Vol 27, No 1 (2021)

Cover Page

Full Issue

Health care organization and public health

Predictors of the quality of life of medical university students in the initial period of schooling

Kuznetsov V.V., Kosilov K.V., Fedorishcheva E.K., Kostina E.Y., Barabash O.A.

Abstract

AIM: This study aimed to examine prognostic parameters of health-related quality of life of medical students to determine the possibilities of its correlation with subsequent optimization of the educational environment of the university.

MATERIALS AND METHODS: The study was conducted from 02/01/2017 to 01/10/2020 at the School of Biomedicine of the Far Eastern Federal University and the Pacific State Medical University. It included 496 students of both sexes [251 (50.6%) women, 245 (49.4%) men; average age, 20.4 years] enrolled in 1–3 medical courses. Demographic characteristics, education and living conditions, and morbidity data were collected using the comprehensive I.V. Pozdeeva questionnaire (2008) supplemented by authors as well as the standard medical documentation of the polyclinic. The MOS SF-36 Health-Related Quality of Life Brief Self-Assessment Questionnaire was used to evaluate the health-related quality of life. The Academic Motivation Scale questionnaire survey was performed, and statistical data on academic performance were collected using K. Maslach and S. Jackson questionnaire for the administrative offices of educational institutions.

RESULTS: The following scores were obtained on the self-assessment of the quality of life: physical functioning, 58.8 points; role functioning, 27.4 points; somatic pain (reverse assessment), 79.4 points; general well-being, 48.6 points; hardiness, 61.2 points; social functioning, 57.3 points; emotional status, 51.0 points; psychological comfort, 53.7 points. The students showed a high level of motivation to learn (47.7–59.8 points by the Vallerand scale) and a low professional burnout index (24.9–44.0 by Maslach and Jackson scale); the performance indicators were 4.1–4.6 points. Each parameter of self-assessment of physical and mental state is significantly associated with the composite average assessment of the health-related quality of life (r=0.49–0.86; p<0.05). The health-related quality of life of medical students was found to be associated with academic performance (β=0.27, p<0.05), but motivation to study (β=0.35, p<0.05) was not correlated with the level of professional burnout. A strong relationship was also found between health-related quality of life and comorbidity (β=−0.30, p<0.05) and sports (β=0.27, p<0.05).

CONCLUSIONS: The scores on the total self-assessment of the quality of life by medical students are within the normal range. Most students are highly motivated to learn, perform well, and have little or no burnout. The health-related quality of life of medical students at the start of their schooling is reliably influenced by academic performance, motivation to study, and level of chronic morbidity and physical activity.

Medical Journal of the Russian Federation. 2021;27(1):5-16
pages 5-16 views

Work organization of outpatient computed diagnostics center under novel coronavirus infection outbreak in a large urban area

Barankin B.V., Fetisov A., Evsyukov A.A., Perevertaylova N.Y., Kravchenko E.I.

Abstract

This study presents joint work experience of the structural divisions of the Federal Siberian Scientific and Clinical Center (FSSCC) as a unified outpatient computed tomography diagnostics center (OCTDC) created to carry out comprehensive medical examination of the population under FSSCC during coronavirus-disease 2019 outbreak as well as patients of medical organizations of the Krasnoyarsk urban area. A patient routing scheme was designed and implemented in OCTDC, and its further interaction with territorial polyclinics and hospitals redesigned into temporary infectious disease hospitals was presented. When planning the work of OCTDC, special emphasis is placed on anti-epidemic measures as well as elements of cost-effectiveness in an outpatient setting. FSSCC was opened for the first time in Krasnoyarsk and became the basis for replicating such computed tomography centers in other medical institutions of the region.

Medical Journal of the Russian Federation. 2021;27(1):17-25
pages 17-25 views

Clinical medicine

Rehabilitation of patients diagnosed with infantile cerebral palsy using reflex gymnastics by Vojta method

Kiselev D.A., Levkov V.Y., Gubanov V.V., Kozlovsky I.V., Laisheva O.A., Panyukov M.V.

Abstract

This paper presents the long-term experience of using reflex gymnastics according to the Vojta method in several medical centers in Russia, which is an important aspect of this method of therapeutic exercises, since no study has provided enough information about such experience. Combining the results of studies from Moscow and Russian cities made it possible to demonstrate the advantages of a highly effective method of treating a serious disease such as cerebral palsy. The variability and variety of technical approaches of the Vojta method depend on the severity and orthopedic manifestations of various diseases, which is an undoubted advantage of the technique. Vojta therapy not only works with human motor activity but has a pronounced and varied effect on numerous actions that are of higher nervous activity. Based on the presented experience of working with patients of different ages diagnosed with cerebral palsy, we can confidently recommend the need to use Vojta therapy in the complex treatment of the disease.

Medical Journal of the Russian Federation. 2021;27(1):27-32
pages 27-32 views

Scar tissue development using an acoustic medical diagnostic device in patients with purulent inflammatory wounds of the face and neck

Khelminskaya N.M., Fedorova V.N., Posadskaya A.V., Kravets V.I., Faustova E.E., Biganov A.V.

Abstract

The paper presents evidence of the effectiveness and safety of using the acoustic method for predicting scar formation in patients with purulent inflammatory diseases of the face and neck. An acoustic medical diagnostic device was used to develop a prognostic criterion for assessing scar formation in these patients, and factors influencing the scarring process have been determined. Results of this study demonstrated that it is possible to determine the type of scarring at the early stage of wound healing in patients with purulent inflammatory diseases in the face and neck area using an acoustic medical diagnostic device that allows the assessment of the scarring type, prescribing adequate treatment, and taking preventive measures against pathological scarring of tissues.

Medical Journal of the Russian Federation. 2021;27(1):33-44
pages 33-44 views

Structural model for formation of packages of clinical and diagnostic tests to organize personalized medical care for patients with malignant tumors of the prostate gland

Andreev D.A., Zavyalov A.A.

Abstract

BACKGROUND: Prostate carcinoma is a serious social and economic problem; it ranks second among the most frequently diagnosed malignant tumors worldwide and it ranks sixth in the structure of causes of death from cancer in men. The correct organization of prevention and screening as well as the use of the latest methods of clinical instrumental and molecular analysis at all stages of treatment and diagnostic process can fundamentally improve the outcomes of the disease.

AIM: This study aimed to analyze of the best international experience in the development of basic clinical and instrumental test packages that determine the personalized choice of medical prescriptions for the treatment and diagnostic process of prostate cancer.

METHODS: The study included papers published after January 1, 2008, with an emphasis on the analysis of results posted in the last 2 years in the PubMed/Medline electronic database as reliable sources of information.

RESULTS AND DISCUSSION: This study explored the basic structural model of the formation of clinical and diagnostic packages at the implementation of a personalized treatment and diagnostic process in prostate cancer. The main biomarkers of prostate cancer used in clinical practice have been identified, and the informative value of the newest biomarker tests has been established. Diagnostic tools that are ready for wider implementation in oncological practice are predictive models, such as the 4K algorithm, Score, SelectMDx, Stockholm-3 model, justifying the need to perform a prostate biopsy in a particular patient. Some promising biomarker characteristics of prostate cancer, assessed at the nonclinical, experimental stage, have been demonstrated.

CONCLUSIONS: This study found that (1) Revision of the algorithms for personalized treatment is becoming an important element in the provision of patient-oriented cancer care. (2) Periodic reassessment of the “individual portrait” of the tumor process is necessary for the correct organization of treatment and diagnostic measures in a particular patient. (3) Finally, for the implementation of the whole range of possibilities of individual treatment, close interaction with the representatives of various medical specialties in the framework of the implementation of translational medicine programs in oncologyis important.

Medical Journal of the Russian Federation. 2021;27(1):45-55
pages 45-55 views

Lectures

Anticoagulant therapy in patients with atrial fibrillation: management of bleeding

Zotova I.V.

Abstract

Bleeding is the most common complication of long-term anticoagulant therapy. For patients with atrial fibrillation, it is important to consider the balance of hemorrhagic and thromboembolic risks in the event of bleeding since unreasonable withdrawal of anticoagulants can worsen the prognosis. The management of patients with hemorrhagic complications is determined according to the severity of bleeding, type of anticoagulant taken, and presence of high thromboembolic risk factors. The paper presents the author’s protocol for the management of patients with atrial fibrillation and various types of hemorrhagic complications against the background of anticoagulant therapy.

Medical Journal of the Russian Federation. 2021;27(1):57-65
pages 57-65 views

Research ethics: respecting the fundamental principles and cultural differences

Sprumont D.

Abstract

The article describes the 10-year experience of distributing the TRREE project (Training and Resources in Research Ethics Evaluation). This is a free open e-learning program for specialists from the Clinical Research Ethics Committees on regulatory standards in this field. The survey of these specialists showed that there are similar needs for training in fundamental ethical principles related to human research, in accordance with the laws and regulations applicable in the respective countries, and in conducting an ethical assessment of the research protocol. TRREE operates in seven languages, providing access to national laws in ten languages related to research ethics and standards of GCP (Good Сlinical Рractice). The author asks whether the module should be created in Russian.

Medical Journal of the Russian Federation. 2021;27(1):67-70
pages 67-70 views

Reviews

Problems of dental preservation and complex therapy of chronic generalized periodontitis

Kopetsky I.S., Pobozhieva L.V., Kopetskaya A.I., Shevelyuk J.V.

Abstract

Epidemiological studies have reported the prevalence of inflammatory periodontal diseases of 85%–90% in individuals aged >30 years. Predicting the possibility of preserving teeth is an important integral part of treatment planning for periodontitis. Traditionally, the prognosis is based on the likelihood of tooth loss. The article presents a review of the literature characterizing the factors that affect the prognosis of the service life of teeth in case of periodontitis. For the literature review, a literature search was performed on the MedLine, EMBASE, CyberLeninka, and eLibrary databases. The following factors should be considered when assessing the long-term prognosis in patients with the highest risk for tooth loss: severity of periodontitis, smoking, bruxism, number of abutment teeth, age, type of tooth, depth of probing the periodontal pocket, bone loss, furcation involvement, root mobility and proportions, and tooth crowns. Indicators for molar loss include furcation lesion, bone loss progression, endodontic treatment, persistent periodontal pocket, age, female sex, smoking, and diabetes mellitus. A favorable treatment result and preservation of teeth depend on the entire group of teeth, with the following values: 85% in single-rooted anterior teeth, 78% in premolars, and 47% in molars. The low accuracy of standard predictive tooth loss indices can be explained by the point that the indices are mainly based on factors related to teeth and do not take into account the influence of patient-related factors. Thus, predicting the service life of teeth with periodontitis is a difficult task and requires taking into account both individual indicators of periodontal status and general factors.

Medical Journal of the Russian Federation. 2021;27(1):71-78
pages 71-78 views

Practice case

Clinical case of a patient with occlusive thrombosis of the right common carotid artery

Zotova A.S., Davydova T.V., Snigireva A.M.

Abstract

The paper presents a case of a patient with floating thrombosis in the right common carotid artery and occlusion of the carotid bifurcation of the right common carotid artery against the background of severe atherosclerosis of the common carotid artery with 70% stenosis. Thrombosis was identified using color duplex ultrasound scanning in an asymptomatic patient. During hospitalization, thrombosis was complicated by a cerebral infarction of the right middle cerebral artery, apparently of embolic origin.

Medical Journal of the Russian Federation. 2021;27(1):79-86
pages 79-86 views

Clinical case of intraocular correction of high-degree anisometropia

Shamratov R.Z., Ramazanova L.S., Napylova O.A., Maremshaova D.A.

Abstract

The paper describes a clinical example of the intraocular correction of high-grade hyperopic anisometropia. Surgical treatment made it possible to restore binocular vision, obtain high visual functions without additional correction, preserve the accommodative ability of the eye, and achieve rapid visual rehabilitation.

Medical Journal of the Russian Federation. 2021;27(1):87-92
pages 87-92 views

In Memoriam

In Memory of Vladimir A. Stakhanov (12.06.1962–26.01.2021)

Romanov B.K.

Abstract

This paper provides information about the sudden death of Professor Vladimir Stakhanov – a member of the editorial board of the Journal "Medical Journal of the Russian Federation", an outstanding Russian phthisiologist, head of the Department of Phthisiology of the Medical Faculty of the N.I. Pirogov Russian National Research Medical University.

Medical Journal of the Russian Federation. 2021;27(1):93-93
pages 93-93 views

In Memory of Yuri N. Chernov (05.11.1937–01.01.2021)

Romanov B.K.

Abstract

This paper provides information about the sudden death of Professor Yuri Chernov – a one of the founders of the Russian clinical pharmacology, a specialist in the field of aerospace radiobiology, Honored Doctor of Russia.

Medical Journal of the Russian Federation. 2021;27(1):95-95
pages 95-95 views

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