Saratov JOURNAL of Medical and Scientific Research

Original article

Pathogenic specifics of articular cartilage metabolism regulation at the initial stage of gonarthrosis

Year: 2019, volume 15 Issue: №4 Pages: 939-943
Heading: Рathophysiology Article type: Original article
Authors: Puchinyan D.M., Gladkova E.V., Karyakina E.M., Belova S.V., Romakina N.A.
Organization: Saratov State Medical University
Summary:

Objective: to clarify specifics of articular cartilage metabolism regulation in early stages of gonarthrosis. Material and Methods. 66 women aged 41 to 60 у. o. (median age 49 years; Q25%=44; Q75%=55) were examined. The control (n=30) and the main (n=36) groups were arranged depending on knee osteoarthritis clinical and instrumental presentations, or their absence. The levels of cartilage oligomeric matrix protein (COMP), acidic fibroblast growth factor (FGF-1), vascular endothelial growth factor (VEGF-A), interleukin-1 (3 (IL-1 (3) and superoxide dismutase-2 (SOD-2) in serum have been determined by solid-phase enzyme immunoassay. Results. There was a statistically significant increase in the level of COMP in blood serum as well as the increase in number and strengthening of negative correlation between cytokinesand SOD-2 in women of the main group. Conclusion. The increased content of COMP in blood serum and the rise in number of negative correlations between SOD-2 on the one hand, and COMP, IL-1 (3 and VEGF-A on the other may be early osteoarthritis presentations in the examined individuals.

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Diagnostic implication of cytokines in musculoskeletal neoplasms

Year: 2019, volume 15 Issue: №4 Pages: 934-939
Heading: Рathophysiology Article type: Original article
Authors: Ponamarev I.R., Puchinyan D.M., Shchanitsyn I.N.
Organization: Saratov State Medical University
Summary:

Objective: to analyze diagnostic significance of neopterin, VEGF, sICAM, sVCAM, IL-6, TNF-a and MMP-9 in determining the nature of tumor process in musculoskeletal neoplasms. Material and Methods. 64 patients with benign (44) and malignant (20) musculoskeletal tumors aged 18to65y. o. were examined. Neopterin, VEGF, sICAM, sVCAM, IL-6, TNF-a and MMP-9 in serum were studied by enzyme immunoassay (p=0.07). Results. A statistically significant increase in the expression of regulatory molecules, neopterin (p<0.001), VEGF (p=0.02), slCAM-1 (p<0.001), IL-6 (p<0.001), TNF-a (p=0.02) in particular has been discovered and a pronounced tendency for the increase of MMP-9 level has been in evidence. Using ROC analysis, threshold values for each parameter have been determined. The most informative cytokines (neopterin, sICAM and IL-6) have been identified with multivariable regression method. Conclusion. The levels of neopterin, slCAM-1, IL-6 in the serum of patients with malignant musculoskeletal neoplasms above the threshold values predict an unfavorable course of the disease.

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Medical rehabilitation after total hip and knee arthroplasty: logistics and resource provision

Year: 2019, volume 15 Issue: №4 Pages: 920-924
Heading: public health Article type: Original article
Authors: Fedonnikov A.S.
Organization: Saratov State Medical University
Summary:

Aim: analysis of problems of logistics and resource provision of medical rehabilitation of patients after total hip and knee arthroplasty. Material and Methods. In the period of 2013-2018 for 24 Russian regions studied: statistic materials of Federal Ministry of Health (form № 14); territorial government guarantee programs. Results. It was developed an author's scheme of logistics and resource provision of medical rehabilitation, describing 4 of its possible trajectories, guaranteed governmental funding sources, and infrastructure capabilities. It was revealed the regional differentiation and the lack of stable dynamics in tariffs growth for in-patient stage of medical rehabilitation — an increase in the tariff was revealed only in 8% of the regions, in a day hospital — in 29% of the regions. Conclusion. The insufficient amount of financial resources within the framework of budgetary allocations and the basic program of compulsory medical insurance leads to limited access for patients to the trajectory of the completed cycle of medical rehabilitation after these surgical interventions. The current practice reduces the medical and social effectiveness of concerned high-tech medical care programs that in the long run creates a risk of socio-economic devaluation of the medical result achieved at the stage of resource demanding surgical treatment.

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Comparative analysis of the attitude of doctors and representatives of social groups without medical education to the problems of organ transplantation

Year: 2019, volume 15 Issue: №4 Pages: 916-920
Heading: public health Article type: Original article
Authors: Romanov S.V.
Organization: Volga District Medical Center of FMBA
Summary:

Purpose: on the basis of the comparative analysis to reveal features of the relation to problems of transplantation and organ donation among doctors and persons without medical education. Material and Methods. The study was conducted on the basis of questionnaires from 266 doctors of donor bases, 420 students and 250 patients of the hospital. The author's questionnaire contained two groups of questions: the awareness of participants about the possibilities of transplantology and the legal component of organ donation. Results. The only difference between doctors and respondents without a medical education was a higher awareness of donor base employees in legal issues related to post-mortem organ donation in Russia (p <0.05). There were no differences between the examined groups in their readiness to support organ transplantation to relatives and to consent to the posthumous organ donation (pva|ue>0.05). Conclusion. Thus, the results of the comparative analysis of the attitude to the problems of transplantation and organ donation among doctors and persons without medical education with a naturally higher level of awareness of doctors did not reveal statistically significant features in the aspect of personal support for these programs. This indicates the need forthe medical community to develop an understanding of the importance of their professional participation in the development of organ transplantation programs to save the lives of the patients.

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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.

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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: Far Eastern Federal University, Pacific State Medical 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.

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

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.

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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.

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

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.

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Shock-wave therapy for combination treatment of plantar fasciitis

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.

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