Vol 21, No 3 (2015)


The activities of ophthalmologists in the Russian Federation from the point of view of the pilot subjects during 2007-2012

Starodubov V.I., Ivanova M.A., Sokolovskaia T.A.


During 2007-2012, the analysis was implemented concerning activities of ophthalmologists in the Russian Federation from the point of view of the Federal okrugs and 17 pilot subjects concerning implementation of timekeeping studies in 2013-2014. The factual function of physician position and coefficients of its deviation from average Russian national and okrug data were analyzed. The significant territorial dissonance in mentioned indicators was established that is directly related to age structure of attached contingent. Under increasing of number of persons of elderly age, that is especially specific for the Central Federal Okrug, the inner indicators of factual function of physician position in the subjects are increasing exceeding Russian national data and indicators of okrug in 83.3% of subjects. The emerged situation requires development of organizational measures targeted to resolve manpower problems in the ambulatory polyclinic section of health care.
Medical Journal of the Russian Federation. 2015;21(3):4-7
pages 4-7 views

The possibilities of improvement of diagnosis of patients with post-infarction cardiosclerosis

Patrikeev A.V., Rudman V.Y., Maksimkin D.A., Mambetov A.V., Veretnik G.I., Baranovich V.Y., Faibushevich A.G., Shugushev Z.H.


The article presents analysis of endovascular treatment of 166 patients with post-infarction cardiosclerosis. It is proved that in patients with post-infarction cardiosclerosis having vital but hibernated myocardium in the zone of affected artery the restoration of coronary blood flow permits not only to eliminate signs of chronic ischemia, to slow down post-infarction remodeling of heart but to restore lost functions of hibernated myocardium. On the whole, these occurrences can benevolently influence the prognosis of disease. The reliable dependence between terms of restoration of coronary blood low and function of hibernated myocardium is established.
Medical Journal of the Russian Federation. 2015;21(3):8-13
pages 8-13 views

The application of combined electrostimulation under isolated and comorbide injuries of peripheral nerves of upper and lower extremities

Mescheriagina I.A., Scripnikov A.A.


The technique of combined implantation of electrodes at the same time instant with osteosynthesis by Ilizarov device is applied in The G.A. Ilizarov Russian research center “The restoring traumatology and orthopedics”. In 2001-2013, the neurosurgery department treated 330 patients with traumatic injuries of peripheral nerves who underwent puncture direct electrostimulation (group of patients I). The results were analyzed concerning operative treatment of 80 patients with combine injury of nerve stem and tubular bone (group of patients II). The courses of electrostimulation by low intensive alternating current through implanted electrodes and cutaneous leads. The good results of treatment were obtained in 76.96% of cases in patients from group I. During the first year after treatment the amplitude of M-responses (A=MR) characterized by expressed positive dynamics i.e. up to fourfold increasing of indicator (p<0.01). The values of average amplitude of total electromyogram increased relatively to previous date of examinations up to 180.1% (p<0.001). In the group II, good results of treatment were obtained in 67.5% of patients. During one year after termination of course of electrostimulation the further increasing of values A=MR was noted related to previous date of examinations up to 52.1%. According criterion of average amplitude of total electromyogram the increase consisted 87%. The results permit made a conclusion that direct electrostimulation of nerve stems by alternating current under combined impact on injured structures is an effective one.
Medical Journal of the Russian Federation. 2015;21(3):14-19
pages 14-19 views

The comparative analysis of methods of evaluation of cognitive dysfunction in peri-operational period in patients of elder age after endoprosthesis replacement of hip and knee joints

Politov M.E., Shteinmetz A.A., Krasnoselskiy M.Y., Bastrikin S.Y., Bulanova E.L., Ovechkin A.M.


The postoperative cognitive dysfunction significantly decreases quality of life, contributes to disability and increases risk of death. Notwithstanding of that, there is no precise criteria and common techniques of diagnostic of postoperative cognitive dysfunction. The study was organized to analyze validity of techniques of fast evaluation of cognitive status in diagnostic of postoperative cognitive dysfunction in patients after endoprosthesis replacement of large joints of lower extremities. The sampling included 41 patient older than 65 years and underwent operation of endoprosthesis replacement of lower extremities. The patients were applied neuropsychologic tests using MoCA and MMSE scales. The full value examination was implemented using word drill test, drawing links test, Stroop test, words encoding test, frontal dysfunction scale. The full value examination of cognitive functions were passed only by 15 patients (36.6%) with initially higher level of cognitive functionality. All the rest patients refused lasting evaluation and were evaluated according Montreal Cognitive Assessment (MoCA) and Mini-mental state examination (MMSE) scales. The postoperative cognitive dysfunction was diagnosed in 7 patients (17%). The results of full value examination were comparable with the results of short estimation according MoCA scale (r=0.84, p<0.05). The most of patients (85.7%) among those who developed postoperative cognitive dysfunction had mild cognitive impairments in pre-operative period. The mild cognitive impairment is a risk factor of post-operative cognitive dysfunction. The application of lasting survey is linked with high percentage of refusals that can artificially underrate morbidity of postoperative cognitive dysfunction.
Medical Journal of the Russian Federation. 2015;21(3):20-25
pages 20-25 views

The application of air-plasma technology under late pyoinflammatory complications of injection contour plastic

Shulutko A.M., Osmanov E.G., Novikova I.V., Mansurova G.T., Gorbacheva O.Y., Mahmudov E.M.


The application of technique of injection augmentation of epidermal tissues using polyacrylamide gel, wide-spread in the 1990s, resulted in increasing of rate of recurring hospitalizations. The cause of this occurrence are late specific pyoinflammatory complications conditioned by negative effect of the given substance on human body tissues and requiring optimization of treatment technologies. The article analyzes the results of complex treatment of 20 women with gel phlegmon during 2004-2013. The age of patients was 44-60 years. The depth of purulo-necrotic damage corresponded to level II-III according classification of D. Ahrenholz (1991) and extent - from 67 to 220 cm 2 . The zone of contour plastic of mammary glands was the most frequent localization of damage (17 patients or 85%). The program of complex treatment of all patients alongside with antibacterial therapy and surgical preparation included impact on suppurative focus with air-plasma flow in modes of dissection and NO-therapy. The application of the given technique permitted to reduce volume of intra-operational blood loss (up to 30-35%) and average number of stage necrotomy and significantly accelerate regeneration processes in suppurative focus (up to 1.3-1.5 times) as compared with control group of patients with "commonplace" phlegmon of thigh treated according standard technique.
Medical Journal of the Russian Federation. 2015;21(3):26-29
pages 26-29 views

The outcomes of pregnancy and delivery in women with mechanical prostheses of cardiac valves

Adilova L.R., Adamian L.V., Liashko E.S., Shifman E.M., Tulkina E.E., Konisheva O.V.


The study was carried out to examine course of pregnancy and cardiologic, obstetrician and neonatal complications in women with mechanical prosthesises of cardiac valves. The prospective study included 16 pregnant women with mechanical prosthesises of cardiac valves. In the first trimester, the thrombosis of prosthesis valve was discovered in 2 pregnant women. The dysfunction of valve prosthesis in the form of thrombosis of prosthesis was discovered in 2 pregnant women in postnatal period. The para-prosthesis fistula was detected in2 pregnant women. The pregnancy proceeded with menace of miscarriage in 9 women out of 16. In one of these women pregnancy ended by premature delivery. In the rest of examined women pregnancy yielded to conservative therapy. The syndrome of growth inhibition was detected in 7 fetuses. The disorder of hemodynamics in fetoplacental system was established in 4 fetuses. The premature aging of placenta was diagnosed in 3 fetuses. The oligohydramnios was discovered in 8 fetuses and hydramnion was diagnosed in one fetus. The birth of alive children occurred in 16 out of 14 pregnancies. The antenatal fetal death occurred in 2 pregnancies. Among children born alive, 11 children were born at full-term period and three were born prematurely at 32, 35 and 36 weeks of gestation. The body mass-body height indicator of full-term children consisted from 44 to 63. In healthy condition 7 newborns were discharged out of hospital with mothers. In specialized children hospitals 7 newborns were transfered because of health condition. The course of pregnancy in women with mechanical prostheses of cardiac valves is related to high risk of complications of fetus and newborn.
Medical Journal of the Russian Federation. 2015;21(3):30-35
pages 30-35 views

The prevention of postnatal endometriosis in puerperae with different degree of infection risk with implementation of application form of sorbent agent

Tirskaia Y.I., Barinov S.V., Pianova L.G., Blauman S.I.


The first stage of study included determination of risk factors of postnatal pyo-septic complications and development of scale of evaluation of degree of infection risk. The second stage of study included implementation of cohort, prospective, randomized research. The sampling included 176 puerperae with infection risk. The observed women were separated on groups depending on degree of infection risk according the developed scale. The puerperae of comparison group received common antibacterial prevention by cephalosporin of third generation. The puerperae of main group during postnatal period besides prevention with antibiotics, were additionally injected into uterine cavity a contact-type form of sorbent VNIITU-1. The effectiveness of prevention was evaluated by determination of the level of proinflammatory and anti-inflammatory cytokines in aspirate from uterine cavity at first and third day and occurrence of growth of pathogenic flora. In puerperae of comparison group after common antibiotic prevention, growth of pathogenic flora in uterine cavity persisted. This process contributed into increasing of activity of local proinflammatory cytokines (IL-1β), acute-phase protein lactoferrin against the background of decreasing of activity of anti-inflammatory cytokines (IL-10, IL-RAIL). It also testified high activity of local macrophages and absence of tendency of suppression of inflammatory cascade. The proposed mode of prevention of postnatal endometriosis in puerperae with infection risk by intrauterine injection of porous carbonic applicator VNIITU-1 is more effective due to stimulation of full value elimination of agents and their excreted toxins from uterine cavity. Additionally, blocking of local proinflammatory cascade and intensification of involutorial processes of myometrium against the background of restoration of hemodynamics occurs.
Medical Journal of the Russian Federation. 2015;21(3):36-42
pages 36-42 views

The disease of hands, feet, mouth associated with infection of Coxsackie virus A6 and A10

Ianovskaia E.Y., Artamonov R.G., Vaganov P.D.


The article presents description of observation of affection of skin of hands, feet and oral cavity under Coxsackie viral infection in child of 5 years old.
Medical Journal of the Russian Federation. 2015;21(3):42-43
pages 42-43 views

The bronchial asthma in pregnant women: view of internist

Krasnovskiy A.L., Loshkareva E.O.


About 4-12% of pregnant women suffer from bronchial asthma. The poor control of disease during pregnancy is fraught with development of serious complications both on mother and fetus part. The review presents actual recommendations concerning diagnostic and treatment of bronchial asthma in pregnant and nursing women.
Medical Journal of the Russian Federation. 2015;21(3):44-51
pages 44-51 views

The transplantation of Descemet's membrane with endothelium in the eye with irideremia

Oganesian O.G., Chentsova E.V., Pogorelova S.S.


The article presents a clinical case of transplantation of Descemet’s membrane with endothelium in the eye with irideremia. According presented data, this a first publication demonstrating possibility of transplantation of Descemet’s membrane with endothelium in the eye with artificial iris. The causes of choice of the given operation are discussed and as well as its results and theoretically possible shortcomings of alternative techniques.
Medical Journal of the Russian Federation. 2015;21(3):52-53
pages 52-53 views

The diagnostic and treatment of acute interstitial pneumonia

Yudin A.A., Yudin A.L., Nikitin A.E., Yumatova E.A., Loshkareva E.O., Tatarinova V.K.


The acute interstitial pneumonia is a disease of group of idiopathic interstitial pneumonias. This illness quite often results in development of respiratory distress syndrome and is characterized by resistance to therapy with systemic glucocorticosteroids. The article presents a case of clinical observation of female patient with acute interstitial pneumonia. The treatment applied included combination of therapy with average high doses of systemic glucocorticosteroids using protective modes of noninvasive ventilation of lungs that resulted in expressed positive effect during short period and permitted to avoid worser scenario of development of disease.
Medical Journal of the Russian Federation. 2015;21(3):54-56
pages 54-56 views

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