Saratov JOURNAL of Medical and Scientific Research

Original article

Carotid arteries ultrasound screening in asymptomatic patients

Year: 2019, volume 15 Issue: №1 Pages: 190-199
Heading: Neurology Article type: Original article
Authors: Shchanitsyn I.N., Shvarts E.Yu., Ishmukhametova R.A., Vozdeeva A.S.
Organization: Saratov State Medical University
Summary:

Objective: to reveal the most important predictors of carotid artery stenosis in ambulatory patients of Saratov and Saratov Region with the help of multivariate analysis and to define an ideal patient for ultrasound screening. Material and Methods. In 2014-2018 off-site consultations and ultrasound screening were performed for asymptomatic patients with suspected carotid artery disease in outpatient clinics of Saratov and Saratov Region. Those patients were referred for screening by neurologists and general practitioners. The study used 470 medical charts. The multivariate regression analysis was performed to identify independent predictors of carotid artery stenosis (>50%). Results. The >30% carotid artery stenosis was detected in 24.5% (115/470) of participants, >50% stenosis — in 10.2% (48/470) of participants, >70% stenosis — in 2.9% (14/470) of participants. The multivariate analysis revealed that the odds of finding >50% stenosis in patients chosen by neurologists and general physicians for screening was significantly higher in the presence of following factors: age older then 72, male sex, acute cerebrovascular event more than 6 months ago, atherosclerosis in arteries of lower extremities, episodes of speech disorder. The point scale for risk assessment has been created. In the absence of prognostic factors the absolute risk of >50% stenosis was only 3%. In the presence of 1 point it was 16% and more than 50% in the presence of 4 points. Conclusion. The analysis we conducted allowed to specify major predictors of atherosclerosis in patients followed in outpatient clinics of Saratov and Saratov Region and to create the patient model which allows to optimize selection for ultrasound screening.

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Specific features of rehabilitation potential in adult patients with cerebral palsy

Year: 2019, volume 15 Issue: №1 Pages: 187-190
Heading: Neurology Article type: Original article
Authors: Shulyndin A.V., Antipenko Е.А.
Organization: Privolzhskiy Research Medical University
Summary:

Objective: to determine the specific features of rehabilitation potential in adult patients with cerebral palsy (CP). Material and Methods. Fifty patients with a confirmed diagnosis of cerebral palsy established in childhood were studied. Level of development of gross motor skills according to GMFCS classification was evaluated in all patients; functions were assessed using the International Classification of Functioning (ICF, version 2.1a, clinical form). Results: In patients with level 2 GMFCS, dysfunctions of muscle tone, muscle strength, implementation and capacity for raising and transferring objects of moderate and severe degree (p<0.05) were more common. The frequency of restricted implementation of precise manual movements is comparable in patients with GMFCS levels 1 and 2 Restricted non- assisted walking was significantly more common in patients with 2nd functional level. The moderately significant positive impact of personal mobility assistive products is more common among level 2 patients, while the importance of communication tools was greater for level 1 GMFCS patients. Conclusion. In adult patients with cerebral palsy it is necessary to assess the rehabilitation potential using ICF. Indicators of activity and participation are of key importance to the rehabilitation potential of adult cerebral palsy patients and should be considered in terms of the possibility of full or partial recovery to a level at which the performance of a certain task will meet the needs of the patient.

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Types of cephalalgia syndrome observed in medical students of Saratov State Medical University

Year: 2019, volume 15 Issue: №1 Pages: 177-179
Heading: Neurology Article type: Original article
Authors: Salina Е.А., Parsamyan R.R., Kuznetsova Е.В., Sholomov I.I., Uzhakhov A.M., Shichanina E.K.
Organization: Saratov State Medical University
Summary:

Purpose: to study the prevalence and clinical features of headache among medical students. Material and Methods. 160 students from the medical faculty on their 3rd and 6th years of education were surveyed. The type of headache was determined according to the International Classification of Headache (version 3, 2018). Neuropsychological status of students with tension headaches was studied with use of Schulte test, digital character substitution test, hospital anxiety and depression scale (HADS), test for determining sleepiness and sleep quality, tests for semantic and phonetic activity and memory. Statistical analysis was performed using MS Excel 2010 Results. The most common type of headache among medical students was primary headache, namely tension headache (78.2%). Migraine without aura (20.5%) and cluster headache (1.3%) were less common. Changes in the neuropsychological status were revealed in students suffering from tension headache. Conclusion. A study conducted among medical students showed a high prevalence of primary headache with a predominance of tension headache combined with anxiety and sleep disorders.

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Preliminary results of study on efficacy of a virtual reality technique for restoration of lower extremity motor function in patients in acute stage of stroke

Year: 2019, volume 15 Issue: №1 Pages: 172-176
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Zakharov A.V., Khivintseva E.M., Pyatin V.F., Kolsanov A.V., Chaplygin S.S., Osminina E.A., Lahov A.S.
Organization: Samara State Medical University
Summary:

Objective: to study efficacy of using immersive virtual reality with proprioceptive sensory effects in the rehabilitation of static locomotor function in patients in acute stage of ischemic stroke. Material and Methods. The study included 33 patients in the acute stage of ischemic stroke in the carotid system. Patients were randomized into two groups, the main group additionally took exercises in immersive virtual reality with sensory stimulation. The course includes 10 sessions 15 minutes each. The comparison group received standard rehabilitation assistance. Results. According to Berg balance scale an improvement in static locomotor function was noted in the main group on the 6th day of exercises (p=0.03). The differences between both groups on the last day of rehabilitation course showed an

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Autonomic dysfunction in patients with chronic cerebral ischemia

Year: 2019, volume 15 Issue: №1 Pages: 167-172
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Khivintseva E.V., Zakharov A.V., Vasemazova E.N., Ananyeva S.A.
Organization: Samara State Medical University
Summary:

Various autonomic nervous system (ANS) disorders exist in 25-80% of the general population. Seniors affected by chronic cerebral ischemia (CCI) are subject to the development of autonomic disorders. Purpose: to carry out the analysis of autonomic dysfunction in subjects with CCI. Material and Methods. Autonomic status was evaluated using autonomic function tests. All patients underwent cardiointervalography. Heart rhythm variability was estimated by mode, amplitude, variation range, power of waves of various frequency, coefficient of vagosympathetic balance etc. as measured by "Rhythm-MET" system. One hundred fifty one patients aged 48-93 years were examined and distributed to three groups depending on the degree of severity of CCI. Results were statistically processed using Statistica 6 software. Results. Patients with CCI had differences in autonomic function parameters which had multidirectional character and were dependent on sympathetic-parasympathetic balance and CCI stage. The obtained data demonstrate that prevalence of sympathetic influence was observed in 52.8% patients with I grade CCI, in 64.8% patients with II grade CCI and prevalence of parasympathetic

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Issues of epidemiology of epilepsy in the Republic of Bashkortostan

Year: 2019, volume 15 Issue: №1 Pages: 163-166
Heading: Neurology Article type: Original article
Authors: Novikova L.B., Akopyan А.Р., Sharapova K.M.
Organization: Bashkir State Medical University of the Russian Health Care
Summary:

Objective: to analyze the prevalence of epilepsy among adult population and the use of antiepileptic drugs (AED) in the Republic of Bashkortostan (RB) in 2013-2017. Material and Methods. Analysis of prevalence of etiological forms of epilepsy and used AEDs was carried out by analyzing data from annual reports of the neurological service of outpatient and inpatient medical institutions in cities and regions of the Republic of Bashkortostan, data of clinical examination of patients with a reliable diagnosis of epilepsy, as well as data from the Medical Information and Analytical Center (MIAC). Results. The prevalence of epilepsy in the Republic of Bashkortostan for the study period was 291.7- 325.8 case per 100 thousand population, which were most often recorded in central and eastern regions of the republic. The average age of patients ranged from 30.5±1.3to 41.8±0.2year. The ratio of men to women was approximately similar: 1.1:1.0. Cases of symptomatic epilepsy ranged from 82.6 to 46.5%. Among AEDs, carbamazepine was mainly used with a frequency of up to 47.4% and valproic acid with a frequency up to 32.9%. New generation drugs (parampanel) were rarely used (2.4%). Conclusion. The study of clinical and epidemiological characteristics of epilepsy is important for systemic organization of specific therapeutic and diagnostic measures and the creation of a specialized service to improve the quality of life of patients with epilepsy.

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Distinguishing features of the range of serum antibodies to nervous tissue antigens in Parkinson's disease

Year: 2019, volume 15 Issue: №1 Pages: 151-154
Heading: Neurology Article type: Original article
Authors: Goncharova Z.A., Kolmakova T.S., Oksenjuk O.S., Morgul E.V., Gelpey M.A., Vlasova N.D., Kalmykova Yu.A.
Organization:
Summary:

The goal of this study was to perform a multivariable analysis of immunobiochemical parameters which reflect the state of nervous system microstructure in Parkinson's disease (PD). Materials and Methods. The study included 54 patients of the main group with a diagnosis of PD and 6 patients of the control group. The immunoreactivity profiles of natural regulatory auto-AB in serum were determined by ELISA using the ELI-P-Complex assay. The following parameters were assessed: ABto NF-200, GFAP, S100 proteins, MBP, beta-endorphin, voltage dependent Ca2+channel, H-cholinergic receptors, glutamate, dopamine, serotonin, opiate, GABA receptors. Results. The study revealed significant abnormalities in auto-AB profiles of the examined patients. Conclusion. The findings on the difference in range of auto- AB dependent on the duration of the disease and the revealed associations with the main characteristics of the disease can be used both for early diagnosis and for predicting the course of PD in the future.

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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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Comparative characteristics of microcirculatory changes in white rats during subcutaneous implantation tests of polycaprolactone scaffolds containing vaterite and hydroxyapatite

Year: 2019, volume 15 Issue: №1 Pages: 98-103
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Ivanov A.N., Kurtukova М.О., Chibrikova Yu.A., Kustodov S.V., Tyapkina D.A., Bugaeva I.O., Norkin IA.
Organization: Saratov State Medical University
Summary:

Objective: comparative evaluation of skin microcirculatory functional changes over the implantation area of polycap-rolactone scaffolds with mineral carriers: vaterite and hydroxyapatite. Material and Methods. The experimental study was performed on 43 rats divided into three groups: two test groups and one negative control group. Polycaprolactone PCL-scaffolds containing ovalbumine and of no biocompatibility were implanted into the rats of negative control group (n=15). The implantation of PCL- scaffolds containing vaterite under their skin was performed on rats of the first test group, and animals of the second test group were implanted with PCL-scaffolds containing hydroxyapatite. The method of laser Doppler flowmetry was used to study the microcirculatory flow. Results. The constant increase in the perfusion index has been observed in the area of non-biocompatibile scaffolds implantation. Thechanges in local skin blood flow modulation have been also detected. The transient character of local microcirculatory responses with total normalization of skin perfusion and its mechanisms has been noticed by the 21st day of the trial following PCL-scaffolds with vaterite and hydroxyapatite implantation. Conclusion. The dynamic monitoring has allowed finding that mineralization of PCL-scaffolds with vaterite as well as hydroxyapatite leads to no prominent changes in skin perfusion at subcutaneous implantation tests on white rats suggesting the biocompatibility of these scaffold types.

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Morphometric parameters of cerebral arteries in the elderly

Year: 2019, volume 15 Issue: №1 Pages: 94-97
Heading: Human anatomy Article type: Original article
Authors: Fomkina О.А., Gladilin Yu.A.
Organization: Saratov State Medical University
Summary:

Objective: to identify the features of morphometric parameters of cerebral arteries in adults aged 55-74 years. Material and Methods. As a material of the study we used samples of anterior (АСА), middle (MCA), posterior cerebral (PCA), posterior connective (PCoA), basilar arteries (BA) and vertebral arteries (VA), seized at autopsy 21 corpses of adults who died in old age. External diameter, wall thickness and length of arteries were studied by morphometry. The lumen diameter was calculated as the difference between the outer diameter and the doubled wall thickness. The material was processed by variational-statistical method. Results. The article presents the average values and parameters of variability of the main morphometric parameters of arteries supplying the brain. The results of the comparative analysis with the average values typical for adults aged 21-90 years are presented. Conclusion. The length, wall thickness, outer diameter and lumen diameter of the cerebral arteries in adults 55-74 years are characterized by significant variability. In the studied age range, АСА and PCA are characterized by the same wall thickness; MCA and VAare the same wall thickness, outer diameter and lumen diameter. The wall thickness of BA and VA in the elderly is 28.1 and 17.9% higher than the average value typical for people 21-90 years.

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