Saratov JOURNAL of Medical and Scientific Research

Original article

Department of oncology at Razumovsky Saratov Medical University and Kunitsyna Research Society of Oncologists of the Saratov Region: History and Modernity (1968-2019)

Year: 2019, volume 15 Issue: №3 Pages: 721-724
Heading: Scientific schools and memorable dates Article type: Original article
Authors: Vertyankin S.V., Konopatskova О.М., Evdokimov G.M.
Organization: Saratov State Medical University
Summary:

The article is devoted to the activity of SSMU department of oncology and to the history and development stages of research society of oncologists named after T. A. Kunitsyna.

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Dynamics of frequency of alcohol-related fatal automobile trauma in the Saratov region from 2006 till 2017

Year: 2019, volume 15 Issue: №3 Pages: 701-706
Heading: Forensic medicine Article type: Original article
Authors: Savenkova E.N., Efimov А.А., Alekseev Yu.D., Raykova K.A., Avdeeva O.S., Gavrichenko E.P.
Organization: Saratov State Medical University
Summary:

Objective; to analyze of the dynamics of frequency of alcohol-related fatal automobile trauma in the Saratov region over the years 2006-2017. Material and Methods. The study was conducted on the basis of the results of forensic medical examinations of the corpses of persons dead in a car accident in the period from 2006 to 2017 Results. During the study period in the Saratov region slightly decreased the proportion of alcohol intoxication in traffic accidents from 35-40% (2012-2015) to 23.5% (2017). Until 2015, the frequency of alcohol intoxication with trauma in the cabin and pedestrian injury almost did not differ, making up 35-40%. By 2017, the proportion of injured pedestrians with ethanol in the blood more than twice exceeded those affected in the cabin, moreover, the structure of ethanol intoxication in pedestrians is dominated by a concentration of 2.5-3.5%o and more. Along with the decrease in the frequency of ethanol in the blood among drivers (from about 40% in 2012-2015 to 23.5% in 2017), the share of heavy ethanol intoxication decreased, which until 2012 ranged from 33 to 60%, in 2017 it decreased to 25%. The age structure of alcohol-associated automobile trauma has changed: the share of intoxication among persons of 17-30 years has decreased, has increased in age groups of 31-40 years and 41-50 years. Conclusion. During the twelve-year period in the Saratov region in the structure of alcohol- associated automobile trauma there have been positive trends, expressed in a decrease in the proportion of victims in the cabin with the presence of ethanol in the blood, among drivers, and also a decrease in alcohol intoxication among young people. Negative trends should be considered an increase in the proportion of pedestrians with the presence of alcohol in the blood with a predominance of concentration corresponding to a severe degree of ethanol intoxication, increase of the share of ethanol intoxication in older age groups.

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Distinctive features of morphological changes in renal tissue with different models of light desynchronosis

Year: 2019, volume 15 Issue: №3 Pages: 697-700
Heading: Рathophysiology Article type: Original article
Authors: Zlobina O.V., Ivanov A.N., Milashevskaya T.V., Bugaeva I.O.
Organization: Saratov State Medical University
Summary:

Purpose: a comparative analysis of the morphological changes of the kidneys that occur with different models of light desynchronization. Material and Methods. The study was conducted in two stages on 60 white male rats. Model LL 0:24 was studied on the first and second experimental groups, which were in conditions of round-the-clock light exposure for 10 and 21 days. Model LD 18: 6 was studied in the third and fourth experimental groups, which were also in the experimental conditions for 10 and 21 days, respectively. The control group throughout the experiment was in vivo. Results. The recorded decrease in the size of the renal corpus in animals of the third and fourth groups is more persistent and pronounced compared with changes in the first group. The reduction in the area of the vascular glomeru-lus and the expansion of the Shumlyansky — Bowman capsule with round-the-clock illumination are observed only for 21 days, and when studying the 18:6 model, these figures are significantly different from the control values already on the 10th day of the experiment. Also, animals of the third experimental group recorded significant changes in thejuxta-medullary nephrons, which is associated with the activation of collateral blood flow on the 10th day of the experiment. Conclusion. The detected morphological changes indicate a stronger stress effect of the LD 18:6 model, compared with the LL 0:24 model. However, in both experimental groups, the observed changes are ischemic in nature, leading to the development of sclerotic changes, which can adversely affect the work of the kidneys and lead to the development of irreversible changes.

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Topography features of the incisive canal in early adults

Year: 2019, volume 15 Issue: №3 Pages: 690-696
Heading: Human anatomy Article type: Original article
Authors: Kalmin O.V., llyunina 0.0., Zyulkina L.A.
Organization: Penza State University
Summary:

Aim is to study topography of incisive canal depending on sex, parameters of craniofacial complex and dentition. Material and Methods. 174 adult persons of both sexes aged 21-35 years (first adult persons) (80 men and 94 women) were objects of the research. Garson facial index, upper face index and average modulus of maxilla were determined. Number of Stensen foramen and foramen incisivum, their sizes and shape; distances between foramen incisivum and inferior palatal and inferior labial point of maxillary alveolar process; length, shape, type and angle of inclination of incisive canal; bone density around incisive canal were determined on CBCT. Results. Size of nasal and incisivum foramen, length of incisive canal is significantly higher in men, and distances between foramen incisivum and inferior palatal and inferior labial points of alveolar process is significantly higher in women. Dimensions of heart-shaped foramen incisivum prevailed over sizes of droplet-shaped and oval foramen incisivum, and oval-shaped sizes were the smallest. Length of hourglass-shaped incisive canal was 3.4% higher than length of funnel-shaped canal, and 5.6% more than cylindrical shaped ones; length of spindle-shaped incisive canal was 12.7% higher than length of cylindrical canal. Conclusion. Incisive canal has individual variability of sizes, shape and topography depending on its shape and type, gender, cephalotype and average modulus of maxilla were determined.

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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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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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