Saratov JOURNAL of Medical and Scientific Research

2014, volume 10

New opportunities in the conservative therapy of hemangiomas in children

Year: 2014, volume 10 Issue: №2 Pages: 332-335
Heading: Proceedings of all-Russia week of science with international participants Article type: Short message
Authors: Popova O.A., Uvarov D.N., Spivakovskiy Yu.M.
Organization: Saratov State Medical University
Summary:

Hemangiomas are the most common tumors of skin and soft tissues in children. In recent years, the number of patients suffering hemangiomas becomes increasing. Aim: to evaluate the efficacy of non-selective (3-blockers in treatment of hemangiomas in infants with short duration of the disease. Materials and methods. Propranolol, a non-selective (3-blocker, was chosen as a medication. Observed group was composed of 5 infants aged 1 year. Starting dosage of propranolol was 2-4 mg, with hemodynamic parameters being controlled before and after the drug administration. Target dosage was 2.0-2.5 mg/kg. Results. All children had a distinct clinical improvement after 1 week of propranolol treatment. In 4 infants Doppler mode ultrasound scan of hemangiomas demonstrated the hollowing of a feeding vessel. Resistance index was reduced in 4 infants. Shrinking of hemangiomas was stated in 2 infants during ultrasound scanning. All infants continue to be observed by surgeons and pediatricians. The drug is well-tolerated. Adverse effects during the treatment with propranolol have not be noticed, both during the in-patient and out-patient phase. Conclusion. Using propranolol as the first-line drug opens new possibilities in the conservative therapy of hemangiomas when surgical intervention is not possible.

Keywords: children, hemangioma, propranolol

Prognosis of prostate gland morphology study using artificial neural network

Year: 2014, volume 10 Issue: №2 Pages: 328-332
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Popkov V.M., Shatylko T.V., Fomkin R.N.
Organization: Saratov State Medical University
Summary:

The research goal is to optimize the management of patients with serum PSA level falling in the range of 4-10 ng/ ml by designing and educating of an artificial neural network, which may be used to predict prostate gland morphology basing on clinical, laboratory and imaging data. Material and methods. Data of 254 patients, who were admitted to the oncological Department of S. R. Mirotvortsev Clinical hospital for transrectal prostate biopsy, was collected to construct several artificial neural networks with different architecture. External validation was performed on 27 patients, who had prostate biopsy in January-February 2014. Results. One-layer network, consisting of 11 input, 9 hidden and 3 output neurons, was determined to be the most successful: in 92.6% cases it was correct in predicting prostate cancer or its absence. Input factors were evaluated according to their relative importance, from more important to less important: prostate volume, serum PSA, patient's age, prostate consistency, PSA velocity, prostate symmetry, previous negative biopsy, free serum PSA, intake of 5-alpha-reductase inhibitors. Conclusion. Artificial neural networks may be used to predict morphological findings in prostate biopsy. High PSA density and firm prostate consistency should cause suspicion of prostate cancer.

Keywords: artificial neural networks, prostate cancer, PSA

Controlled physical activity for functional operability determination

Year: 2014, volume 10 Issue: №2 Pages: 324-328
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Luchenkov А.А., Prigorodov M.V.
Organization: Saratov State Medical University
Summary:

The aim: to use veloergometry test at patients of high anaeshtesiology-operative risk before traumatic operations for functional operability determination. Material and methods: Randomized prospective research with the double "blind" control has been performed at 95 patients of high risk (ASA>III), undergoing long and traumatic operations on thoracic and abdominal organs. Patients have divided into groups without complications and with complications (51 and 44 patients) which one day prior to operation have spent veloergometry test (VEMT). Average dynamic pressure (ADP), the general peripheral resistance of vessels (GPRV), a core index (Cl); arterio-venous (a-v) difference on oxygen, oxygen delivery to tissues, consumption of oxygen and coefficients extraction oxygen in tissues; energy consumption have been investigated. Statistics has been done by nonparametric methods. Results. In response to veloergometry test in both groups growth of Cl at the expense of a tachycardia and GPRV fall which in complication group remains above norm is noted. In group without complications coefficients extraction oxygen in tissues were normalised, a-v difference on 02 became above norm, in other group — coefficients extraction oxygen in tissues and a-v difference on 02 began to exceed norm, and oxygen consumption has grown almost in 2 times. After VEMT a-v a difference on О and oxygen consumption were essentially above in group with complications. Under the influence of VEMT markecT stabilization of function of vegetative nervous systems (VNS). The number of complications made 39: intraoperation cardiovascular — 23, postoperative respiratory — 16. Clinically important connection (p=0,069) of perioperative complications with growth a-v differences on oxygen and a power interchanging have been received. Conclusion. Thus, the oxygen-energy exchange and the vegetative status can be referred to clinical functional operability determination.

Keywords: functional operability, oxygen-energy exchange, perioperative complications, veloergometry test

Internet technologies in the provision of pharmaceutical care

Year: 2014, volume 10 Issue: №2 Pages: 322-326
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Lobova E.D., Smolina V.A.
Organization: Saratov State Medical University
Summary:

Purpose: to study the use of Internet technologies in the provision of pharmaceutical care to the population and pharmacists' attitude to this problem. Material and Methods. Various interpretations of the term «Internet pharmacy» in the literature and regulations were studied by the method of content analysis, pharmacists' attitude to the online pharmacies was revealed by conducting surveys in Saratov and the Saratov region. Results. Current legislation restricts the remote drug sale, thus functioning of full-scale Internet pharmacies in the Russian Federation is not possible. Most pharmacists are not aware of the legitimacy of online pharmacies, legality of home and work delivery of drugs, purchased in the online pharmacy, and are not familiar with the existing documents regulating the activities of online pharmacies. Conclusion. The current situation with online pharmacies working in the Russian Federation produces difficulties in the control of online pharmacy activity and involves significant risks for consumers.

Keywords: Internet technology, online pharmacy, pharmaceutical care

Choice of the method of teleroentgenogram analysis in treatment of different sagittal occlusion anomalies

Year: 2014, volume 10 Issue: №2 Pages: 320-322
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Gogoleva A.V., Kochetova M.S.
Organization: Saratov State Medical University
Summary:

Aim. The optimization of orthodontic treatment planning of patients through the study of different methods for calculating the teleroentgenogram (TRG). Material and Methods. The analysis was conducted in patients' teleroentgenogram with various dentoalveolar anomalies. Materials were taken from the archives of the clinic of pediatric dentistry and orthodontics. TRG calculation was made by the method of Schwarz, the method of Downes and the method of Tweed. Results. The research identified the types of profiles of patients. Each author had his own idea about «ideal face» and ways to achieve a harmonious profile. It is not enough one method to analyze TWG for planning orthodontic treatment because it does not give a complete clinical picture. Conclusion. It is necessary to find a comprehensive research method TRG which will combine the advantages of the proven methods.

Keywords: teleroentgenography, orthodontics

Symptomatic epilepsy in children

Year: 2014, volume 10 Issue: №2 Pages: 318-319
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Еlaginykh E.S.
Organization: Saratov State Medical University
Summary:

Research goals were to evaluate the etiological structure of symptomatic epilepsy in children, age structure of period of disease manifestation, average length of latent period among children with different characters of lesions, dependence between frequency of seizures and character of lesion. Material and methods. A total of 180 case-records of patients with symptomatic epilepsy were analyzed by the next criteria: anamnesis, materials of electroencephalogram and neurovisualization. Results. The hypoxic-ischemic encephalopathy was dominated among other etiologies. The most frequent age of manifestation was period from 1 to 14 years of life. The most frequent localization of epileptic focus was determined in the temporal and frontal lobes of brain. The longest latent period was in case of brain injury, the shortest period was in case of neuroinfection and the result of prenatal infections. Conclusion. The research shows that symptomatic epilepsy in children is a multi-factorial disease, which character and manifestation in greater extent depends on the initial damage as a cause of this pathology.

Keywords: age of manifestation, hypoxic-ischemic encephalopathy, latent period, symptomatic epilepsy

Remote monitoring in patients with spondylitis

Year: 2014, volume 10 Issue: №2 Pages: 314-317
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Akulova A.l., Gaydukova I.Z.
Organization: Saratov State Medical University
Summary:

Objective: to evaluate the adherence to therapy and treatment outcomes in patients with spondylitis (SpA) in which activity of the disease managed remotely. Material and Methods. 193 patients with axial SpA were randomized into 3 groups with the different ways of the disease activity monitoring: 96 patients were managed in free way, 26 patients visited rheumatologist every 12 weeks, 69 patients managed remotely — we called them every 4 weeks. After the first year of follow up we made 3-month break in the telephone monitoring. The data on the treatment and SpA activity (indexes BASDAI, PASS, ESR, CRP) were collected. Results. In patients managed in a free way SpA activity was severe after a year. In groups managed remotely and once in 3 month the significant reduction in the disease activity was achieved with maximal decrease in remote monitoring group. Positive PASS group 3 was found in 15 patients (57.69%, n=26), in group 2 — in 4 patients (20%, n=20), in group 1 — no patients (0%). NSAIDs intake was arbitrarily changed by 5 (19.23%, n=26), 15(75%, n=20), and 93(96.87%, n=96) patients of groups 3, 2 and 1, respectively. After a 3- month break in remote monitoring in 13 patients with initial BASDAI>4 disease activity significantly increased, in 33 patients with BASDAK4 disease activity decreased. 17 (51.5%) patients independently changed the drug intake regimen after the break in monitoring. Conclusion. Remote monitoring is associated with better adherence to therapy and the best results of treatment of patients with SpA than the other modes of observation. Remote monitoring frequency must be determined individually.

Keywords: ankylosing spondylitis, Bechterev's disease, remote monitoring, spondylitis, the activity monitoring

Personal characteristics of students entering higher medical school

Year: 2014, volume 10 Issue: №2 Pages: 311-314
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Akimova O.V., Shchibrya A.V., Aranovich I.U.
Organization: Saratov State Medical University
Summary:

The article presents the structure of personal features of students decided to devote their life to medical profession, their personal readiness for a profession of a doctor. 241 students going to enter the Saratov Medical University in 2013 serve as an object of research. Methods of research included psychology tests on a self-assessment of a mental state, ability to empathy, a motivation orientation. Result. It was revealed that the majority of respondents low level of uneasiness, low level of frustration, the average level of aggression, the average level of a rigidity, and also high rates on an empathy scale. The types of the personality in relation to work are emotive and intuitive. Prevalence of motive of achievement of success or motive of avoiding of failures directly depends on specifics of a situation. Conclusion. Students possess qualities which are necessary in professional activity for doctors, namely high resistance to stress, absence of fear before difficulties, low level of rigidity, high level of empathy, the average level of aggression. Students are motivated on success, in situations when they are fully confident.

Keywords: empathy, personality, professional competence

Analysis of the results of multifocal electroretinogram and optical coherence tomography in diagnosis and monitoring of patients with age-related macular degeneration

Year: 2014, volume 10 Issue: №2 Pages: 308-313
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Ait Ahmed Кh., Kamenskikh T.G.
Organization: Saratov State Medical University
Summary:

Purpose: to study the correlation between the results of the macular area responses by multifocal-electroretinog-raphy (mf-ERG) and the retina thickness obtained by the spectralis optical coherence tomography (ОСТ) in patients with age-related macular degeneration (AMD). Material and methods. 28 patients (32 eyes) where enrolled in the main group. The control group was up to 10 patients without any AMD's pathological sign in retina. All patients were examined by the optical coherence tomography (ОСТ) and multifocal electroretinography (mf-ERG). Results. The data showed a high level of negative correlation between the retinal thickness and electrical amplitudes of the fovea. With the group of "dry" AMD the rise of the macular thickness (drusen) not over 290 urn showed a moderate reduction of the amplitude on mf-ERG The group with "wet" AMD showed that a higher rise of the retinal thickness (edema, fibrosis) of the macular zone negatively influences the bio-electrical activity of this area and this fact was confirmed by a considerable decline of the amplitude on the mf-ERG. Conclusion. The AMD's pathological changes that have been observed by ОСТ are objectively confirmed by mf-ERG. The mf-ERG in supplement of ОСТ can be used as an important element in the complex studies and objectively monitoring of patients with AMD.

Keywords: age-related macular degeneration, multifocal electroretinogram (mfERG), optical coherent tomography

Evaluation of severity and prognosis of the disease course in ulcerative gastroduodenal bleeding

Year: 2014, volume 10 Issue: №2 Pages: 301-307
Heading: Surgery Article type: Review
Authors: Potakhin S.N., Shapkin Yu.G., Chalyk Yu.V., Zevyakina V.A.
Organization: Saratov Clinical Hospital № 8, Saratov State Medical University
Summary:

The systems of evaluation for severity and prognosis of the disease course constitute an important resource for the improvement of treatment parameters in patients with gastroduodenal bleeding. Although in practice more common methods with limited accuracy and high percentage of subjectivity are often used. The work shows the analysis of the situation and possible ways of resolution.

Keywords: evaluation of the disease severity, prognosis of the disease course, recurrent bleeding, ulcerative gastroduodenal bleeding