Saratov JOURNAL of Medical and Scientific Research

2017, volume 13

Sclerosurgical and surgical treatment of patients with lower extremity varicose vein disease: analysis of results in a long-term period of observation

Year: 2017, volume 13 Issue: №4 Pages: 839-845
Heading: Surgery Article type: Original article
Authors: Gafurova D.R., Kulikova A.N., Chabbarov R.G., Pyatnitsky A.G.
Organization: Saratov Regional Clinical Hospital, Saratov State Medical University, Saratov «Omega-clinic»
Summary:

Aim: to analyze and evaluate the long-term results of sclerosurgical and surgical treatment of patients with lower extremity varicose vein disease (VVD). Material and Methods. Diagnostics and treatment findings of 228 patients are presented. The main group consists of 153 patients (189 extremities) after intraoperative trunk catheter sclerotherapy of the great saphenous vein (GSV) with a crossectomy. The comparison group consists of 75 patients (96 extremities) after the GSV phlebectomy by Babcock — Narat. Long-term results (5-9 years) of treatment were evaluated by comparing the quality of life (QL) parameters of patients, the ultrasonic characteristics of venous bed for operated extremities, and the progression of VVD. Results. There was not found any considerable differences in respondents' QL during the comparison. Duplex ultrasound scanning of the lower extremities in most cases revealed a wide spectrum of pathological ultrasound signs (6 of 13 signs, the differences in which are statistically significant, but not specific for stem sclerotherapy and phlebectomy). Investigation of VVD dynamics after correction of the varicose syndrome revealed three variants of the disease course: regression, lack of dynamics, progression. Conclusion. The effectiveness of sclerosurgical interference in the long-term observation period is comparable with the surgical one, which is confirmed by the total number of positive (good and satisfactory) treatment results after using both methods (93.7 and 81.3% respectively), ultrasound diagnosis results, absence of significant differences in QL of patients.

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Emotional intelligence as an indicator of cognitive functioning in patients with schizophrenia

Year: 2017, volume 13 Issue: №4 Pages: 834-838
Heading: Psychiatry Article type: Original article
Authors: Samoylova D.D., Barylnik Yu.B.
Organization: Saratov State Medical University
Summary:

Aim: to analyze the variability of emotional intelligence as an indicator of cognitive functioning in groups of patients with schizophrenia, depending on the duration of the disease, the duration of treatment and the treatment regimen used. Material and Methods. A total of 420 patients with a clinical diagnosis of paranoid schizophrenia were examined. All patients were divided into groups according to the duration of the disease and the therapy. The research included the medical documentation analyses and the application of «Ekman's Faces» psychodiagnostic scale. Results. There was an improvement of the indicator in the group of primary patients receiving treatment with atypical antipsychotics in combination with rehabilitation. Conclusion. The obtained data allows to make a conclusion about the effect of the duration of the disease, the observation, and also the nature of the conducted therapy on the variability of the emotional intelligence indicator in patients with a paranoid form of schizophrenia and may be used to select a psychotherapeutic algorithm for this category of patients. The obtained results prove the necessity of using questionnaire for emotional intelligence «Ekman's faces» and specific therapy in the early stages of the disease.

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Pulmonary lymphangioleiomyomatosis (case report)

Year: 2017, volume 13 Issue: №4 Pages: 828-833
Heading: Internal Diseases Article type: Case report
Authors: Shashina M.M., Shapovalova T.G., Kazimirova N.E., Ryabova A.Y., Arkhangelskaya Е.Е., Lifanova D.V., Chernyshkova M.A.
Organization: Saratov Clinical Hospital № 8, Saratov State Medical University
Summary:

This article presents a clinical observation of a patient with a proven diffuse-nodular form of lymphangioleiomyomatosis of the lungs. Features of the course of the process against the background of pathogenetic therapy which included sirolimus and progesterone have been considered. It is necessary to raise awareness of doctors about the disease that facilitates timely diagnosis and treatment.

A rare case of Loeffler endocarditis associated with eosinophilic granuloma-tosis with polyangiitis

Year: 2017, volume 13 Issue: №4 Pages: 823-828
Heading: Internal Diseases Article type: Case report
Authors: Skryabina E.N., Safonova V.N., Agareva Т.А.
Organization: Saratov State Medical University
Summary:

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare disease that affects small and medium-sized blood vessels of different organs, characterized by asthma, prominent peripheral blood eosinophilia. Cardiac involvement was reported in 20-50% and it is the major cause of mortality. A case of EGPA in a 43-year-old female, who had endocarditis, associated with thrombus formation in left ventricle, thromboembolic syndrome and recurrent stroke has been reported. The described case has showed that it is of crucial importance to perform the full cardiac imaging even in asymptomatic patients with suspected EGPA. The early identification of cardiac involvement may lead to better prognosis.

A clinical case of fast progression of amyloidosis of kidneys in rheumatoid arthritis

Year: 2017, volume 13 Issue: №4 Pages: 821-823
Heading: Internal Diseases Article type: Case report
Authors: Romanova I.A., Magdeeva N.A., Nikitina N.M.
Organization: Saratov State Medical University
Summary:

The article presents clinical case of unfavorable outcome of amyloidosis of kidneys in a patient with rheumatoid arthritis. The absence of basic treatment and persistent activity of disease leads to fast progression of nephrotic stage of secondary amyloidosis in a young woman.

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Platelet indices as markers of platelet turnover and aggregation: pathophysiological interpretation, clinical impact, perspectives in research

Year: 2017, volume 13 Issue: №4 Pages: 813-820
Heading: Internal Diseases Article type: Review
Authors: Malinova L.I., Furman N.V., Dolotovskaya P.V., Puchinyan N.F., Kiselev A.R.
Organization: Saratov State Medical University n.a. V.I. Razumovsky Research Institute of Cardiology
Summary:

The purpose of the review is to characterize existing in open access bibliographical databases such as eLibrary and PubMed evidence on clinical impact of morphometric platelet indices as markers of platelet aggregation ability and turnover as a methodology and theoretical framework of further investigation. Studies results were pooled from open access bibliographic databases (eLibrary, and PubMed) according to modified PRISMA algorithm. Relevant studies were identified by systematic searches of the original studies published during the last 10 years in the Russian and English languages. Results of 96 original studies in accordance with inclusion criteria were published during the last 10 years in scientific journals indexed in eLibrary, and PubMed. The majority of publications (64.58%) consist of evidence pro diagnostic and prognostic significance of platelet indices. Studies demonstrating the significance of platelet indices as possible risk markers of thrombotic events in cardiovascular patients were predominating among "pro" publications. In 15.63% published results contradict concept of platelet indices usefulness as diagnostic and prognostic markers in clinical practice. Morphometric platelet indices can be considered as useful diagnostic and prognostic markers of thrombotic events in cardiovascular patients. Existing gaps in evidence suggest the need of further investigations.

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Peculiarities of clinical course of gastroesophageal reflux disease in patients with type 2 diabetes and obesity

Year: 2017, volume 13 Issue: №4 Pages: 809-812
Heading: Internal Diseases Article type: Original article
Authors: Andreeva E.l.
Organization: Stavropol State Medical University
Summary:

Aim: to study the clinical course of gastroesophageal reflux disease (GERD) in patients with type 2 diabetes and evaluation of the parameters of the esophagus 24-hour pH-metry. Material and Methods. In the examination of patients with GERD, three groups of patients were selected for 50 people each. The first group includes patients with GERD with combined course of obesity and type 2 diabetes (mean age 54.6±2.73 year; 32 females and 18 males). The second group included patients with GERD against obesity (mean age 42.3±2.11 year; 30 females and 20 males). The control group consisted of patients with GERD without excess body weight and concomitant pathology (average age43.6±2.11 year; 29 females and 21 males). In addition to collecting complaints and anamnesis, the patients and the control group underwent a 24-hour pH-metric study of the esophagus according to a conventional method. Results. Patients suffering from GERD in the background of type 2 diabetes have a clinically asymptomatic or asymptomatic course; there is a significant increase in the daily pH-metry, indicating a more pronounced nature of the changes. Conclusion. Patients suffering from GERD in the background of type 2 diabetes require a comprehensive examination of the upper digestive tract to identify GERD, even if there are no complaints characteristic of the disease.

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Interdisciplinary aspects of rehabilitation of patients with oncological diseases in non-terminal situation of the disease

Year: 2017, volume 13 Issue: №4 Pages: 806-808
Heading: Health Service Organization Article type: Review
Authors: Shmerkevich А.В., Vodolagin A.V., Balakina D.D.
Organization: Saratov State Medical University
Summary:

Medical social rehabilitation of patients with oncological diseases in the non-terminal stage of the disease is based on the principle of an interdisciplinary approach, which involves complex special treatment, providing patients and their families with various types of social and psychological support at all stages of specialized care. The authors of the review consider the solution of medical and social problems in the rehabilitation of patients with oncological diseases in the context of the synergistic effect. Weak social and psychological protection of patients with oncological pathology adversely affects the prognosis of the disease and worsens patients quality of life. The review provides evidence that patients who receive social support are best adapted to the cancer situation, while a lack of social support is a significant risk factor for increased mortality in cancer patients.

Keywords: quality of life
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The role of health centers in preventive care provision

Year: 2017, volume 13 Issue: №4 Pages: 803-805
Heading: Health Service Organization Article type: Original article
Authors: Shemetova G.N., Sidorova N.V., Gubanova G.V.
Organization: Saratov State Medical University
Summary:

Aim: to assess the importance of the Centers of Health in the organization and provision of preventive care to the population, in the early detection of risk factors for the development of chronic non-communicable diseases and the development of a healthy lifestyle. Material and Methods. On the basis of the Health Center of Engels Center for Medical Prevention in the Saratov Region, the detection of risk factors for 2011-2015 was analyzed according to statistical reporting (form No. 68) and health cards (form025-CZ/y) of 207 patients. To assess the satisfaction of visitors with the work of the Center, a specially developed questionnaire was conducted, which included 22 questions that characterize the patient profile, his attitude to the organization and the results of the survey, and the motivation to modify the way of life. Results. The study confirmed the important role of the Centers of Health in the organization and provision of preventive care to the population, the formation of a healthy lifestyle and the early detection of diseases and risk factors for their development. Conclusion. Only joint efforts of medical institutions, authorities, educational organizations, mass media can lead to the formation of the population's responsibility for their health and readiness to modify the way of life.

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Analysis of activity of health workers in educational organizations and needs for medical care of children with disabilities

Year: 2017, volume 13 Issue: №4 Pages: 800-802
Heading: Health Service Organization Article type: Original article
Authors: Fomina A.V., Grigorieva N.A., Shovkun N.V.
Organization: Peoples' Friendship University of Russia
Summary:

Objective: study of the current state of medical support for children in educational organizations and an assessment of the needs of children with disabilities in medical care. Material and Methods. According to the results of the sociological survey (1796 profile views), the analysis of the health workers' activities in educational organizations implementing the adapted basic general education programs was carried out. According to the preventive examination of children with disabilities (124 people) and of the survey of parents (124 profile views), the article assesses the effectiveness of preventive work with children and parents to strengthen the dental health of schoolchildren in Moscow. Results. The majority of medical workers in educational institutions implementing adapted basic general education programs are represented by specialists with secondary medical education (77.2%). Among specialists needed in educational organizations, dentist is often called. The need for children with disabilities in dental care is confirmed by data obtained during the study of dental health of children with hearing impairment and children with visual impairments. Conclusion. One of the areas of medical care for children with disabilities in educational organizations is active monitoring of the health of children and the implementation of comprehensive preventive measures, which requires the involvement of more health workers.

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