Saratov JOURNAL of Medical and Scientific Research

Saratov State Medical University

www.sgmu.ru

Professor Valeriy Vladimirovich Shchukovsky (to the 70th anniversary)

Year: 2018, volume 14 Issue: №2 Pages: 309-311
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Ulyanov V.Yu., Grishin S.E., Puchinyan D.M., Fedonnikov A.S., Shchukovsky N.V., Norkin I.A.
Organization: Saratov Socio-Economic Institute of Plekhanov Russian University of Economics, Saratov State Medical University
Summary:

The article illustrates the life of Professor Valeriy Vladimirovich Shchukovsky and his scientific contribution into the development of separate branches of emergency medicine, namely intensive care of patients with embolism and acute thromboses of large vessels, severe thermal traumas, endotoxemia and multiorgan dysfunction syndrome, traumatic disease of spinal cord and its visceral complications in acute and early periods, reperfusion visceral injuries following its transplantation and patients with coagulopathic hemorrhage.

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Professor V.A. Surat and his contribution to the development of national pediatrics (to the 125th birth anniversary)

Year: 2018, volume 14 Issue: №2 Pages: 306-308
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Zavyalov A.l., Denishev R.R.
Organization: Saratov State Medical University
Summary:

The article is devoted to medical, scientific, pedagogical and public activities of V.A. Surat who was a professor and a head of pediatric departments in Saratov, Alma-Ata and Stalingrad Medical Universities.

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Variability of linear parameters of frontal sinuses in adults

Year: 2018, volume 14 Issue: №2 Pages: 302-305
Heading: Human anatomy Article type: Original article
Authors: Mareev O.V., Aleshkina O.Yu., Mareev G.O., Kuchmin V.N., Afonina O.I., Kapustina N.Yu.
Organization: Saratov State Medical University
Summary:

Objective: to identify the variability of frontal sinuses size patterns divided by sex and age in adults. Material and Methods. 83 X-ray computer tomograms of the head of adults without any signs of paranasal sinuses pathology and without traces of surgery on the external structures and internal nose in the history were studied. Results. It has been found the best pneumatized frontal bones in males; the rapid growth of the frontal sinuses occurs more in men in the 1st age group, whereas in women, the formation of the frontal sinus is smoother and more uniform during the whole life. Conclusion. Men have depth prevailing characteristics of frontal sinuses in the 1st age group and the width on the left side in the 2nd age group differing significantly in comparison to women group; height of the sinus in men decreases with age, whereas in women it does not change its value significantly; bilateral values for the parameters of the frontal sinus do not have reliable sex and age differences.

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Risks of sexual relations in representations of students

Year: 2018, volume 14 Issue: №2 Pages: 297-301
Heading: Sociology of Medicine Article type: Original article
Authors: Chernyshkova E.V., Zaviyalov A.l., Tupikin D.V., Denishev R.R., Uzhakhov A.M., Uzhakhov T.M., Andriyanova E.A.
Organization: Saratov State Medical University
Summary:

.The goal of the workwasto determine on the basis of sociological research the representation of medical students about the possible risks of sexual relations. Materials and methods. The survey of 659 students of medical and pediatric faculties of Saratov State Medical University n.a. V. I. Razumovsky and Volgograd State Medical University. Results of the research demonstrate that the most significant risks of sexual relations considered by the students are sexually transmitted infections and unwanted pregnancy. However, despite a high level of awareness of probability of their occurrence less than a half of the students always use necessary remedies to avoid these risks, this fact allows to refer students to a group with an increased risk of STI and unwanted pregnancy. It is determined that self-treatment practice in regard to STI is not wild-spread among medical students due to the presence of deeper knowledge about reproduc- tive health. Conclusion. The analysis of author's research data and the works devoted to the problem of sexual relations risks among youth allows to state the imbalance between students' knowledge of sexual contacts risks and their real behavioral practices, and a significant decrease in the level of preventive work. Medical students can be considered as a resource for optimizing this type of work with students of high schools, colleges and other universities.

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Analysis of resources of therapeutic institutions providing medical care to patients with diseases of the circulatory system

Year: 2018, volume 14 Issue: №2 Pages: 293-290
Heading: Health Service Organization Article type: Original article
Authors: Sazanova G.Yu., Shulpina N.Yu., Dolgova E.M., Tupikin D.V.
Organization: Saratov State Medical University
Summary:

Objective: to conduct an analysis of the provision of beds and medical personnel of medical institutions in the region that render medical care to patients with circulatory disorders. Material and Methods. Calculation of the optimal volume of inpatient medical care, the required number of beds and staff units of cardiologists in the region was carried out in accordance with regulatory legal acts. Results. In medical organizations, an excessive number of round-the-clock beds on the "cardiology" profile (more for 186 beds) and insufficient number of cardiac beds in day hospitals (less than 40 beds) were deployed; the number of cardiologists working in cardiological rooms of polyclinic medical organizations, dispensaries for cardiology and daily hospitals has been identified. Conclusions: Redistribution in the region's medical organizations of the bed fund, material, and financial resources leads to the optimization of patients' referrals and promotes rational use of resources of health care, increasing the availability and improvement of quality of medical care to adult population of the region.

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Comparative hygienic assessment of working conditions and quality of life of urban and rural doctors

Year: 2018, volume 14 Issue: №2 Pages: 281-286
Heading: Hygiene Article type: Original article
Authors: Petrosyan А.А.
Organization: Saratov State Medical University
Summary:

Objective: assessment of the impact of labor peculiarities in urban and rural areas on the quality of life of doctors. Material and Methods. The study involved 198 doctors of various specialties from rural areas of the Saratov region and the city of Saratov. Sanitary hygienic examination of labor conditions and questionnaire SF-36 on quality of life assessment of health-care workers were conducted. Results. The objective hygienic characteristics of working conditions of city doctors of various specialties, and physicians working in rural areas are presented. It was found that doctors in rural areas are much more likely to combine work in the main and related specialties than urban ones: 31,6 and 15,6% respectively. It is important to note that the frequent combination of rural doctors in related professions also adversely affects the quality of their lives. Conclusion. The analysis of the results of the conducted research proves that when assessing the severity and intensity of the labor process of rural and urban health workers, it is necessary to take into account not only the working conditions but also the level of compatibility.

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Endoscopic correction of obstructive complications after HIFU-ablation of the prostate with holmium laser

Year: 2018, volume 14 Issue: №2 Pages: 272-277
Heading: Urology Article type: Original article
Authors: Popkov V.M., Fomkin R.N., Shatylko T.V.
Organization: Saratov State Medical University
Summary:

Purpose: to improve the results of treatment of the obstructive complications (an urethra stenosis, a bladder neck sclerosis) caused by application of the high-intensity focused ultrasonic ablation (HIFU) concerning treatment of the localized prostate cancer. Material and Methods. An object of the research included 41 patients, with the infravesical obstruction (IVO) which has arisen in the postoperative period to which elimination the holmium laser is used. Results. The bladder neck was the most frequent place of obstruction. Average time before emergence of the first episode of IVO: 8.2±1.3 months. Distinctions on time before development of an episode of IVO depending on the fact of carrying out TURP before HIFU not confirmed (p=0.440). More advanced age for a moment HIFU-ablation has been associated with much higher frequency of IVO (p=0.021). Considerably smaller frequency repeated was observed by IVO at a larger ratio transurethral resection to the initial volume of a prostate (p=0.031). Duration of a laser endoscopic ure-throtomy was 27 [10-70] minutes, serious perioperative or postoperative complications were not determined. Average term before removal of a catheter of Foley: 3 [1-5] days, hospitalization duration included 4 [3-6] days. After treatment considerable improvement on indicators of the maximum speed of a stream of urine (Qmax) and volume of residual urine was observed. The total score according to the questionnaires of IPSS and QoL has considerably improved, significant changes on symptoms of accumulation are noted. After the first holmium laser urethrotomy of 80.4% of patients have noted satisfactory results without recurrence of IVO; 19.6% of patients were required a repeated laser endoscopic urethrotomy. Recurrence term after the first laser urethrotomy is on average equal to 2.5 months. Conclusion. The endoscopic urethrotomy by means of the holmium laser is safe, effective and minimum invasive type of treatment of a stenosis of a neck of the bladder / urethra after ablative cancer therapy of prostate. The advantages are the minimum of traumas of surrounding tissues and preservation of the mechanism of deduction of urine.

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The prospects for application of biomarker "vascular endothelial growth factor" in predicting the treatment outcomes of bladder cancer

Year: 2018, volume 14 Issue: №2 Pages: 268-272
Heading: Urology Article type: Original article
Authors: Zakharova N.B., Ponukalin A.N., Skriptsova S.A.
Organization: Saratov State Medical University
Summary:

Purpose: assessment of the diagnostic value of Vascular Endothelial Growth Factor (VEGF) in predicting the outcome treatment of patients with muscle-invasive bladder cancer. Material and Methods. The study involved 264 people: 204 patients with RMP; 60 people aged 21 to 60 years were the comparison group. Patients with RMP are divided into stages of the disease. With non-muscle-invasive ВС (NIRMP) under TA-1NxMo there were 75 patients. Out of 129 patients with muscle-invasive ВС (MIRE) within the body (pT2aN0M0-T2bN0M0) was diagnosed in 69 of people. In 60 patients, the tumor sprouted paravesical tissue and surrounding organs (rt3a-bn0m0-41; pT36N1M0-11; pT4N1M0-5; T4N1M1-3); 19 patients had metastases to the iliac lymph nodes are installed only after the operation. Metastases were found in three patients out of 19 in addition to the lymphonoduses in the lungs. Tumors had the following gradations: G1-97; G2-37; G3-58. All patients NMIN (n=75) completed a TUR of the bladder wall with the tumor. MERE patients underwent radical cystectomy (n=117), open resection of the bladder (n=12), palliative surgery (n=3). The period of follow-up after surgical treatment was 3.5±0.5years. Quantitative determination of VEGF in blood serum was performed by solid-phase ELISA. Results. Despite the fact that the increase in VEGF level of blood serum in groups of patients with NIMRE and MIRE has significant differences both before and in the postoperative period, it is associated with the aggressiveness of tumor growth, development of metastases and recurrences of the disease. Conclusion. The increase in the content of VEGF serum suitable for use as an indicator: the risk of relapse within the first year after TUR in patients NMIN; development of relapses and metastases in pre and postoperative periods in MERE patients.

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Efficacy of surgical treatment of renal form of hyperparathyroidism

Year: 2018, volume 14 Issue: №2 Pages: 265-267
Heading: Surgery Article type: Original article
Authors: Kovalenko Yu.V., Tolstokorov A.S., Rossolovsky A.N., Kravchenya A.R., Manakhov G.A.
Organization: Saratov State Medical University
Summary:

Objective: to study the efficacy of surgical treatment of primary hyperparathyroidism in risk of uronephrolithiasis progression. Material and Methods. The research involved 55 patients, the biochemical and clinical parameters before and after treatment with retrospective-prospective method of analysis were studied and analyzed. Results. It is established that the surgical treatment of patients with uronephrolithiasis is proved to be effective in 96,4% of the cases, as it allows to eliminate the classic symptoms of primary hyperparathyroidism, and urolithiasis. Improvement of laboratory hormonal and biochemical indices of mineral metabolism, and, consequently, reducing the severity of risk factors of urolithiasis is marked. Conclusion. Surgical treatment of renal forms of primary hyperparathyroidism is a pathogeneti-cally reasonable method. Parathyroidectomy performed in an adequate amount prevents relapses and progression of diseases that are the consequence of primary hyperparathyroidism.

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Comparative analysis of clinical outcomes of various methods of anterior cruciate ligament arthroplasty in knee joint in complete rupture of the ligament.

Year: 2018, volume 14 Issue: №2 Pages: 251-259
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Shormanov A.M., Norkin A.l., Klimov S.S., Chibrikova Ju.A., Ulyanov V.Yu., Bakhteeva N.Kh.
Organization: Saratov State Medical University
Summary:

The aim is to carry out the analysis of outcomes of anterior cruciate ligament arthroplasty undertaken by various methods in patients with complete ligament rupture. Material and Methods. 104 patients diagnosed with complete rupture of anterior cruciate ligament (ACL) in knee joint who underwent knee joint arthroplasty fulfilled by various methods were the object of the present study. Clinical outcomes of the treatment were estimated by clinical signs of ACL failure, the degree of functional impairment of knee joint (IKDC 2000) and motor pathology assessed instrumentally. Results. Significantly better function restoration in knee joint occurring as early as 3 months postoperatively has been stated in the group of patients with two-bundle ACL arthroplasty by synthetic implant "DONA-M" on the basis of IKDC subjective knee indices. Negative Lachman test and Pivot shift test were demonstrated as early as 3 months postoperatively by all patients after two-bundle ACL arthroplasty with synthetic implant "DONA-M", reduced support asymmetry 6 months postoperatively was stated in all patient groups as well as run path and surface area in patients with single-bundle ACL arthroplasty by synthetic implant "DONA-M". Conclusion. The use of single- and double-bundle ACL arthroplasty with synthetic implant and ACL arthroplasty with autograft of semitendinosus (ST) and gracilis allows providing equally full-fledge restoration of injured knee joint, without statistically significant differences between the groups, in great majority of patients up to 12 months of follow-up period which is proved by normalized knee joint function, the absence of ACL failure and motor pathology signs estimated instrumentally. Key words: knee joint, anterior cruciate ligament (ACL), co

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