bluuebunny/crossref_metadata_2025 huggingface dataset:
STATISTICAL ANALYSIS OF THE RESULTS OF SYNCHRONIZATION OF THE CONTOURS OF AUTONOMIC CONTROL OF CARDIOVASCULAR SYSTEM DURING THE FUNCTIONAL TEST WITH BREATHING OF VARIABLE FREQUENCY
Authors: Borovkova EI I , Manafova EA A , Zazulya AA A , Karavaev AS S , Kiselev AR R
Published: October 2020

Aim - the study of characteristics of the interaction between the contours of autonomic regulation of the cardiovascular system. Materials and methods. We studied the recordings of electrocardiograms and photoplethysmograms of 25 healthy subjects taken during the functional test with chirp breathing. Synchronization of the regulation contours was studied using the previously proposed approaches. Statistical analysis of the results was carried out. Results. We have studied the rhythms with a frequency of about 0.1 Hz. It was revealed that these rhythms are synchronized under the influence of breath. We calculated the duration of the synchronization intervals. Conclusion. The results support the hypothesis for autonomy and functional independence of the studied regulation contours.
ANALYSIS OF MORPHOLOGICAL PARAMETERS OF DENTAL SYSTEM WITH GNATHIC FORM OF MALOCCLUSION CLASS III USING SIMPLYCEPH SOFTWARE (RUSSIA)
Authors: Kuznetsova GV V , Persin LS S , Kuznetsov DA A , Markaryan LG G , Batler MA A , Novitskaya AD D , Rodivilova IB B
Published: October 2020

Mesiocclusion associated with asymmetric mandibular development is a gnathic form of mesiocclusion characterized by asymmetric deformation of the facial skeleton, requiring detailed examination to perform differential diagnostics. We need to analyze lateral teleroentgenogram of the head using «SimplyCeph» software, frontal teleroentgenogram of the head, multidetector computed tomography. According to scientific data, asymmetric mandibular development is much rarer in clinical practice. Etiology of this abnormality is not determined to date. It is believed that growth zones are activated in condyloid process and mandibular angle for unknown reasons. Aim - to determine the morphological condition of stomatognathic system on the stages of rehabilitation after complex treatment of patients with asymmetric growth of mandible. Materials and methods. We examined 40 patients with malocclusion class III aged from 16 to 40. The examined group included patients with malocclusion class III that corresponded to the certain degree of severity of the abnormality: Grade I - joining of the first permanent molars and canines for Class II Angle, displacement value does not exceed 1/2 of the first permanent molar cusp. Sagittal overjet is absent; the value of anterior crossbite is minimal, moderate or deep. Results. During the stages of rehabilitation of patients with malocclusion class III and asymmetry of the mandible it is necessary to conduct a comprehensive study of facial and gnathic areas of dental system, analyze the results of radiodiagnosis of sagittal, transversal and vertical skull parameters. Conclusion. Method of subcondylar vertical osteotomy helps to normalize the morphological state of dental system. Keywords: malocclusion class III, computer program «SimplyCeph», analysis of lateral teleroentgenogram.
TREATMENT OF PATIENTS WITH OCCLUSAL CANTING USING ORTHODONTIC MINISCREW SYSTEM FOR MAXILLARY MOLAR INTRUSION
Authors: Popov SA A , Frolov AO O
Published: October 2020

Dentoalveolar vertical deformation has to be treated by intrusion with surrounding bone and tissues safety. More than 50% of orthodontic patients have lack of one or more teeth with dentoalveolar deformation. Removable orthodontic appliances are not able to intrude teeth with necessary long-lasting force, but mostly move abutment teeth inversely and extrude them. Optimal method used for upper teeth intrusion has to consist of non-invasive temporary anchorage devices and force that moves teeth fast but carefully, with periodontal tissues and surrounding bone safety. Aim - to justify the use of orthodontic miniscrews as temporary anchorage devices for occlusal canting with dentoalveolar component treatment. Materials and methods. Intrusion technique has been developed. It moves the teeth with elastic chain to two miniscrews. The volume of the surrounding bone and periodontal tissues after intrusion is the same as before the movement; the dental arch has not changed after the teeth movement; this method of intrusion is less traumatic and is done in shorter time. Conclusion. Developed intrusion method justifies the use of miniscrews and improves upper teeth intrusion making it faster, less traumatic and safer for surrounding tissues and teeth.
RECOGNITION OF COGNITIVE POTENTIALS TO THE TARGET STIMULI IN THE BRAIN-COMPUTER INTERFACE ON THE BASIS OF THE ENSEMBLE OF CLASSIFIERS
Authors: Kirjanov D A , Kaplan A Y
Published: October 2020

Background. A number of studies have been done on detection of human visual attention focus by means of P300 brain-computer interfaces (BCI). However, the performance of interfaces on P300 is still low, since this technique requires the repeated presentation of target and non-target stimuli. There are some indications that it is appropriate to use ensembles of classifiers to improve the accuracy of recognition of multidimensional objects. The goal of the present study was to verify the feasibility of application of ensembles of classifiers to speed up the work of the BCI P300. Methods. The study involved 22 subjects, whose task was to closely monitor the highlights of target objects on the computer screen, presented as 8 triangles located in a circle (angle of 7.7 degrees). Single classifiers and ensembles of classifiers based on linear discriminant of Fisher were used to detect the target responses in the EEG. Results. The use of the ensemble of classifiers provided almost the same accuracy of algorithmic choice of target reactions, EEG in 78-80%, as compared with the use of single classifiers, but with two times smaller number of repetitions of the test stimuli and, therefore, faster detection of the target reactions of the EEG. Conclusions. This work implies that the P300 BCI with the participation of the ensemble of classifiers can be used to build high-speed communication systems for both the stroke patients and healthy people in special circumstances for additional alarm at the inability to use speech.
DEVELOPMENT OF THE HARDWARE AND SOFTWARE COMPLEX CONTROLLING ROBOTIC DEVICES BY MEANS OF BIOELECTRIC SIGNALS OF THE BRAIN AND MUSCLES
Authors: Gordleeva S Yu , Lobov S A , Mironov V I , Kastalskiy I A , Lukoyanov M V , Krilova N P , Mukhina I V , Kaplan A Ya , Kazantsev V B
Published: October 2020

Aim - to develop a hardware-software complex with combined command-proportional control of robotic devices based on electromyography (EMG) and electroencephalography (EEG) signals. Materials and methods. EMG and EEG signals are recorded using our original units. The system also supports a number of commercial EEG and EMG recording systems, such as NVX52 (MCS ltd, Russia), DELSYS Trigno (Delsys Inc, USA), MYO Thalmic (Thalmic Labs, Canada). Raw signals undergo preprocessing and feature extraction. Then features are fed to classifiers. The interpretation unit controls robotic devices on the base of classified EEG- and EMG-patterns and muscle effort estimation. The number of controlled devices includes mobile robot LEGO NXT Mindstorms (LEGO, Denmark), humanoid robot NAO (Aldebaran, France) and exoskeleton Ilia Muromets (UNN, Russia). Results. We have developed and tested an interface combining command and proportional control based on EMG signals. We have determined the parameters providing optimal characteristics of classification accuracy of EMG patterns, as well as the speed and accuracy of proportional control. Also we have developed and tested a BCI interface based on motor imagined patterns. Both EMG and EEG interfaces are included into hardware and software system. The system combines outputs of the interfaces and sends commands to a robotic device. Conclusion. We have developed and approved the hardware-software system on the basis of the combined command-proportional EMG and EEG control of external robotic devices.
METHOD OF GRAVITATIONAL THERAPY IN TREATMENT OF GASTROINTESTINAL TRACT DISORDERS
Authors: Fatenkov O V , Sadomova E А , Rubanenko O A
Published: October 2020

Aim - to increase the efficiency of treatment of patients with gastrointestinal tract disorders by including the method of gravitational therapy into the treatment complex. Methods. The method of gravitational therapy was used to achieve beneficial impact on the diseases of the gastrointestinal tract. Results. The paper presents the relevance of the treatment of gastrointestinal tract diseases and the search for new treatment options that have fewer side effects and reduce the cost of treatment. It also explores the influence of gravitational therapy on diseases of the gastrointestinal tract, and further introduction of this method in the treatment regimens. It specifies the importance of complementing medical treatment of gastrointestinal tract diseases with the physiotherapy methods. We present indications for diseases of the digestive system and contraindications for gravitational therapy. Conclusion.Positive influence of gravitational therapy in cases of gastrointestinal tract disorders was revealed.
GENETIC POLYMORPHISMS OF CYTOCHROME P450 2C9, VITAMIN K EPOXIDE-REDUCTASE SUBUNIT 1 AND WARFARIN DOSING IN PATIENTS WITH PERMANENT ATRIAL FIBRILLATION
Authors: Rubanenko A O , Shchukin Yu V
Published: October 2020

Aim - to assess the influence of genetic polymorphisms of CYP2C9 and VKORC1 on warfarin dosing in patients with permanent form of atrial fibrillation. Methods. The study included examination of 100 patients with coronary heart disease and permanent form of atrial fibrillation; mean age 60.5±5.8 years. Conclusion. In patients with permanent form of atrial fibrillation, genotypes CYP2C9*1/*3, TT and GG genotypes of VKORC1 are associated with low warfarin dose, compared to other genotypes. Genotype CYP2C9*1/*3 increases the risk of bleeding complication during warfarin therapy.
SYSTEM OF MEASURES FOR REPRODUCTIVE HEALTH IMPROVEMENT IN WOMEN OF LATE REPRODUCTIVE AGE WITH INFERTILITY
Authors: Tyumina C V , Melnikov V A , Chertuhina O B
Published: October 2020

Aim - to develop and evaluate the effectiveness of the system of the medical and organizational measures aimed at improvement of reproductive health in women of late reproductive age with infertility, and at increase in the effectiveness of the IVF programs. Materials and methods. The study of the efficiency of the developed system of measures was carried out in a representative group (650) of women 35-44 years old (mean age - 37.01+ 1.74 years) with infertility, living in the Samara region and referred to the medical center «Dynasty» for treatment with in vitro fertilization. The following methods of research were used: direct observation, organizational experiment, sociological and analytical methods. Results. The main components of the developed system of events are: medical measures (extended timely examination and treatment; comprehensive assessment of women's reproductive health based on proposed medical criteria, the use of new medical technologies); social measures (individual program of social and hygienic rehabilitation); organizational measures (automation of infertility register control, routing of patients depending on the initial state of health). Implementation of the developed system of measures can improve women's reproductive health according to the criteria of objective and subjective evaluation: it reduces the incidence of miscarriage from 37.5% to 15.3% (p
INFLUENCE OF INTERMITTENT PNEUMATIC COMPRESSION ON ARTERIAL BED
Authors: Diachkov VA A , Rubanenko AO O , Gritsin AV V
Published: October 2020

Aim - to estimate the influence of intermittent pneumatic compression on arterial bed. Material and methods. The paper presents a literature review concerning the use of pneumatic compression in patients with peripheral artery disease. Results. Possibilities of pneumatic compression for prophylaxis and treatment of chronic ischemia in patients with peripheral artery disease are under discussion. Conclusion. The rapid growth of investigators’ interest in nonmedical methods of influence on arterial bed, and also the search for new and efficient methods and regimens highlight the significance of medical pneumatic compression. Currently, there is limited literature available about customization of pneumatic compression in accordance with nosology and individual indicators of blood circulation in lower extremities. As mentioned above, the most relevant and perspective direction is investigation of complex key indicators of arterial biomechanics with possibilities of the regimen correction, i.e. with implementation of feedback mechanism.
POST-RADIATION OSTEOMYELITIS OF THE STERNUM: CURRENT TREATMENT OPTIONS
Authors: Korymasov ЕА A , Medvedchikov-Ardiya МА A
Published: October 2020

Background. Post-radiation sternal osteomyelitis is a late local complication of radiation therapy for chest cancer. Due to a chronic process and low reparative capacity, the conservative therapy of post-radiation osteomyelitis of the sternum is ineffective, and often there is a need for surgery. It is a two-step surgery that includes elimination of purulent inflammation followed by plastic reconstruction of the chest wall. Materials and methods. Two clinical observations of post-radiation osteomyelitis of the sternum were presented. The vacuum therapy was applied at the stage of controlling purulent inflammation in the chest wall. Result. The use of vacuum therapy had a positive effect on the rapid cleansing of the wound. Conclusion. Application of vacuum therapy is indicated at the first stage of treatment, after debridement and after plastic phase as an additional method of stabilization of the chest wall, and in case of postoperative infectious complications.
COMBINED IMPACTION AUTOPLASTY OF THE FEMORAL HEAD IN THE TREATMENT OF PATIENTS WITH EARLY STAGES OF ASEPTIC NECROSIS
Authors: Kudashev DS S , Zuev-Ratnikov SD D , Shorin IS S
Published: October 2020

Aseptic necrosis of the femoral head refers to the number of severe, rapidly progressing destructive-dystrophic hip joint lesions. In the overwhelming majority of cases, the disease develops in young and most active age group. In the absence of necessary treatment, the result of the disease is the early disability retirement with the need for radical reconstructive interventions on the joint. The use of modern diagnostic methods makes it possible to detect the beginning of the pathological process in the femoral head in the early stages and to conduct the most effective treatment of patients of this category. Aim - to improve the results of treatment of patients with early stages of aseptic necrosis of the femoral head due to the development and introduction into clinical practice of a new method of combined impaction autoplasty of the femoral head. Materials and methods. A new method of combined impaction autoplasty of the femoral head was used, including decompression, intraosseous resection and excision of the focus of osteonecrosis followed by combined autoplasty of the postresection defect (RF patent No. 2583577 dated 13.04.2016). Intraosseous resection of the focus of destruction of the femoral head was performed with the help of a specially developed device - milling cutters for bone tissue resection (RF patent for utility model No. 171951 dated 21.06.2017). Evaluation of the effectiveness of the treatment was carried out on the basis of the severity of the pain syndrome and functional capabilities of patients defined by the Harris scale (Harris Hip Score). Results. The analysis of the medium-term results of the conducted treatment showed that good results were obtained in 67.4% of cases in which the proposed method was used.
ANALYSIS OF SURGICAL TREATMENT OF SUBCUTANEOUS RUPTURES OF ACHILLES TENDON (LITERATURE REVIEW)
Authors: Kim YuD D , Chernov AP P , Ardatov SV V , Shitikov DS S , Bardovskaya YuI I
Published: October 2020

In our opinion, the treatment of patients with subcutaneous ruptures of the Achilles tendon is poorly covered in special literature, and in many cases the information is biased. These preconditions are the cause of the lack of awareness of surgeons, traumatologists, orthopaedic surgeons, rehabilitation therapists about the real complexity of treatment of this category of patients. In this context, this paper focuses on the literature review of recent works on surgical treatment of patients with subcutaneous Achilles tendon rupture, summarizing the data of foreign and Russian researchers.
PREVALENCE OF ANXIETY AND DEPRESSION SYNDROMES IN CORRELATION WITH MAJOR RISK FACTORS FOR CHRONIC NONINFECTIOUS DISEASES AMONG PATIENTS OF THE SAMARA REGION
Authors: Krylova IA A , Kupaev VI I , Slobodyanyuk AL L , Nurdina MS S , Borisov OYu Yu
Published: October 2020

Aim - to study the prevalence of syndromes of anxiety and depression in correlation with major risk factors (RF) of chronic noninfectious diseases among patients of the Samara region considering themselves healthy. Materials and methods. A comparative population-based cross-sectional study was based on a representative selection of patients (95 people) from the Samara region (rural and urban population) at the age of 19-68 years. Results. The study revealed a significant increase in the rates of fatigue, anxiety and depression in outpatients. The syndrome of anxiety of subclinical level was detected in 35.7% of patients, clinical level - in 23.2% of patients; the syndrome of subclinical depression was revealed in 21.0% of patients, and 4.2% had the clinical level. We discovered the correlation between the syndromes of anxiety and depression and the major RF of chronic noninfectious diseases and patient’s satisfaction with quality of medical care in the clinic. High levels of anxiety were more frequent in men, at older age, and were associated with physical inactivity. Severe depression more often occurred at older age and in the presence of hypercholesterolemia. The income level of the patient correlated with the level of stress exposure, physical activity and satisfaction with the work of the policlinics. We did not reveal the relationship between the syndromes of anxiety and/or depression and the level of income, degree of hypertension, social activity, smoking, alcohol consumption, and body mass index. Conclusion. The results indicate that the presence of the syndromes of anxiety and depression increases the risk of occurrence of other independent risk factors of chronic noninfectious diseases. The identified trends can serve as the basis for targeted screening programs for diagnostics and prevention of chronic noninfectious diseases.
IMPROVING THE QUALITY OF THE ORGANIZATION OF TEMPORARY DISABILITY EXAMINATION IN A CITY HOSPITAL
Authors: Suslin SA A , Pavlov VV V
Published: October 2020

Aim - improving the quality of the organization of temporary disability examination (TDE) in a city hospital. Materials and methods. The research focuses on the organization of temporary disability examination in Samara City Hospital No. 10 providing services to the population of Kuibyshevsky district of Samara, which amounts to more than 87 thousand people. The study involved the following research methods: statistical, analytical, expert assessment, organizational modeling. Results. We implemented an organizational model of TDE improvement, which is based on organizational and methodological aspects of TDE development, methodological approaches to the quality control of TDE, indices of efficiency of TDE organization system. Conclusion. Development of an organizational model for the improvement of TDE based at the City general hospital contributes to the timely acceptance of instructive and methodological documents, raising the level of personnel qualification, developing information support for TDE, and providing quality control of TDE. The following results of the implementation of the organizational model for improving the organization of TDE from 2010 to 2015 were obtained: an increase in the quality of TDE; a reduction in the number of all defects per 100 cases of temporary disability - from 257.2 to 111.1; a reduction in the proportion of unreasonably issued sick-leaves from 4.8% to 1.9%; an increase in the integrated assessment of the quality of care in the model of the final results of the TDE service performance in the City general hospital from 0.75 in 2010 to 0.85 in 2015.
OSTEOPETROSIS AND ENDOPROSTHETICS - CLINICAL OBSERVATIONS
Authors: Nikolaev NS S , Borisova LV V , Didichenko SN N , Bezludnaya NV V , Bashkova IB B , Lyubimov EA A
Published: October 2020

Aim - to evaluate the efficacy of treatment of secondary arthrosis of the coxofemoral joints associated with osteopetrosis using arthroplasty. Materials and methods - clinical observation of two cases of treatment of patients with autosomal dominant form of osteopetrosis who underwent total hip arthroplasty at the Federal State Budgetary Institution Federal Center of Traumatology, Orthopaedics and Endoprosthesis replacement (Cheboksary). Results. We obtained positive results and patient’s satisfaction with the function of prosthetic joints with a follow-up period of 3.5 years. This method of treatment showed its efficacy during the specified follow-up period. Arthroplasty provides relief from pain, improved quality of life and increased mobility of the joint for patients with coxarthrosis associated with osteopetrosis.
TONE TIMBRE AS HEARING QUALITY: VISUALIZATION OF THE CONDITION AND DYNAMIC PATTERN
Authors: Minaeva T I , Ovchinnikov E L , Yashin S S
Published: October 2020

Aim - definition of perceived timbre of sounds (tones) as hearing quality; determining the criterion of hearing quality and assessment of effectiveness of the prevention and treatment of hearing disorders and concomitant pathologies. Materials. Audiometric indicators obtained with the use of all-frequency sound generator in patients with hearing disorders. Methods. Audiometric method with the use of allfrequency sound generator; methods of mathematical calculation and analysis. Results. The performed experiments and computer simulation showed that the timbre of perceived sound represents the hearing quality. Hearing quality criterion can be used to assess the effectiveness of treatment of hearing disorders and concomitant pathologies, medical manipulations and physical therapy for rapid control and monitoring of the hearing state. Conclusions. Assessment of the hearing quality and the effectiveness of preventive and therapeutic measures. Results of the study are safe and reproducible; monitoring is fast, visualized and reliable.
Modern Capabilities of Diagnostic Analytical Module "Verion Reference Unit" and Navigation System "Verion Digital Marker Microscope" in High-Tech Cataract and Presbyopia Surgery
Authors: Malov IV V , Stebnev SD D , Stebnev VS S
Published: October 2020

Aim - to show the possibilities of diagnostics with the use of VERION Measurement Module, followed by personalized drawing up an operation plan on the analytical module "VERION Vision Planner" and the calculation of high-tech IOLs. The evaluation of the work of the navigation system "VERION Digital Marker Microscope" in high-tech cataract surgery and presbyopia. Materials and methods. The results of the prospective open study of phacoemulsification of cataract and refractive lens surgery with implantation of high-tech intraocular lenses of Alcon company (USA) were studied. The calculation of the optical power of the IOL was performed using a navigation system, "VERION" (Alcon). Functional and refractive data before and after surgery were evaluated. Results. High-tech IOL implanted 100 patients (180 eyes). Sphericules clinical refraction was -0,15±0,28 diopters. Refraction of the target (em±0,5 DPT) was achieved in all patients. Intraoperative and postoperative complications were not observed. In all patients, the obtained refractive effect practically coincided with the potentially expected one. All patients are satisfied with the results of the operation and the choice of intraocular lens. Conclusion. 1. Diagnostic analytical module "VERION Reference Unit" of "VERION" system allows accurately selecting of the optical power of high-tech IOLs and their toric component with the preparation of the individual operation plan for each patient. 2. Navigation system "VERION Digital Marker Microscope" allows to carry out high-tech surgery of cataract and presbyopia according to the developed plan of operation. Deviation of the spherical refraction component obtained in the postoperative period from the expected, according to "VERION Vision Planner", was 0.2+0.15 DPTR; deviation of the cylindrical refraction component was 0.3+0.26 DPTR.
The Quality Improvement of Periodic Medical Examinations of Working People and Professional Aptitude Expertise
Authors: Strizhakov LA A , Babanov SA A , Budash DS S , Baikova AG G
Published: October 2020

Aims - to analyze the historical aspects of the formation of the national normative framework in the field of primary and periodic medical examinations, to discuss the existing problems in the carrying out of primary and periodic medical examinations of workers and also to make suggestions for quality improvement of primary and periodic medical examinations and for introduction of occupational risk assessment into the practice of primary and periodic medical examinations. Conclusion. For quality improvement of primary and periodic medical examinations, for efficiency improvement of primary and secondary prevention of occupational diseases it is considered to be necessary to take the following suggestions: - fuller coverage of working people by periodic medical examinations; - thorough selection of organizations that perform the special assessment of working conditions; - the use of the results of the special assessment of working conditions for improving working conditions and informing workers about working conditions; - implementation of occupational risk assessment into practice of primary and periodic medical examinations; - the use of modern methods of molecular and genetic screening;
The Model for Assessing the Risk of Cardiovascular Complications in Patients with Type 2 Diabetes Mellitus
Authors: Begun DN N , Borshchuk EL L , Leushina KV V
Published: October 2020

Aim - to identify the most significant risk factors that affect the occurrence of cardiovascular complications in patients with type 2 diabetes and to create the supplement for the risk assessment of cardiovascular complications in patients with type 2 diabetes. Methods of research. The object of the study is adult patients with type 2 diabetes mellitus (n = 60). For the development and analysis of the material, a statistical method is used, a modeling method of constructing the classification trees. Discussion and results. Statistically significant risk factors for cardiovascular complications in type 2 diabetes are a high body mass index, the presence of insulin therapy, the duration of the disease, a high maximum level of systolic blood pressure, high concentrations of LDL, markers of cell damage, and some hemodynamic parameters of myocardial function. A multidimensional model of the risk of complications was developed, which served as an algorithm for the created computer program, their early prognosis and timely carrying out of preventive measures.
The Results of Cytoreductive Operations in Patients with Colorectal Cancer with Simultaneous Liver Polymetastases
Authors: Kozlov SV V , Kaganov OI I , Orlov AE E , Kozlov AM M
Published: October 2020

Aim - to improve the long-term results of cytoreductive treatment of patients with simultaneous multiple bilobar liver metastases of colorectal cancer by the use of RFTA. Materials and methods. The study presents the results of treatment of 168 patients diagnosed with colorectal cancer of stage IV with simultaneous bilobar metastases in the liver. In the main group, cytoreductive tumor removal was accompanied by radiofrequency thermal ablation (RFTA) of metastatic formations. In the control group only the primary tumor was removed. Results. The use of RFTA during cytoreductive surgery does not worsen the immediate results of surgical treatment, in comparison with patients, where the effect on liver metastases has not been performed, but allows to increase medians of uneventful and overall survival from 9 and 22 months to 17 and 29 months, respectively. Conclusions. The use of RFTA for simultaneous multiple bilobar metastases in the liver during cytoreductive surgery makes it possible to achieve 22.7% of the three-year uneventfulness and 4.3% of the five-year overall survival.
The Development of Ultrasound Method of the Study of the Inferior Alveolar Arteries
Authors: Bakhteeva GR R , Lepilin AV V , Erokina NL L , Savelieva SS S , Chibrikova LM M
Published: October 2020

А^ - the development of ultrasound method of the study of inferior alveolar arteries and their normal data of blood circulation. Materials and methods. In 20 men the apparatus «Vivid E9» the study of the bipolar bloodstream in the inferior alveolar arteries was performed. Results. In the study of the facial arteries the following results were obtained: PS - 55,7+0,9 cm/s, ED - 10,15+0,3 cm/s, TAMX - 52,0+1,1 cm/s, PI - 1,32+0,06, RI - 0,77+0,03, PS/ED - 2,30+0,1, HR - 35,36+1,9 bpm. In the study of the inferior alveolar arteries the following results were determined: PS bloodstream 57,96+0,7 cm/s; ED bloodstream 5,47+0,1 cm/s; TAMX 17,22+0,5 cm/s; PI 3,05+0,1; RI 0,91+0,05; PS/ ED 10,60+0,2; HR 69,48+0,4 Ьрм. Conclusion. The methodology of ultrasound study of the inferior alveolar arteries and bloodstream parameters in them was developed.
MODERN ALGORITHMS OF THORACIC CAGE STABILIZATION IN PATIENTS WITH MULTIPLE RIB FRACTURES AND FLAIL CHEST
Authors: Benyan A S , Korymasov E A , Borkovskiy A Yu
Published: October 2020

Objectives - to improve the treatment results in patients with multiple rib fractures and flail chest via the development and implementation of modern therapeutic and tactical algorithms. Material and methods. A non-randomized prospective study has been carried out to evaluate the results of treatment in 198 patients with multiple rib fractures and flail chest in the period of 2011-2017. Three clinical types were identified: 1) patients with multiple rib fractures with disordered thoracic cage structure - 77 (38.9%); 2) patients with flail chest - 71 (35.9%); 3) patients with multiple rib fractures without disordered thoracic cage structure - 50 (25.2%). There were developed and applied the diagnostic and treatment algorithms depending on the severity of injures of sternocostal frame and intrapleural organs, the presence and severity of associated injuries and background diseases, the conditions of medical aid. Results. The treatment tactics of all patients was based on the differentiated, staged and combined use of various methods of stabilizing the thoracic cage including the advanced types of medical care. Surgical stabilization methods were used in 162 patients, in 26 of them a combination of surgical techniques was applied, in 20 - the internal pneumatic stabilization, in 42 - the conservative treatment was performed. The retrospective analysis and the obtained results compared to the results of the equivalent historical group allowed us to state the decrease of mechanical ventilation time from 11.0 ± 3.9 to 5.1 ± 3.2 days (t = 1.17; p> 0.05), the length of stay in the ICU from 11.5 ± 5.4 to 6.8 ± 3.7 days (t = 0.72; p> 0.05), the complications frequency from 36.5% to 15.9% and mortality rate from 22.3% to 8.7%. Conclusion. Modern diagnostic and treatment algorithms in patients with multiple rib fractures and flail chest are based on stage-by-stage application, succession and combination of various methods of the thoracic cage stabilization throughout the medical assistance process. The algorithms, allowing to stabilize the thorax and to improve the condition of the patients in general, make it possible to realize the full potential of modern thoracic surgery.
INNOVATIVE METHOD OF PERICARDIAL FENESTRATION ASSOCIATED WITH UNDERLYING CHRONIC RECURRENT PERICARDITIS: CASE REPORT
Authors: Medvedchikov-Ardiya M A , Benyan A S , Mukhambetaliev S A
Published: October 2020

Objectives - to illustrate the clinical follow-up of a patient with chronic recurrent pericarditis subjected to a pericardial fenestration performed in a new manner, with subxiphoidal pericardiotomy, pericardioscopy followed by trans-pericardial thoracoscopy. Material and methods. A 69-year-old woman with chronic recurrent pericarditis and the threat of cardiac tamponade was subjected to subxiphoidal pericardiotomy, pericardioscopy and subsequent transpericardial thoracoscopy forming the pericardial window and junctions with pleural and abdominal cavity. Results. The first special aspect of the presented case is the combination of access types and the usage of non-standard access to the pleural cavity; the second one is the combined formation of fistulae between the pericardial cavity and two other cavities - the left pleural and abdominal. The positive outcome of this operation was the bidirectional drainage of pericardial exudate, as well as the minimal postoperative pain syndrome due to the absence of transthoracic access. Conclusion. The positive clinical result in the early postoperative period and during the long term followup period, the absence of complications allows for the safety of the technique and the possibility of performing such surgical operations in patients with acute and chronic exudative pericarditis and the threat of cardiac tamponade.
DYNAMICS OF MORPHOLOGICAL CHANGES IN FRACTURE SITES IN VICTIMS WITH THORACIC TRAUMA AND FLAIL CHEST
Authors: Belokonev V I , Pushkin S Yu , Ardashkin A P , Ushakov N G , Kameev I R
Published: October 2020

Objectives - to improve the treatment results in patients with a closed chest injury complicated by the flail chest through the evaluation of the pathomorphological changes in the fracture sites on the background of their stabilization. Material and methods. The study is based on the autopsy protocols of 402 victims, whose primary cause of death was a closed chest injury with multiple rib fractures. In total 289 histological specimens were studied, including 82 samples taken from the rib fractures zones of the persons with a flail chest died in different periods after the injury. Depending on the time passed from the injury till death, there were identified 5 groups of patients. So It was possible to reveal the consistency of the evolution of morphological changes in the zone of rib fractures on the 1st, 2nd, 5th, 14th, and 21st day after the injury, with preserved breathing without stabilizing the rib cage. Results. We found out that on the 1st, 2nd, 5th day there were no morphologically significant changes in the fracture zone, aimed at its stabilization. With breathing preserved for more than 5 days, there was a delay in the primary callus formation and enhanced bone resorption in the fracture site. Osteoblasts activation, which manifests the proliferation of cellular elements in fragmentary rib fractures, occurred 7-9 days later than in a single fracture. It was conditioned by the persistent "floating" of the rib fragments which impacted the newly formed trabeculae of bone and forced them to rearrange twice during the bony callus formation. The increased time of the rib fractures repair aggravated the lung injury, contributed to the development of pneumonia and purulent-septic complications detected posthumously which, in their turn, were the primary cause of deaths. Conclusion. In 17.4% of victims with severe chest injury and flail chest the death is conditionally preventable. The crucial requirement of the effective treatment of patients with the thoracic trauma and flail chest is the usage of various methods of the thoracic cage stabilization.
ADVANCED APPROACH TO DIAGNOSTICS OF CHRONIC ALCOHOL ABUSE
Authors: Tsarev Sergei A. , Shcherban Andrei V. , Suslin Sergei A. , Katin Aleksei A. , Sirotko Il'ya I.
Published: October 2020

Objectives - to identify the criteria of selecting the applicants for professional drivers who require the carbohydrate-deficient transferrin (CDT) assay, which can be applied by an addiction psychiatrist. Material and methods. The extensive analysis of testing results of 232 patients admitted to Samara Regional Narcological Dispensary from its local subsidiaries in Samara and the Samara Region was carried out. Results. The fact of driving in drunk condition in the past was defined as the criterion having the diagnostic value. Conclusion. The patients with the known fact of drunk driving had the majority of positive test results of the chronic alcohol abuse, compared to other groups of patients in this study. These findings make it possible to declare the deprivation of driving license due to the drunk driving to be a valuable criterion to submit the applicant for the CDT assay during his qualifying as a driver.
Evaluation of doctors' level of proficiency, based on self-assessment
Authors: Petrova N. G , Gorinshtein V. V
Published: October 2020

Objectives - to assess the level of doctors' qualification by means of sociological survey. Material and methods. The study was conducted in a large city out-patient hospital, where 105 doctors of different specialities were interviewed. The respondents' average age was 44.7+1.9 years; average period of work -16.4+1.8 years. A special questionnaire comprised of 35 questions. The respondents were asked to assess, using a five-point scale, their skills and knowledge of various topics, including special clinical knowledge, prevention, sanitary-epidemiological regimen, psychology, healthcare organization and economics, legal regulation of medical activity. The statistical processing of collected data was performed with the Microsoft Office 2016 programs: Microsoft Word, Microsoft Excel. Results. The average self-assessment score for various aspects ranged from 3.1 to 4.4. The lowest score was registered in the knowledge of public health organization, regulations and healthcare economics. Among the respondents, the maximum self-assessment scores were given by emergency doctors, and the lowest - by therapeutists (general practitioners). Conclusion. The revealed deficit of knowledge in some aspects (especially in matters of healthcare organization) is a factor that may impede the implementation of one of the basic principles of total quality management - the principle of staff involvement. This requires not only a review of educational programs in medical universities, but also the appropriate adjustment of the programs of postgraduate training, as well as tasks (tests, OSCE stations) performed by doctors of different specialities in the process of their accreditation.
Statistical diagnostics of postmortem artifacts for determination of ethanol concentration
Authors: Nedugov German V. , Ardashkin Anatoliy P. , Nedugov Vladimir G.
Published: October 2020

Objectives - statistical estimation of the physiological limits of the quantitative distribution of ethanol in cadaveric blood and bladder urine and development of an automated method for diagnosing postmortem artifacts of forensic medical examination of acute alcohol intoxication on the corpse. Material and methods. We performed a retrospective statistical analysis of the results of toxicological determination of ethanol concentration in a blood and in the urine in 2376 deaths from acute alcohol intoxication. Results. Regression equations have been developed that allow us to determine the physiological limits of the quantitative distribution of ethanol in blood and urine with any confidence probability for any degree of alcohol intoxication and phase of acute alcohol intoxication. The set of computational procedures is implemented in the format of the computer program "Alcohol calculator Z 3.0". Conclusion. If the concentrations of ethanol in the blood or in the urine are beyond their physiological limits, the results of toxicological analysis should be considered as a postmortem artifact.
Features of local pulmonary hemostasis in patients who received surgical treatment for benign peripheral lung tumors
Authors: Bogorodskiy Andrey Yu. , Kuligin Aleksandr V. , Fisun Aleksey M.
Published: October 2020

Objectives - to develop a method for prevention of thromboembolic events in small branches of pulmonary artery in post-operative period, based on features of local pulmonary hemostasis in patients who underwent lung surgery for benign tumors. Material and methods. 30 male patients aged 62 ± 2.4 years old were included in the study. All patients underwent lung surgery (mainly lobectomy). Blood was drawn intra-operationally from a. pulmonale (arriving venous blood), v. pulmonale (outflowing blood) and cubital vein. The following parameters of coagulative and thrombocytic-vascular hemostasis were examined: free endogenous heparin was evaluated by protamine titration, platelet count and platelet aggregative properties were registered, using hematology analyzer, activated partial thromboplastin time (aPTT), quantitative analysis of fibrinogen and protein C was performed using CoaLAB 1000 analyzer. Results. Study of hemostasis features in patients, who underwent lung surgery, has revealed an imbalance of coagulation and anticoagulation systems, which manifested itself as dysfunctions in thrombocytic-vascular hemostasis (increase in platelets aggregative properties, most notable in peripheral venous blood), plasma hemostasis (decrease in aPTT, most notable in arterial blood, and increased fibrinogen level) and anticoagulation (modestly decreased protein C and heparin levels in peripheral blood), which is characteristic of hypercoagulation, being the possible basis for development of thromboembolic complications in post-operative period. These changes are most typical for blood taken from cubital vein, which is indicative of increased possibility of clot formation specifically in systemic circulation, which is indicative of increased possibility of clot formation specifically in systemic circulation. The least risk of clot formation was established in pulmonary vein blood (outflowing blood). Moderate correlation between free heparin level in arterial blood and venous blood was established. Conclusion. The derived results have allowed us to develop an individual management plan for patients with increased risk of thromboembolic events, which includes early administration of anticoagulant agents in prophylactic doses.
The use of speech sentence audiometry in a free sound field
Authors: Boboshko Mariya Yu. , Berdnikova Irina P. , Maltzeva Natalya V.
Published: October 2020

Objectives -to determine the normative data of sentence speech intelligibility in a free sound field and to estimate the applicability of the Russian Matrix Sentence test (RuMatrix) for assessment of the hearing aid fitting benefit. Material and methods. 10 people with normal hearing and 28 users of hearing aids with moderate to severe sensorineural hearing loss were involved in the study. RuMatrix test both in quiet and in noise was performed in a free sound field. All patients filled in the COSI questionnaire. Results. The hearing impaired patients were divided into two subgroups: the 1st with high and the 2nd with low hearing aid benefit, according to the COSI questionnaire. In the 1st subgroup, the threshold for the sentence intelligibility in quiet was 34.9 ± 6.4 dB SPL, and in noise -3.3 ± 1.4 dB SNR, in the 2nd subgroup 41.7 ± 11.5 dB SPL and 0.15 ± 3.45 dB SNR, respectively. The significant difference between the data of both subgroups and the norm was registered (p
Current aspects of treatment of patients with bilateral laryngeal paralysis
Authors: Kirasirova Elena A. , Lafutkina Nadezhda V. , Mamedov Ramis F. , Rezakov Ruslan A. , Usova Mariya I. , Kulabukhov Egor V.
Published: October 2020

Objectives - to improve the effectiveness of treatment of patients with bilateral laryngeal paralysis by developing a treatment algorithm, justifying the surgical methods and the criteria for the effectiveness evaluation. Material and methods. 52 patients (including 49 women and 3 men) with bilateral larynx paralysis were examined and operated in 2017-2019. The age of the patients ranged from 27 to 71 years. 20 patients underwent the laryngoplasty, including the right-side myoaritenoidchordectomy with laterofixing of the opposite vocal fold with external access. 32 patients received the laryngoplasty with microsurgical technique under the direct support laryngoscopy. Results. The differentiated approach to the surgical treatment of patients with bilateral larynx paralysis allowed to decannulate 97% of patients in early postoperative period with restoration of the respiratory function and preservation of the voice function. In 2 patients it was impossible to form a physiological glottic chink due to a rough scar-dystrophic process in the surgery area. Conclusion. The preliminary use of tracheostomy tube is a factor that impairs the effectiveness of reconstructive surgical interventions in patients with bilateral laryngeal paralysis, if compared to patients with single-step tracheostomy and laryngoplasty. The long course of the bilateral laryngeal paralysis (more than 1 year) leads to persistent and irreversible pathological changes in the arytenoid cartilage and vocal folds. Minimally invasive techniques for the bilateral laryngeal paralysis treatment under the direct support laryngoscopy are the "gold standard" of global laryngology, if the indications for surgery are strictly observed. In all other cases, the patients are subject to a one-step reconstructive surgery with an open approach to the paralyzed voice fold.
Opportunities for the influence of humanitarian subjects on the spiritual and moral development of the cadets of higher educational organizations of the MIA of Russia
Authors: Vasileva Zlata
Published: October 2020

The relevance of the topic is related to the importance of humanitarian education for the formation of worldview and spiritual and moral foundations of the personality. The need for humanistic and humanitarian orientation of University education is justified by many pedagogues. Universities of the MIA of Russia provide students with the opportunity to master a wide range of Humanities. The article presents the results of a study that developed a system of Humanities that affect the spiritual and moral development of students. In the course of the analysis, the worldview and psychological and pedagogical blocks of Humanities were identified, and the number of hours for each course of study was indicated. In addition, the article shows the interdisciplinary connections of Humanities that integrate knowledge on the spiritual and moral sphere of personal development. There are four thematic modules of Humanities: “Man”, “Society”, “Activity”, “Universe”. The analysis of the interdisciplinary interaction of the selected thirteen Humanities is carried out. Examples of forms and methods of formative work are shown, according to the curricula for the mastering these disciplines. The topics, their content, forming competencies, forms and methods of experimental work are correlated, which allows us to clearly trace the interdisciplinary connections.