Saratov JOURNAL of Medical and Scientific Research

2019, volume 15

Decision making support system in spine-and-pel-vic surgery as an instrument of branch control automation

Year: 2019, volume 15 Issue: №3 Pages: 677-682
Heading: Health Service Organization Article type: Original article
Authors: Fedonnikov A.S., Kolesnikova A.S., Rozhkova Yu.Yu., Kossovich L.Yu.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University
Summary:

Aim: to prove the use of decision making support system (DMSS) in spine-and-pelvic surgery as an instrument of control automation in health branch. Material and Methods. Development of DMSS presented in current work made at the base of methodology «planning-modeling-forecasting». For graphical analysis and description of DMSS performance applied the logic diagram method. Materials of DMSS performance evaluation were the data extracted from 22 protocols of its beta-testing processing. Results. Description of the development and beta-testing of organization tech- nology allowed to implement DMSS in healthcare at the base of Regional center (fulfilling medical and expert activity) and Technological center (fulfilling computational functions) interaction. Conclusion. Development and implementation of DMSS as an instrument of branch control automation allow influence the heath quality increasing by means of raising accuracy, specificity and personalizing of diagnostics, decreasing of complications and terms of rehabilitation. Besides this kind of systems allow reduce workload for medical personnel with rising of its labor efficiency that meets the needs of innovative development of medicine and healthcare.

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Evaluation of influence of social factors on the psycho-emotional state of persons of elderly and senile age

Year: 2019, volume 15 Issue: №3 Pages: 674-677
Heading: Health Service Organization Article type: Original article
Authors: Sazanova G.Yu., Shulpina N.Yu., Ponomarev A.D., Kraynova A.M., Isakova E.A., Tsapikova Yu.S.
Organization: Saratov State Medical University
Summary:

Objective: to identify patterns of influence of social factors on the psycho-emotional state of the elderly and senile age. Material and Methods. A survey of 385 patients (average age-78.5±0.5 years). The following research methods were used: sociological (questionnaires composed of questions relating to the psycho-emotional state from the social block of the WHO quality of life questionnaire), statistical (Chi-square and the coefficient of mutual conjugacy of Chuprov»s qualitative signs using SPSS). Results. In the course of the study it was proved that the psycho-emotional state of the elderly and senile age is influenced by age, marital status, education and the number of children. Life satisfaction among married people was 3.4, widows and widowers 3.3, divorced 2.9 points. The strongest relationship between the level of education and satisfaction of respondents with their ability to make decisions and satisfaction with themselves as a person was revealed in persons with full secondary education (3.6 and 3.2 points, respectively), the lowest — in persons with secondary special (2.9 points) and incomplete secondary education (2.6 points). Respondents with two children and more (1.8 points) who are married (2.0 points) feel less lonely. In general, there is a reassessment of the individual, social status has a huge impact on the well-being and lives of people. They begin to perceive everything that is happening around them more sharply. All this together affects the objective component of life. Conclusion. The regularities of the influence of social factors on the psycho-emotional state of the elderly and senile age. Satisfaction with life in old and old age depends on marital status, education and number of children, which is connected with the opportunity to receive help and help others, and, accordingly, a higher appreciation of oneself as a person.

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The role of doctors in the formation of preventive compliance in patients of cardiological profile

Year: 2019, volume 15 Issue: №3 Pages: 669-674
Heading: Health Service Organization Article type: Original article
Authors: Gruzdeva А.А., Ilyin M.V.
Organization: Kostroma District № 1 Hospital, Yaroslavl State Medical University
Summary:

The purpose of the study is to analyze the compliance of cardiological patients to participate in the prevention of coronary risk and the role of doctors in the compliance formation. Material and Methods. The base of the study was the outpatient medical organizations of the Kostroma region. The study design included a systematic coronary risk assessment using the SCORE European scale; randomization of patients into groups according to the risk degree; assessment of prophylactic patient compliance; analysis of patient compliance; assessment of patient potential; assessment of the relationship between the level of prophylactic compliance of patients with the level of coronary risk; assessment of the quality of compliance prevention by primary care physicians. Scope of the study: 400 patients with cardiac profile, 200 cases of dynamic observation of patients with high and very high levels of coronary risk. Results. We found that 32.4% of patients had a high level of compliance; 64.5% of patients had an average level of prophylactic compliance and 3.1 % of patients had a low level (p<0,05). We discovered the main parameters of reducing of prophylactic compliance of patients, determining factors, as well as the parameters for reducing the quality of compliant prophylaxis in the primary health care system. Conclusion. The obtained data became the theoretical basis for the development of the technology for coronary risk compliance prevention including 7 stages and 3 levels.

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Possibilities of radiological methods in the diagnosis of bilateral uroepithelial cancer (clinical case)

Year: 2019, volume 15 Issue: №3 Pages: 666-668
Heading: Urology Article type: Case report
Authors: Chekhonatskaya M.L., Rossolovsky A.N., Kryuchkov I.A., Kondratyeva O.A., Bobylev D.A., Klimashin D.F., Kondratyeva D.A., Zuev V.V., Gladkov V.A.
Organization: Saratov State Medical University
Summary:

The article presents data on the development of urothelial cancer and methods of its diagnosis. A clinical case of diagnosis of bilateral uroepithelial cancer in a patient by magnetic resonance imaging is described.

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Magnetic resonance imaging in the diagnosis of bladder cancer (review)

Year: 2019, volume 15 Issue: №3 Pages: 662-666
Heading: Urology Article type: Review
Authors: Bobylev D.A., Chekhonatskaya M.L., Rossolovsky A.N., Ponukalin A.N., Kryuchkov I.A., Kondratieva O.A., Zakharova N.B., Abramova A.P., Popkov V.M.
Organization: Saratov State Medical University
Summary:

The current review represents possibilities of magnetic-resonance imaging in bladder cancer diagnostics. The most important indicator that determines the bladder cancer prognosis and surgical treatment tactics is the muscle wall invasion. Dynamic-contrast-enhanced magnetic resonance imaging and diffusion-weighted magnetic resonance imaging can determine the depth of invasion, although although both are susceptible to over-staging. Magnetic resonance imaging and computed tomography have approximately the same accuracy in determining perivesical invasion as well as in relation to metastatic lymph nodes less than 8 mm in diameter. A promising new technique is the ultra-small paramagnetic iron oxide particles-enhanced magnetic resonance imaging.

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The history of epidural anesthesia (review)

Year: 2019, volume 15 Issue: №3 Pages: 657-661
Heading: Anaesthesiology and Reanimatology Article type: Review
Authors: Prigorodov M.V.
Organization: Saratov State Medical University
Summary:

The method of a long-term epidural anesthesia has been significantly improved and acquired the status of a well-developed and widely used clinical manipulation. Epidural anesthesia is a type of local anesthesia. Until now, there is no single definition of «epidural anesthesia» (or «epidural blockade»). The review is devoted to the history of the formation of epidural anesthesia and substantiation of the term «epidural anesthesia».

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Determination of anterior cruciate ligament attachment with radiographic quadrant method to analyze complications following anterior cruciate ligament reconstruction

Year: 2019, volume 15 Issue: №3 Pages: 653-656
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Sadykov R.Sh., Bogatov M.B.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

Objective: to demonstrate the potential of radiographic quadrant method for defining the correspondence of the administered femoral tunnel to the anatomical anterior cruciate ligament attachment. Material and Methods. We have surveyed 18 patients aged 23 to 36 yo. (mean age 26±2 yo.) who had underwent ACL arthroscopic transtibial plastic reconstruction in 2012-2014, and had post- surgical ACL graft rapture or knee joint instability. All patients had their knee joints X-raid in standard projections. Bernard and Hertel radiographic quadrant method was employed to take lateral view pictures for defining the accuracy of the administered femoral tunnel. Results. In all cases the sites of the administered femoral tunnels did not match ACL anatomic attachments, defined with Bernard and Hertel grid. Conclusion. Radiographic quadrant method of defining ACL anatomic attachments can be used for post-surgery complications analysis.

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PRP-therapy efficiency analysis for various shoulder tendinopathies

Year: 2019, volume 15 Issue: №3 Pages: 648-653
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Norkin A.I., Malanin D.A., Tregubov A.S., Demeshchenko M.V., Cherezov L.L., Shormanov A.M., Emkuzhev O.L., Anisimova E.A.
Organization: Saratov State Medical University, Volgograd Medical Scientific Center, Volgograd State Medical University
Summary:

Objective: to perform comparative analysis of PRP-therapy efficiency in patients with various shoulder tendinopathies. Material and Methods. 122 patients with rotator cuff tendinopathies (66%), subacromial impingements and rotator cuff tendinopathies (16%), CLB tendon tendinopathies (18%) participated in the research. The diagnostic scales for estimation of pain syndrome and shoulder joint function, as well as ultrasound and MRT examinations were employed to assess the outcomes in 1 and 6 months after PRP-therapy. Results. Patients of all groups had significant improvements by scales compared to their condition at the beginning of PRP-therapy. The positive response obtained in one month after the treatment still subsisted in 6 months. The most impressive responses to treatment were observed in patients with rotator cuff and CLB tendinopathies (strong middle effect 0.8-0.88). The patients of these groups self-estimated their outcomes relatively high. The scores defining outcomes were somewhat lower in the group of patients with both rotator cuff tendinopathies and subacromial impingements. Both MRT and ultrasound examinations revealed improvements in shoulder joint structures: edema reduction and dissipation, hypoechoic signal areas. Conclusion. PRP-therapy at shoulder tendinopathies may be referred to safe effective biological methods of treatment.

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Surgical correction of the first ray deformity using osteotomy biomechanical modeling

Summary:

Objective: to enhance the outcomes of the first ray surgical correction using osteotomy biomechanical modeling of the first metatarsal bone. It allows obtaining quantitative data for the «bone — fixator» system stability as additional criteria for selecting surgery methods and surgery therapeutic approaches. Material and Methods. 97 female patients underwent surgical corrections of static deformities in the anterior parts of the feet. Biomechanical modeling of osteotomies for the first metatarsal bone was used for the main group (50 patients) at the stage of pre-surgery planning. Results. Radiological results showed no significant differences between the groups of patients. The integrated ACFAS index in post- surgery period was statistically significant inpatients of the main group. The detection rate of the restriction of movements, pain syndrome and edema around the first metatarsal bone was higher in the control group. Conclusion. The identified differences in the dynamics of functional and restorative processes proved the efficiency of objective estimation and obtaining stability in «bone — fixator» system. Biomechanical modeling is an efficient tool of the decision making support system for surgical correction of the first ray deformities.

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Comparative analysis of surgical outcomes for patients with femoral ununited midshaft fractures

Year: 2019, volume 15 Issue: №3 Pages: 641-643
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Zuev P.P.
Organization: Saratov State Medical University
Summary:

Objective: to perform comparative analysis of surgical outcomes in patients with types A2 and A3 ununited midshaft fractures of the femurs using Oswestry Disability Index (ODI), standardized assessment system for bone fracture outcomes and their consequences (SOI-1) and modified radiographic assessment of fracture healing (mRUS). Material and Methods. 40 patients with ununited midshaft fractures of the femurs including 22 patients with type A fractures (Group I) and 18 patients with type В fractures (Group II) were surveyed. The average follow-up period was 29.5±19.5 months. Results. In Group I the average ODI score made 47±0.9 and SOI-1 scores made 85±1.8% in 12 months. The mRUS fracture union score corresponded to 13.9±0.6. In Group II the average ODI score made 46.2±0.9 and SOI-181.8±1.7% in 12 months. The mRUS fracture union score corresponded to 13.7±0.6. Conclusion. The injured limbs functionality recovered sooner in patients of Group I (type A3 fractures) specifically in 6 months of a surgery proven by the absence of statistical differences in the results of estimation with ODI questionnaire and SOI-1 system observed in 12 months owing to the nature of fractures rather than the degree of their unions or the methods of surgical invasion applied.

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