Vol 3, No 2 (2018)

Articles
The Innovative Approach to Study of the Levator Ani Anatomy
Chemidronov S.N., Suvorova G.N., Chicheva I.S., Zelter P.M., Bakharev D.V.
Abstract
Aim - to study the structure of levator ani muscle in men and women of the first and second adult periods and elder group according to CT scan. Materials and methods. Data from CT scans of 40 patients aged 20 to 70 years were used. In the "Autoplan" system, in the semi-automatic mode, threedimensional models of levator ani muscle were created. Results. Three-dimensional models of levator ani muscle were created and described: for young women and men of all ages, a keel-shaped and funnel-shaped levator ani muscle forms; and for women of advanced age - horseshoe form.
Science and Innovations in Medicine. 2018;3(2):6-9
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Modern Capabilities of Diagnostic Analytical Module "Verion Reference Unit" and Navigation System "Verion Digital Marker Microscope" in High-Tech Cataract and Presbyopia Surgery
Malov I.V., Stebnev S.D., Stebnev V.S.
Abstract
Aim - to show the possibilities of diagnostics with the use of VERION Measurement Module, followed by personalized drawing up an operation plan on the analytical module "VERION Vision Planner" and the calculation of high-tech IOLs. The evaluation of the work of the navigation system "VERION Digital Marker Microscope" in high-tech cataract surgery and presbyopia. Materials and methods. The results of the prospective open study of phacoemulsification of cataract and refractive lens surgery with implantation of high-tech intraocular lenses of Alcon company (USA) were studied. The calculation of the optical power of the IOL was performed using a navigation system, "VERION" (Alcon). Functional and refractive data before and after surgery were evaluated. Results. High-tech IOL implanted 100 patients (180 eyes). Sphericules clinical refraction was -0,15±0,28 diopters. Refraction of the target (em±0,5 DPT) was achieved in all patients. Intraoperative and postoperative complications were not observed. In all patients, the obtained refractive effect practically coincided with the potentially expected one. All patients are satisfied with the results of the operation and the choice of intraocular lens. Conclusion. 1. Diagnostic analytical module "VERION Reference Unit" of "VERION" system allows accurately selecting of the optical power of high-tech IOLs and their toric component with the preparation of the individual operation plan for each patient. 2. Navigation system "VERION Digital Marker Microscope" allows to carry out high-tech surgery of cataract and presbyopia according to the developed plan of operation. Deviation of the spherical refraction component obtained in the postoperative period from the expected, according to "VERION Vision Planner", was 0.2+0.15 DPTR; deviation of the cylindrical refraction component was 0.3+0.26 DPTR.
Science and Innovations in Medicine. 2018;3(2):10-14
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New Approaches to the Diagnosis of Liver Fibrosis in Patients with Chronic Hepatitis C
Vasilev S.Y., Konstantinov D.Y., Popova L.L.
Abstract
Aim - to develop the method of non-invasive determination of liver fibrosis in patients with chronic hepatitis С. Materials and methods. 446 patients with chronic HCV infection (aged from 18 to 65 years; male -52.3%; female - 47.7%) were comprehensively surveyed. The linear discriminant analysis with the exception of discriminatory variables used by the all registered laboratory and ultrasound indicators, as well as the age of patients was performed. The results of the survey of 223 patients were used to create the discriminant model and the results of a survey of the remaining 223 patients, were used for the testing of the accuracy of the received discrimination. Conclusion. The discriminant model for noninvasive determination of the degree of liver fibrosis in patients with chronic hepatitis C with high sensitivity - 88.0% and specificity is 96.2% is developed.
Science and Innovations in Medicine. 2018;3(2):15-18
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Residual Risk of Cardiovascular Complications in Case of Adequate Lipid-Lowering Therapy
Simerzin V.V., Fatenkov O.V., Gagloeva I.V., Galkina M.A., Panisheva Y.A.
Abstract
This article is devoted to the problems of residual risk of cardiovascu1ar comp1ications deve1opment for high and very high risk patients under adequate lipid-fowering pharmacotherapy in spite of c^lestera! and tow-density 1ipoproteins target level achievement. Afong with classic risk factors the special atte^ton is given to 1ipoprotein (a) [LP (a)] as the most aggressive factor of cardwvascular system atherosclerotic diseases devetopment and their comp1ications. Great importance is attached to 1ipidopheresis.
Science and Innovations in Medicine. 2018;3(2):19-25
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Emotional Burnout Syndrome Among Physicians and Teachers of Higher Education
Petrova N.G., Murzenko O.V.
Abstract
The bumout syndrome is becoming increasingly important especially in the conditions of social and psychological tension in the society. Health workers and teachers are at very high risk of it’s possessing. Aim - the study of the severity of burnout syndrome among different categories of medical staff and teachers of higher education and the development of proposals for its prevention. Materials and methods. By the method of K. Maslach and S. Jackson using a special questionnaire the data on the burnout syndrome severity of such manifestation as emotional exhaustion in doctors, nurses (working in the city polyclinic, hospital, commercial medical organization) and teachers of the medical University was studied. The total number of examined persons is 100 people. Results and discussion. The low attrition rate was presented in 37.0% cases; medium - in 44.0%; high - in 19,0%. The most marked signs were determined as emotional exhaustion among persons under 40 years of age, with an experience of up to 10 years; among those working in a polyclinic, teachers and nurses. Conclusion. On the basis of the data obtained, the measures for the prevention of burnout syndrome were proposed.
Science and Innovations in Medicine. 2018;3(2):26-29
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The Quality Improvement of Periodic Medical Examinations of Working People and Professional Aptitude Expertise
Strizhakov L.A., Babanov S.A., Budash D.S., Baikova A.G.
Abstract
Aims - to analyze the historical aspects of the formation of the national normative framework in the field of primary and periodic medical examinations, to discuss the existing problems in the carrying out of primary and periodic medical examinations of workers and also to make suggestions for quality improvement of primary and periodic medical examinations and for introduction of occupational risk assessment into the practice of primary and periodic medical examinations. Conclusion. For quality improvement of primary and periodic medical examinations, for efficiency improvement of primary and secondary prevention of occupational diseases it is considered to be necessary to take the following suggestions: - fuller coverage of working people by periodic medical examinations; - thorough selection of organizations that perform the special assessment of working conditions; - the use of the results of the special assessment of working conditions for improving working conditions and informing workers about working conditions; - implementation of occupational risk assessment into practice of primary and periodic medical examinations; - the use of modern methods of molecular and genetic screening;
Science and Innovations in Medicine. 2018;3(2):30-36
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The Methods of Detection of Gait Disturbance and Postural Instability in Case of Parkinson’s Disease
Poverennova I.E., Kalinin V.A., Shpileva S.A.
Abstract
Parkinson’s disease takes first place among neurological diseases of senior persons and its prevalence consists of 2% among people elderly than 65 years old. Disturbance of gait and postural instability are the most important motor disorders in case of Parkinson’s disease. Aim - to reveal factors which influence on the falling down of patients with Parkinson’s disease. Materials and methods. The use of unified Parkinson’s disease rating scale for examination of patients with Parkinson’s disease was performed. Results of rating scales were analyzed due to regression analysis. Results. It was revealed that the most important factor of falling down is the disturbance of gait. Freezing of gait has little influence on falling. Conclusion. The use of such diagnostic tests in the routine neurological examination allows to optimize medication therapy and to use modern non- medication methods of correction of gait.
Science and Innovations in Medicine. 2018;3(2):37-40
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The Model for Assessing the Risk of Cardiovascular Complications in Patients with Type 2 Diabetes Mellitus
Begun D.N., Borshchuk E.L., Leushina K.V.
Abstract
Aim - to identify the most significant risk factors that affect the occurrence of cardiovascular complications in patients with type 2 diabetes and to create the supplement for the risk assessment of cardiovascular complications in patients with type 2 diabetes. Methods of research. The object of the study is adult patients with type 2 diabetes mellitus (n = 60). For the development and analysis of the material, a statistical method is used, a modeling method of constructing the classification trees. Discussion and results. Statistically significant risk factors for cardiovascular complications in type 2 diabetes are a high body mass index, the presence of insulin therapy, the duration of the disease, a high maximum level of systolic blood pressure, high concentrations of LDL, markers of cell damage, and some hemodynamic parameters of myocardial function. A multidimensional model of the risk of complications was developed, which served as an algorithm for the created computer program, their early prognosis and timely carrying out of preventive measures.
Science and Innovations in Medicine. 2018;3(2):41-44
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Psychological Prophylaxis of Eхogenous Constitutional Obesity of Adolescents with Social Psychological Factors, Taken into Account
Kireeva T.I.
Abstract
Aim - psychological prevention of development of exogenous-constitutional obesity on the basis of the definition of early diagnostic socio-psychological criteria for the risk of obesity in adolescents. Materials and methods. The study was conducted on the basis of the Department of Endocrinology of the Children's City Clinical Hospital No. 1. The sample of the study consisted of 40 adolescents, 20 of whom had a diagnosis of "Exogenous-constitutional obesity", grade 3-4 (the clinical group), while the other 20 adolescents had normal weight (the control group). The following psychodiagnostic methods were used in the study: the test of character accentuation by K. Leonhard, S. Schmieschek, the Dutch food questionnaire, the test "Adolescents about Parents" (ADOR), the method of directed retrospective analysis on "My Relations with Food" topic by V.I. Shebanova. Results. Adolescents with obesity are characterized by high sensitivity, empathy, a tendency for prolonged experience of grievances, suspicion, mistrust, emotional discomfort. In the families of adolescents with obesity, there is a cult of food, which negatively affects the formation of eating behavior. Adolescents with obesity are prone to emotionally dependent eating behavior. The social-psychological risk factors for obesity in adolescents are stuck and emotional character accentuations, low level of restrictive eating behavior, lack of intimacy with the mother, mother’s hostility and domination. Conclusion. Knowledge of the identified factors allows to predict the risk of obesity in adolescents at the early stage of weight gain and to carry out its timely prevention by correcting the characterological features, parent-child relationships and eating style in the family.
Science and Innovations in Medicine. 2018;3(2):45-48
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The Use of Radiofrequency Thermal Ablation in Combine Treatment of Patients with Liver Bilobar Metastases from Colorectal Cancer
Kaganov O.I., Kozlov S.V., Orlov A.E., Blinov N.V.
Abstract
Aim - determination of RFTA place in the combined treatment of bilobar liver metastatic process of colorectal cancer. Materials and methods. 176 patients with colorectal cancer with multiple (more than 4) bilobar liver metastases were included in the study after primary tumor removal. The research was held in Samara Regional Oncology Centre from 2001 to 2014. According to the treatment method patients were divided into two groups. Main group got the combined (chemotherapy + RFTA) treatment (98 patients). In control group only chemotherapy was applied to 78 patients. Results. One-, two- and three-year OS were 73.5%, 25.1%, 7.2% in the main group and 39.6%, 6.3%, 2.1% in the control group. With RFTA application we reached the 1.8% index of four-year survival in the main group, while three-year survival in the control group was only 2.1%. The OS median reached 18 months in the main group and 11 months in the control group, OS curves in two comparing groups were significantly different( log-rank test 3.77, р=0,000). Conclusion. Combination of RFTA with chemotherapy as the treatment of bilobar liver metastases of colorectal cancer, significantly improves the DFS and overall survival indexes, comparing to the group of patients who received only chemotherapy.
Science and Innovations in Medicine. 2018;3(2):49-53
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The Results of Cytoreductive Operations in Patients with Colorectal Cancer with Simultaneous Liver Polymetastases
Kozlov S.V., Kaganov O.I., Orlov A.E., Kozlov A.M.
Abstract
Aim - to improve the long-term results of cytoreductive treatment of patients with simultaneous multiple bilobar liver metastases of colorectal cancer by the use of RFTA. Materials and methods. The study presents the results of treatment of 168 patients diagnosed with colorectal cancer of stage IV with simultaneous bilobar metastases in the liver. In the main group, cytoreductive tumor removal was accompanied by radiofrequency thermal ablation (RFTA) of metastatic formations. In the control group only the primary tumor was removed. Results. The use of RFTA during cytoreductive surgery does not worsen the immediate results of surgical treatment, in comparison with patients, where the effect on liver metastases has not been performed, but allows to increase medians of uneventful and overall survival from 9 and 22 months to 17 and 29 months, respectively. Conclusions. The use of RFTA for simultaneous multiple bilobar metastases in the liver during cytoreductive surgery makes it possible to achieve 22.7% of the three-year uneventfulness and 4.3% of the five-year overall survival.
Science and Innovations in Medicine. 2018;3(2):54-59
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Morphological Features of the Inflammatory Myofibroblastic Tumor
Yunusova Y.R., Fedorina T.A., Rozumny D.V., Shamin A.V.
Abstract
Introduction. Inflammatory myofibroblastic tumor (IMT) is a rare form of children neoplasm, characterized by intermediate biological behavior. In case of this, pathological diagnostics and valid tumor prognosis are difficult to perform; practitioners are not familiar enough with this pathology. Aim - to get an idea of the tumor morphological features, approaches to differential diagnosis of IMT, spreading in pediatric oncopathology, based on a review of modern literature. Material and methods. The retrospective analysis of soft tissue tumors in children operated for the period from 2007 to 2017 in Samara City Children's Clinical Hospital №1 n.a. Ivanova N.N. was performed. Among 1344 tumors, 5 cases verified as were detected IMT Results. Own clinical observations with children’s sex and age, tumor localization and speed of development, results of surgical treatment, tumor description in gross and in histological specimens, results of additional methods used in differential diagnostics from sarcomas are presented. Conclusions. Taking into account the tendency of tumor recurrence, the conclusion of the importance of morphological study of margins of tumor resection is made.
Science and Innovations in Medicine. 2018;3(2):60-65
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The Development of Ultrasound Method of the Study of the Inferior Alveolar Arteries
Bakhteeva G.R., Lepilin A.V., Erokina N.L., Savelieva S.S., Chibrikova L.M.
Abstract
А^ - the development of ultrasound method of the study of inferior alveolar arteries and their normal data of blood circulation. Materials and methods. In 20 men the apparatus «Vivid E9» the study of the bipolar bloodstream in the inferior alveolar arteries was performed. Results. In the study of the facial arteries the following results were obtained: PS - 55,7+0,9 cm/s, ED - 10,15+0,3 cm/s, TAMX - 52,0+1,1 cm/s, PI - 1,32+0,06, RI - 0,77+0,03, PS/ED - 2,30+0,1, HR - 35,36+1,9 bpm. In the study of the inferior alveolar arteries the following results were determined: PS bloodstream 57,96+0,7 cm/s; ED bloodstream 5,47+0,1 cm/s; TAMX 17,22+0,5 cm/s; PI 3,05+0,1; RI 0,91+0,05; PS/ ED 10,60+0,2; HR 69,48+0,4 Ьрм. Conclusion. The methodology of ultrasound study of the inferior alveolar arteries and bloodstream parameters in them was developed.
Science and Innovations in Medicine. 2018;3(2):66-68
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Influence of Combined Laser and EHF-Irradiation on Correction of Microcirculator Disorders in Inflammatory Diseases of Parodont
Parfenova S.V., Bulkina N.V., Kobzeva Y.A., Parfenov A.K., Klinger I.S.
Abstract
Aim - to prove the necessity of including the methods, which normalize the vascular and intravascular component of the hemostasis system, in the combined therapy of inflammatory periodontal diseases, as the microcirculation disorders play the most important role in the pathogenesis of inflammatory periodontal diseases and correlates with severity level. Materials and methods. In order to study the possibility to correct the malformation of the adhesive and aggregation activity of the blood platelets in patients with inflammatory periodontal diseases, we carried out a study of the adhesion and aggregation of platelets after a course of combined therapy, which included combined effects of laser and EHF radiation. The most important link in restoration of microcirculation is the vasoregulative effect of laser irradiation. Results. There is a partial or complete restoration of aggregation and adhesive activity of the blood platelets. Conclusion. The use of combined laser and EHF radiation of the “Matrix” equipment allows stopping the inflammation of the tissues quickly. Correction of these disorders by non-drug methods, in comparison with a medication-assisted treatment, has no side effects, and can be recommended as a component of combined therapy in patients with inflammatory periodontal diseases.
Science and Innovations in Medicine. 2018;3(2):69-72
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