Vol 8, No 2 (2011)

The present lecture contains fundamentals of evidence based medicine; it provides a definition of its role in clinical practice. Wide-ranging material demonstrates that evidence based medicine cannot replace the art of healing and clinical thinking, but should serve for improvement of the quality and effectiveness of clinical practice.

We analyzed the causes of conflicts in the dyads of «physician - patient» relationship arising in outpatient hospitals, when you give a voluntary informed consent for medical procedures. Ways of reducing the possibility of conflicts at the doctor's patient reception are proposed.

The effect of a single intake of piracetam (0,4 g), phenibut (0,25 g) and obsidan (0,08 g) on the thermal state, gas-energy exchange, cardiovascular system, physical working capacity and subjective status of 22 sportspersons performing submaximal physical loads in the ambient conditions of heightened temperature (31 ± 1) °C, high humidity (80 ± 1) % and low air movement (0,3 ± 0,1) m/s. It was established that these drugs increased thermoresistance, maintained a high level of physical working capacity and reduced the negative influence of hyperthermia on human subjective status. Obsidan produced a normalizing effect on the cardiovascular system during the development of hyperthermia.

We studied differences in the nature and degree of expression of changes of indicators of the immune status and condition of lipid peroxidation and their dynamics in conventional therapy depending on genetic determinancy of erythrocytes on system AB0 and Rh in patients with chronic prostatitis.

A retrospective pharmacoepidemiological study of the practice of prescribing medications in an out-patient department when treating patients with chronic obstructive pulmonary disease (COPD) was carried out. An analysis of medications consumption revealed the specifics of treating COPD by physicians of different medical specialties.

16-week simple parallel group randomized investigation was performed. Ivabradine, verapamile SR or bisoprolol were administered for treatment of postMI silent ischemic patients with stable angina and concomitant chronic obstructive pulmonary disease. Hemodynamic, antianginal and anti-ischemic activity, and dynamics of the bronchoobstruction disease are studied.

Highly selective and highly sensitive HPLC-analysis of ivabradine concentration in CHD patient plasma was developed.

This epidemiological study revealed a significant deviation from standards in management in the administration of laboratory and instrumental examinations to patients with stroke in Volgograd hospitals. Urgent correction of these deviations will improve the quality of medical care for this category of patients.

Successful work of health keeping agents of foreign students in the educational environment of the medical university will raise the effectiveness of the educational process.

205 patients were enrolled in the study which included endoscopic transpapillary intervention for correction of bile hypertension syndrome. The patients were divided into groups depending on the type of analgesia. The first group (n = 101, prospective study) included patients receiving epidural analgesia, the second group (n = 104, retrospective study) - narcotic analgesics. The results of the study have shown that epidural analgesia effectively reduces the risk of development of post-ERCP pancreatitis.

A method of investigating Na+/H+ exchange activity on rabbit platelets was described. It was shown that amiloride inhibits the Na+/H+ exchanger, and IC50 was calculated. This method can be used for screening of new antiischemic compounds.

The study has been carried out on the comparative analysis of the cytokine profile in 59 patients with irritable bowel syndrome (IBS), 20 patients with ulcerative colitis (UC) and 45 healthy subjects (HS). The increased levels of proinflammatory cytokines in combination with anti-inflammatory interleukin(IL)-10 deficit was revealed. The content of proinflammatory cytokines in IBS patients with postinfectious diarrhea variant also was significantly higher than in patientswithIBS without acute enteritis infection(AEI) at anamnesis.

Modified gel Polykatan in combination with lincomycine under study was applied in combination with the conventional therapeutic pattern in patients with chronic inflammatory periodontal disease. The medical form of gel provides long-term persistence in oral cavity and has a positive action on microbiological changes of the oral cavity.

The paper presents a study of clinical and epidemiological features of viral hepatitis with parenteral transmission mechanism in the Volgograd region. Prevalence of chronic hepatitis C over acute hepatitis C and over all forms of hepatitis B virus was revealed. Prevailing viral genotypes are assessed, as well as the age and gender characteristics of parenteral hepatitis in our region.

The aim of the study was to evaluate the diagnostic and prognostic significance of biopsy in inflammatory diseases of the bladder. A review of 260 patients led to some practical conclusions. Biopsy of the bladder in chronic cystitis is not feasible. Biopsy of the bladder should be performed in patients with potentially possible loss of bladder function, as it significantly affects the treatment strategy and prognosis.

106 patients with toxic hepatitis were treated with the infusion course of sodium hypochlorite as monotherapy. Levels of lipid peroxidation, antioxidative enzymes activity, cytolytic and mesenchimal-inflammatory syndrome were determined before and after therapy course. Treatment revealed valuable positive dynamics of all indexes, improvement of the general status of patients after therapy. Thus, treatment with sodium hypochlorite is a new effective medicamentous method in patients with toxic hepatitis.

The quality of nutrition and state of health of schoolchildren trained in educational establishments with different forms of the organization of public catering are studied. A difference of functional state of health of schoolchildren of studied modeling groups is revealed. The risk of health disorders in schoolchildren due to nutrition disturbances is calculated.

The administration of cyclosporine in patients with severe chronic idiopathic urticaria provides a more rapid achievement of clinical effect than the therapy with H1/H2 histamine antagonists. This is confirmed by a significant decrease of the total index of severity of illness and major symptoms of skin lesions. Thus, administration of cyclosporine can be considered as therapy of choice in patients with chronic idiopathic urticaria with a severe course and ineffective long-term therapy with antihistamines / systemic corticosteroids.