Saratov JOURNAL of Medical and Scientific Research

Samara State Medical University

Analysis of working conditions of employees of Samara medical institutions

Year: 2018, volume 14 Issue: №3 Pages: 427-433
Heading: Hygiene Article type: Original article
Authors: Tupikova D.S.
Organization: Samara State Medical University
Summary:

Objective: an analysis of the conditions and nature of the work of public health workers in the city of Samara, according to their own research and the results of a special assessment of working conditions for the development of preventive measures. Material and Methods. The study analyzed the results of assessing the factors of the production environment, such as microclimate and illumination in 70 rooms of two large medical institutions of the city of Samara. An estimation of the qualitative and quantitative microbial composition of the air medium in the analyzed rooms was carried out. The analysis of registration cards for a special assessment of the working conditions of workplaces in the same organizations was carried out between 2012 and 2017. Results. In analyzing the conditions and nature of the work of medical workers, it was revealed that the final class of working conditions for doctors and nurses of surgical departments was 3.3, therapeutic 3.2 as a result of biological factors. At the same time, the air in the working area of the study rooms of the surgical and therapeutic sections differed significantly in the structure of the conditionally pathogenic microflora. Physical and chemical factors did not exceed the level of class 3.1-3.2. Conclusion. An analysis of the results of the studies showed the need to optimize ventilation in the residents and nurses, as well as the need to improve the quality of natural and artificial lighting. The expediency of standardization of the conditionally pathogenic microflora of the air environment in class «B» premises is shown.

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Dynamics of acetylcholine receptors antibody titer in myasthenia gravis

Year: 2018, volume 14 Issue: №1 Pages: 164-168
Heading: Neurology Article type: Original article
Authors: Romanova T.V., Poverennova I.E., Zakharov A.V.
Organization: Samara State Medical University
Summary:

The aim was to examine the longitudinal association between myasthenia gravis clinical severity and concentration of acetylcholine receptor (AChR) antibodies to evaluate if AChR-antibody variations correlate to disease severity. Material and Methods. Antibodies were determined by enzyme immunoassay. The International Clinical Classification (MGFA) was used to grade the severity of the disease. The level of antibodies was compared with the severity of the condition and the form of the disease at the stage of diagnosis in 65 patients, as well as in repeated studies in 26 patients. Results. The titer of AChR-antibodies did not correlate with the severity of the condition, however, a direct relationship between the change in the level of acetylcholine receptor antibodies and the change in the clinical state during the course of the disease was obtained. Conclusion. Repeated AChR-antibody measurements will help to predict the clinical state of the patient and can be used to correct immunosuppressive therapy.

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Use of the scale of clinical expression of the stroke for determining the rehabilitation prediction

Year: 2018, volume 14 Issue: №1 Pages: 161-164
Heading: Neurology Article type: Original article
Authors: Repina L.A., Romanova T.V., Poverennova I.E.
Organization: Samara State Medical University
Summary:

The aim is to study the relationship between the parameters of neurological status and quality of life of patients who first underwent ischemic strokes in the carotid basin to predict the outcome of an acute cerebrovascular accident. Material and Methods. 73 patients with ischemic stroke in the carotid artery basin were examined. Analyzed indices of the scales, reflecting the severity of motor deficit (NIHSS, Rankin, Rivermead, Fugl-Meyer), the initial evaluation and parameters of quality of life using the questionnaire SF-3624-36 months after inpatient treatment. Patients were divided into groups of favorable and unfavorable outcome according to the questionnaire SF-36. Results. A direct correlation between the level of physical and psychological health and indicators Of the Fugl-Meyer scale and a negative correlation between the level of psychological health and the severity of stroke on the NIHSS scale in a group with an adverse outcome was revealed. Conclusion. Indicators scales Fugl-Meyer, and NIHSS obtained in the acute period of ischemic stroke can be used to build a predictive model of outcome of stroke.

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Multimodal evoked potential in monitoring activity relapsing and remitting multiple sclerosis

Year: 2018, volume 14 Issue: №1 Pages: 157-160
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Zakharov A.V., Khivintseva E.V.
Organization: Samara State Medical University
Summary:

The aim of the study was to examine multimodal evoked potential in patients with or without relapse
multiple sclerosis during 12 month. Material and Methods. The study included 32 patients with
established diagnosis of clinically significant multiple sclerosis, a relapsing-remitting course. The EDSS
score was evaluated. All patients underwent a study of multimodal evoked potential. All examined
patients were divided into 2 groups depending on the relapse multiple sclerosis by the end of the year.
Results. Multimodal evoked potentials show ambiguous data on the activity of multiple sclerosis. The
greatest correlation with subsequent activity of multiple sclerosis is shown by stem evoked potentials.
Conclusion. This study is the initial stage in the search for a tool for predicting the course of the disease
in patients with multiple sclerosis. An increase in the group of subjects and inclusion in the analysis of
structural changes in the central nervous system according to magnetic resonance imaging probably will
increase the information content of predictions.

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Analysis of the coagulates intensity in laser treatment of diabetic macular edema in a Navilas robotic laser system

Year: 2017, volume 13 Issue: №2 Pages: 375-378
Heading: Ophtalmology Article type: Original article
Authors: Zamytskiy Е.А., Zolotarev A.V., Karlova E.V., Zamytskiy P.A.
Organization: Samara Regional Clinical Ophthalmological Hospital n.a. T. I. Broshevskiy, Samara State Medical University
Summary:

The aim ofthisworkwasto analyze the intensity of the laser coagulates in the treatment of diabetic macular edema conducted in navigation mode on robotic laser system Navilas. Material and Methods. Retrospective analysis of outpatient cards and photographs of the fundus 20 patients (28 eyes) had been done. The patients had type II diabetes mellitus. We performed laser treatment of diabetic macular edema. There were evaluated 4260 coagulates, of which 0 degree 2166 (50.85%), I degree —525 (12.32%), II degree —747 (15.74%), III degree—498 (11.96%), grade IV — 324 (7.6 per cent). Result. The thickness of the retina before treatment in the area of edema was made 339.72±45.3 urn, and after treatment 346±70 urn, student's t-test 0.7124, a difference of 6.5±57.4. Visual acuity before treatment 0.532±0.3, after— 0.521±0.3mm, student's t-test 0,889. Conclusion. The facts obtained in the analysis suggests that the algorithm of selection of power and the way it adjustments in the course of treatment are the weak point of this technique. Development of new methods, giving the possibility to adjust the power depending on the height of the swelling region of the retina, thereby gaining coagulates strictly necessary for the specific case of intensity, will enable to increase the efficiency and safety of laser treatment.

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Early detection of cognitive impairment in patients with multiple sclerosis

Year: 2017, volume 13 Issue: №1 Pages: 164-168
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Romanova T.V., Zakharov A.V., Khivintseva E.V.
Organization: Samara State Medical University
Summary:

The aim of the study was to examine cognitive impairment in patients with multiple sclerosis with an emphasis on the speed and efficiency of information processing. It was supposed to reveal the patterns of these disorders depending on the duration and severity of the disease. Material and methods. The study included 50 patients with established diagnosis of clinically significant multiple sclerosis, a relapsing-remitting course. The EDSS score was evaluated. Cognitive functions were assessed using SDMT and PASAT-3 tests. All patients underwent a study of cognitive evoked potential. All examined patients were divided into 2 groups depending on the duration of the disease. Results. Cognitive screening tests PASSAT and SDMT showed no correlation with the duration of the disease severity and cannot serve as a tool for screening early signs of cognitive impairment in young patients with multiple sclerosis. A significant increase in latency of the P300 potential was obtained with increasing duration and severity of the disease, which correlates with the severity of cognitive dysfunction. Conclusion. This study is the initial step in the search for a tool for screening early manifestations of cognitive impairment in patients with multiple sclerosis. In the future it is planned to expand the research with the modernization of its design.

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The analysis of the clinical and tool parameters characterizing a cardiomyopathyat various forms of the progressing muscular dystrophies

Year: 2017, volume 13 Issue: №1 Pages: 160-164
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Zakharov A.V., Chernikova V.V.
Organization: Samara State Medical University, Samara Regional Clinical Hospital n.a. V. D. Seredavin
Summary:

Purpose: studying of clinical and tool characteristics of cardiomyopathies at various forms of the progressing muscular dystrophies. Material and methods. There had been 103 patients with hereditary forms of the progressing muscular dystrophies examined, among which 35 persons were with Duchenne muscular dystrophy, 28 with an atrophic myo-tonia, and 40 with a limb girdle dystrophy is conducted. Assessment of clinical and tool features of cardiomyopathies at these types of the hereditary progressing muscular dystrophies had been carried out. Results. In the group of patients with diffusion damage of a myocardium in the form of dystrophic violations had been revealed. Existence of a negative tooth of T in some assignments and lengthenings of an interval of QT is noted. With a dystrophic myotonia violation of a warm rhythm occurred at patients by 87 times more often than in the group of comparison. Violation of a rhythm of heart in group of patients with a limb girdle dystrophy came to light 91 times more often in reference to the group of comparison. Conclusion. Violations in a cardiovascular system at Duchenne muscular dystrophy are preferentially diffusion changes in a myocardium. At a dystrophic myotonia and a limb girdle dystrophy cardial violations concern mainly excitability and the conductivity of heart which are the main reason of developing of this disease at these patients.

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Innovation in diagnostics and treatment of epilepsy

Year: 2017, volume 13 Issue: №1 Pages: 143-147
Heading: Neurology Article type: Review
Authors: Kalinin V.A., Poverennova I.E., Yakunina A.V., Beketova E.M.
Organization: Samara State Medical University, Municipal Hospital No. 1 n.a. N. I. Pirogov, Samara
Summary:

The aim of the review is try to systematize the innovative achievements of modern epileptology and indicate the levels of diagnosis and treatment of epilepsy that are not sufficiently developed, from our point of view. Applied to epileptology, the innovation process is realized at all levels. In principle, you can divide the entire process into a diagnostic and treatment level. Promising in the diagnosis of epilepsy should be considered the analysis of age characteristics, new methods of EEG analysis and evoked potentials, innovative methods of functional neuroimaging, genetic testing. New anticonvulsants with the original mechanism of action allow to overcome pharmaco-resistance of epilepsy in a number of observations. In rare cases it is necessary to use minimally invasive surgical methods of treatment.

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Improvement of technology of clasp dentures manufacture

Year: 2016, volume 12 Issue: №4 Pages: 589-592
Heading: Stomatology Article type: Original article
Authors: Komlev S.S.
Organization: Samara State Medical University
Summary:

The aim of the article is to improve the technology of clasp dentures manufacture. Material and Methods. Orthopaedic treatment of 27 patients was conducted using advanced technology of manufacturing clasp dentures at the Department of Prosthetic Dentistry at Samara State Medical University. Results. Conducting the orthopaedic treatment a method of obtaining an impression in prosthetics on implants and teeth, a method of manufacturing clasp denture with locking fasteners and a method of manufacturing a clasp denture with a questionable prognosis of bearing tooth were used. Conclusion. Using the advanced technology of manufacturing clasp denture has solved the problem with unreliable periodontal tissues, loss of a removable part of clasp denture and allowed to improve the quality of obtaining impression from bearing teeth.

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Clinical and instrumental risk factors for epileptic seizures in patients after traumatic brain injury

Year: 2016, volume 12 Issue: №3 Pages: 366-370
Heading: Neurology Article type: Original article
Authors: Zakharov A.V., Poverennova I.E., Kurov M.V., Khivintseva E.M.
Organization: Samara State Medical University
Summary:

The aim: analysis of factors influencing the risks of posttraumatic epilepsy (РТЕ). Materials and Methods. The study involved 71 patients with traumatic brain injury of moderate and severe with emerging after her epileptic seizures. Among the subjects was 56 (78.9%) males and 15 (21.1%) females. The average age of the subjects was 65.6±10,3 years. The control group was 25 (71.4%) male patients and 10 (28.6%) females. The average age of the patients was 54.4.±9.3 years. Analysis of factors influencing the risks of РТЕ use nonparametric Spearman correlation and multivari-ate analysis of variance. Results. Among the many factors to be statistically significant risk factors for РТЕ was alcohol intoxication at the time of trauma 27 (38,0%), relative to the control group 2 (5.7%) p

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