Saratov JOURNAL of Medical and Scientific Research

I.M. Sechenov First Moscow State Medical University

Modern practical-oriented approach to professional selection for medical professions among school graduates

Year: 2019, volume 15 Issue: №2 Pages: 338-341
Heading: Health Service Organization Article type: Original article
Authors: Kasimovskaya N.A.
Organization: I.M. Sechenov First Moscow State Medical University
Summary:

Objective: to study efciency of introduction of new instrument of vocational guidance in the feld of medicine — «Pre-Professional Examination» (Practical part), to estimate the current state of readiness for choice of medical profession among school leavers. Material and Methods. In 2017, for the frst time, an organizational experiment on the technology «Objective Structured Clinical Examination» (OSKE) for students of 11 grades of schools in Moscow (n=2703) was conducted and a comparative analysis with the results of obligatory «Pre-Professional Examination» (Practical part) (n=3100 respectively) to assess the practical skills of frst aid, also applied a sociological method to assess the readiness of graduates of secondary general educational organizations to the choice of the medical profession (n=300). Results. As a result of research it is established that at voluntary choice of participation in the practical-oriented examination (organizational experiment) the results are higher (60 points — 35.1±1.4 %), than at obligatory passage of «Pre-Professional Examination» (Practical part) (60 points — 2.1±0.3 %) which determines its importance as a motivational factor in the choice of professions in the feld of medicine. The sociological survey showed that 49±3.1 % of students-graduates of schools have not yet decided on the choice of profession. Conclusion. The efectiveness and signifcance of introducing the «Pre- professional exam» (practical part) as a promising method of strategic planning in government regulation of the formation of human resources for the health care system from school graduates and challengers for medical specialties has been scientifcally proven.

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Principles of the program of enhanced recovery of patients after radical prostatectomy

Year: 2019, volume 15 Issue: №2 Pages: 324-327
Heading: Urology Article type: Review
Authors: Pavlov V.N., Tarasenko A.I., Korelov Yu.A., Maksimova S.Yu., Khotko D.N., Khotko A.I.
Organization: Bashkir State Medical University of the Russian Health Care, I.M. Sechenov First Moscow State Medical University, Saratov State Medical University
Summary:

Analysis of statistical data on cancer incidence shows a high prevalence of such diseases as prostate cancer. The existing methods of treatment of this pathology are efective, but the question of reducing the surgical stress of patients who underwent surgery, reducing the number of complications, early mobilization and early recovery remains relevant. The presented literary review reveals the provisions proposed in the XX century, multimodal strategy «Fast track sur-gery», revealing the tactics of surgical patients throughout the perioperative period. The application of this protocol shows its efectiveness in reducing the duration of hospitalization and early rehabilitation of the considered group of patients.

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Principles of the program of enhanced recovery of patients after radical prostatectomy

Year: 2019, volume 15 Issue: №2 Pages: 324-327
Heading: Urology Article type: Review
Authors: Pavlov V.N., Tarasenko A.I., Korelov Yu.A., Maksimova S.Yu., Khotko D.N., Khotko A.I.
Organization: Bashkir State Medical University of the Russian Health Care, I.M. Sechenov First Moscow State Medical University, Saratov State Medical University
Summary:

Analysis of statistical data on cancer incidence shows a high prevalence of such diseases as prostate cancer. The existing methods of treatment of this pathology are efective, but the question of reducing the surgical stress of patients who underwent surgery, reducing the number of complications, early mobilization and early recovery remains relevant. The presented literary review reveals the provisions proposed in the XX century, multimodal strategy «Fast track sur-gery», revealing the tactics of surgical patients throughout the perioperative period. The application of this protocol shows its efectiveness in reducing the duration of hospitalization and early rehabilitation of the considered group of patients.

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Features of dental prosthetics at patients with chronic periodontitis and coronary heart disease

Year: 2019, volume 15 Issue: №2 Pages: 251-256
Heading: Stomatology Article type: Original article
Authors: Lepilin A.V., Eremin A.V., Lipatova T.E.
Organization: I.M. Sechenov First Moscow State Medical University, Saratov State Medical University
Summary:

Objective: at patients with chronic generalized periodontitis in combination with chronic ischemic heart disease to study the change of cytokines, biomarkers of osteoproliferation and osteoresorption in comparison with the character- istics of endothelial functions and the determine rational approaches to prosthetics. Material and Methods. 90 patients with periodontitis and coronary heart disease, who use metal, metal-ceramic and removable partial dentures using thermoplastic resin were survey. We studied of cytokines, markers of bone metabolism in the oral fuid, evaluated va-sodilating, vasoconstrictor and adhesive endothelial function. Results. The coronary heart disease in combination with chronic periodontitis is characterized by the endothelial dysfunction, which associated with the activity of periodontitis. Biochemical manifestations of periodontitis, bone resorption and endothelial dysfunction are more pronounced by the use patients metal dentures compared to metal-ceramic and removable partial dentures using thermoplastic resin. Conclusion. The use of patients at periodontitis and coronary heart disease metal dentures, in contrast to patients using metal-ceramic and removable partial dentures using thermoplastic resin, is accompanied the increase of biochemical markers of infammation and bone resorption in the oral fuid and the endothelial dysfunction.

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Features of dental prosthetics at patients with chronic periodontitis and coronary heart disease

Year: 2019, volume 15 Issue: №2 Pages: 251-256
Heading: Stomatology Article type: Original article
Authors: Lepilin A.V., Eremin A.V., Lipatova T.E.
Organization: I.M. Sechenov First Moscow State Medical University, Saratov State Medical University
Summary:

Objective: at patients with chronic generalized periodontitis in combination with chronic ischemic heart disease to study the change of cytokines, biomarkers of osteoproliferation and osteoresorption in comparison with the character- istics of endothelial functions and the determine rational approaches to prosthetics. Material and Methods. 90 patients with periodontitis and coronary heart disease, who use metal, metal-ceramic and removable partial dentures using thermoplastic resin were survey. We studied of cytokines, markers of bone metabolism in the oral fuid, evaluated va-sodilating, vasoconstrictor and adhesive endothelial function. Results. The coronary heart disease in combination with chronic periodontitis is characterized by the endothelial dysfunction, which associated with the activity of periodontitis. Biochemical manifestations of periodontitis, bone resorption and endothelial dysfunction are more pronounced by the use patients metal dentures compared to metal-ceramic and removable partial dentures using thermoplastic resin. Conclusion. The use of patients at periodontitis and coronary heart disease metal dentures, in contrast to patients using metal-ceramic and removable partial dentures using thermoplastic resin, is accompanied the increase of biochemical markers of infammation and bone resorption in the oral fuid and the endothelial dysfunction.

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Local effect of vitamin D on the immune system of periodontium

Year: 2019, volume 15 Issue: №1 Pages: 41-47
Heading: Stomatology Article type: Review
Authors: Ostrovskaya L.Yu., Zakharova N.B., Bodyleva А.Р., Bulkina N.V., Lysov A.V., Osipova U.L.
Organization: I.M. Sechenov First Moscow State Medical University, Saratov State Medical University
Summary:

 Literature review is devoted to the analysis of scientific findings about extraosseous effects of vitamin D on the immune system of the periodontal tissues. It was found that the biological functions of vitamin D (VD) in the body are diverse.Along with the detailed study of the effect on metabolic processes in bone tissue, VD makes a significant contribution to a large number of processes that ensure the activity of the immune system. In addition, VD increases the production of "endogenous antibiotics". This allows us to consider VD as a therapeutic agent that prevents the development of inflammatory and destructive changes in the periodontal tissues in population with simultaneous slowing of bone loss and preservation of bone mass of the dentofacial system. Currently detected hidden hypovitaminosis VD in almost majority of the population is considered a leading factor in the development of periodontal disease and its prevention and treatment is one of the most important tasks of therapeutic dentistry.

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Preventive care for the patients with chronic kidney disease in the Russian Federation: analytical review of the prevalence and existing programs

Year: 2019, volume 15 Issue: №1 Pages: 24-28
Heading: Internal Diseases Article type: Review
Authors: Milchakov K.S., Shilov Е.М., Gabaev M.l.
Organization: I.M. Sechenov First Moscow State Medical University
Summary:

This article aims to provide an analytical review of existing organizational and methodological approaches to the prevention and control of chronic kidney disease (CKD) in the Russian Federation. Various aspects of the current situation of CKD in the Russian Federation are considered and national institutional mechanisms applicable to this state are analyzed. Despite the obvious positive developments in the prevention of noncommunicable diseases in the Russian Federation, the problem of CKD in Russia is not sufficiently covered as a result of this situation there is personnel and methodological deficit, weak interdisciplinary interaction of health care organizations, as well as underreporting of specific nephrological risks of CKD progression.

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Transplantation tourism as an international problem: prerequisites and ways of prevention

Year: 2018, volume 14 Issue: №4 Pages: 683-685
Heading: Sociology of Medicine Article type: Author's opinion
Authors: Romanov S.V., Abaeva O.P.
Organization: I.M. Sechenov First Moscow State Medical University, Volga District Medical Center of FMBA
Summary:

The purpose of scientific work was to substantiate the relevance ofthe problem of transplant tourism, which is a way for a recipient to obtain an organ for transplantation bypassing national wait lists by finding a donor in a foreign country on a commercial basis. The authors have performed analysis of literary sources related to issues ofthe development of transplant tourism around the world, origins of its existence as well as possible ways to prevent the following practive. In conclusion, authors underline the necessity to establish the development of transplantology based on principles of gracious organ donations and fairness in terms of recipient election.

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Biomarkers of renal damage and immunohistochemical detection of oncogenesis in the surgical treatment of renal cell carcinoma

Year: 2018, volume 14 Issue: №3 Pages: 420-426
Heading: Urology Article type: Original article
Authors: Tarasenko A.l., Rossolovsky A.N., Berezinets O.L., Ponukalin A.N., Medvedeva A.M., Zakharova N.B., Popkov V.M., Maslyakova G.N.
Organization: Saratov State Medical University, I.M. Sechenov First Moscow State Medical University
Summary:

Objective: to assess the possibility of using markers of renal injury and carcinogenesis as additional criteria for the choice of the method of surgical treatment of RCC and to minimize the risk of development and progression of kidney injury. Material and Methods. 60 patients with morphologically confirmed RCC T1-3M0N0 operated on in the volume of open nephrectomy or laparoscopic nephrectomy or laparoscopic resection and the kidney were examined. Patients were divided into 3 groups: group 1: patients after nephrectomy performed for kidney cancer using traditional surgical technique, group 2: patients after laparoscopic nephrectomy and group 3: after laparoscopic resection of kidney tumor. Before surgical operation, on the 5-7 day and after 1 month, all patients were examined by concentrations of urinary excreted lipocalin 2 (NGAL), and serum concentrations of IL-18, MMP-9 and IGF-1. Renal function was estimated using the calculated GFR equation (CKD-EPI 2009) based on serum creatinine level. Immunohistochemical study of histological preparations of distant tumors on proliferation antibodies (Ki-67, PCNA), apoptosis (BAX, Bcl-2) was performed. Differences in clinical data and clinical variables were compared using Spearman rank correlations and t-test. Results. The studied indices of renal damage of IL-18, NGAL, MMP-9 and IGF-1 both in the early (5-7 days) and later (1 month) postoperative period showed a correlation between the surgical intervention method and the degree of tumor cell differentiation. Conclusion. The levels of biomolecular markers of renal damage (IL-18, NGAL, MMP-9 and IGF-1) correlate with the degree of differentiation in thetumoral cells and functional activity of the remaining renal parenchyma in the postoperative period, but also depend on the individual characteristics of the patient's body. A certain level of expression of MMP-9 and IL-18 with a small tumor size can be a guide to determine the indications for the choice of organ-preserving surgery in patients.

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