bluuebunny/crossref_metadata_2025 huggingface dataset:
AN APPROACH FOR MEDIASTINITIS PREVENTIONIN PATIENTS FOLLOWING CARDIAC SURGERY
Authors: Sotnikov A V , Melnikov V M , Almadi R V , Gorbunov G N
Published: May 2018

The aim of this study was to reduce incidence of sternal deep wound infection (DWI) in patients following cardiac surgery. An experience of cardiac surgery by sternotomy access in 429 consecutive patients was presented. Perioperative intravenous injections of cefazolin were used in 225 patients (control group). Combination of perioperative intravenous injections with local retrosternal irrigation of cefazolin before sternum closure was used in 204 patients (study group). In control group sternal DWI occurred in 10 patients (4.4%), and in 4 patients a resternotomy sanation required. There were no deaths in this group due to infection or sepsis. In follow-up period (3 years), instability of sternum occurred in 3 patients (1.3%), and in 1 (0.4%) sternum reosteosynthesis required. In studied group the sternal DWI did not occur (p<0.01). Sternum instability and/or indications for sternum reosteosynthesis were not determined in follow-up period (2 years). It was concluded, that combination of intravenous and local usage of cefazolin in cardiac surgery patients is a simple and effective approach to prevent sternal DWI. Application of this method significantly (p<0.01) reduces the incidence rate of mediastinitis.
EFFICIENCY OF GAIT FUNCTION CORRECTION AT PATIENTSWITH CEREBRAL PALSY IN THE FORM OF SPASTIC DIPLEGIA
Authors: Eliseev V V , Kulishova T V
Published: May 2018

Under our observation were 71 patients with a spastic diplegia in the age of 3-16 years. Patients are parted on 2 groups. The first group have made 38 children received a treatment complex with application of a functional programmed electrical stimulation on apparatus «ACorD», the second - 33 children received a complex of treatment with application of an electrostimulator «Miorithm-040». Electrical stimulations in both groups of patients were exposed the weakened muscles of legs and a back. Both groups of patients received paraffinic applications, manual massage, a specialized complex of medical physical training, employment in a corrective suit «Adeli». Before and after a complex of procedures function of walking by a technique of research children's orthopedic institute was investigated. At observable patients after application of a rehabilitational complex with including various kinds of a muscle electrical stimulation improvement of gait parameters is noted. Authentically best results are received at application of a rehabilitational complex with including a functional programmed electrical stimulation of muscles.
CLINICAL SIGNIFICANCE OF MICRORNA-21 ExPRESSION IN MONITORINGOF TUMOR PROGRESSION WITH CEREBRAL GLIOMAS
Authors: Seliverstov R Yu , Zarayskiy M I , Sazanov A A , Zueva E E , Lobzyn S V , Gurchin A F , Sterlikova N V , Gaidaenko K P , Volov M B , Tymonina O I , Tolstyh N V
Published: May 2018

The early verifying of cerebral ’s gliomas progression is an actual problem. It was found that the level of mircroRNA-21 expression is a highly specific in a tumor’s evolutional process. That the aim of the study was the assessment with level of mircroRNA-21 expression in blood and saliva of patients with cerebral glioma progression and patients without it which were verified by PET using [ 11C] methionine. It was found that in majority of cases, the negative dynamics of cerebral neoplastic lesions coincided with an increase in metabolic changes in the residual glioma and highly correlated with the level of mircroRNA-21 expression. This allows us to consider a highly significant the level of mircroRNA-21 expression as a screening technique in monitoring the evolution of the tumor process and the effectiveness of the treatment.
DIFFERENTIAL DIAGNOSTICS OF ADRENOCORTICAL INCIDENTALOMASWITH DIFFERENT LABORATORY TECHNOLOGIES
Authors: Velikanova L I , Shafigullina Z R , Vorokhobina N V , Grigoryan K , Lisitsin A A , Obedkova E V
Published: May 2018

The article provides an analysis of the use of immunoassay methods, high performance liquid chromatography and gas chromatography-mass spectrometry in the differential diagnosis of adrenal incidentalomas. Criteria of subclinical Cushing’s syndrome, primary hyperaldosteronism, adrenal incidentalomas without hypersecretion of hormons, early signs of malignant tumors of the adrenal glands are obtained.
BURN STRICTURE OF THE ESOPHAGUS: THE CURRENT STATEOF THE PROBLEM AND THE POSSIBILITY OF ENDOSCOPIC TREATMENT
Authors: Myaukina L M , Trishin V M , Filin A V
Published: May 2018

The article describes the modern methods of diagnosis and treatment of patients with burn strictures of the esophagus. It describes the tactics of planning and supporting dilatation procedures, the reasons for complications and their prevention methods. We are discussing proposed and existing methods bougie with flexible conductor, which allows to minimize the radiological control during medical procedures.
GENETIC POLYMORPHISM OF HAEMOSTASIS
Authors: Sherbak S G , Kamiliva T A , Lisovetch D G , Sarana A M , Jurina E A , Jurkin A K , Makarenko S V , Klenkova N A , Anisenkova A J , Saharovskaia A A , Glotov O S , Glotov A S , Maximov A G
Published: May 2018

Platelets activation and aggregation play an important role in the pathogenesis of atherothrombotic disease and its most important complications such as coronary artery disease and myocardial infarction. In clinical practice it is well-known that, in spite of the documented presence of advanced atherothrombotic disease, only a subset of patients develops acute myocardial infarction during their life-course. The reasons for individual differences in susceptibility to MI are poorly understood. Subjects with hypercoagulability and an increased tendency to form blood clots may be at increased risk. However, this is difficult to assess in clinical practice, since we lack a unique and reliable laboratory marker of hypercoagulability. Moreover, functional tests evaluating concentration and function of blood coagulation proteins are often subjected to multiple transient interferences, e.g. due to the use of antithrombotic and anticoagulant agents or the presence of concomitant inflammation. Genetic polymorphisms with a documented functional effect on blood coagulation proteins may represent a useful diagnostic and prognostic tool. During the last decade the study of polymorphisms as a risk factor for coronary artery disease and myocardial infarction were given largely convincing results. It demonstrated that gene polymorphisms of hemostasis and especially their combined effects are a risk factor for coronary heart disease and its major thrombotic complication - myocardial infarction. Hemostasis as a complex phenomenon modulated by the interaction of multiple genetic factors that do not have predominant action. Polygenic approach as a tool to identify subject at increased risk of developing complications suggests that the simultaneous presence of multiple genetic variations with a weak but significant effect on the process of hemostasis can affect the risk of serious thrombotic complications and that the number of prothrombotic alleles correlates with the risk of myocardial infarction in patients with advanced atherothrombotic disease.
THE PROBLEMATIC ISSUES OF USING MODERN NORMATIVE INDICATORS FOR AN OBJECTIVE ASSESSMENT OF NEEDS PRIMARY HEALTH CAREIN THE SPECIALIST
Authors: Hurtsilava O G , Avdeeva M V , Vaschenkov V V , Luchkevich V S , Logunov D L
Published: May 2018

The article presents the results of determining the needs of a typical urban polyclinic in medical personnel in accordance with the recommended load standards 1 medical post. Show that the existing federal method has a number of drawbacks, since it ignores the differences in measuring units of the volume of medical care that can be calculated not only with a single visit, but finished case of treatment of the disease. In particular, according to the calculated data, made under the federal method, in an urban polyclinic should be cut 55 full-time medical posts because of their overabundance. However, in reality, for polyclinic is typical not surplus, but a deficit of medical personnel. This disagreement is due to the fact that 55,3% of the total number of visits took place during the year amounted to finished cases of treatment of the disease in accordance with the current standards of medical care. Therefore, at the present stage of development of human resources planning it is extremely important improvement of the federal method of calculating the needs of medical institutions in medical personnel due to the development of the correction coefficients, corrective statistics on the total number of visits for the year.
MUSIC THERAPY OF PREMATURE NEONATES:ACHIEVEMENTS AND PROSPECTS
Authors: Dumov E L , Nöcker-Ribaupierre M , Andrushchenko N V , Iova A S
Published: May 2018

Research of effects of music on premature infants has been performed since 1970 th. The vast majority of investigations have revealed essential positive effects of music on various physiological indices of infants. During the previous 40 years, music therapy has developed from simple acoustic stimulation of a neonate to complex types of musical and psychotherapeutical interventions directed not only at an infant, but also at caregivers (primary at a mother) in order to support bonding of the dyad, disconnected by perinatal stress and long-term hospitalization in a NICU. In spite of multiple works about music therapy of neonates, a couple of aspects still require further research. Unfortunately, in the domestic literature we have succeeded to find relatively few reports about music therapy of neonates, whereas in several foreign clinics this method has already been included in the routine clinical practice. Possibly, “the acoustical mama-therapy” could appear optimal in domestic neonatal units.
THE PROCESS APPROACH IN THE MANAGEMENT OF A MULTI-HOSPITAL, AS A TOOL IMPROVE ITS EFFICIENCY
Authors: Filatov V N , Khayrullin I I , Kadyrov F N
Published: May 2018

In view of the increasing demands from stakeholders (patients, management, insurance companies, media, etc.) to ensure the quality of health care and the implementation of the program of state guarantees in the current difficult conditions of increasing importance is the efficient and performance management of medical organisation (MO). As part of these requirements has been widely discussed question of the necessity of building a system of quality management MO. Practical experience shows that building a systematic approach to quality management depends primarily on the availability of managerial competencies for managers and heads of departments MO, as well as their level of motivation, or resistance to organizational change. One of the tested and proved to be a reliable tool in the management of the quality of medical practice is a process approach. With this management tool, it is possible to present the activities of MO as a chain of interrelated processes. It defines the criteria for the quality of the product, the necessary resource and regulatory support, introduces the institute of internal and external customer, which ultimately has a positive effect on the performance indicators and efficiency MO.
RATING ASSESSMENT OF KEY INDICATORS OF WORKOF THE EMERGENCY MEDICAL SERVICE
Authors: Barsukova I M
Published: May 2018

In article the rating assessment of 51 indicators influencing work of an emergency medical service for identification of the most actual for increase of efficiency of its work is carried out. Indicators are considered on three characterologic signs (the directions of influence): from the point of view of its influence on achievement of optimum volume indicators of work of service (number of departures; number of the persons who received medical care including on 1000 population); from the point of view of its influence on achievement of availability (efficiency) of work (increase of a share of departures with "arrival time" to the patient in the range of 20 min) ; from the point of view of its influence on achievement of quality of rendering an emergency medical service (improvement of quality of medical and diagnostic process, decrease in a share of a divergence of diagnoses of an emergency medical service with clinical diagnoses of hospitals). The method of expert evaluations with calculation of weight coefficients is used. The most significant indicators of work of an emergency medical service (in the all 3rd directions of influence) became: compliance of total of crews of population of the served territory (first of all - medical all-profile and medical assistant's); average daily load of crew of an emergency medical service; compliance of total number of cars of an emergency medical service to settlement indicators. Thus, the conducted research directed on determination of the importance of indicators of work of an emergency medical service with use of method of expert evaluations allowed to allocate the most actual, to recommend them further as indicators of work of an emergency medical service.
NARROWBAND OPTICAL EMISSION WAVELENGTH OF 540 NMIN THE COMPLEX TREATMENT OF CHILDREN WITH CHRONIC GASTRODUODENITIS
Authors: Kiryanova V V , Alexandrova V A , Gordeichuk A V
Published: May 2018

Effects of low-intensity narrow-band optical irradiation wavelength of 540 nm on the clinical course of chronic gastroduodenitis in children, the mucous membrane of upper gastrointestinal tract morpho- logical status, the motor function of the gallbladder and esophagus. It was discovered that combina- tion therapy has a definite advantage over drug treatment on elimination of clinical manifestations and morphological and motor indicators of gastrointestinal tract dicfunction
MOTIVATION AS A FACTOR OF INFLuENCE ON THE SuCCESS OF FOREIGN LANGuAGE TEACHING OF POSTGRAduATES IN MEdICAL SCHOOLS
Authors: Kubacheva K I
Published: May 2018

The article is devoted to investigation of the motivation in learning a foreign language by postgrad- uates in the medical school. Motivation is regarded by the author as a factor of influence on the success of the professional foreign language teaching. The paper presents a theoretical analysis of experimental studies of postgraduate teaching issues such as: individual personality traits, the status in the group, positive or negative experience of learning a foreign language, etc. This article contains the material on the results of the postgraduate students’ survey on issues related to the objectives of learning a foreign language, its application possibilities in practical professional work and so on.
AGE-RELATED CHANGES IN THE LIVER
Authors: Radchenko V G , Seliverstov P V
Published: May 2018

In the process of life the human body undergoes a number of changes which, in lead to its aging. Physiological aging is accompanied by irreversible functional and organic restructuring of all systems and organs, including the liver. The most common cause of diffuse changes of a parenchyma of the liver in elderly patients is steatosis, which is an important role of mitochondrial dysfunction. For the treatment and prevention of liver diseases, against skin aging is inevitable, it is expedient to apply preparations with a multidirectional effect on the various links in the pathogenesis of liver damage. Systematic implementation of preventive measures will allow older people to maintain good health and performance for years to come.
EVOLUTION OF THE FRAILTY CONCEPT
Authors: Turusheva A V , Frolova E V , Degryse J M
Published: May 2018

Following the worldwide trend of population ageing, the number of older adults in Russia is increas- ing. The population of older adults is highly heterogeneous. Some people live to old age in good health and retain the ability to be independent and active participants of society, while others experience a reduction in physical and cognitive functions and lose their ability to live independently. This group of older adults needs additional assistance leading to increased financial costs due to their treatment and follow up. The concept of frailty was proposed as a potential predictive tool for this population of older adults. The aim of this study was to present different frailty models and history of development of the frailty concept.
CASE REPORT ABOUT LEBER HEREDITARY OPTIC NEUROPATHY:DIAGNOSTICS AND TREATMENT
Authors: Golovkin V I , Shandurina A N , Fomintseva M V , Pervova E M , Zhulev S N , Garyshina Yu O
Published: May 2018

The article presents clinical case of rare form of Leber hereditary optic neuropathy with permanent hand tremor. diagnosis is confirmed by genetic test for major mutation. The possibility of treatment with transcutaneous electrostimulation of optic nerves in case of epigenetic provocation on a intoxicat- ing theory of gene expression is discussed.
DIAGNOSIS AND TREATMENT OF STOMACH CANCERCOMPLICATED BY BLEEDING
Authors: Zemlyanoy V P , Sigua B V , Gubkov I I , Zakharov E A , Mavidi I P , Mikhailov G A , Sakhno D S
Published: May 2018

The article presents an analysis of domestic and foreign literature on the diagnosis and treatment of stomach cancer complicated by bleeding. The absence of unanimity in the choice of treatment strategy, timing and extent of surgical intervention, the feasibility and scope of lymphadenectomy
EPIDEMIOLOGY, SOCIAL ASPECTS AND PATHOGENESIS OF OBESITY
Authors: Simanenkov V I , Tikhonov S V , Ilyashevich I G , Ledovay A V , Makiyenko V V , Fedorova N V
Published: May 2018

The article presents modern data on epidemiology, risk factors, social aspects, etiology, pathogenesis of obesity, particular attention is paid to the influence of maternal nutrition and child in the perinatal period, genetics and epigenetics, microbiome in the pathogenesis of obesity, physiology and pathophysi- ology of adipose tissue
LATE-ONSET HYPOGONADISM EFFECTS ON CORONARY HEART DISEASE
Authors: Shustov S B , Kitsyshin V P , Frolov D S , Makarova A V
Published: May 2018

A total of 161 men with at a mean age of 58 (52; 64) years were available for examination. Sixty of them presented with coronary artery disease and confirmed late-onset hypogonadism, 80 had coronary artery disease and normal testosterone, 21 had no coronary artery disease and no hypogonadism. The study included echocardiography, Holter monitoring, heart computed tomography, coronarography and estimation of depression level. We found that low testosterone in patients with coronary artery disease is associated with decreased left ventricular ejection fraction, atypical anginal syndrome and subclinical depression. Men with androgen deficiency and ischemic heart disease have lower heart rate variability, longer time of ST interval depression and greater amount of extrasystoles, than patients with ischemic heart disease and no androgen deficiency. There is a negative correlation between total testosterone and amount of myocardial revascularisation operations in men with normal testosterone. Patients with free testosterone <9pg/ml have more severe coronary artery disease than men with free testosterone >9pg/ml according to coronary angiography.
NON-ALCOHOLIC FATTY LIVER DISEASE AS A NEW COMPONENT OF THE METABOLIC SYNDROME IN THE LIGHT OF MODERN METHODS OF DIAGNOSIS
Authors: Denisov N V , Grinevich V B , Chernetcova E V , Kornouchova L A , Kravchuk U A , Partsernyak S A , Mironenko A N
Published: May 2018

The aim of the research was to study the biochemical model of morphological changes in the liver of patients with different forms of non-alcoholic fatty liver disease NAFLd, overweight and abdominal obesity (AO). Morphological changes in liver tissue were determined by non-invasive method Ste- atoskreen . The study evaluated the relationship between the cytolytic syndrome, forms of NAFLd and various manifestations of metabolic syndrome (MS). According to the survey, morphologically NAFLd was confirmed in 98% of patients using non-invasive diagnostic test Steatoskreen . The progression of different forms of NAFLd was significantly correlated with various metabolic disorders (dyslipidemia, impaired glucose metabolism, insulin resistance, obese) increases with the progression of NAFLd.
THE MODERN APPROACHES TO DIAGNOSIS AND LASER TREATMENTOF AGGRESSIVE POSTERIOR RETINOPATHY OF PREMATURITY
Authors: Saidasheva E I , Buynovskaya S V , Kovshov F V , Levadnev Y V
Published: May 2018

Presented of сomparative results of diagnostics and laser treatment of 63 very premature born babies with aggressive posterior form of retinopathy of prematurity, divided into two groups: 1 (main) - 39 (62%) children to whom except standard ophthalmologic methods of research it was fluorescein angio- graphic of a retina with the pediatric retinal camera RetCam3; 2 (control) group made 24 (38%) the child without FA. The angiographic signs allowing to diagnose the beginning of a disease and its recur- rence are defined. Installed the difference in efficiency of laser treatment in groups: 87,2% in 1 group and 79,2% in the 2nd group. FA is a safety and high informational method in diagnostic and treatment process of aggressive posterior retinopathy at babies with the term of a gestation of 22-30 weeks is shown.
THE ACTIVITY OF APOPTOSIS AND PREMATURE AGING IN YOUNGAND MIDDLE-AGED MAN WITH POLYMORBID CARDIOVASCULAR DISEASEAND NON-PSYCHOTIC MENTAL DISORDERS
Authors: Partsernyak A S , Aflitonov M A , Khalimov Y Sh , Kireeva E B , Mironenko A N , Partsernyak S A
Published: May 2018

Objective: To study the activity of apoptosis and premature aging in individuals of middle age with polymorbidity cardiovascular disease and non-psychotic mental disorders.Design and methods: The study included 78 men with MCVP and 20 healthy men. used in the study: complex psychological test methods and laboratory-instrumental evaluation of the cardiovascular system. definition p53 protein was performed by ELISA using kits BMS eBioscience BMS256 (BenderMedSys- tems, uSA). Results: n the group of patients with polymorbidity cardiovascular disease (PTS) of the p53 protein level was 4,89 uI / ml in the control group, p53 0,93 uI / ml. In all groups celebrated the acceler- ated pace of aging by an average of 10 years, compared with the control group. In the second phase of the study, patients were divided into three groups, depending on the planned treatment scheme. In the group of patients treated with standard therapy of p53 protein level was 3,51 uI / ml, from the group comprising in addition to standard therapy, psychotherapy - 2,34 uI / ml, in the third group, where the methodology of psycho-physiological and psychological visual and auditory correction - 1 8 uI / ml. After a course of treatment in all groups showed slowing premature aging . The first and second groups , a transition of V in class IV , the third group III to V of the functional class of aging . during the correlation analysis it was found a strong correlation between p53 protein and BV (r + 0,69; p < 0.05).Conclusions: Patients with polymorbidity cardiovascular disease marked increase in titer of apop- tosis protein p53 , accelerating premature aging 7-10 years. A direct correlation between p53 protein and biological age (r + 0,69; p < 0.05). Against the background of complex treatment with standard therapy with psycho-physiological and psychological visual and auditory correction decreased prema- ture aging, as compared with the groups that used the standard therapy for 8-10 years.
СHOICE METHOD OF OSTEOSYNTHESIS HIGH FRACTURES CONDYLAR PROCESSOF THE MANDIBLE
Authors: Devdariani D Sh , Kulikov A V , Bagnenko A S , Baranov I V , Aleksandrov A B , Arno A V
Published: May 2018

Osteosynthesis condyle without replantation , with replantation and osteotomy of the mandible branch at, modification A. Zhilonov, gives good results if the indications for their use are defined by J. Prein classification , taking into account the nature of the displacement of the small fragments
LOW-VOLUME CARDIOPLEGIA BY «CUSTODIOL» SOLUTIONIN CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS
Authors: Istomin T A , Kurapeev I S , Mihaleva Y B , Suborov E V , Domanskaya I A , Vasilieva G N
Published: May 2018

The study presents the results of quality assessment of antiischemic myocardial protection by low- volume method of cardioplegia by «Custodiol» solution during operations with cardiopulmonary by- pass. The study involved 57 patients who underwent different cardiosurgery operations with cardio- pulmonary bypass. The patients were divided into two groups on the basis of the volume of cardioplegic solution. Research group (Group № 1) consists of 33 patients who were administered «Custodiol» in low volume limited by 1000 ml. The control group (Group № 2) consists of 24 patients who were ad- ministered standart volume of the solution corresponding to the manufacturer's instructions: 1 ml per 1 g of myocardial mass during 6-8 minutes. The results has indicated that the use of low volume of car- dioplegic «Custodiol» in a single administration manner provides a complete antiischemic protection of the myocardium during the correction of valvular heart disease, including combination with coronary artery bypass grafting. usage of low volume «Custodiol» solution method does not increase the need of inotropic and vasopressor usage and pacing time. The use of low volumes of «Custodiol» helps to reduce transfusion requirements of blood and its components.
TREATMENT AND RECURRENCE PREVENTION OF ACUTE ADHESIVE INTESTINAL OBSTRUCTION
Authors: Filenko B P , Zemlyanoy V P , Kotkov P A
Published: May 2018

Surgical treatment of acute adhesive intestinal obstruction is an unsolved problem due to the high frequency of relapses. The aim of this work was to improve the results of treatment of patients with acute adhesive intestinal obstruction by preventive measures improvement. The paper set out the principles of curative and prophylactic algorithm, that can help to reduce the frequency of relapses and improve long-term results. The algorithm includes operative treatment using endovideosurgical access and differentiated approach to the use of preventive measures. The best results were achieved by per- forming planned surgical operations.
RADIOFREQUENCY ABLATION AS SUPPORTING METHOD IN METASTATICHEPATIC TUMORS TREATMENT FOR COLORECTAL CANCER PATIENTS
Authors: Topuzov E E , Bobrakov M A , Balashov V K , Drogomireckaya E I , Erokhina T A , Kislicina O N , Petriashov A N , Kruglov A N , Topuzov R E , Napolskaya E V
Published: May 2018

In article introduced modern research data. Made a comparative evaluation of several treatment methods: radiofrequency ablation, liver resection, combination of those those methods. At the moment, comparison of these methods is difficult, because liver resection candidates usually have better health status. Even when compared radiofrequency ablation and liver resection in comparable groups, results ambiguous. despite the accumulated experience of radiofrequency ablation use in colorectal cancer treatment, Many questions remain unsolved - indications and contraindications, optimal size and num- ber of tumor focuses, surgery implementation ways, navigation and postoperative monitoring, combina- tion with other treatment methods and etc. In this review examined different views on treatment with radiofrequency ablation use.
CLINICAL AND MEDICO-LEGAL ASPECTS OF INJURIES OF THE MAXILLOFACIAL AREAAND NECK, COMPLICATED BY INFECTIOUS PROCESSES
Authors: Mironenko A N , Popov V L , Egorova O A
Published: May 2018

Two clinical cases of maxillofacial and neck injuries complicated by acute inflammatory processes demonstrated the necessity of involvement of the maxillofacial surgeon in expert commission and al- gorithm design.
ASSESSMENT OF AWARENESS OF FAMILY PHYSICIANSABOUT THE OSTEOPOROSIS AS A PROBLEM OF ELDERLY
Authors: Kuznetsova O Yu , Moiseeva I E
Published: May 2018

The prevalence of osteoporosis in Russia is about 10%, and in the age group over 50 years - up to 25-35%. The role of primary care physicians in the prevention, diagnosis and treatment of this disease is high, because 80% of patients seeking medical help in primary health care. The article presents the results of the assessment of the awareness of the general practitioners (family doctors) on the preven- tion, diagnostics and treatment of osteoporosis
PSYCHOLOGICAL CHARACTERISTICS AND QUALITY OF LIFE OF CANCER PATIENTS WITH CONCOMITANT CARDIOVASCULAR PATHOLOGY
Authors: Poroshina E G , Vologdina I V , Pestereva E V
Published: May 2018

The aim of the study was to explore the psychological characteristics and quality of life of patients with cancerous tumor combined with cardiovascular disease. 81 middle-aged patient (51,4±4,6 years) with cancer of different localization examined. Additionally, 42 patients had a concomitant cardiovas- cular pathology. Group of comparison consisted of 39 patients. The following tests and scales were used: test TOBOL for studying the issues of patients’ reaction to desease, Spielberger-Khanin scale to monitor level of anxiety, SF-36 questionnaire to analyze the quality of life. unlike the patients without cardiac pathology, the cancer patients with concomitant cardiovascular pathology showed higher anxi- ety and lower quality of life assessment
ANALYSIS OF STABILOMETRY BY PEOPLE OVER 65 YEARS
Authors: Safonova Yu A , Emelyanov V D
Published: May 2018

The study was conducted to assess the risk of postural balance disorders among people older than 65 years with various diseases by analyzing stabilometric indicators. Among people older than 65 years the risk of falls into the position in the the side and back (r = 0,89, r = 0,96, respectively) during self-ver- ticalization was identified. At the age of 85 years and older the length and speed of displacement of the center of pressure (p <0.01) is significantly increased, which corresponds to the high frequency of falls 61.36% (95% CI 10,5-21,8, p <0.001). Among men, deviations of length, speed and area of the center of pressure are greater than that of women (p <0.001). A significant influence on stabilometric indicators was revealed in obesity, COPd, coronary heart disease, postmenopausal osteoporosis, sarcopenia, and a history of stroke. At the same time comorbid conditions, sleep disorders, lone accommodation had no significant impact on stabilograms.
INVESTIGATION OF CYTOCHROM P450 2C19 GENETIC POLYMORPHISM AND ITS EFFECT ON THE THERAPY OUTCOME IN PATIENTS WITH GERDIN THE CRIMEAN POPULATION
Authors: Rabotyagova Yu S , Klyaritskaya I L
Published: May 2018

Was investigated genetic polymorphism of cytochrome P450 2C19 and studied its effect on out- come of PPIs therapy in 136 patients of the Crimean population suffering from gastroesophageal reflux disease. Patients were divided into three groups: those with erosive esophagitis - 49, with non-erosive reflux disease - 60, with reflux hypersensitivity - 27. It was found that in that sample of patients of the Crimean population genetic polymorphism was introduced *1/*1 and *1/*2 genotypes. Carriage genotypes *1/*1 and *1/*2 are equally common among male and female. Patients with genotype *1/*2 are more likely to occur a complete response to PPIs therapy, than those who carry genotype *1/*1 (odds ratio 3.237). Patients with erosive esophagitis equally common carriers of both genotypes but patients with genotype *1/*1 more common show patrial respons to PPIs therapy (odds ratio 1,795). Among patients with NERd more often met favorable outcome of PPIs therapy, but the carrier of any of the genotypes was not identified as risk factor. Among patients with reflux hypersensitivity clinical respons to PPI therapy affected by CYP2C19 genotype condition: patients with genotype *1/*1 were more likely to develop treatment failures than those with *1/*2 genotype (odds ratio 2,786).
DEVELOPMENT OF AN AUTOMATED WORKPLACE OF THE DOCTOR-SPECIALIST IN DERMATOLOVENEROLOGY
Authors: Kupeeva I A , Raznatovsky K I , Ravodin R A
Published: May 2018

In the article the questions of creation of the automated workplace (AWP) specialist doctor are considered. On the example of development of the automated workplace of the dermatoven- erologist shown its functionality and ways of interacting with other structural elements in the provi- sion of dermatological care to the population. On the basis of the developed automated workplace the algorithm of work of the dermatovenerologist is offered
USING QUALITY EVALUATION CRITERIA FOR EDUCATIONAL SERVICES IMPROVEMENT IN THE CHALLENGING POST-GRADUATE MEDICAL EDUCATION CONDITIONS
Authors: Rizakhanova O A , Melnikova E A , Filatov V N , Gonchar N T
Published: May 2018

The article is devoted to the research of evaluation criteria of the educational services' quality and search possibilities of these criteria analysis influence on educational process improvement. The work presents theoretical analysis of the problem of assessment of the quality of education in the conditions of additional professional education system reform in Russia. The article presents data from retrospec- tive analysis of questionnaires from the trainees of the department of Public Health, Economics and Management in Health Care System on the questions, related to the quality of educational process in the frame of the post-graduate training courses and primary professional education. The work presents retrospective analysis of the education quality assessment based on the testing methods of professional competencies of trainees. Approaches towards educational process, proposed in the research, aimed to help in the objective assessment of the readiness of the suppliers and end-users of educational services in the professional medical additional professional education to implement new forms of education in the conditions of the challenging professional education in Russia.
EFFICIENT TREATMENT TO BETA-AMYLOID VASCULITIS
Authors: Golovkin V I , Ovdienko O A , Tikhonova M L , Gulak D A , Zhulev S N
Published: May 2018

The article contains own observation beta-amyloid cerebral vasculitis (associated with cerebral amyloid angiopathy), a diagnosis using the MRI gradient echo mode, immunoassays for the mainte- nance of serum amyloid, interleukin-1, intrathecal antibody synthesis and immunosuppressive treat- ment metipred and azathioprine positive result.
EXTRAPONTINE MYELINOLYSIS: CLINICAL AND IMMUNOLOGY FEATURES ONE CASE
Authors: Lobzin S V , Golovkin V I , Ephymov I M , Timonina O I , Garishina J O
Published: May 2018

The article presents clinical observation of a rare form of demyelinating diseases of the brain - ex- trapontine of myelinolysis, a feature which was detection of intrathecal synthesis of light chains of im- munoglobulins.
FEATURES OF COLON DIVERTICULOSIS LATE COMPLICATIONS SURGICAL TREATMENT
Authors: Zemlyanoy V P , Sigua B V , Nikiforenko A V , Latariya E L , Sharvadze K O , Dadalov S A
Published: May 2018

Diverticular disease of the colon is frequent bowel disease. Wide spread of this pathol- ogy, especially among elderly patients, is caused by characteristics of the diet in developed countries. In modern conditions the clinician is faced with the complicated forms of diverticular disease, in some cases requiring urgent surgical intervention. However, the frequency of diagnostic errors on the back- ground of complicated diverticular disease can reach significant values. A clinical case, indicating the significant difficulties, appearing while diagnosis and surgical treatment of diverticular disease late complications is exampled.
OCULAR DIROFILARIASIS CASES IN A TEMPERATE ZONE
Authors: Zumbulidze N G , Khokkanen V M , Kasimov F O
Published: May 2018

Over the last years, there is a pronounced tendency of increase in number of dirofilariasis infected animals and humans in the temperate climate area. In the article, four clinical cases of ocular dirofila- riasis are presented, diagnosed in ural and North-Western Regions of the Russian Federation. upon larvoscopic examination, dirofilaria Repens immature female was identified in all cases.
THE WAY OF RECONSTRUCTIVE SURGERY IN CHRONIC DUODENAL ULCER, COMPLICATED BY BLEEDING WITH SEVERE BLOOD LOSS AFTER RETROCOLIC GASTROJEJUNOSTOMY
Authors: Sigua B V , Zemlyanoy V P , Danilov A M , Klimov S E , Romanenko O A , Rodin A O
Published: May 2018

Currently, surgical treatment of gastrointestinal bleeding is based primarily on topical preoperative identification of their source. In this regard, the treatment of patients with bleeding from unknown sources is a difficult task and is accompanied by a high mortality rate. In such cases, in the absence of confirmation of gastrointestinal bleeding source, treatment should base on the clinical pic- ture. A successful case of surgical treatment of patient with chronic duodenal ulcer, complicated with bleeding after retrocolic gastroenteroanastomy is described.
FROM PATHOLOGICAL PROCESSES TO PATHOGENESIS OF MEdICALLY ALLERGY
Authors: Mavlyanov I R , Ashirmetov A H , Mavlyanov Z I
Published: May 2018

. In modern medicine huge interest causes the analysis of the nature of allergic diseases from positions of a complete organism. Are given total approach to an assessment of pathogenesis of an allergic disease which gives the chance to understand a number of situations which can be observed in the field of practical allergology in the present article. It is known that the sensitization of an organism can be shown to different factors (allergens) as rather exotic on the properties which aren't possessing any specific characteristics, that is symptoms of an allergic state can be shown and regardless of a type of allergen. Any allergic state needs to be considered through a prism of reaction of all organism which level is reflection of its reactivity. That is why symptoms of an allergy need to be considered as addi- tional protective mechanisms which turn on in regulation of a homeostasis at certain, often not shown clinically insolvency drainage дезинтоксикационных functions of an organism.
CLINICAL ANd IMMuNOLOGICAL CHARACTERISTICS POSTOPERATIVE PERIOd AT HEMIFACIAL ALLOGRAFTS AVASCuLAR SKIN FLAP
Authors: Hurtsilava O G , Voloh M A , Lila A M , Aksenova S A
Published: May 2018

In an experiment on rats Wistar family and dark Agouti immunological status of recipients has been studied with facial allograft skin flap in the early and late postoperative periods. The evaluation of the state of the transplant and the general condition of the recipient rats after surgery immunosuppressive therapy.
ASSESSING THE POSSIBILITY TO APPLY THE FIBRIN GLuE BY CORd BLOOd PLASMA AS A SCAFFOLd FOR MESENCHYMAL STEM CELLS TRANSPLANTATION
Authors: Enukashvily N I , Aizenshtadt A A , Bagaeva V V , Supilnikova O V , Ivolgin D A , Maslennikova I I , Novikova S V , Adylov Sh F
Published: May 2018

Mesenchymal stem cells (MSCs) and pre-chondrocytes (MSK-Ch) derived from them are an ef- fective tool for the restoration and maintenance of joint cartilage. This approach is based on the use of MSCs as a) chondrocyte precursor to form a cartilaginous implant, b) producing a large number of bioactive factors in the area of implantation. delivery of MSC and MSC-Ch into the damaged joint can be achieved by the implantation of scaffold with cells to ensure retention of the cells at the injection site and an additional supply of cells of biologically active substances.Scaffold based on fibrin glue (FG) are promising because of the high biocompatibility, biodegrad- ability, ease of use. FG cryoprecipitate of autologous plasma (Au-FG) patient or allogeneic umbili- cal cord blood plasma (uCB-FG) in some cases may be regarded as a preferred embodiment of ready commercial products. The advantages of the Au-FG are to minimize the side effects, risks of infection and the occurrence of allergic reactions, availability and reduced cost of the procedure. uCB-FG is enriched with biologically active substances and derived from byproduct during collection stem cells from the cord blood.We have developed a protocol that allows to obtain FG in a closed system throughout the entire process of blood sampling until the transplant procedure, which makes it possible clinical application of the Au-FG and uCB-FG. Also shown that cultivation in Au-FG and uCB-FG does not change the immunophenotype of cells and the level of their proliferation and has a stimulating effect on chondro- genic differentiation.
FEATURES OF LEFT VENTRICLE DIASTOLIC FUNCTION IN PATIENTS WITH NON Q-WAVE MYOCARDIAL INFARCTION AFTER PERCUTANEOUS INTERVENTION
Authors: Khomyakova D A , Sayganov S A , Grishkin Y N
Published: May 2018

Aim: To make natural development more exact to state the value of scientific prognostication of dia- stolic dysfunction with acute myocardial infarction without Q-wave after percutaneous intervention.materials and methods: 95 patients were subjected to coronography and revascularization of in- farct-related artery. The patients were divided into 2 groups depending on angiographic results with single and multivessel affection. during first 48 hours from the beginning of the disease they were under ECHO examination.Results: Left ventricle affections dF data were revealed relatively to heaviness of affection in cor- onary vessels without reliable differences in local and global contractility. Primordialy the 1 group contained 14 (54%) patients of I grade dd, 5 (19%) with II grade, 1 (8%) with III grade, 6 (19%) without dd. A year later: 18 (70%) with I grade dd, 3 (12%) with II, patients with III grade were not redictered, 5 (18%) without dd. In group 2 within first 48 hours 37 (54%) patients had I grade,25 (36%) II grade, 7 (10%) III grade. In a year there were 46 (67%) with I grade, 13 (19%) II grade, 3 (4%) with III grade dd, 7 (10%) without dd.Conclusions: Obtained data indicate of a higher sensitivity dependently dF ischemia.In contrast to myocardial infarction group with coronary bloodstream fully restored within short terms, in group with multivessel affections a more heavy dd data preserved longer, in spite of infarct related artery revascularization. Also unfavourable events were revealed.
REMOdELLING OF THE LEFT ATRIAL AT THE PATIENTS WITH ATRIAL FIBRILLATION IN VARIOuS METHOdS OF SINuS RHYTHM RECOVERY
Authors: Gromyko T Y , Sayganov S A
Published: May 2018

Aim. To compare features of straight and return remodeling of the left atrial (LA) at patients with atrial fibrillation (AF) at various options of sinus rhythm (SR) restoration depending of a choice of the cardioversion. Material and methods. We examined.153 patients with the nonvalvular AF lasting from24 hours to 6 months. All patients were divided in 3 groups. In group 1 (49 patients) SR was restored medically, in the group 2 (57 patients) SR was restored by means of electrical cardioversion (EC), in the group 3 (47 patients) underwent radio-frequency isolation of pulmonary veins (RFI PV). Echocardiog- raphy was performed to all patients at the time of AF, and also on 1, 3, 5, 15 days and in 6 months after recovery of SR with an assessment systolic and the diastolic function of left ventricle (LV), thickness of walls of a myocardium, the front and back size of the LA, volume of LA, and also design parameter of LA pressure (E\E’) by Tissue doppler visualization.Results. Index LA (ILA) authentically decreased at the patients, who are exposed to RFI PV, at preservation of SR compared with recurrence of AF for 6 months (р<0,05). In group of medical therapy index of volume LA (IVLA) initially it was authentically lower at patients with resistant SR for 6 months, compared with recurrence of AF (р<0,05). And also IVLA authentically decreased in group RFI PV without paroxysms of AF for 6 months (р<0,001). At the medical cardioversion LA pressure (E\E’) authentically decreased by 2 weeks (р<0,05) without paroxysms of AF and significantly didn't change by 6 months. While in the presence of paroxysms of AF for 6 months only the tendency to de- crease of this parameter was noted. And in group of RFI PV reliable dynamics of pressure in LA was recorded at patients without paroxysms of AF by 2 weeks (р<0,05) and by 6 months (р<0,05). While in the presence of paroxysms of AF this parameter significantly didn't change by 6 months. In the group of EC reliable dynamics of the estimated parameters of LA remodeling isn't detected.Conclusions. At patients with AF after cardioversion and without paroxysms of AF for 6 months LA sizes authentically decrease in group of medical therapy (IVLA, (р<0,05)) and at RFI PV (ILA, (р<0,05), IVLA (р<0,001)). LA pressure (E/E’) could be considered as a reliable parameter of the return remodeling of LA after cardioversion and without paroxysms of AF for 6 months in cases of medical therapy (р<0,05) and RFI PV (р<0,05).
POTENTIAL ROLE OF INTRAVITAL ARTERIAL EMBOLOGENIC THROMBI ON CARDIO-VASCULAR CATASTROPHIC EVENTS ACCORDING TO POSTMORTEM INVESTIGATIONS
Authors: Melnikov M V , Sotnikov A V , Vinnichuk S A , Melnikov V M , Korostelev D S
Published: May 2018

Aim. The purpose of our study was to value the role of potential arterial emboli sources in death cause according to postmortem data collected in deceased from all causes in a multifield hospital.Material and methods. We performed retrospective analysis of 1324 postmortem records of died pa- tients for the past 6 years (2011-2016). We registered patients’ age and sex, thrombus site, definite intravital clinical and anamnestic data, individual features of tanathogenesis.Results. Intravital thrombus formation was found in 64 of died patients (4,8%), mean age 73,9±2,7 years, women 51,5%. In 41 patients (1 group) there were firm wall thrombi in aorta, in 23 patients thrombi were found in heart cameras (2 group), mostly in left atrial appendage (LAA). Generalized atherosclerosis presented more often in 1 group - 95,5% vs 39,1 in 2 group (p<0,005). The most com- mon cause of death in both groups was acute myocardial infarction. In 1 group infarction was often in combination with acute blood supply disturbances in various arterial regions. For deceased of 2 group thromboembolic fatal events were more typical.Conclusion. It was found that the most dangerous thrombi regarding thromboembolic events were intracardiac ones, mainly in LAA. Aortic wall thrombi have become the marker of generalized athero- sclerosis. The last ones predetermined high probability of ischemic complications in multivessel areas.
DIAGNOSTIC AND SURGICAL TREATMENT OF ACUTE DESTRUCTIVE CHOLECYSTITIS IN PATIENTS WITH SUB- AND DECOMPENSATED CARDIOVASCULAR DISEASES
Authors: Gurtskaya L Z , Kokhanenko N Y , Lugovoy A L , Danilov S A , Ivanov A L , Morozov E A
Published: May 2018

The work presents the indications for the choice of methods of diagnostic and surgical treatment of acute cholecystitis in patients with decompensated cardiovascular diseases. When covering the possibil- ity of diagnostic methods, their specificity and sensitivity. detailed characteristics of such instrumental techniques as ultrasonography, magnetic resonance cholangiopancreatography, magnetic tomography, echocardiography, electrocardiography, diagnostic laparoscopy has been given. The role of specific bio- chemical markers of myocardial necrosis has been showed: kretinfosfokinaza, cardiac troponin-I. Pos- sible changes on the electrocardiogram in these patients with acute cholecystitis and reasons for their appearance have been described.
НIGH-RENIN HYPERTENSIONS: FROM SYMPTOM TO dIAGNOSIS
Authors: Barsukov A V , Korneychuk N N , Shustov S B
Published: May 2018

The article highlights the current understanding of renin-angiotensin-aldosterone system function- ing, as well as mechanisms for blood pressure raising depending on its activity. Authors presented data on the prevalence and characteristics of arterial hypertension with high levels of renin. Along with high-renin essential hypertension authors considered secondary arterial hypertensions accompanied by high-renin status increasing the diagnostic value of this hormone determination and explains the fea- tures of pathophysiological processes occurring in patients’ organism. Authors proved the importance of renin status diagnostic studies allowing defining a successful strategy of antihypertensive therapy.