Saratov JOURNAL of Medical and Scientific Research

2019, volume 15

Features of the level and dynamics of early social orphanhood as a medical and social phenomenon in various administrative-territorial formations of the Chelyabinsk region

Year: 2019, volume 15 Issue: №4 Pages: 904-909
Heading: public health Article type: Original article
Authors: Markina A.Yu.
Organization: South Ural State Medical University
Summary:

The aim is study the features of the level and dynamics of early social orphanhood as a medical and social phenomenon in various administrative and territorial entities of the Chelyabinsk region. Material and Methods. The method of copying data from the accounting documentation of the maternity hospital was applied (Form No. 32 "Information on medical care for pregnant women, puerperals and parturient women" for 2009-2017, Form No. 96 "Birth history"). A total of 1438 observation units were investigated. Results. During the period from 2009 to 2017 in the Chelyabinsk region there is almost two-fold reduction in the number of early social orphans: from 175 to 84 newborns. The highest prevalence of newborns abandonment was in urban districts:4.5±0.9 cases per 1000 newborns. Among women from rural areas and from megalopolis those indices did not differ significantly: 3.5±0.2 and 3.3±0.4 cases per 1000 newborns respectively (p>0.05). Conclusion. In the Chelyabinsk region the number of early social orphan hood decreased by almost half by the period of 2009-2017. The number of these children in megalopolis, urban and rural districts was subjected to serious fluctuations in the particular years of the study. Considering the differences in the level of birth rate and female population of reproductive age in urban and rural areas it is necessary to use index "prevalence of newborns abandonment per 1000 newborns" proposed by us. After a sharp decrease in absolute and relative values reflecting the number of early social orphans at the turn of 2013-2014, the indicators stabilized in subsequent years. This may be a consequence of both the reduction of preventive measures and the formation in the population of mothers of refusers of a certain contingent, which is insensitive to traditional methods of socio-psychological impact.

Keywords: the Chelyabinsk region, medical organization, infant failure rate, early social orphanhood

Academic performance, motivation and quality of life associated with the health of senior students of medical and humanitarian specialties

Year: 2019, volume 15 Issue: №4 Pages: 897-904
Heading: public health Article type: Original article
Authors: Kuznetsov V.V., Bayramov R.A., Smirnov E.A., Kosilova E.K., Kosilov K.V., Karashchuk E.M., Zayko A.A.
Organization: Pacific State Medical University, Far Eastern Federal University
Summary:

Objective: a comparative analysis of the relationship of quality of life associated with health with academic performance and motivation to learn from students of humanities and medical specialties of senior courses. Material and Methods. The study was conducted at the School of Biomedicine of the Far Eastern Federal University and Pacific State University. The sample size is 516 students (51% girls). 272 (52.7%) students studied medical specialties; 244 (47.3%) — humanities. For questioning students used a comprehensive questionnaire self-assessment of socio-economic and medical status of a student of the University (Pozdeyeva, 2008), the questionnaire MOS SF-36. Academic motivation was assessed on the scale of Т. О Gordeeva and O. A. Sychev (2014); academic performance — according to the semester statistical reports of the relevant departments and faculties. Results. The total indicators of physical and mental health in the assessment of quality of life associated with health among students of medical and humanitarian specialties did not differ significantly, although the assessment of their quality of life by humanitarians was slightly higher (67.1/64.1; p>0.05). It was found that strong relationships are characteristic of variables: learning conditions (r=0.89, p<0.05); academic performance and motivation to study (r=0.75, p<0.05; r=0.79, p<0.05); the presence of bad habits (r=0.77, p<0.05); self-assessment of physical health (r=0.67, p<0.05). Conclusion. The quality of life associated with health at students of medical and humanitarian specialties is interconnected by motivation to study and progress, and also a number of variables of the social and economic status and morbidity.

Keywords: quality of life, performance, motivation to learn, comorbidity

Optimization of medical organization activities by implementation of lean-production

Year: 2019, volume 15 Issue: №4 Pages: 893-897
Heading: public health Article type: Author's opinion
Authors: Breusov A.V., Fenyutina V.A., Orudzhev A.A.
Organization: Peoples' Friendship University of Russia, Bauman Moscow State Technical University
Summary:

The existing health care system in the Russian Federation requires significant changes related to the reorganization of the current processes of medical care in medical institutions, therefore, the topic of introducing the principles of lean production in the healthcare sector is extremely relevant today. Lean healthcare is aimed at increasing the availability and quality of medical care to the population by streamlining processes and eliminating losses. The main objectives of the medical institution as part of the implementation of the concept of lean manufacturing are to increase the satisfaction of consumers of medical services, increase the quality and productivity of medical personnel. The need to implement these tasks is caused by the unreasonably long time spent of patients in the clinic during research, the uneven workload of medical institution specialists, queues at the reception desk, filling in a large number of different paper forms and processing of unnecessary information. The study allowed us to comprehensively analyze the basic principles of the concept of lean manufacturing, to substantiate the relevance and the possibility of extrapolating its principles to the healthcare sector, as well as to study the organization of the activities of the best "lean" clinics abroad, which could become role models when introducing the principles of lean manufacturing in domestic medical organizations.

Keywords: optimization of the institution, management of a medical organization, lean manufacturing, improvement of medical activities

Information systems perspectives in the improvement of dental care quality (review)

Year: 2019, volume 15 Issue: №4 Pages: 888-893
Heading: public health Article type: Review
Authors: Bragina М.G., Fomina A.V.
Organization: Peoples' Friendship University of Russia
Summary:

The analysis of literature data on the possibilities and prospects for the use of information technologies (IT) to improve the efficiency and quality of dental medical care (QDMC) to the population has been performed. The need for the introduction of IT systems as part of pilot projects in dental facilities was noted. According to a number of researchers, the prospects for introducing medical information systems (IS) are associated with increasing the supporting business processes. The results of a number of studies are presented in which it is demonstrated that the use of the software systems proposed by different authors allows for the operative control of the QDMC with the evaluation of medical personnel, as well as for improving the effectiveness of treatment and optimizing the patient flow. It is indicated that the electronic method of collecting, storing and processing data makes it possible to combine the efforts of specialists who are participants in the process of providing dental care to the population in a single information field, which undoubtedly should make a significant contribution to improving the efficiency of their treatment.

Keywords: algorithms, dental care, health care quality, IT-technology

Basic principles of prenatal counseling by a pediatric urologist: challenges and opportunities

Year: 2019, volume 15 Issue: №4 Pages: 884-887
Heading: Urology Article type: Author's opinion
Authors: Deryugina L.A.
Organization: Saratov State Medical University
Summary:

This publication is based on the results of the accumulated experience of a practicing pediatric urologist during prenatal counseling in the framework of the regional prenatal consultation and is the result of long-term research work in the field of pediatric urology, fetal urology, prenatal ultrasound diagnosis of urinary system defects. The system of prenatal diagnosis of urinary system pathology proposed in the article will significantly increase the reliability of antenatal diagnosis and prognosis, plan the timing, scope and tactics of treatment activities carried out as early as possible after birth at the stage of preclinical manifestations. To do this, it is assumed, firstly, the creation of a group of perinatal observation of patients; secondly, the use of evaluation and interpretation of ultrasound data that determine the level and nature of urodynamic lesions of the fetal urinary system, the severity of urinary tract dilatation, the preservation of renal parenchyma, which is the basis for prenatal diagnosis, evaluation of prospective kidney function. The signs of prognostically unfavorable malformations of the urinary system, in which the question of termination of pregnancy is discussed, are highlighted.

Keywords: congenital malformations of the urinary system, prenatal counseling

Evaluation of the efficiency of simultaneous rigid fixing and interspinous stabilization in patients with degenerative diseases of the lumbar spine

Year: 2019, volume 15 Issue: №4 Pages: 877-883
Heading: Surgery Article type: Original article
Authors: Byvaltsev V.A., Kalinin А.А., Okoneshnikova А.К., Shepelev V.V., Pestryakov Yu.Ya.
Organization: Irkutsk Research Center of Surgery and Traumatology, Irkutsk SBI of Post-graduate Education — Branch of Russian Medical Academy of Continuing Professional Education, Irkutsk State Medical University, Road Clinical Hospital, Irkutsk-Passenger Station of the Russian Railways
Summary:

Purpose: to assess the effectiveness of simultaneous rigid fixation and interspinous stabilization in patients with degenerative diseases of the lumbar spine. Material and Methods. The study included 216 patients with degenerative diseases of the lumbar spine, who in 109 cases underwent isolated rigid fixation, and in 107 cases, additional simultaneous interspecific stabilization. Results. When compared with the group of isolated rigid fixation, when conducting an additional simultaneous interspinous stabilization of the adjacent segment, lower indices of the level of pain syndrome and better functional status were noted. The total number of postoperative complications in the first group is 17.4%, in the second 5.6% (p=0.02). According to the instrumental data, a statistically significantly lower degeneration of the adjacent segment in group II (p<0.001) was noted, while in 11 group I patients additional decompression-stabilizing interventions at the adjacent level were performed. Conclusion. Simultaneous rigid fixation with the installation of an interspinous stabilizer at an adjacent level in the treatment of patients with degenerative diseases of the lumbar spine can significantly reduce the level of pain, improve functional status and also protect the adjacent segment from the progression of the degenerative process in it and reduce the number of repeated surgical interventions.

Keywords: adjacent level syndrome, combined stabilization, degenerative diseases of the lumbar spine, interspinous stabilization, posterior rigid fixation

Endovascular treatment for critical limb ischemia in patients with diabetes mellitus (review)

Year: 2019, volume 15 Issue: №4 Pages: 873-876
Heading: Surgery Article type: Review
Authors: Bakhmetyev A.S., Anisimova Е.А., Temerezov T.Kh., Zotkin V.V., Rudakov M.O.
Organization: Medical Di Center, Regional Vascular Center of the Karachay-Cherkess Republican Clinical Hospital, Saratov State Medical University
Summary:

The literature review is devoted to the contemporary possibilities of endovascular surgery for patients with critical lower limb ischemia and diabetes mellitus. Surgical indications based on non-invasive methods such as measuring ankle-brachial and shoulder-finger indexes, as well as transcutaneous oximetry are considered. The material outlines both positive and negative aspects of interventional surgery in this cohort of patients included in the group of extremely high atherosclerotic risk.

Keywords: critical limb ischemia, diabetes mellitus, endovascular revascularization

Results of electroneuromyographic studies in children with talipes valgus

Year: 2019, volume 15 Issue: №4 Pages: 868-872
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Korshunova G.A., Rubashkin S.A.
Organization: Saratov State Medical University
Summary:

Objective: to estimate the condition of lower extremities neuromuscular apparatus in children with talipes valgus using electroneuromyographic data. Material and Methods. M- and F-responses from foot and lower leg muscles, fibu-lar and tibial nerves in 65 patients aged 7 to 17 у. o. were studies. Results. Decline in M-responses form tibial nerves was detected in 61.8% of cases alongside low activity of spinal cord motor neurons. Significant increase in amplitudes of fibular nerve M- and/or F-responses was detected; this was registered from gastrocnemius muscles in 63.1% of children and was independent of either their age or foot deformity degree. Conclusion. Electroneuromyographic data of the study in children with talipes valgus deformity allowed revealing evidences of segmental and suprasegmental CNS structures as well as lower extremity peripheral nerves involvement into the process.

Keywords: electroneuromyography, F-wave, M-respons, talipes valgus deformity

X-ray morphological features of vertebrae at idiopathic scoliosis of a high risk

Year: 2019, volume 15 Issue: №4 Pages: 861-868
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Zeynalov Yu.L., Chertkov A.K., Diachkova G.V., Diachkov K.A., Larionova Т.А.
Organization: Clinic of Military-medical Management of Service of State Security of the Azerbaijan Republic, Medical Center "Mirt", Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»
Summary:

Aim: to study anatomic and X-ray morphological changes of vertebrae at patients with idiopathic scoliosis of varying severity with method of a multislice computer tomography (MSKT). Material and Methods. At 27 patients with idiopathic scoliosis of varying severity, the MSKT method studied a condition of vertebrae in chest and lumbar department of a backbone within the continuous, retrospective one-center research. Anatomic and X-ray morphological changes of vertebrae depending on expressiveness of deformation are studied. Results. Results of a research showed that, at more expressed deformation the prevalence of frontal diameter over sagittal is 4-5% more, than at deformation less than 90°. At deformation of a backbone 65-80° vertebra height on the convex party is 22.3±1.7% more, than on concave, at deformation more than 90° the difference made 28.9±2.1 %. The median density of bodies of vertebrae on the convex party was 256.6± 44.7, on convex 267.1±36.2 HU. Patients with size have deformations more than 90°, the maximum density of bodies of vertebrae on the concave party was in 1.1 times more, than from convex, minimum in 2.1 times more, and median by 1.04 times. Conclusions. The anatomy, structure and density of the vertebrae in patients with scoliosis depend on the magnitude of the deformities and are characterized by more pronounced changes with deformities of more than 90°. The maximum changes are noted on the concave side of the scoliotic arch and are manifested by an increase in the maximum and median density of the vertebrae and the presence of areas with a lower density than on the convex side.

Keywords: idiopathic scoliosis, multislice computer tomography, vertebrae, X-ray morphology

Shock-wave therapy for combination treatment of plantar fasciitis

Year: 2019, volume 15 Issue: №4 Pages: 858-861
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Belonogov V.N., Kireev S.I., Kireev S.N., Semenov N.S.
Organization: Saratov Multidisciplinary Clinic "SOVA", Scientific Research Institute of Cardiology of Saratov State Medical University n.a. V.I. Razumovsky
Summary:

The objective is enhancing outcomes of plantar fasciitis patients using proprietary shock-wave technique. Material and Methods. There were 65 active plantar fasciitis patients under our care, and we used shock-wave therapy as a part of their combination treatment. The patients were divided into 2 groups depending on the specifics oa shock-wave therapy applied to them. The proprietary technique based on the combination of local cryotherapy and heel area enthe-sises traction during shock-wave sessions was applied for patients of the main group (35 patients) while 30 patients of the control group had conventional shock-wave technique applied to them. Results. Patients of the main group showed better dynamics of pain syndrome reduction (p<0.05), as well as normalization of plantar fascia anatomy parameters on ultrasound evidence. Conclusion. The combined application of local cryotherapy as well as enthesises traction allows enhancing shock-wave therapy efficiency as a component of comprehensive medical rehabilitation of plantar fasciitis patients.

Keywords: shock-wave therapy, Plantar Fasciitis