Vol 25, No 5-6 (2019)

Articles
MEDICAL AND SOCIAL STUDY OF PATIENTS WITH DRUG TOXICODERMIA
Davydov Y.V., Polunin V.S.
Abstract
The relevance of the study. Social and hygienic research began in the mid-XIXth century, in the XXth century they began to be actively conducted in 1966, in the last decade there has been a decrease in the incidence of patients diagnosed with skin disease and subcutaneous fiber, little-studied questions remain concerning the effect of medical and social factors on the development of drug toxicodermia - MT. The aim is to determine the risk factors of the disease on the basis of a medical and social study of patients with toxiermia, as well as a clinical picture of the course of the disease, taking into account the severity of the pathological process. Material and methods. The subjects of the study were patients with MT (men and women between the ages of 18 and 70 years). Patients with light mt (I group - 1139 people), patients with moderate to MT (II group - 129 people). Control group (KG - 3729 people) - patients with no signs of MT (applied for another profile disease). Results. Most patients with MT are women under the age of 30, married, living in a separate apartment, more often they are workers, employees and students who are not committed to bad habits, with an allergist history, the most pronounced MT manifestations are itching, swelling and erythematosis rashes. Conclusion. In the implementation of preventive measures to prevent the development of MT among the population, it is necessary to pay special attention to women under 30 years of age with an allergist history.
Medical Journal of the Russian Federation. 2019;25(5-6):250-255
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THE COMPARATIVE CONTENT ANALYSIS OF THE NORMATIVE DOCUMENTS GOVERNING THE X-RAY MAMMOGRAPHY IN THE RUSSIAN FEDERATION
Vasil’ev A.Y., Buromskiy I.V., Pavlova T.V., Manuylova O.O.
Abstract
The article discusses the normative documents in force in our country of the Ministry of Health that regulate the timing, order and age criteria for examining the mammary glands using x-ray mammography. A sufficient number of disagreements were revealed among the Orders, Letters, and Methodological and Clinical Recommendations that have not lost their legal force, which significantly complicate the daily work of clinicians and radiologists of mammography rooms. The lack of a unified approach to the standard of mammographic examination among the medical community inevitably leads to medical errors and increases the number of untimely diagnoses. In order to improve indicators of early diagnosis of breast cancer and minimize the amount of subsequent treatment, it is necessary to develop a single normative document that defines the algorithm for mammographic examination of the population.
Medical Journal of the Russian Federation. 2019;25(5-6):256-258
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EXPERIENCE OF MEDICATION AND MEDICAL PRODUCT SUPPLY ORGANIZATION FOR INTERNATIONAL SPORTS EVENTS ON THE EXAMPLE OF THE WINTER UNIVERSIADE 2019
Barankina T.A., Krasnopeeva I.V., Fetisov A.O.
Abstract
Relevance: lack of regulations on the medication and medical product supply for the participants of international sports events and other accredited groups. Aim: to propose a new model for medical supplement during international sports events in accordance with the WADA requirements. Methods and materials: Legislation and experience of medical organizations providing medical care during international sports events, regulations on providing medical care during the international sports events. Medical care and diagnostics were implemented in accordance with principles of lean manufacturing. Results and conclusions: internal regulations on 24-hour medical assistance during the Winter Universiade 2019 were developed for the FSRCC. The regulations were devised with consideration of the peculiarities of medication marking in accordance with WADA requirements. FSRCC staff has developed a certain procedure for the newly introduced free medication supplement to all accredited groups as was required by the Universiade Directorate.
Medical Journal of the Russian Federation. 2019;25(5-6):259-263
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MEDICAL STUDENTS’ ATTITUDE TOWARD CHILDFREE PHENOMENON
Kasimovskaya N.A., Tikhomirova L.L., Mikerova M.S., Alieva A.M., Garaeva A.S., Korkmazova L.C.
Abstract
One of the determinants of the birth rate trends is value system and attitudes of the population, especially young people. Increasingly building a successful career, achieving high social status and financial independence become the priorities of modern youth. The presence of children in this case could considered being a hindrance in achieving these goals. The emergence of the childfree phenomenon indicates the processes of changing the family-value orientations of the population. With the aim to analyze the attitude of the medical university students to the childfree phenomenon in dynamics, we conducted surveys among Sechenov University students in 2009 and 2019. A comparative analysis of the survey results allowed us to make conclusions about a decrease in the number of students with chronic diseases (54.0% and 63.9% respectively deny the presence of chronic diseases), a decrease in the number of students with bad habits (31.0% and 14.5% of students smoke, 16.0% and 9.2% drink alcohol, respectively), a decrease in the number of students with children from 20.0% to 2.3%, as well as an increase in the number of students who are not ready for independent childrearing from 59.0% to 76.2%. In addition, our findings show an increase in number of students aware about childfree phenomenon (from 36.0% to 84.8%) and a more loyal attitude towards it among students (3.0% in 2009 and 18.5% of students in 2019).
Medical Journal of the Russian Federation. 2019;25(5-6):264-267
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POSSIBILITIES FOR RISK ASSESSING IN PATIENTS WITH ACUTE CORONARY SYNDROME OLDER THAN 75 YEARS
Zubova E.A., Brazhnik V.A., Minushkina L.O., Zateyshchikov D.A.
Abstract
The aim of the study was to assess the possibility of using risk assessment scales for adverse outcomes in patients with acute coronary syndrome (ACS) of older age groups. Materials and methods. The study included 988 patients with ACS who were followed up within 1 year after discharge from the hospital as part of the ORACLE II study. The average age of patients was 61.7±4.22 years, 582 (58.9%) men, 405 (40.1%) women. Results of the study: Within 1 year of observation, death from any causes was recorded in 52 (8.2%) patients younger than 75 years old and in 89 (26.6%) patients older than 74 years; coronary outcomes - in 80 patients (12.4%) under the age of 75 years and in 80 patients (23.3%) aged 75 years and older. Any adverse outcome, including atherothrombotic events and bleeding, was recorded during the year in 148 (43.1%) patients of the older age group and in 211 (32.7%) patients under 75 years of age. In patients younger than 75 years, when predicting the risk of death using the GRACE risk score, the area under the ROC curve was 0.794, in the group of patients over 75 years old it was only 0.575, which indicates a low diagnostic value. Similar data were obtained regarding the risk of coronary events. The Russian RECORD scale had the best predictive ability with respect to the prognosis of mortality in patients older than 75 years. the area under the ROC curve was 0.691, as well as in predicting repeated ischemic events in both subgroups. Conclusions: widely used scales for assessing the prognosis of mortality and recurring ischemic events, which well predict the prognosis in patients under 75 years of age in a group of patients older than 75 years have low prognostic value. The highest score in the older age group may have a risk score scale RECORD.
Medical Journal of the Russian Federation. 2019;25(5-6):268-273
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CLINICAL POLYMORPHISM OF THE DIGESTIVE SYSTEM’S DISORDERS AND METHODS OF THEIR CORRECTION IN CHILDREN OF EARLY AGES BORN WITH EXTREMELY LOW AND VERY LOW BODY WEIGHT
Mironova A.K., Yudina T.M., Osmanov I.M.
Abstract
The article presents the data of our own observations of children born with extremely low and very low body weight. The leading pathological conditions in the digestive tract have been determined and the need for an early start of rehabilitation effects aimed at preventing and correcting these conditions has been substantiated. The paper highlights the difficulties in assessing the physical development of deeply premature babies. The necessity of improving the system of medical support for such children at all stages of nursing and the introduction into widespread practice of a personalized approach to rehabilitation is substantiated.
Medical Journal of the Russian Federation. 2019;25(5-6):274-279
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METHOD OF USING PROPRIOCEPTIVE CORRECTORS
Kiselev D.A., Levkov V.Y., Timonin E.M., Laysheva O.A., Shishkin A.A., Plotnikov V.P., Yunusov F.A.
Abstract
Research objective: development of a new technique of physiotherapy exercises in rehabilitation of children with orthopedic and neurologic diseases. Materials and methods: the technique is applied more than at 467 patients with various disturbances of a musculoskeletal system. The technique is based on use of proprioceptive proofreaders as “Propriofoot”. Advantages of this way of therapy are: purposeful correction of certain orthopedic disturbances, increase in efficiency parallel to the carried-out rehabilitation therapy; simplicity of implementation of the method connected with use of simple technical means and a variety of the technical and methodical approaches changed depending on severity of post-urological disturbances at the patient. Results: new approach to correction of various post-urological disturbances accompanying many neurologic and orthopedic diseases of the lower extremities, a pelvic girdle, a backbone is developed. Conclusions: use of a method of proprioceptive proofreaders leads to the pronounced improvement of results of rehabilitation, receiving earlier affirmative answers of treatment during the work with various pathologies, to turning on of additional mechanisms of post-urological regulation.
Medical Journal of the Russian Federation. 2019;25(5-6):280-286
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COMPARATIVE ANALYSIS OF THE IMPACT OF PSYCHOLOGICAL CHARACTERISTICS OF THE QUALITY OF LIFE AND SOCIO-ECONOMIC STATUS ON ACADEMIC PERFORMANCE OF RUSSIAN AND CHINESE STUDENTS OF MEDICAL SPECIALTIES IN THE ADJACENT TERRITORIES OF THE FAR EAST
Kuznetsov V.V., Kosilov K.V.
Abstract
The purpose of the study is to analyze the relationship of semester performance with the level of self-assessment of the psychological characteristics of quality of life related to health and factors of socio-economic status in Russian and Chinese students of medical specialties in the neighboring territories of the Far East. The study was conducted from 01.12. 2017 to 05.15.2019 at the School of Bio-Medicine of the Far Eastern Federal University (SBM FEFU), Pacific National Medical University (TSMU) of the Russian Federation, medical faculties of Harbin and Mudanjiang Universities (PRC). It was attended by 316 Russian and 302 Chinese students (total - 618 people with equal gender representation), the average age is 21.6 years. The average response rate was 92.8%. Students who took part in the study completed the standardized questionnaire “Short form of self-assessment of the quality of life associated with the health of the MOS SF-36” (MOS SF - Medical Outcomes Study-Short Form). The study of mental status was carried out using scales of resilience (FS), social functioning (SF), emotional status (ES), psychological comfort (PC). The study of socio-economic status was carried out according to the Questionnaire Pozdeeva (2008) with the additions of the authors. As a result of the study, it was found that the level of self-esteem of the psychological component of the quality of life related to health among Russian and Chinese medical students is within the range of standard values; Russian medical students rate psychological comfort higher, while their Chinese peers rate their own social functioning and resilience. Students of both samples showed a high level of correlation of the psychological component of the quality of life associated with health and academic performance. In addition, in both samples, the level of performance correlates with assessments of the conditions of study and living, as well as with individual characteristics of psychological status.
Medical Journal of the Russian Federation. 2019;25(5-6):287-292
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CONDUCTING COMPARATIVE CLINICAL-PHARMACOLOGICAL EVALUATION PHARMACOTHERAPY PREPARATIONS OF BOTULINUM TOXIN A IN CHILDREN WITH CEREBRAL PALSY SYNDROME WITH MARKED SPASTICITY
Solovieva A.P., Arkhipov V.V., Goryachev D.V.
Abstract
The original methodology for retrospective clinical studies on the criteria of “efficiency/safety” and pharmacoeconomics on the criteria of “cost/effectiveness”is proposed. The results of a retrospective study of medical records in 169 patients with cerebral palsy, which showed that the use of drugs botulinum toxin type A is an important integral component in the long-term treatment of children with spastic forms of cerebral palsy. Presents the results of pharmacoeconomic analysis of the treatment of the syndrome of spasticity in cerebral palsy when used in the complex treatment of Dysport, Botox and Xeomin.
Medical Journal of the Russian Federation. 2019;25(5-6):293-302
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EFFECT OF AMINOGUANIDINE ON CATARACTOGENESIS IN EXPERIMENTAL DIABETES MELLITUS
Spasov A.A., Govorova Y.A., Naumehko L.V., Babkov D.A., Taran A.S., Smirnov A.B., Velikorodnaya Y.I.
Abstract
Nonenzymatic glycosylation of lens proteins in diabetes mellitus is one of the pathogenetic mechanisms of cataract formation. According to the results of this study, aminoguanidine, which has anti-glycation activity, inhibits cataractogenesis in experimental diabetes. Laboratory animals with streptozotocin-induced diabetes mellitus treated with aminoguanidine showed less clouding in the lenses, and the content of advanced glycation end products, in particular, carboxymethyllysine, in the lenses was found to be reduced compared to the same parameters in animals from the control diabetic group.
Medical Journal of the Russian Federation. 2019;25(5-6):303-308
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PROTOCOL FOR PRESCRIBING ANTICOAGULANTS FOR ATRIAL FLUTTER: ARE ALL ISSUES RESOLVED?
Zotova I.V.
Abstract
The article is devoted to the issue of prescribing long-term anticoagulant therapy for patients with atrial flutter. Currently, a unified approach to prescribing anticoagulants for atrial flutter and fibrillation is generally accepted. However, this approach does not have strong evidence. The article provides a comparative analysis of the risk of thromboembolic complications and left atrium thrombosis in atrial flutter and fibrillation, discusses possible mechanisms of these differences. The results of studies confirming and refuting the unified approach to anticoagulant therapy for these arrhythmias are discussed. The author’s clinical protocol for prescribing long-term anticoagulant therapy to patients with atrial flutter is presented. a comparative analysis of current clinical recommendations on this problem is carried out.
Medical Journal of the Russian Federation. 2019;25(5-6):309-315
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ROLE OF LABORATORY METHODS IN INTEGRATED DIAGNOSTICS OF ACUTE MESENTERIAL ISCHEMIA
Belov D.V., Garbuzenko D.V., Lukin O.P., Anufrieva S.S.
Abstract
The aim of the review: to present literature data on the role of laboratory methods in the complex diagnosis of acute mesenteric ischemia. The main provisions. To search for scientific publications, we used the PubMed database, the RSCI, the Google Scholar search engine, as well as cited references. Articles relevant to the purpose of the review were selected for the period from 1999 to 2019 in the following terms: “acute mesenteric ischemia”, “pathogenesis”, “diagnosis”, “biomarkers”. Inclusion criteria were limited to acute arterial mesenteric ischemia. Acute mesenteric ischemia is an emergency condition caused by a sudden violation of the blood flow through the mesenteric vessels, which rapidly progresses to a heart attack of the intestinal wall and is accompanied by high mortality. Four main mechanisms of OMI are distinguished: embolism from the left parts of the heart or aorta, thrombosis of arteries or veins of the intestine, non-occlusive acute mesenteric ischemia (NOMI), due to vascular spasm. In this case, destructive disorders occur in the intestinal wall, starting from the mucous membrane to the serous, which leads to bacterial translocation and the development of a systemic inflammatory response syndrome. Early bowel revascularization is a key factor in reducing complications and mortality associated with it. However, in the initial stages of the disease has no specific signs, which complicate its diagnosis. The only way to detect mesenteric blood flow disorders is MSCT with angiography, and with non-occlusive lesions, mesenteric angiography, which in normal clinical practice is not always possible. Conclusion. It can be assumed that the use of laboratory methods will expand the range of diagnostic measures and will make it possible to conduct timely treatment aimed at restoring the mesenteric blood flow and improve the prognosis in patients with acute mesenteric ischemia.
Medical Journal of the Russian Federation. 2019;25(5-6):316-323
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MODERN ASPECTS OF PERIIMPLANTITIS TREATMENT METHODS
Kopetsky I.S., Strandstrem E.B., Kopetskaya A.I.
Abstract
Dental implantology is currently one of the relevant areas of orthopedic dentistry. The introduction of the following methods in practical medicine (bone grafting, sinus lifting, transposition of the mandibular nerve) contributed to a significant expansion of the indications for this treatment method. The negative side is the possible development of the most formidable complication, peri-implantitis, which contributes to dysfunction of the installed implants and worsens the quality of life of patients. Important in preventing re-implantation in this area is the timely implementation of conservative therapy methods (systemic and local antibiotic therapy; use of antiseptics). Among antiseptics, particular importance is given to chlorhexidine-containing drugs, the effectiveness of which has been demonstrated in many studies.
Medical Journal of the Russian Federation. 2019;25(5-6):324-327
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AN INDIRECT PATHWAY FOR GENETIC INFLUENCE ON THE FORMATION OF THE CEREBRAL PALSY PHENOTYPE: GENOME AND HYPOXIA TOLERANCE
Sokolov P.L., Prityko A.G., Chebanenko N.V., Romanov P.A.
Abstract
The incidence of cerebral palsy is increasing. In 70% of cases, the disease develops as a result of exposure to known pathogenesis factors, such as hypoxia-ischemia, infectious, toxic, and traumatic damage to the fetus. In 30% of cases of the disease, the effect of pathogenetic factors is absent. This determines the relevance of the search for genetic anomalies responsible for the formation of this phenotype. Many genome disorders associated with the development of the cerebral palsy phenotype have been identified. Of particular interest is the indirect influence of genetic factors of pathogenesis, affecting the formation of the disease indirectly, through the mechanisms of formation of hypoxic-ischemic brain damage. Such factors affect almost all stages of the “ischemic cascade”: the formation of a “glutamate shock”, the realization of a “glutamate shock” by cytokines, the defect of the antioxidant defense of a neuron, the realization of the cytotoxic effect of nitric oxide (NO), and the stimulation of apoptosis of neurons and microglia. This makes it possible to identify genome variants that determine the tolerance of the child’s brain to hypoxic-ischemic damage. The combination of carriers of such anomalies into risk groups will make it possible to differentiate the tactics of their observation in the natal and postnatal periods in order to reduce the likelihood of the formation of severe hypoxic-ischemic lesions of the central nervous system and cerebral palsy. Today, a large amount of scientific data has been accumulated on the molecular genetic mechanisms of the pathogenesis of perinatal brain lesions. Such as epigenetic, transcriptome gene expression control mechanisms via micro-RNA. The available information allows us to experimentally develop new methods for protecting the fetal brain from hypoxia-ischemia and stopping the effects of hypoxia-ischemia in the neonatal period.
Medical Journal of the Russian Federation. 2019;25(5-6):328-334
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FEATURES OF MENTAL DISORDERS IN NEUROLOGICAL DISEASES
Damulin I.V., Romanov D.V., Ninoy I.V.
Abstract
The deals with the features of mental disorders in neurological diseases - dementia, epilepsy, Parkinson’s and Huntington’s diseases, multiple sclerosis. It is emphasized that psychopathological syndromes are not pathognomony for certain neurological diseases. Among the signs that help in the correct diagnosis of mental disorders caused by neurological pathology, their sudden occurrence on heteronomy soil with very variable and atypical for mental diseases of clinical manifestations, the absence of aggravated by mental illness (including family) history, resistance to the drugs commonly used in psychiatric pathology, the patient’s intake of drugs, among side effects which are mental disorders. In the diagnosis, the key is the correct assessment of neurological status, its dynamics, as well as confirmed by paraclinical research methods, in patients with neurological diseases, which in themselves can lead to the development of mental disorders. However, ignoring the features of mental disorders, the lack of a clinically adjusted approach to this category of patients, difficulties in highlighting the most significant symptoms, can lead to misdiagnosis. Therefore, it is so important to know not only the neurological manifestations of certain neurological diseases, but also to properly navigate their mental manifestations. To solve this problem, it is necessary to closely interact psychiatrists with neurologists. Only with this condition will it be possible to effectively help the patient.
Medical Journal of the Russian Federation. 2019;25(5-6):335-342
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