Vol 19, No 3 (2013)

Articles
The innovative computer technologies in the development of personalized medicine
Pikhlak A.E., Sarukhanov V.A., Logatchev V.A., Nosovskiy A.M., Shuvalov A.V., Lysenkov I.A., Mutyeva N.A.
Abstract
The article demonstrates the suitability of application of distributed automated system of health monitoring under implementation of methodology of personalized medicine in clinical practice. The architecture of system is proposed and its advantages in its application using innovative micro miniature computers μPC are marked. The proposed technologies are tested on such metabolic diseases as osteoporosis and gout under which the significant importance of genetic determinants and gender differences is proved. The need of prolonged sometimes life-long monitoring o patients is substantiated.
Medical Journal of the Russian Federation. 2013;19(3):3-5
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The actual issues of professional training of physicians and administrators of medical organizations
Gontcharov N.G., Boiytchenko Y.Y.
Abstract
The article discusses the issues of professional training of physicians and administrators of medical organizations as determined by normative decrees in view of the Federal law N323-FZ of 21.11.2011. It is pointed out that in the Russian Federation the right to execution of medical activity have persons obtained the higher or secondary medical education and professional certificate according the education standards. The attention is paid to new rules of accreditation and advanced training of specialist. Minutely are discussed the license requirements to medical organization administrator and the availability of additional professional education and certificate of specialist in health organization and public health.
Medical Journal of the Russian Federation. 2013;19(3):5-9
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The medical social portrait of patient with maxillofacial trauma
Dubrovin M.S., Polunin V.S.
Abstract
The article demonstrates that medical social studies of particular groups of population provide an opportunity to analyze their health conditions, social characteristics and organization of corresponding medical care. In the structure of morbidity adult population of the Russian Federation the maxillofacial traumas take tenth place and are mostly registered among population aged 18-50 years. The most examined patients suffered of domestic traumas. The broad propaganda of basics of healthy life-style can input into decrease of population traumatism.
Medical Journal of the Russian Federation. 2013;19(3):9-11
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The factorial conditionality of health conditions of patients with dorsopathies and its role in implementation of health promotion activities
Kostenko E.V., Polunina N.V.
Abstract
The article analyzes the characteristics of life-style of patients with dorsopathies. The factors impacting the health indicators of the mentioned group of patients are explained. The priority role of medical activities in formation of benevolent health indicators of examined patients is demonstrated. The study results provided an opportunity to develop medical social health promotion activities implemented in the School of patients with dorsopathies to improve health conditions of this category of patients.
Medical Journal of the Russian Federation. 2013;19(3):11-14
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The markers of inflammation and their diagnostic and prognostic significance under infectious endocarditis
Fedorova T.A., Semenenko N.A., Tazina S.Y., Roiytman A.P., Kim T.V., Stefanenko N.I.
Abstract
The article presents the analysis of dynamics of markers of inflammation (C-reactive protein, tumor necrosis factor (α)) and procalcitonin in 66 patients with infectious endocarditis during six months of monitoring. The carried out study and clinical laboratory comparison made it possible to reveal consistent dynamics of indicators among patients with different course of disease at its various stages. The alterations of concentration of indicators are established in dynamics determining unfavorable prognosis under infectious endocarditis. The high sensitivity and informativeness of tumor necrosis factor (α) is established at all stages of course of disease.
Medical Journal of the Russian Federation. 2013;19(3):15-18
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The optimization of rehabilitation strategies in patients with sensorimotor disorders under different levels of central nervous system damage
Ekusheva E.V., Shavlovskaya O.A., Damulin I.V.
Abstract
The article demonstrates that despite undeniable achievements in the field of neurorehabilitation, a significant percentage of patients has persistent locomotion disorders even after timely and adequately applied rehabilitation measures. This is especially concern the patients during tardy rehabilitation and residual periods after stroke and with consequences of damage of spinal cord. The techniques of transcranial magnetic stimulation and somato-sensorial evoked biopotentials were applied to 100 patients with sensomotorial disorders after old stroke and after spinal damage at the level of thoracic spine. It was established that under different levels of damage of central nervous system occurs the formation of various pathologic states with complex of sensorimotor disorders. Hence, the detected patho-physiological alterations can be putted to the foundation of determination of the optimal program of neuro-rehabilitation process to attain better degree of recovering locomotion functions of these patients.
Medical Journal of the Russian Federation. 2013;19(3):18-23
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The comprehensive approach in evaluating functional conditions of the brain in patients with ischemic stroke at the stage of rehabilitation
Sorokina N.D., Selitskiy G.V.
Abstract
The article presents the results of study of informativeness and prognostic value of complex of neuropsychologic, electro-physiologic and clinical data in the evaluation of functional conditions of brain and parameters of mnestic functions in patients with aftermaths of ischemic stroke. The character and degree of memory disorders depends on localization of post-ischemic focus and correlates with characteristics of pathologic activity in brain biorhythmics. This approach makes possible to produce particular prognosis and recommendations in neurorehabilitation of patients with stroke.
Medical Journal of the Russian Federation. 2013;19(3):23-27
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The psycho-vegetative disorders and their treatment of patients in remote period of brain concussion
Schekolova N.B., Mudrova O.A., Drozdov S.N.
Abstract
The posttraumatic headache share 11.8% in the general structure of headaches. The headache after old light craniocerebral injury disturbs more than 80% of the injured. The sampling consisted of 125 patients with headache in the remote period of brain concussion. The domestic trauma dominated. The psycho-emotional sphere and vegetative nervous system were studied. The psychometric tests and cardiointervalgraphy were applied. The development of chronic post-traumatic headache in examined patients was paralleled by development of secondary psycho-vegetative disorders. The syndrome of vegetative dystonia with marked sympaticotonia was established in 86.4% patients. The comprehensive approach is proposed to rationally correct the intensity of headache, anxiety depressive disorders and syndrome of vegetative dystonia in dynamics.
Medical Journal of the Russian Federation. 2013;19(3):27-30
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The impact of regional methods of post-surgery analgesia on the dynamics of intra-abdominal pressure after cesarean section
Marshalov D.V., Salov I.A., Petrenko A.P., Shifman E.M.
Abstract
The study was carried out to compare dynamics of intra-abdominal pressure and compliance of front abdominal wall after cesarean section depending on method of post-surgery analgesia. The opened prospective randomized study was organized using the sample of 40 female patients divided in two groups. In the first group the post-surgery analgesia was applied using method of prolonged epidural analgesia. In the second group the method of bilateral blockade of nerves of neuro-fascial space of abdomen was applied. The level of post-surgery pain, the degree of sedation, dynamics of intra-abdominal pressure and compliance of front abdominal wall were examined. It was demonstrated that after cesarean section the epidural analgesia and blockade of nerves of neuro-fascial space of abdomen effectively decrease the level of post-surgery pain, increase compliance of front abdominal wall and decrease the level of intra-abdominal preassure. In the groups the examined indicators had no reliable differences.
Medical Journal of the Russian Federation. 2013;19(3):30-33
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The ultrasound diagnostic of atypical venous thrombosis in the system of inferior vena cava as one of methods of differential diagnostic of thrombembolia of pulmonary artery from unclear source
Maruschak E.A., Zubarev A.R.
Abstract
The article presents the experience of ultrasound examinations of blood flow in the system of inferior vena cava using the sample of 21 patients with atypical sources of development of thrombi. The most probable atypical zones of thrombi outcome and their relationship with main disease of patients are described. The particular attention is paid to application of ultrasound examinations of venous blood flow in case of diagnosis of "thrombembolia of pulmonary artery from unclear source". The article presents the characteristics of ultrasound picture of atypical phlebothrombosis and describes possible difficulties and errors during their examination. The algorithm of verification of ultrasound diagnosis using the application of other methods of examination is exposed.
Medical Journal of the Russian Federation. 2013;19(3):33-36
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The infectious complications of bacterial nature in cardio-vascular surgery
Arefyeva L.I., Gorskaya E.M., Savostiyanova O.A., Senchenko O.R., Gabrieliyan N.I.
Abstract
The article presents the analysis of rate and character of post-surgery infectious complications of bacterial nature in car-diosurgery mainly after coronary artery bypass grafting. The risk factors capable to lead to infectious complications and to aggravate them are presented. The attention is focused on such more frequent post-surgery infectious complications as pneumonia, tracheobronchitis, blood flow infection, wound infection and more rare but severe post-surgery infectious complications as mediastinitis. The agents of various types of post-surgery infectious complications including ones related to mechanical devices of blood flow support are discussed. The importance of specific and non-specific prevention oof post-surgery infectious complications is emphasized. The various schemes of application of antibiotics considering antibiotics resistance are given.
Medical Journal of the Russian Federation. 2013;19(3):36-42
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The lacunar infarction
Domashenko M.A., Damulina A.I.
Abstract
The article considers pathogenic, clinical and therapeutic aspects of lacunar infarctions. It is emphasized that the source of their occurrence can be found in arterial hypertension, affection of arterioles supplying blood to remote section of cerebral hemispheres and brain trunk as well. The description of clinical characteristics of main lacunar syndromes (purely locomotor stroke, purely sensitive stroke, sensorimotor stroke, ataxic hemiparesis, syndrome of dysarthria and inept hand) is given. The recommendations on treatment and prevention of lacunar infarction are proposed.
Medical Journal of the Russian Federation. 2013;19(3):42-48
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The diagnostic value of proteinuria and microalbuminuria in pregnant women with increased arterial pressure
Brytkova Y.V.
Abstract
The article presents the summary of results from national and international studies concerning the diagnostic value of proteinuria and microalbuminuria in pregnant women with increased arterial pressure. The physiologic alterations of renal function occurring with progression of pregnancy are described. The pathogenic aspects of hemodynamic and morphologic alterations in kidneys under hypertension of pregnant women are discussed. The evaluation of sensitivity and specificity of different techniques of identification of proteinuria and microalbuminuria is presented. The opposite suggestions concerning the role of mentioned indications of disorders of kidneys functioning in pregnant women with arterial hypertension are presented. The analysis of large factual material made it possible to assess the role of proteinuria and microalbuminuria in prognosis of complications of pregnancy and perinatal outcomes. The conclusion is made about the need of further studies of diagnostic value of development of these symptoms under pregnancy.
Medical Journal of the Russian Federation. 2013;19(3):48-51
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The new methodology of medicine 2. The matrix of particular indicators of cardiovascular system: practice (private study)
Shpakov A.A.
Abstract
The empiricism was motive force of progress ensuring in particular development of medicine by method of trial, detection and correction of errors which were often irreparable for suffered patients. However, the experiment revealed no many delusions of compilers of manuals of internal diseases propaedeutics. The author using a new methodology discovered certain methodological and other inaccuracies of mentioned œmpilers, composed list of true alternatives and proposed the matrix of indicators of cardiovascular system. This matrix can facilitate the work of physicians, economize their labor time, enhance diagnostics, treatment, scientific research, etc. The transformation of empirical medicine into methodological medicine demands considerable means and decades of work of devoted group of researchers ("Informotron" project).
Medical Journal of the Russian Federation. 2013;19(3):53-56
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