Saratov JOURNAL of Medical and Scientific Research

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

The effect of changes in homeostatic constants of blood parameters in patients with cardioembolic stroke on the clinical course and prognosis of the disease

Year: 2020, volume 16 Issue: №1 Pages: 384-388
Heading: Neurology Article type: Original article
Authors: Khakhanova O.N., Skorokhodov А.Р., Kutashov V.A., Ulyanova O.V.
Organization: Federal State Institution "416 Military Hospital", Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Objective: to assess the effect of changes in homeostatic constants of blood parameters in patients with cardioembolic stroke (CEI) on the clinical course and prognosis of the disease. Material and Methods. 90 patients were treated and examined in the acute period of CEI: 60 patients were discharged (main group) and 30 died (control group). A detailed study was made: general blood count, hemostasis, and biochemical changes in the blood. Neurological deficit was evaluated according to the NIHSS, Rivermead, and Rankin scales. Results. All homeostatic blood constants are higher than normal in patients who died compared to survivors (p <0.05). In patients with mortality on the first day, changes in blood biochemical parameters are more pronounced than in patients who died at a later date. The most pronounced changes in the biochemical analysis of blood (glucose, urea, creatinine, AsAT, AIAT), acid-base imbalance are associated with severe clinical manifestations of CEI and a high probability of death. The diabetes mellitus in patients with CEI is a kind of pathognomonic sign, marker and predictor of adverse outcome. Metabolic acidosis prevailed in the group of deceased patients, and respiratory acidosis prevailed in the group of survivors. Conclusion. Marked changes in homeostatic blood constants and pronounced neurological deficit at the time of the development of the disease are associated with severe clinical manifestations of CEI and a high probability of death.

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Comprehensive correction of cognitive impairment in patients of older age groups with chronic heart failure

Year: 2020, volume 16 Issue: №1 Pages: 367-371
Heading: Neurology Article type: Original article
Authors: Pokachalova M.A., Silyutina M.V., Chernov A.V.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Objective: to identify the features of changes in cognitive functions (CF) and systemic hemodynamic effects in patients of older age groups with chronic heart failure (CHF) in various treatment regimens, including the use of low-intensity laser radiation (LILR) and akatinol memantine. Material and Methods. The study was conducted on the basis of the Cardiology Department of the NKZ DKB with direct consultation of neurologists: 120 patients of both sexes (average age 77.3±2.2 years) with heart failure. LILR was carried out on a Mustang-2000 low-intensity magnetic laser radiation apparatus. The following scales were used to assess CF: Montreal Cognitive Assessment (MoCA); Mini-Mental State Examination (MMSE); Frontal Assessment Batter (FAB). Results. Patients of older age groups with heart failure receiving combination therapy using LILR have an improvement in CF and quality of life, there is a positive trend in intracardiac hemodynamics, characterizing the processes of diastolic function of the left ventricular myocardium, 6 months after the start of treatment. Conclusion. The best recovery of CF occurs with complex therapy using LILR.

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A rare neurological disease leading to cerebrovascular accident

Year: 2020, volume 16 Issue: №1 Pages: 360-363
Heading: Neurology Article type: Case report
Authors: Kutashov V.A., Ulyanova O.V.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Purpose: to develop an algorithm for the clinical diagnosis and treatment of a little-known Moya-Moya disease. This disease is manifested by a transient ischemic attack in childhood and subarachnoid hemorrhage in the young. The analysis of the patient's own clinical observation of N., aged 14, with Moya-Moya disease, is presented. The disease debuted at the age of 9, the clinical manifestation was a transient ischemic attack. On the basis of MRI data, lacunar infarctions in "silent zones" were detected. Conclusion. With the introduction of modern methods of neuroimaging in medical institutions, it became possible to reliably diagnose such a rare neurological pathology as Moya-Moya disease and conduct adequate optimal therapeutic measures.

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Internal quality control of medical care in scientific publications and regulatory legal acts of the Russian Federation (review)

Year: 2019, volume 15 Issue: №4 Pages: 925-930
Heading: public health Article type: Review
Authors: Chubirko M.I., Chubirko Yu.M., Antonenkov Yu.E.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

The review is devoted to the current state of the problem of activity, which is assigned to each medical organization without taking into account the forms of ownership: the organization of internal quality control and safety of medical activity in medical organizations in Russia. The authors analyzed scientific publications, regulatory legal acts and laws on internal quality control and safety of medical activities at present and made recommendations on the issue under consideration.

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Clinical experience of express repair of ceramics in the oral cavity

Year: 2019, volume 15 Issue: №3 Pages: 623-626
Heading: Stomatology Article type: Case report
Authors: Shumilovich B.R., Vorobyeva Yu.B., Rostovtsev V.V., Kryukova S.N., Malykhin D.V., Akhtanin A.A.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Ceramic cleavage on fixed orthopedic structures is a very common complication of occlusive trauma. Attempts intraoral repair of such defects have been undertaken since the 90s of the last century. The existing technique, including the treatment of the prosthesis with hydrofluoric acid and the subsequent application of silanes, quite successfully coped with the task at the boundary of the chip within the ceramics. When chipping to metal, this technique does not provide adhesion of the composite to the metal. The situation has changed dramatically with the appearance unsilane primers containing MDP monomer and providing reliable chemical adhesion of the metal to the composite. As follows from the presented clinical case, even after 1 year after the repair of the ceramic prosthesis, the anatomical, functional and aesthetic characteristics of the dentition are fully preserved.

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Investigation of abnormalities in buccal epithelial cells in patients with lichen planus of the oral mucosa and lips

Year: 2019, volume 15 Issue: №3 Pages: 611-616
Heading: Stomatology Article type: Original article
Authors: Serikova O.V., Kalaev V.N., Vasilyeva A.Yu., Kalaeva E.A., Filippova Z.A.
Organization: Voronezh State Medical University n.a. N.N. Burdenko
Summary:

Objective: to study the incidence of buccal epithelial cells with nuclear abnormalities in women aged 50- 60 years, suffering from lichen planus; identification of the spectrum of nuclear aberrations and analysis of diagnostic information content of the studied indicators in assessing the risk of complications. Material and Methods. The incidence of nuclear aberrations in buccal epithelial cells was studied in 20 women aged 50 to 60, patients with lichen planus. 10 women of the same age group without the disease were selected for the control group. The use of ROC-analysis allowed to determine the most informative cytogenetic criteria, allowing to establish the diagnosis of «lichen planus», calculating their critical values, sensitivity and specificity for their use as diagnostic tests. Results. A change in the number of cells with micronuclei and signs of destruction of the nucleus, and cells with nuclear aberrations in patients in the area of disease was revealed. Indicators of nuclear destruction in cells outside the affected area in the group of patients differed from those in the control sample. Conclusion. The increase in the number of cells with micronuclei in the area of lesion with lichen planus is a sign of genetic instability, which can start the process of their malignancy. Recognition of nuclear aberrations against the background of nuclear destruction makes it possible to diagnose lichen planus. Determination of the frequencies revealed perinuclear vacuoles and karyopyknosis in the affected cells of the oral mucosa and lips may serve as a confirmation of diagnosis.

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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

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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.

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