Vol 21, No 5 (2015)

Articles
The eighty-fifth anniversary of pediatric education in Russia
Roshal L.M., Baranov A.A., Polunina N.V., Albitskiy V.Y.
Abstract
The article exposes the causes conditioned development of national system of maternity and childhood care in Russia, including organization of training of pediatricians in our country. The presented data testifies extremely high indicators of infant mortality in the beginning of XXI century. Among main causes are low standards of living and absence of children curative organizations and special medical manpower. The retrospective analysis of training of pediatricians in Russia is presented. It is noted that training of pediatricians is permanently developing and it is always implemented according the needs of health care. The considerable attention is paid to characteristics of training of pediatricians according to the Federal state education standard taking effect in 2010. It is demonstrated that progress in achievements of the most benevolent indicators of health of children population can testify high quality of training of pediatricians.
Medical Journal of the Russian Federation. 2015;21(5):4-8
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The function of position of physician and attendance of otolaryngologists in 2007-2012
Starodubov V.I., Ivanova M.A., Sokolovskaya T.A., Bantyeva M.N.
Abstract
The function of medical position of otolaryngologists increased up to 6.8% during 2007-2012 on the whole in the country. The highest indicator is marked in the South, Central and Ural federal okrugs. The coefficients of denial of function of medical position of otolaryngologists exceeded all-Russian indicator in the Central, South, Privoljskii and Ural federal okrugs. The total number of visits to the specialists of given profile increased up to 0.4% and home attendance up to 8.1% on the whole in the country. Against this background, number of visits to specialists because of diseases decreased except the Central federal okrug. The visits to specialists by rural residents increased in most federal okrugs.
Medical Journal of the Russian Federation. 2015;21(5):8-11
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The cardiologic prevention of stroke: current state of problem
Melekhov A.V., Gendlin G.E., Alekseeva E.M., Dadashova E.F., Storozhakov G.I., Sertakova O.V., Zakharova I.I.
Abstract
The stroke is one of the most significant medical social problems of the present time. The prevention of thromboembolism complications under cardiac fibrillation becomes a real mode of struggling with stroke. The formation of registries is often used as an instrument of evidence based medicine in this area. The article presents short review of recent studies in this field. The one's own original results are presented too: retrospective analysis of patient records and out-patient medical records of 1610 patients with fibrillation of atriums.
Medical Journal of the Russian Federation. 2015;21(5):12-17
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The bacteriemia of hospital period after cardio-surgical operations
Gabrielyan N.I., Gorskaya E.M., Drabkina I.V., Savostyanova O.A., Romashkina L.Y., Zakharevich V.M., Saitgareev R.S.
Abstract
The study was carried out to determine specter of agents of bacteriemia and their sensitivity to antibiotics in patients after cardiosurgery operations during hospital period. The analysis of bacteriemia after 850 cardiosurgery operations of 2013 was implemented. The agents of bacteriemia were identified using panels BD Crystal and database BBL Crystal MIND. The sensitivity of microorganisms to antibiotics was determined using disk-diffusion test according standards NCCLS. During monitored period after cardiosurgery operations occurrence of bacteriemia was established in 8.4% (71 out of 850 patients). The Gram-positive microflora with dominance of methicillin-resistant and coagulase-negative staphylococci prevailed in specter of microflora of hemocultures of patients of profile departments. In patients of reanimation and intensive therapy department sixfold increasing of amount of non-fermentative Gram-negative bacteria with prevalence of acinetobacters was marked. The poly-resistance of main agents of bacteriemia to antibiotics, including non-fermentative Gram-negative bacteria to carbapenems, was noted. In deceased patients, acinetobacters dominated under prevalence of Gram-negative agents in hemocultures.
Medical Journal of the Russian Federation. 2015;21(5):17-21
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The chronic obstructive disease of lungs as occupational illness: risk factors and problem of medical social rehabilitation of patients
Vasilyeva O.S., Kravchenko N.Y.
Abstract
The chronic obstructive disease of lungs by its prevalence and severity of course represents real threat of increasing of morbidity and mortality all over the world. Alongside with cigarette smoke, such unfavorable production factors as dust, smoke, toxic and biologically active substances are the causes of disease in 15% of cases. The study was carried out to analyze publications of national and foreign researchers concerning issues of occupational chronic obstructive disease of lungs for comparing with materials of one's own investigations. The history of issue covers period of thirty years when for the first time the experts of American thoracic society in accordance with European colleagues proposed to acknowledge occupational chronic obstructive disease of lungs as an independent form of pathology. The dosage-dependent and cumulative effects of exposition of aerosols at working place on development of occupational chronic obstructive disease of lungs were established. The significance of work experience in decreasing of pulmonary function was detected too. The mutual intensification of effect of cigarette smoke and occupational dust on development of chronic obstructive disease of lungs and severity of its course was proved. The results of one's own studies demonstrated that diagnosis of chronic obstructive disease of lungs was established in 20.5%-35.1% of 986 workers of various "dust occupations". The clinical picture was dominated by cough and short breath. The character of symptoms and degree of their expression depended on concentration of aerosols and duration of exposition. The statistically reliable increasing of number of workers with disorders of external respiration and signs of chronic obstructive disease of lungs depending on augmentation of occupational work experience is noted. The treatment is targeted to relief of main symptom of chronic obstructive disease of lungs - short breath. The social rehabilitation of patient consists in establishment of optimal conditions for continuation of labor activity.
Medical Journal of the Russian Federation. 2015;21(5):22-26
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About the mechanisms of radiation complications in patients with cancer of nasopharynx
Frantsiyanz E.M., Kozlova L.S., Gusareva M.A., Rosenko L.Y.
Abstract
The trypsin-like proteinases and their inhibitors are required participants of inflammatory processes, including those developing after remote gamma-therapy under treatment of oncological diseases. The sample included 59 patients with nasopharynx cancer (R1-4N0-3M0). The assays of blood plasma were taken to analyze state of proteinases of trypsin type of serine group, kinin system and universal inhibitors. The spectrophotometric kinetic techniques in dynamics of remote gamma-therapy. The results were compared with data obtained before the treatment (background). The analysis established combination of regenerative and regressive occurrences depending on absorbed energy and time passed after irradiation. Despite successful treatment of malignant neoplasm, no restoration of protein balance was observed in blood plasma of patients. This situation inhibited timely activation of anti-inflammatory mechanisms and significantly increased period of recovery in case of occurrence of radiation complications of inflammatory character. Under remote gamma-therapy of nasopharynx cancer, rheological disorders and inflammatory manifestations are conditioned by unbalance of interaction of proteinases and inhibitors. The complications manifested in progression of local inflammation and also in negative dynamics of indicators of activity of serine proteinases, serpins of blood and coefficients of their interaction during all period of monitoring. The dynamics of indicators permitted to detect occurrence of local inflammation already after first stage of treatment that facilitated individualization of therapy in early period.
Medical Journal of the Russian Federation. 2015;21(5):26-30
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The comparison of functional result of treatment of patients after arthroplasty of coxofemoral joint using hard friction pairs
Skoroglyadov A.V., But-Gusaim A.B., Sirotin I.V., Mkrtchyan V.A.
Abstract
The article presents comparison of functions of mounted femoral endoprosthesis with hard friction pairs in two groups of patients of younger and middle age. In the first group the hard friction pair “ceramics-ceramics” with diameter of head 36 mm was used. In the second group hard friction pair “titanium nitride-titanium nitride” with diameters of heads from 44 to 52 mm were used. The purpose of study was to compare functional results depending on size of head of endoprosthesis and to determine indications for application of big heads. The results were evaluated according Harris hip scope. The statistical analysis of obtained data established no reliable difference between the groups. However, evaluation of range of motions of joints established significant higher range of motions in patients with mounted heads of big diameter. The given advantage can be actual for patients sportsmen and those individuals whose profession and style of life require greater physical activity.
Medical Journal of the Russian Federation. 2015;21(5):31-34
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The positive and negative aspects of adhesive activity of human thrombocytes
Makarov M.S.
Abstract
The article presents review of data concerning significance of adhesion of human thrombocytes in norm and pathology. The methods of investigation, regulation and application of adhesive activity of human thrombocytes in medicine, biology and bioengineering.
Medical Journal of the Russian Federation. 2015;21(5):34-40
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The study of thymopoesis in children with thymomegalia using identification of thymus excisional rings
Donetskova A.D., Vaganov P.D., Nikonova M.F., Yanovskaia E.Y., Mandzhieva E.T., Rodionova E.M., Donin I.M., Pushkarev M.A., Yarilin A.A.
Abstract
The article demonstrates that in children with thymomegalia the process of T-lymphopoesis in thymus is depressed. The functional condition of thymus was evaluated by detection of T-receptor excisional rings using polymerase chain reaction technique in real time. The T-receptor excisional rings are circular molecular structures developing in the process of rearrangement of V-genes of T-cell receptor. The most intensive and statistically reliable decreasing of content of T-receptor excisional rings in lymphocytes of blood is detected during first two years of life: 29.6 (18.1-41.0) copies per 1000 lymphocytes against 73.3 (54.0-83.8) copies in control. Hereinafter, (after two years) difference in level of T-receptor excisional rings inc children with thymomegalia in comparison with children without enlargement of thymus is less expressed i.e. it amounts to 1.8 times at the age before 10 years. In individuals of older age thymomegalia is a rather rare pathology. The examination of single patient aged of 40 years and with thymomegalia factually total absence of T-receptor excisional rings in cells of his blood was established.
Medical Journal of the Russian Federation. 2015;21(5):40-43
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The algorithm of evaluation of interchangeability of pharmaceuticals
Romanov B.K., Sakaeva I.V., Bunyatyan N.D., Vasilyev A.N., Bondarev V.P., Prokofyev A.B., Yagudina R.I., Alyautdin R.N., Kovaleva E.L., Pereversev A.P., Zatolochina K.E., Kazakov A.S., Komratov A.V., Koshechkin K.A., Pasternak E.Y.
Abstract
The article presents originally developed algorithm of expertise of interchangeability of pharmaceuticals for medical application. The interchangeable pharmaceutical is a pharmaceutical with evidenced therapeutic equivalence or bioequivalence concerning reference (original) pharmaceutical with equivalent qualitative and quantitative compound of active substances, auxiliary substances, medicinal form, identical way of administration and mode of application and manufactured according requirements of rules of proper processing practice. The interchangeability of pharmaceutical to reference pharmaceutical is established during state registration of pharmaceutical or at introduction of changes into documents contained in registration dossier of already registered pharmaceutical in the Russian Federation. The application about establishment of interchangeability by applicant - holder or owner of registration certification of pharmaceutical for medical application is required.
Medical Journal of the Russian Federation. 2015;21(5):43-47
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The information about pharmaceuticals. The national regulation and international approaches
Rostova N.B., Kudryashova A.I.
Abstract
The article determines significance of neatly organized system of information about pharmaceuticals in rational application of remedies. The characteristic is given concerning sources of information about pharmaceuticals regulated by documents in the Russian Federation. The results of comparative analysis of information sources about pharmaceuticals and requirements to them according the Russian legislation and WHO guidelines are presented. The weak aspects of regulation and control in sources of information about pharmaceuticals are established. The main requirements for information about pharmaceuticals to be complied with according WHO guidelines are formulated.
Medical Journal of the Russian Federation. 2015;21(5):47-52
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The brain concussion: clinic, diagnostic, treatment
Voskresenskaya O.N., Damulin I.V.
Abstract
The lecture considers clinical characteristics and pathogenic aspects of brain concussion as a most prevalent form of craniocerebral injury. The neuropsychologic examination of this category of patients established decreasing of velocity of psychomotor processes and derangement of attention and minor defect of regulative functions (abstraction, development of judgments, etc.). It is emphasized that in significant percentage of patients the post-traumatic disorders have psychogenic character. At that, the role of psychogenic factor in genesis of post-traumatic psychoneurological disorders is quite often underrated, especially in practical activities. The tactics of monitoring of this category of patients is considered.
Medical Journal of the Russian Federation. 2015;21(5):53-56
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