clinical practice.
Chronic constipation: diagnostics and surgical treatment issues
Authors: Kostyrnoy A V , Shevketova E R
Published: December 2015

The article reviews chronic constipation diagnostics and treatment issues. According to the russian and foreign authors data, chronic constipation is a common pathology, which requires an individual approach to the patient and a spacious approach to a diagnostics and treatment problem. Chronic constipation syndrome feature is the delicacy of the problem which makes patients do not seek medical help for a long time, abuse laxatives, trying to eliminate the consequence but not the cause of a latent disease which leads to constipation. The article gives constipation syndrome definition from modern positions and its main classifications, considers the commonest risk factors for chronic constipation in clinical practice. It presents the different pathogenesis theories of the constipation syndrome. Various methods of the intestine anatomical and functional features instrumental diagnostics, as well as anorectal function assessment tests are described. Chronic constipation medicamental treatment results are given. Views on the colostasis resistant forms surgical treatment and different approaches to the selection of surgery type are covered. It is concluded that the chronic constipation problem remains relevant in abdominal surgery due to its wide prevalence, pathophysiological heterogeneity and low efficiency of therapy. At this stage, there are no evidence-based recommendations on the treatment choice for chronic constipation, made on the therapy effectiveness analysis. Rational use of the known diagnostics methods, new directions in diagnostics and therapy, for example, the determination of intestinal microbiota metabolites and designing metabolite-type drugs offers the prospects in solving this problem. The main causes of failure in chronic constipation surgery are inadequate selection of the surgery extent and marked disturbance of the colon evacuation function. Evaluation of the chronic constipation new surgical treatment methods value in the arsenal of modern coloproctology requires the accumulation of more meaningful experience. In addition, surgical interventions methods should be individual and based on understanding of the disease etiopathogenetic aspects. The review is of interest for general practitioners, gastroenterologists, coloproctologists and surgeons.
Angiotensin II receptors blockers in the treatment of patients with cardiorenal syndrome
Authors: Nasybullina A A , Bulashova O V , Khazova E V , Gazizyanova V M , Malkova M I
Published: December 2015

Literature review on the use of angiotensin II receptors blockers in patients with combined pathology of the cardiovascular and renal systems: chronic heart failure and chronic kidney disease is presented. The angiotensin II receptors blockers positive effect is determined by the selective and complete type 1 receptors blockade and simultaneous stimulation of the type 2 receptors. On the one hand angiotensin II blockers are well-studied and widely used class of drugs in patients with cardiac pathology. On the other hand, the efficacy and safety of this drugs group in patients with renal impairment due to cardiac pathology or coexisting urinary system diseases are not well studied. Clinical studies have confirmed the angiotensin II receptor blockers pharmacotherapeutic activity and safety in reducing the cardiovascular events rate, including cardiovascular mortality, myocardial infarction, stroke, number of hospitalizations due to decompensated heart failure. There is data regarding the heart failure poor prognosis in decreased kidney function, but most of these studies were conducted in patients with end-stage renal failure. Data on angiotensin II receptor blockers effect on the course and prognosis of patients with heart failure in association with kidney damage is not enough. The effect of angiotensin II on the heart failure clinical presentation and outcomes according to the left ventricular ejection fraction preservation or reduction, and on the severity of kidney damage is not studied.
Modern view on the problem of children and adolescents physical development assesment
Authors: Izotova L D
Published: December 2015

The aim of work was to compile information on current international approaches to children and adolescents physical development assessment. Physical development is an important health indicator of children and adolescents, which reflects individual sexual and constitutional features, different climatic and socio-economic living conditions. Currently different of methods are used to assess children physical development. In 2006, the World Health Organization introduced a reference growth rates of children under 5 years («Child Growth Standards for children»), which show how children should grow while ensuring proper care, feeding and healthy environment. These standards make it possible to assess the physical development of children all over the world, regardless of ethnicity, feeding type and socioeconomic status. «WHO Growth Reference 2007» standards are developed for children from 5 to 19 years. It is recommended to evaluate nutritional status from 2 years of age by calculating the body mass index standard deviation score (SDS) on the standard for the corresponding age and sex. The program for personal computers «WHO Anthro» was developed for individual assessment of children under 5 years anthropometric indicators using both parametric (sigma - Z-score determination) and nonparametric (centile - percentile determination) methods, and the program «WHO AnthroPLUS» - for children and adolescents over 5 years. The programs allow to asses physical development easily and conveniently in practical application and to visualize the results. The World Health Organization international reference standards allow to evaluate physical development pathology, including nutritional status, according to international criteria for malnutrition, overweight and obesity, short and tall stature diagnosis. Adoption of the World Health Organization standards unifies the methodology for assessing the children and adolescents physical development, will make comparable the results obtained at different time, in different countries and regions of the world.
Contemporary issues and prospects of skin-sparing mastectomy performance in patients with breast cancer
Authors: Ismagilov A Kh , Vanesyan A S , Khamitov A R
Published: December 2015

For breast reconstructive surgery oncological requirements are imposed, which include the principle of radicality, ablastics, antiblastics and minimal impact on the general and disease-free survival rate, as well as aesthetical requirements - excised breast volume replacement, recovery of tactile sensitivity and shape most closely resembling the natural one. The mastectomy technique determines the breast reconstruction aesthetic results. In 1991 skin-sparing mastectomy combined with the one-stage breast reconstruction, which allows to preserve the organ skin, was described by B.A. Toth and P. Lappert. In 1997, G. Carlson proposed the classification of incisions for skin-sparing mastectomy, which considers both aesthetic and oncological aspects of the surgery, thereby it is successfully used to the present day. In 2003, R.M. Simmons published his incision classification in skin-sparing mastectomy, which differs from the G. Carlson classification only by type III incision. Determinant factors for skin-sparing mastectomy type choice are the presence of scars from previous biopsies, tumor topographic and anatomical parameters and planned reconstruction method. Selection of the appropriate incision type for skin-sparing mastectomy depends on the location and the tumor invasion depth in the breast tissue, the distance of the tumor from the nipple-areola complex and aesthetically favorable zones, as well as biometric data (the areola diameter, breast hypertrophy and ptosis) and the patient desires. Thus skin-sparing mastectomy is aimed to the closest possible to the preoperative level result achievement.
Guillain-Barre syndrome
Authors: Kutepov D E , Litvinov N I
Published: December 2015

Guillain-Barre syndrome is an acute inflammatory demyelinating polyradiculoneuropathy of autoimmune etiology, which is characterized by peripheral paralysis and protein-cell dissociation in the cerebrospinal fluid in most cases. The Guillain-Barre syndrome prevalence is 0.6-2.4 cases per 100 thousand population. In Moscow, about 200 people are taken ill with Guillain-Barre syndrome each year. Currently, four main clinical variants of Guillain-Barre syndrome are described: acute inflammatory demyelinating polyradiculoneuropathy, axonal form, acute motor axonal neuropathy, and Miller-Fisher syndrome. Disease development is preceded by contact with the viral or bacterial infections causative agent such as Campylobacter jejuni, Mycoplasma pneumonia, cytomegalovirus, Epstein-Barr virus and influenza virus. Guillain-Barre syndrome pathogenesis is «molecular mimicry» between infectious agents surfaces and the peripheral nerves structures. High titer of antibodies to the GM1, GD1a, GD1b and GQ1b gangliosides is found in patients blood serum. Diagnostic criteria for the Guillain-Barre syndrome diagnosis are the physical examination results, cerebrospinal fluid analysis and electroneuromyographic study. The North American motor deficit severity scale is used to assess the neurological status. This scale allows to evaluate the patient’s condition and movement abilities. Currently plasmapheresis and immunoglobulin G therapy are the main treatment options for patients with Guillain-Barre syndrome. The favorable prognosis in the form of disease clinical manifestations regression reaches 60-80%. Mortality in Guillain-Barre syndrome is 5% in average and may reach 20% in patients on mechanical ventilation. The most common death causes of patients with Guillain-Barre syndrome are respiratory failure, aspiration pneumonia, sepsis, and pulmonary embolism. Early treatment initiation can reduce serious complications risk, including respiratory failure, what ultimately leads to decrease in mortality and patients disablement.
Execution of minor patients’ right for information in professional activities of medical assistants
Authors: Baklushina E K , Eremtsova I A
Published: December 2015

Aim. To examine the problems of implementing patients’ rights for information by medical assistants in providing medical care of a minor under 16 years of age.

Methods. The study was conducted as a poll using anonymous questionnaires and semi-standardized interviews using specially designed questionnaires and the method of expert evaluations. The study involved 407 medical assistants providing medical care for children’s population, and 427 parents of minor patients (under 15 years of age). The department of health management and public health of institute of postgraduate education of Ivanovo State Medical Academy conducted the study at the medical settings of the Vladimir and Ivanovo regions.

Results. The study revealed low awareness of the medical assistants in patient’s rights for information, in particular, to have access to medical documents. Execution of the right of minor patients and their legal representatives to obtain information on the health status was shown to be inadequate, with medical assistants often ignoring the parents’ request to provide information about the health status of the child and access to medical charts and results of diagnostic procedures. A significant part of medical assistants do not consider mandatory to explain to minor patients parents the diagnostic data within their competence.

Conclusion. The currents state of affairs in implementing patients’ rights for information requires development and implementation of medical and organizational measures for better awareness of medical assistants about patients’ rights, in particular, right to be informed, as well as optimizing execution of this right.
Retrospective analysis of the superficial dermatomycosis prevalence in areas of the Greater Caucasus of Azerbaijan
Authors: Akhmedova S D
Published: December 2015

Aim. Study the epidemiological situation regarding the prevalence of skin, hair or nails superficial mycoses in 15 districts of the Greater Caucasus of Azerbaijan for the period from 2000 to 2012.
Methods. Such indicators as the number of patient visits, periodic screening examinations and admissions were analyzed using the current and archived medical records of the Municipal Center for Skin and Sexually transmitted diseases №1, Republican Center for Skin and Sexually transmitted diseases, Republican Paediatric Center for Skin and Sexually transmitted diseases №3 of the Azerbaijan Republic. Skin superficial mycoses were diagnosed after laboratory (microscopic) verification of fungal mycelium presence. Intensive indicators were calculated, such as the prevalence of skin superficial mycoses and the number of patient visits due to skin superficial mycoses.
Results. The prevalence of the skin superficial mycoses has increased in the Greater Caucasus of Azerbaijan area at the examined period (2000 to 2012) since 2004, with the prevalence peaks in 2007, 2009 and 2011. Men were twice (61.54%) more commonly affected compared to women (38.06%). The highest prevalence of skin superficial mycoses was registered in age groups of 0-10 (38.69%) and 11-20 (20.83%) years, the main diagnosis were «scalp mycosis» (27.98%) and «tinea versicolor» (22.62%). The prevalence of skin candidiasis (1.19±0.84%), onychomycosis (4.17±1.54%), tinea cruris (5.36±1.74%), combined scalp and glabrous skin mycosis (5.95±1.83%), athlete’s foot (8.93±2.20%), «Kerion» lesions (10.71±2.39%), glabrous skin mycosis (13.10±2.60%) increased. The prevalence of skin superficial mycoses was the highest in 2011 - 1.980±0.388%, the number of patient visits due to skin superficial mycoses - 0.712±0.140%; in 2007 the following numbers were 1.911±0.390% and 0.607±0.124% respectively, in 2009 - 1.637±0.357% and 0.537±0.117%, duplicating the prevalence peaks. High prevalence of superficial dermatomycoses was seen in Khizi and Ismailli Districts, the lowest - in Balakan, Qusar, Oghuz, Shaki Districts. Conclusions. In the current social and economic conditions, the system of complex examination (cultures, microscopy) of patients with skin mycoses is required, as well as the program of targeted preventive measures and improvement of medical and social aid management.
Medical and social health problems of convicted and health care delivery to this category
Authors: Timerzyanov M I
Published: December 2015

An overview of the literature of domestic and foreign authors concerning the prisoners incarceration conditions and the health status, the most important disease groups and the medical support organization is presented. The prisoners health status significantly differs from the nationwide values, what is related to the maladgusted population stratum concentration, the prison conditions that facilitate some infectious diseases spread, and other factors. These problems are not isolated, as the majority of persons who are in prison, sooner or later return to the community. In the second half of the 1990s in Russia the leading in morbidity structure of convicted were respiratory diseases - 23.5% (respiratory viral infections, chronic non-specific lung disease, pneumonia, etc.); mental disorders - 19.6% (alcoholism, drug addiction), infectious and parasitic diseases - 17.3% (tuberculosis, sexually transmitted infections) diseases of the skin and subcutaneous tissue - 10.9% (scabies, pediculosis). In Russia during the 1990s, the death rate of prisoners increased by 3.2 times (from 323.0 to 1027.3 per 100 thousand of convicts). However, since the late 1990s, there is a steady decline in mortality, which is determined primarily by a decrease in prisoners mortality from tuberculosis. Doctors availability (excluding dentists) for persons who are in prisons in republic of Tatarstan is 45.4 per 10 thousand, nurses availability - 109.1. These values are higher than in the institutions of the Ministry of Health, in terms of doctors - by 3.2%, and nurses - 18.1%. Prisons represent an important public healthcare resources, allowing to identify, treat, and prevent a large group of diseases in complicated target group which is often difficult to get by civilian health services. Existing problems in the prisoners health, poor material and technical resources of medical services are due to inadequate funding of the Department of the correctional system. Lack of legal framework does not allow the administration to take into account features of the most vulnerable categories of prisoners.
Training of specialists in healthcare management: the importance of competences formation
Authors: Reshetnikov V A , Korshever N G , Dorovskaya A I
Published: December 2015

Aim. To justify the lists and the importance of knowledge, abilities and skills, which healthcare professionals, holding various management positions in health care organizations, should have - the competencies formation (models) profiles development.

Methods. Expert interviews of 16 members of organizational departments teaching staff (professional experience in the specialty for at least 10 years) of Saratov State Medical University named after V.I. Razumovsky of Ministry of Health care of Russian Federation were conducted.

Results. Based on the competencies presented in the state educational standard for the specialty «Organization of Healthcare and Public Health», the required positions lists of categories «know» - 37, «be able» - 25, «have skills» - 25, are specified. Their importance for structural divisions heads (chiefs) - medical specialists, deputy heads and head physicians (chiefs) of medical organizations - is established. Statistically significant differences are found on the importance of a number of all three categories positions what allowed to develop the appropriate models or profiles of formation. Considered categories lists included positions that have been evaluated by experts as «it is absolutely necessary for successful work in a particular position», «necessary» and «more necessary than not». The last estimate was recorded only in respect of the three positions for the heads (chiefs) of medical institutions structural units in the «have skills» category.

Conclusion. The study results can be implemented in the medical institutions daily activities organization, as well as in the educational process of advanced training and medical schools specialists professional retraining faculties.
Some challenges in legal regulation of the minor patients rights and freedoms
Authors: Khamitova G M
Published: December 2015

The problem of securing and protecting the citizens rights for the medical care delivery in the existing legislation is one of the most relevant in the modern Russian law. In domestic legislation the right to health and medical care is primarily enshrined in the Constitution of the Russian Federation. For example, the article 41 establishes the right to get free medical care in accordance with the state guarantees program of free medical care delivery to citizens, and to receive paid medical and other services. However, there are some peculiarities and problems of these rights implementation in minor patients. This article is devoted to the analysis of this problem certain aspects. In particular, it raises questions on the patient’s right to get information about his/her health status, enshrined in the Fundamentals (article 19) and the Law of the Russian Federation «On Protection of Consumers’ Rights of 07.02.1992». Quite controversial is the situation when the legal representatives of a minor under the age of 15 years strongly refuse medical intervention and hospital insists on it. Considering the features of the right ofminors to confidentiality, it should be noted that providing the information constituting patient’s confidentiality to legal representatives is not stipulated by the national medical legislation standards in case of minors over 15 years old. However, it should be taken into account that in case of harm infliction to a minor or unlawful interference with the minor’s health, the latters not having full legal capacity, are not able to protect themselves. Also in the current legislation in the field of donation and transplantation the problem of the minors lifetime donation regulation remains unsolved. In summary, it should be noted that, despite the relative development of the legislation on the minor patients rights, in reality unusual situations that create psychological, moral and ethical problems for doctors occur quite often.
The role of eye diseases in disabilities of children population
Authors: Kagramanova L F , Agaeva K F
Published: December 2015

Aim. To estimate the disabilities new cases incidence dynamics in children population of the Azerbaijan Republic and define the role of eye diseases in the formation of the children disability risk.
Methods. The State Statistics Committee of Azerbaijan materials over a period of 2009-2013 were used, which included information on primary cases of children disabilities. To study the children population disabilities nosologic causes as a result of eye diseases children medical examination results in 2013 (total 497 children considered disabled) were used. Statistical analysis was performed using the qualitative characteristics analysis method.
Results. In children up to 18 years old over a period of 2009 and 2013 a statistically significant increase in disabilities new cases rate was observed as a result of all the selected diseases groups, except for ear diseases (0.80±0.05 and 0.78±0.05 per 10 thousand respectively; p >0.05). The eye diseases proportion among the causes of disabilities primary cases did not significantly change in 2009, 2010 and 2011 (7.3±0.33; 7.1±0.34 and 7.9±0.29% respectively; p >0.05). In 2012, its value significantly (p
Neurological and psychological status in acute stage of ischemic stroke
Authors: Dementeva O V , Starikova N L
Published: December 2015

Aim. Assess the changes of neurological and psychological status in patients with acute stage of the first ischemic stroke. Methods. The study included 25 patients with ischemic stroke, the average age was 65.72±12.49 years. Neuropsychological examination was performed using a Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment scale (MoCA), Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, Lazarus Ways of Coping Questionnaire. All studies were performed twice on day 1-3 and on day 19-21 after the stroke. Results. Mild motor dysfunction by National Institute of Health Stroke Scale (NIHHS) was registered at admission. By the end of the acute period, positive changes were registered: NIHSS score decreased by 66.4%, significant improvement in patient’s cognitive status was seen. The average depression score by Beck Depression Inventory was 15.6 points, with severe depression diagnosed in 2 patients. By the end of the acute period, depressive symptoms regressed to the average level of 11.1 points. Reactive anxiety at admission was low, personal anxiety - high. By the end of the acute period anxiety remained at the same level or slightly reduced. Direct correlations of the neurological deficit degree by NIHSS and depression score by Beck Depression Inventory, as well as the later with personal anxiety level were revealed. Inverse correlation between the MMSE cognitive status and depression levels was discovered. Conclusion. By the end of the acute period, the severity of emotional disorders decreases and cognitive function improves together with restoring motor activity.
Experience of individualization of oral anticoagulants use and dosage in personalized medicine centre conditions
Authors: Rumyantsev N A , Sychev D A , Kukes V G , Kazakov R E , Rumyantsev A A , Taratuta T V
Published: December 2015

The application of pharmacogenetic testing was analyzed in patients treated at the center of personalized medicine, in order to analyze gene polymorphism frequency - response predictors to indirect anticoagulants therapy, estimation of the warfarin dose selection time, the hospitalization duration. The presence of VKORC1 and CYP2C9 polymorphisms or homozygous polymorphisms combinations is quite common in the Russian population: CYP2C9*2 polymorphism (15.3%) was observed in 8 patients, CYP2C9*3 (9.6%) in 5 patients. VKORC1 gene A allele was detected in 18 patients, accounting for 34.6% of the whole group. In patients with this polymorphism warfarin administration according to the traditional algorithm often leads to excessive anticoagulation and bleeding. Initiation of warfarin therapy according to the scheme taking into account genotyping significantly increases the treatment safety and reduces the adverse events incidence in this group of patients.
A rare case of two-chambered heart in an adult patient
Authors: Mukhametzyanova N A , Valeeva M R
Published: December 2015

Congenital heart diseases are third most prevalent congenital disorders right after congenital musculoskeletal and central nervous system disorders. Up to 30-35 thousand of children with congenital heart disease are born annually in USA, 20-22 thousand - in Russia, 320-350 children - in the Republic of Tatarstan. Univentricular heart is among rare and unique congenital heart disorders. The natural course of the disease is poor, with two thirds of patients passing away within the first year due to severe pulmonary hypertension, progressing heart failure, and severe hypoxia and heart arrhythmias. Prenatal influence of the disorder on hemodynamics is not significant, and babies are born with normal body weight and length. In most of the children, the disease is diagnosed within the first months after birth. If combined with pulmonary artery stenosis and transposition of the great vessels, clinical manifestations are associated with serous hypoxia and cyanosis. Intensive cyanosis is observed since birth, peripheral signs of hypoxia - phalangeal and nail deformities are seen early. Such children do not frequently have respiratory diseases, despite shortness of breath; there is no crackles in lungs. In the absence of pulmonary artery stenosis, the clinical picture reminds congenital heart disorder with big ventricular septal defect and left to right shunt with the expressed hypervolemia and moderate cyanosis, which becomes more severe while crying and at feeding. Children often have recurrent pneumonia and bronchitis, lag behind in physical development, they constantly have a shortness of breath and tachycardia, hepatomegaly occurs early. A clinical case of the patient with congenital heart disease (univentricular heart) and severe congestive heart failure is presented. The peculiarity of this case is the presence of the single atrium communicating through a common atrioventricular valve with a single ventricle, from which two main vessels begins with the aortic and pulmonary valves, as well as atypical long clinical course associated with heart arrhythmia and extensive cardiac remodeling.
Optic nerve and retinal damage in a patient with post-hemorrhagic anemia
Authors: Grishina E E , Ryabtseva A A , Belova T V , Andryukhina O M
Published: December 2015

There is a number of literature data on ischemic optic neuropathy development in acute hemorrhage. However, ocular disorders in prolonged chronic hemorrhage and iron-deficiency anemia are not well studied. We present a clinical case of optic nerve and retinal damage in a patient with prolonged chronic gastrointestinal bleeding. 53-year-old patient S. presented with complaints on dramatic sudden loss of vision of his right eye (visual acuity was 0/02 and was not improving with correction). Visual acuity of the left eye was good. Ophthalmoscopy revealed right optic nerve swelling, flame-shaped disc and peripapillary hemorrhages, and multiple soft exudates along blood vessels of the right eye. Optic nerve head of the left eye was pale pink, with well-defined borders. Multiple soft exudates along blood vessels and few flame-shaped hemorrhages were identified as well. Clinical examination revealed iron-deficiency post-hemorrhagic anemia. The diagnosis of anterior ischemic neuropathy of the right eye, ischemic neuroretinopathy of left eye associated with post-hemorrhagic anemia was established. Conservative treatment increased hemoglobin level up to 82 g/l, the red blood cells count - up to 2,88×1012/L, hematocrit was 0.25%, platelet count reached 344×109/L, but the signs of rectal bleeding remained. The patient underwent surgery for hemorrhoids. After the increase of hemoglobin level, visual acuity of the right eye improved to 0.1, the visual acuity of the left eye was 1.0. According to the results of computed peripheral vision test (Humphrey Full Field 120 Point Screening Test), central scotoma and scotomas in the lower half of the field of vision of the right eye remained. In the field of vision of the left eye, the area of absolute arcuate scotoma in the lower-nasal quadrant decreased significantly. Reduced visual acuity was the main complaint of the patient with a longstanding gastrointestinal bleeding. A careful history and thorough clinical examination allowed to establish the cause of the optic nerve and retinal damage, to assign pathogenetically based treatment, which led to an improvement in visual function.
History of Voroshilov (Stavropol) medical institute: background, problems, solutions
Authors: Spevak R S
Published: December 2015

The aim of work was the objective coverage of the 1930s events, associated with the opening of Medical Institute in Voroshilov (Stavropol), revealing the background of its creation, analysis of the problems accompanying decision implementation. Using the comparative analysis method in the archival sources study common trends and patterns of regional development and their cause and effect relationships, which contributed to pauses in the university organization, were identified. The main prerequisites for the institute creation were general tendency to increase the medical schools number in the country to provide the population with medical staff of expanding network of health care institutions; regional features, reflected in the fact that the Stavropol was one of the major administrative, cultural and scientific centers in the region, which had a favorable equidistant position from the cities with already existing medical schools. In addition to that, Voroshilov Medical Institute was not established on the basis of the department or by already established institution transfer to the city, as it has been originally planned by the RSFSR Council of People’s Commissars. Although the decision to open a medical school in Stavropol has been made, the city did not have the necessary areas for its placement. Local authorities petitions on medical school establishment were of adventurous nature, the measures they took were not implemented in time. The university organization proceeded in difficult conditions: academic buildings, dormitories for students and teachers were lacking; premises surrender to medical institute from other organizations was delayed for objective reasons. Thanks to the university administration persistent efforts, with the higher authorities support Medical Institute was opened and began its work. We can not say that with the opening of the Institute the stage of its organization was completed as abovementioned problems had to be solved in the future. Otherwise, liquidation threatened to the university.