Saratov JOURNAL of Medical and Scientific Research

Voronezh State Medical University n.a. N.N. Burdenko

Balloon pulmonary angioplasty — an efective method of treatment for patients with pulmonary arterial hypertension

Year: 2019, volume 15 Issue: №2 Pages: 222-224
Heading: Cardiology Article type: Case report
Authors: Starodubtseva I.A.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

The article presents the clinical case of patient with chronic thromboembolic pulmonary hypertension. It is describes the classical course of the disease with use of full spectrum of diagnostic procedures. Pulmonary endarterectomy (PEA) is a gold standard of treatment. Nevertheless, performance of PEA is possible in only 60 % of patients with chronic thromboembolic pulmonary hypertension. Balloon pulmonary angioplasty and drug therapy with a stimulator of soluble guanylate cyclase are alternative treatment strategy.

The impact of the competence-based approach to training on the results of intermediate certification of students at the Department of General Hygiene of Voronezh State Medical University

Year: 2019, volume 15 Issue: №1 Pages: 114-119
Heading: Pedagogics and Education Article type: Original article
Authors: Popov V.I., Fertikova Т.Е.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Purpose: analysis of the level of competence formation on the basis of the results of intermediate certification of students at the Department of General Hygiene of Voronezh Medical University. Material and Methods. The article describes the dynamics of the results of intermediate certification of students enrolled in the Department of General Hygiene of Voronezh Medical University, in connection with the implementation of the competence approach. Results. A conclusion about stable results of examinations of students of all faculties for the last years is made. The highest proportion of excellent and good grades was noted among students of the medical faculty. The share of excellent marks received by students of the medical faculty was 17.4-20.7%, by students of the pediatric and medical preventive faculties — 9.6-17.8 and 1.9-17.1%, respectively. The proportion of satisfactory marks among students of the medical faculty — 31.2-37.2%. Most of all the proportion of satisfactory assessments among students of the medical preventive faculty — 51.2-69.7%. The directions of activity of the teaching staff of the department have been proposed, they will allow to increase the level of development of competencies, especially professional ones. These include the widespread use of innovative educational technologies, such as problem- oriented and design-organized learning technologies. Examples of new approaches to teaching in a

AttachmentSize
2019_1_114-119.pdf271.95 KB

The use of original device for positioning tools during the installation of femoral component of hip joint

Year: 2019, volume 15 Issue: №1 Pages: 57-61
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Varfolomeev D.l., Samoday V.G.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Objective: to assess the accuracy of the femoral neck resection using the developed "Device for positioning tools for the installation of the femoral component of the hip prosthesis". Material and Methods. On the basis of the Department of traumatology and orthopedics of Voronezh state medical University n.a. N.N. Burdenko conducted experimental studies on 40 models of plastic bones. In the comparison group resection was performed using the proposed device, in the control group — using a standard guide. Results. Experimental studies have demonstrated higher accuracy of femoral neck osteotomy in the comparison group. The average value of the neck filing angle in the frontal plane in the comparison group was 3.2° higher than in the control group (p<0.05), and in the sagittal difference was 3.1°. The average distance from the line of the osteotomy to the apex of the greater trochanter in both groups was not significantly different (p=0.62). Conclusion. The use of the developed device allows to perform osteotomy of the femoral neck with high accuracy, as well as to control the position of the leg endoprosthesis, which helps to reduce the number of complications and improve the quality of life of patients.

On the clinical picture and diagnosis of rare neurological diseases

Year: 2018, volume 14 Issue: №1 Pages: 174-177
Heading: Neurology Article type: Case report
Authors: Ulyanova O.V., Kutashov V.A., Brezhneva N.V.
Organization: Regional Children's Clinical Hospital No. 1 (Voronezh), Voronezh State Medical University n.a. N.N. Burdenko
Summary:

 The article presents clinical observation of patient H, 2007 year of birth., with X-linked adrenoleukodystrophy (X-ALD). This is a rare hereditary metabolic disease, not only in Russia but also worldwide. It belongs to the group of peroxisomal diseases, is associated with the accumulation of fatty acids with a very long chain and is characterized by a combined lesion of the nervous system and adrenal glands. X-ALD in neurology and Pediatrics require a targeted individual approach to each patient, genetic tests in relatives and prenatal diagnosis among patients at risk.

AttachmentSize
2018_01-1_174-177.pdf256.65 KB

Features of the medical and social characteristics and anxiodepressive disorders in patients with little brain insult in the early recovery period

Year: 2018, volume 14 Issue: №1 Pages: 141-144
Heading: Neurology Article type: Original article
Authors: Kutashov V.A., Ulyanova O.V., Zakharov O.P.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

The aim of the study was to study medical and social and anxiodepressive disorders (ADR) in patients with little brain insult (LBI) in the early recovery period. Materials and Methods. 140 patients were examined, the mean age of which was 57.2±2.2 years. The patients were examined in the early recovery period. Among the 140 patients with LBI, 62% were men and 38% women. The level of anxiety and depression was assessed using the Hamilton psychometric scales (HPMS). Results. In 6% of patients there are relatives who have undergone an acute cerebrovascular acident. 50% of patients live with their families, 27.2% lived with relatives and 22.8% lived alone. Only 25.5% of patients had a daily monitor blood pressure (BP), 17.8% of patients — several times a week and 17.8% of people — several times a month. In addition, 16.4% of patients are forced to measure BP in the health facility, since they do not have a personal tonometer. 26.4% of patients did not measure their BP. 16.4% measure blood pressure once a year. A high level of depression occurred in 3.57% of patients, an average level in 27.86% of patients, mild depression in 33.57% of patients and absence of depressive symptoms in 35% of patients. A high level of anxiety was found in 17.50% of patients with Ml, moderate anxiety level in47.86% of patients, low anxiety level in 45.00%, no anxiety in 1.43% of patients. Conclusion. In patients with LBI in the early recovery period a rather high level of ADR severity was revealed. That causes as early as possible the identification and administration of specific therapy for ADR with LBI.

AttachmentSize
2018_01-1_141-144.pdf249.01 KB

Cardioembolic stroke: risk factors, forecast, secondary prevention

Year: 2017, volume 13 Issue: №1 Pages: 187-192
Heading: Neurology Article type: Original article
Authors: Khakhanova O.N., Skorokhodov А.Р., Kutashov V.A., Ulyanova O.V.
Organization: Voronezh Emergency City Hospital №1, Voronezh State Medical University n.a. N.N. Burdenko
Summary:

The goal of the study is to evaluate the effectiveness of warfarin and the new direct anticoagulants (xarelto and pradaxa) in the secondary prevention of re-occurrence of cardioembolic stroke (CES). Material and methods. Inclusion criteria of patients in the study: migrated CES, confirmed the presence of a pathology of heart; reception of indirect anticoagulant (warfarin) or direct inhibitors of factor Xa (xarelto, pradaxa) to prevent re-CES. Exclusion criteria from the study: patients with other subtypes of ischemic stroke (IS), hemorrhagic stroke (HS), patients receiving aspirin, diseased patients with CES. The severity of neurological deficit was assessed according to the NIHSS, Rivermead, Rankine and Barthel scales. Results. By the end of the second year of monitoring after suffering CES number of patients with full recovery a self-service increased by 3% and decreased by the same number of patients with moderate and severe dependence on assistance in everyday life. More efficient and faster neurological function was restored in patients taking warfarin is worse in the group of patients receiving pradaxa. However, a second stroke in the first year after suffering several CES were more frequent in the group of patients receiving pradaxa, and usually fatal. Conclusion. Change of medications in the group of patients receiving xarelto and warfarin, other anticoagulants have not led to the emergence of recurrent stroke.

AttachmentSize
2017_01-1_187-192.pdf258.11 KB

Revisiting of etiology, clinical picture and diagnosis of the Kleine-Levin syndrome.

Year: 2017, volume 13 Issue: №1 Pages: 181-187
Heading: Neurology Article type: Case report
Authors: Ulyanova О.V., Kutashov V.A.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Objective: to draw the attention to the Kleine - Levin syndrome (SKL), a rare, poorly understood disease, not only in Russia but throughout the world. We analyzed the case of the 23-year old patient M, with the Kleine — Levin syndrome. SKL belongs to the group of recurrent hypersomnia and is characterized by long bouts of sleep lasting an average of 10-14 days, beginning with the imperative and difficulty awakening. During bouts of sleep observed unusual behavior of patients: hyperphagia; hypersexuality in males; irritability, restlessness, impaired mental activity; aggression; feeling of unreality of it all; confusion, hallucinatory episodes and depression in females. During wakefulness, marked dyspho-ria, emotional stupefaction, loss of memory. The syndrome develops in 4 times more often in men than in women, aged 12-25 years. Etiological factors: brain tumor, head trauma, metabolic disorders, acute infectious diseases with fever. Often the development of the syndrome is preceded by hyperemia and hypothalamic-pituitary dysfunction. The article discussed the etiology, diagnosis, and possible combinations of clinical manifestations in SKL.

AttachmentSize
2017_01-1_181-187.pdf276.47 KB

Applying of classification and predictive modeling to predict individual risk factors for depressive disorders

Year: 2017, volume 13 Issue: №1 Pages: 168-174
Heading: Neurology Article type: Original article
Authors: Samsonov A.S., Kutashov V.A.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Purpose: the formation of mathematical models and algorithms for predicting the development of depressive disorders in patients based on their individual medical and social characteristics. Material and methods. The substantiation of the urgency of the problem is given. The methods and the course of the research are described. Results and conclusions. On the basis of the data obtained, a set of the most significant medical and social characteristics of patients was formed, an integral indicator for assessing the degree of risk of depressive disorders was developed, a computer program was created to predict the probability of development of affective pathology. Appropriate conclusions had been made.

AttachmentSize
2017_01-1_168-174_1.pdf400.02 KB

Neurological presentations of a secondary antiphospholipid syndrome

Year: 2017, volume 13 Issue: №1 Pages: 139-143
Heading: Neurology Article type: Case report
Authors: Yesaulenko I.E., Kutashov V.A., Ulyanova O.V.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

The aim of the study is to turn the attention of specialists to antiphospholipid syndrome (APS), which is of interest to physicians of many specialties. The observation of the patient W., 32 years, with secondary APS was analyzed. Poor prognostic factors in CFA are the high frequency of thrombotic complications and thrombocytopenia, and laboratory markers — the presence of lupus anticoagulant. All patients with APS should be under medical supervision, whose main task is to assess the risk of recurrence of venous or arterial thrombosis and its prevention.

AttachmentSize
2017_01-1_139-143.pdf243.92 KB

The issue of neuropsychiatric disorders in patients with hypothyroidism

Year: 2016, volume 12 Issue: №3 Pages: 375-378
Heading: Neurology Article type: Original article
Authors: Kutashov V.A., Budnevsky A.V., Ulyanova O.V., Priputnevich D.N.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

The aim of the study was assessment of thyroid function in patients with psychiatric and psychological assistance; to study the structure of AR in patients with hypothyroidism, to reveal alexithymical identifying of personality characteristics of patients with hypothyroidism and AP Materials and Methods. 406 patients with AR at the age of 51.3±4.7 years. To verify the useofTSH hypothyroidism rate and to assess depressive disorder — Hamilton Scale and the Montgomery— Asberg; with clinical and psychopathological study: 1) the scale of self-BH alarm Spielberger (Y. L. Hanin), 2) questionnaire G. Shmisheka 3) Toronto alexithymia scale. Results. Hypothyroidism is set at 116 (28.6%) of 406 patients suffering from RA. Among the 374 patients with depressive disorders hypothyroidism was observed in 116: subclinical — in 76 patients (65.5%), symptomatic — in 40 (34.5%). The first group consisted of 258 patients with the presence of depressive disorders and without hypothyroidism; second — 116 patients with the presence of depression and hypothyroidism. TSH in patients suffering AR, without thyroid dysfunction was 5.2 times lower than in patients with the presence of hypothyroidism. Among AP comorbid with hypothyroidism, are predominant depressive with a predominance of mild and moderate forms. Dominating are anxious-depressive, dysphoric, adynamic, sad, depressive disorders. Conclusion. In patients with AR and hypothyroidism predominant types of personality accentuation are dysthymic, anxious, demonstrative and meticulous.

AttachmentSize
2016_03_375-378.pdf261.66 KB