Saratov JOURNAL of Medical and Scientific Research

Original article

Readiness to realize the skills of professional communication among senior students of a medical university

Year: 2018, volume 14 Issue: №4 Pages: 691-695
Heading: Sociology of Medicine Article type: Original article
Authors: Shemetova G.N., Sidorova N.V., Gubanova G.V.
Organization: Saratov State Medical University
Summary:

Aim: to assess the readiness for effective communication of senior students of medical university. Material and Methods. A survey of 158 students of the 5th and 6th courses of the medical faculty of SSMU was conducted in February 2017 according to the original questionnaire aimed at assessing the theoretical knowledge in the field of communication and readiness to communicate with patients in practice. Results. The study revealed a number of problematic issues related to the communicative competence of senior students of the medical University. Most respondents (88%) rated their training in communication technologies as high and sufficient, and knowledge of theoretical issues does not always meet the requirements of today. Despite the support of the majority of students for a paternalistic approach to the relationship between the doctor and the patient (44% in general, 94,7% among sixth- year students), many respondents (85%) agreed with the involvement of the patient in the process of discussing the planned diagnostic and therapeutic measures, more than half of the students (57,6%) expressed a desire to undergo additional training on the basics of communication. Conclusion. In accordance with the new challenges in the native health care training of graduates of medical universities should include the formation and improvement of communicative competence with the realization that in the modern system of relations the Central person is a patient with his problems and

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Medical students representations on socially significant aspects of influenza prevention

Year: 2018, volume 14 Issue: №4 Pages: 680-682
Heading: Sociology of Medicine Article type: Original article
Authors: Mikhailova E.V., Malugina T.N., Levin D.Yu., Averianov А.Р., Serdyukov A.Yu., Zheleznikov P.A.
Organization: Saratov State Medical University
Summary:

The aim of the study is to assess the attitude to influenza prevention among medical students. Material and Methods. The survey of first-year students of Saratov State Medical University n.a. V. I. Razumovsky was conducted (n=110). Results included an analysis of the prevalence of different influenza prevention methods. We have identified the main causes of failures of specific influenza prevention and identified the most common ways of non-specific prevention. Conclusion. Despite the fact that the majority of students consider it necessary to carry out specific prevention of influenza, active immunization is used only by 15% of the surveyed students. Others prefer the methods of nonspecific prophylaxis of influenza.

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Regional problems of organization of medical rehabilitation of children who underwent neuroinfection.

Summary:

The purpose of the study is to demonstrate the main problems of rehabilitation aid to children who underwent neuroinfection. Material and Methods. Statistical evaluation of the results of the survey of doctors, nurses and heads of medical organizations (n=690) of various regions of the Russian Federation involved in the treatment of children with neuroinfections. These results were compared with the opinion of experts of the leading organization that provides assistance to this category of children at the Pediatric Research and Clinical Center for Infectious Diseases of Federal Medical and Biological Agency (n=121). Results. Specialists of all institutions note the growing need for children in rehabilitation activities after neuroinfections. 20,7% of specialists from regional medical organizations and 22,4% of experts from Pediatric Research and Clinical Center for Infectious Diseases of Federal Medical and Biological Agency indicate that continuity between medical organizations of different levels of medical care for children who have undergone neuroinfection is rather ineffective. The survey found that 25,9% of specialists of regional medical organizations pointed to funding problems. 28,3% of regional specialists indicated an insufficient number of medical organizations providing rehabilitation to children, and 59,0% of specialists from regions and 50,2% of Pediatric Research and Clinical Center for Infectious Diseases of Federal Medical and Biological Agency experts indicated the need to improve the legislative base. In addition, the interviewed experts ascertained an insufficient number of doctors and nurses in the organizations of the profile in question. Conclusion. According to the results of the study, the main problems in the organization of children's medical rehabilitation were established. This work can be one of the reasons for making management decisions aimed at improving the quality of this type of care for children who have undergone neuroinfections.

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Analysis of incidence of eye and adnexa diseases in the Central Black Earth region

Year: 2018, volume 14 Issue: №4 Pages: 670-676
Heading: Ophtalmology Article type: Original article
Authors: Osmanov RE, Zhabina UV, Manyakov RR, Osmanov EM.
Organization: S. Fedorov Eye Microsurgery Federal State Institution, Tambov State University n. a. G.R. Derzhavin
Summary:

The purpose is to study the dynamics of general and primary incidence of eye diseases and accessory apparatus among the population of the Central Black Earth region for the period 2008-2017, in comparison with similar indicators in the Russian Federation. Material and Methods. The article presents the data on the dynamics of general and primary incidence of eye diseases as a whole, as well as myopia and cataracts in comparison with Russia and the five regions of the Central Black Earth region (Belgorod, Voronezh, Kursk, Lipetsk, Tambov) from 2008 till 2017 Results. A comparative analysis of morbidity indicators allowed us to identify regions that are unfavorable for ocular morbidity in general and for cataracts and myopia in particular. Conclusion. The total incidence of eye diseases among the population of Russia in 2008 accounted 10994,0±2,6 cases, over ten years there was a decrease to 10370,9±2,5 cases per 100000 persons. The primary incidence rate of eye diseases among the population of Russia in 2008 accounted 3422±1,5 cases, over a ten-year period there was a decrease to 3161,1±1,4 cases per 100000 persons. Among the regions of the Central Black Earth region in the Belgorod region, the indicators studied are higher than the average in Russia. The incidence of eye diseases, in particular, cataracts and myopia tends to decrease. However, its level remains significantly high, which requires the improvement of organization of eye care and the development of measures aimed at preventing the development of eye pathology.

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The role of chronic inflammation in the formation of dentigerous (follicular) cysts of the jaws in children

Year: 2018, volume 14 Issue: №4 Pages: 657-660
Heading: Stomatology Article type: Original article
Authors: Slesareva О.А., Potemina Т.Е.
Organization: Privolzhskiy Research Medical University, Nizhny Novgorod Regional Children's Hospital
Summary:

Purpose: to determine the role of chronic inflammation in deciduous teeth data in the formation of dentigerous (follicular) cysts of the jaws in children; to considerthe pathophysiological mechanism of follicular cysts formation. Material and Methods. Case histories of 134 patients of the department of maxillofacial surgery (dentistry) "Nizhny Novgorod regional children's hospital" from 2003 to 2013 with a diagnosis of "follicular jaw cyst" with different localization. Results. The dental status, specifically centers of chronic inflammation, in the area of follicular cyst formation was assessed. The connection with the ecological situation of the residence area of patients with the prevalence of follicular cysts of the jaws in children was found. Conclusion. The key role of chronic inflammation in the form of complicated forms of caries of temporary teeth for the development of follicular cysts of the jaws. The data of the study (the important role of chronic inflammation of the deciduous teeth in the formation of follicular cysts of the jaws in children) adverse environmental conditions of the place of residence will help to develop principles of prevention and examination for early detection of pathological changes.

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Cortisol level as a marker of adaptation processes in children with acute respiratory viral infections

Year: 2018, volume 14 Issue: №4 Pages: 646-650
Heading: Infectious Diseases Article type: Original article
Authors: Malyugina T.N., Malinina N.V., Averianov А.Р.
Organization: Saratov State Medical University
Summary:

Aim: to study changes in the level of cortisol in children in the acute period of respiratory viral infection, depending on the etiology, severity of the disease and the presence and nature of the developed complications to establish an adaptation option. Material and Methods. 74 patients aged 1 to 10 years on day 1-3 from the beginning ofARVI (adeno-virus, parainfluenza, respiratory syncytial infection and mixed infection) and 15 healthy children were examined. The etiology ofARVI was established by PCR. Patients in the first three days from the beginning ofARVI were determined by the level of cortisol by the method, according to the indications, chest x-ray examination was performed. The type of adaptive response in children was determined by the value of the lymphocytic index and the level of cortisol in the blood serum. Results. The study showed that in children with ARVI there is a different reaction of the adrenal glands to the disease, which is characterized by both an increase and a decrease in their function. An increase in cortisol concentration characteristic of an adequate adaptation reaction was found in 59.2% of patients. In 12.3% of children noted a decrease in cortisol compared with the control group, in the remaining patients (28.5%) cortisol content did not differ from that in healthy children. Adaptation by the reaction type of "stress" alarm stage was observed in 37.1 % of children, the reaction of "stress" in the stage of resistance at 14.3% of patients, the reaction of "stress" with the development

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Perinatal lesions of the central nervous system in newborns according to the data of Clinical perinatal center of the Saratov region

Year: 2018, volume 14 Issue: №4 Pages: 639-645
Heading: Pediatrics Article type: Original article
Authors: Nechaev V.N., Chernenkov Yu.V., Averianov А.Р., Utts I.A.
Organization: Saratov State Medical University
Summary:

The purpose was to analyze the risk factors for the development of perinatal lesions of the central nervous system and to identify cause-effect relationships. Material and Methods. The retrospective analysis of primary documentation: history of childbirth and history of development of newborns is carried out. The work is based on the results of a comprehensive clinical and neurological examination, neurosonographic data and individual laboratory parameters. Results. In 2017 in the clinical perinatal center of the Saratov region 3301 births were conducted, of which the first delivery was performed in 69,4%, repeated in 30,6% and cesarean section in 41,2% of women. Hypoxic-ischemic disorders were observed in 928 newborns (27,7%). Children with low Apgar score had a combined genesis of chronic intrauterine hypoxia and acute asphyxia in childbirth in 3.8% of cases. Intraventricular hemorrhages (IHD) were diagnosed in 4,3% of cases, birth injuries in 3,6%. Congenital malformations of the central nervous system (CNS) were detected in 31 children (24,4%). Conclusion. The pathological course of pregnancy, problematic natural childbirth and emergency cesarean section are the most frequent risk

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The experience of using biodegradable drainage in combination with traditional sinustrabeculectomy

Year: 2018, volume 14 Issue: №4 Pages: 633-638
Heading: Ophtalmology Article type: Original article
Authors: Krasyuk E.Yu., Noskova O.G., Akulov S.I., Strelnikova N.V., Tokareva E.G.
Organization: Tambov Ophthalmological Clinical Hospital, S. Fedorov Eye Microsurgery Federal State Institution
Summary:

Purpose: analysis and comparison of the degree of intraocular pressure (IOP) compensation, the presence and nature of postoperative complications in traditional sinustrabeculectomy (STE) and STE using biodegradable drainage. Material and Methods. Surgical intervention — sinustrabeculectomy (53 — traditional, 53 — using drainage, DDA drainage type) was performed with stationary diagnosis (106 patients) with a verified diagnosis of "primary open-angle glaucoma" (106 eyes). A comparative analysis was carried out for the stages of glaucoma, the degree of compensation of IOP, the presence and nature of postoperative complications. Results. In the course of sinustrabeculectomy with the use of drainage, a high level of the degree of IOP compensation and a low level of postoperative complications were noted in comparison with traditional sinustrabeculectomy. Gradual resorption of drainage prevents sharp decrease in ophthalmotonus, which allows to significantly reduce the risk of postoperative complications. At the same time, the presence of drainage interferes with the adhesion of the scleral flap and contributes to the gradual formation of a filtration pillow, which, accordingly, leads to a prolonged hypotensive effect. Conclusion. Sinustrabeculectomy with the use of drainage is pathogenetically grounded, which does not complicate the operation, it allows to achieve a persistent and prolonged hypotensive effect and to reduce the risk of postoperative complications.

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Dorsal correction of rigid posttraumatic deformities of thoracic spine in spinal cord injury

Year: 2018, volume 14 Issue: №3 Pages: 611-617
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shul'ga А.Е., Zaretskov V.V., Likhachev S.V., Smolkin A.A.
Organization:
Summary:

Aim: the analysis of the outcomes of dorsal remedial operation in patients with rigid posttraumatic deformities in thoracic spine accompanied by spinal cord injury. Material and Methods. We analyzed surgical outcomes of transpe-dicular anchorage of 28 patients aged 34.5±19.5 with rigid posttraumatic deformities of thoracic spine: 12 patients with acute injury (1st group), 16 patients with long-term deformities (2nd group). The results were estimated by the severity of neurological deficit, pain intensity,the grade of deformity correction as well as by the LQ indexes. All interventions were performed from lateral medial approach with transpedicular anchorage. Results. There were no changes of neurological deficit in both patient groups, however we managed to obtain sufficient spine deformity correction. Pain intensity in patients of 1st group was 6 (5.3-7.8), function — 46.5 (42.5-49.8); 12 months postsurgically pain intensity corresponded to the score of 0 (0.0-0.1); function — 82 (79.0-86.0). The intensity of pain syndrome was significantly reduced in 2nd group patients (VAS reduced from 6 (4.0-7.0) to 1 (0.0-2.0), which in turn allowed for earliest rehabilitation of patients in sedentary position, thus increasing their mobility and functional independence (FIM increased from 70 (65.0-76.0) to 92 (89.0-95.0). Conclusion. Single-step dorsal surgical interventions in patients with rigid deformities of thoracic spine allow restoring normal spinal column axis, performing reconstruction of spinal cord column and safely stabilize injured locomotor segments both in acute and in late periods of spinal cord injury.

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The capacity of the thrombin generation test in the diagnostics of hemostasis system disorders in patients with osteoarthritis

Year: 2018, volume 14 Issue: №3 Pages: 602-606
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shakhmartova S.G., Vorobyova I.S., Puchinyan D.M.
Organization:
Summary:

Aim: to determine the diagnostic significance of thrombin generation test parameters in the diagnostics of hemostatic disorders in patients with osteoarthritis of large joints in preoperative period. Material and Methods. 137 subjects have been investigated, among whom there were 115 hip and knee osteoarthritis patients, submitted for primary arthroplasty (68) and re-prosthetics (47); control group — 22 conventionally healthy blood donors. All subjects underwent plasma hemostasis study and thrombin generation test with two activators — RB (TF 2 pmol/ml) and RC-low (TF 5 pmol/ ml). Osteoarthritis patients were divided into two groups according to the results of thrombin generation test. The 1st group included patients with an adequate response to the stronger activator (t-lagR >t-lag ow, tt-peak^tt-peak^^), the 2nd —with an inversion response (t-lagRBlow). Results. In trie control group and group 1 patients, the thrombin formation process is more pronounced when using an activator with a high TF(RC-low) content than when using an activator with a lowTF (RB) content, which is regarded as an adequate reaction of thrombin formation to the action of a stronger agonist. Patients of the 2nd group inresponse to the action of the activator with a high content of TF was observed inhibition of the reaction of formation of thrombin, which was reflected in the slowdown in the speed of the generation of this enzyme and reduce its quantity. Conclusion. The use of two activators with different concentrations of tissue factor in the test of thrombin generation allows the nature of the response of the hemocoagulation system to initiate the process of thrombin formation to identify patients with adequate and inadequate response.

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