Saratov JOURNAL of Medical and Scientific Research

2014, volume 10

Rating system — innovative method of evaluation of students academic and practical preparation

Year: 2014, volume 10 Issue: №3 Pages: 471-474
Heading: Pedagogics and Education Article type: Short message
Authors: Chernenkov Yu.V., Gumenyuk 0.I.
Organization: Saratov State Medical University
Summary:

The rating evaluation is a type of quantitative and qualitative monitoring of students' academic and practical activities. In this article the authors demonstrate the experience of the use of rating system in the assessment of academic and practical preparation of students in the Russian higher schools.

Keywords: rating system, rating, medical education, innovation, higher nursing education, competence, Bologna process

Competence approach to the education of undergraduate students

Year: 2014, volume 10 Issue: №3 Pages: 469-471
Heading: Pedagogics and Education Article type: Short message
Authors: Aleshkina O.Y., Logashova N.B.
Organization: Saratov State Medical University
Summary:

Modernization programs of higher education in "Nursing" preparation is aimed at improving the competitiveness of graduates in the labor market. The article discusses the features of bachelor degree within the Federal State Educational Standard Generation III approved in 2011. The key differences include the obtaining of professional competence of students, the creation of training modules, integrated approach to the teaching, problem-oriented training and development of prospects and ways to improve training of specialists with higher education.

Keywords: Bachelor, competence, higher nursing education, organization and optimization of the educational process

Influence of value orientations of rural population on formation of self-preserving behavior

Year: 2014, volume 10 Issue: №3 Pages: 465-468
Heading: Sociology of Medicine Article type: Review
Authors: Yurova I.Yu., Fyodorova L.M., Chernyshkova E.V.
Organization: Saratov State Medical University
Summary:

Formation of self-preserving behavior of rural population is defined both by external conditions and factors, and by way of living of a particular person, its value orientations towards his or her own health, and later — by practical implementation of appropriate behavioral values. System of values as the element of culture and essential factor that forms people's attitude to their health determines health-saving or health-destructing practice. In reality, however, there is a mismatch of value orientations of rural population and practical actions for maintaining (destructing) its health.

Keywords: health, rural population, self-preserving behavior, value orientations

Assessment of efficiency of application of various analogues of insulin in treatment of diabetes type 2

Year: 2014, volume 10 Issue: №3 Pages: 461-464
Heading: Endocrinology Article type: Original article
Authors: Rodionova T.l., Orlova M.M.
Organization: Saratov State Medical University
Summary:

Purpose: to estimate efficiency of treatment of analogues of insulin Glargin and insulin Detemir in patients with diabetes type 2. Material and methods. 147 patients with diabetes type 2 which have been initially receiving combined therapy by oral antihyperglycemic agent and NPH-insulin have been under the study. Level of glycated hemoglobin has been defined in 3 and 6 months for the general assessment of control of aglycemia. Results. According to the study the use of insulin analogues (Detemir, Glargin) versus NPH insulin for 6 months allowed to reach individual target values of glycemia in 70% of patients with diabetes type 2 with a low risk of hypoglycemia. Conclusion. The use in clinical practice of modern insulin analogues and simple algorithm for dose titration, allows simulating as closely as possible the physiological insulin secretion, helping to achieve compensation of carbohydrate metabolism in larger numbers of patients in comparison with NPH insulin.

Keywords: diabetes II type, glycemic control, insulin Detemir, insulin Glargine

The dynamics of main indicators for the treatment of ulcerative gastroduodenal bleedings — the analysis of several years studies

Year: 2014, volume 10 Issue: №3 Pages: 456-460
Heading: Surgery Article type: Original article
Authors: Shapkin Y.G., Potahin S.N.
Organization: Saratov State Medical University
Summary:

The research goal is evaluation of influence of changes in diagnostic & treatment possibilities and surgical approach on the results of treatment of patients with ulcerative gastro-duodenal bleedings (GDB). Material and methods: An analysis of the treatment results of 1885 patients suffering from ulcerative GDB, which have been treated in the surgery department of the "State clinical hospital No.6" in Saratov has been done. The information about the patients suffering from GDB has been retrieved from the digital archives, which were filed from 1991 to 2009. The patients have been divided into five groups according to five periods of work, each one differ by its own diagnostic & treatment possibilities and approaches. The evaluation was based the amount of operations, the number of different types of operations, the efficiency of endohemostasis, the amount of bleeding relapses and the lethality. Results: The introduction of computer prognosis for bleeding relapse, the increase in the number of endoscopic hemostatic methods, the application of Laser Doppler Flowmetry (LDF) for the evaluation of reliability of hemostasis, the use of dynamic endoscopy and testing probe for bleeding relapse in the state of prerelapse syndrome with the combination of preventive measures on the source of bleeding and antisecretory therapy have led to the decrease of overall lethality from 6,5% to 1,9%, and the postoperative lethality from 9,1% to 1,7%. Conclusion: The analysis of treatment results by periods made it possible to have an overview on different factors as they undergo changes during these periods, evaluate weak points in the current treatment tactic and set a direction for further investigations.

Keywords: results of treatment, surgical treatment, ulcerative gastroduodenal bleeding

Combination of the transurethral resection and prostate HIFU ablation at treatment of the localized cancer

Year: 2014, volume 10 Issue: №3 Pages: 450-455
Heading: Urology Article type: Original article
Authors: Popkov V.M., Fomkin R.N., Blyumberg B.l., Shatylko T.V., Sedova L.N., Abramova E.P.
Organization: Saratov State Medical University
Summary:

Research objective: to estimate results of treatment of patients with the localized form of a cancer of a prostate at a combination of a transurethral resection (TURP) and HIFU of an ablation. Objects and research methods: From February, 2009 to February, 2014 of 100 patients with the localized form of a cancer of a prostate were selected for research:
26 patients were included into HIFU and 74 group in group of the combined treatment (TURP+HIFU). Selection criteria for HIFU ablation were the localized cancer of a prostate concerning which earlier it wasn't carried out treatments, and level of a PSA at the time of statement of the diagnosis 15 ng/ml. All patients corresponding to these by criteria, were considered as candidates for treatment and inclusion in the analysis. The nadir and stability of PSA, the histologic conclusion, IPSS, quality of life and complication were estimated at time of postoperative supervision. Results: Statistically significant influence of a combination TURP+HIFU for the term of transurethral drainage of a bladder (a median of 40 days against 7 days), incontience frequency (15.4% against 6.9%), infections of urinary ways (47.9% against 11.4%) and IPSS change during the postoperative period (on the average 8.91 against 3.37) is noted. During the short period of supervision it wasn't observed considerable changes in relation to efficiency: in HIFU group the frequency of repeated sessions made 25%, in TUR/HIFU group 4%. Conclusion: HIFU therapy is modern, minimum invasive method of a cancer therapy of a prostate. The combination of a transurethral resection and HIFU ablation significantly reduces the frequency of the complications connected with treatment. Maintaining the patient after combined TURP and HIFU ablation is comparable with maintaining the patient after usual TURP.

Keywords: high intensity focused ultrasound (HIFU), prostate-specific antigen, the cancer of a prostate (CP), transurethral resection (TURP), treatment

Nerve tissue growth factors as markers of evaluation of neuro-genesis processes in traumatic spinal cord disease

Year: 2014, volume 10 Issue: №3 Pages: 446-449
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Uljanov V.Yu., Norkin I.A., Drozdova G.A., Konjuchenko E.A.
Organization:
Summary:

Objective: immunological differentiation effects regeneration of nerve tissue in the acute and early periods of traumatic spinal cord disease on the basis of assessment of the dynamics of content neurospecific proteins in serum affected. Material and Methods. Content of neurospecific proteins in the blood serum has been studied by enzyme immunoassay in 40 patients with spinal cord injuries. Results. Dynamics and quantitative changes in the content of chronometric neurospecific proteins in serum of patients in acute and early periods of traumatic spinal cord disease is characterized by two-phase increase in the concentration CNTF; monotonic increase in the content of NT-3 in all periods of observation; biphasic increase in the levels of NT-4 to 1-4th and 14-th day from the date of injury. Conclusion. Complex research of neurospecific levels of proteins in the serum allows one to evaluate selectively the individual components of the process of regeneration of nerve tissue in acute and early periods of traumatic spinal cord disease.

Keywords: enzyme immunoassay, nerve tissue growth factors, neurogenesis, regeneration, spinal cord, traumatic disease

Transpedicular fixation in comminuted fractures of bodies of thoracic and lumbar vertebrae

Year: 2014, volume 10 Issue: №3 Pages: 441-446
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Zaretskov V.V. Arsenievich V.B, Likhachev S.V., Shulga A.E., Titova Ju.l..
Organization:
Summary:

Research Objective: improvement of transpedicular fixation technique in cases with spine injuries accompanied by vertebral body splintering. Material and Methods. Transpedicular spondylosynthesis was performed in 52 patients aged 18-49 years with comminuted fractures of thoracic and lumbar vertebral bodies. Individual peculiarities of the operation depended on the character of the injury ascertained during the preoperative examination. Standard roentgenography and computer tomography were used. Results. Lasting antalgic effect was observed in 94,2% of the operated patients. In cases with type A3 fractures according to F. Magerl the rate of the surgical correction of the pathologic posttraumatic kyphotic deformity averages 87%. Injuries classified as type A2, B2 or C2 were the indication for transpedicular os-teosynthesis by advanced techniques. Conclusion. Transpedicular spondylosynthesis is one of the effective methods of treatment of patients with comminuted fractures of thoracic and lumbar vertebral bodies, and the choice of carrying out of the procedure depends on the injury character. In cases with comminuted fractures of type A2, B2, C2 it is reasonable to perform transpedicular spondylosynthesis with introduction of the transpedicular screws into the injured vertebral body, and the technique of their use depends on the injury character.

Keywords: comminuted fractures, transpedicular fixation, vertebral bodies

Cytokines balance change in gingival fluid at periodontal diseases and its value for the prognosis of regeneration disturbances in periodontal tissues

Year: 2014, volume 10 Issue: №3 Pages: 435-440
Heading: Stomatology Article type: Original article
Authors: Ostrovskaya L.Yu., Zakharova N.B., Mogila А.Р., Katkhanova L.S., Akulova E.V., Popykhova E.B.
Organization: Saratov State Medical University
Summary:

Purpose: To establish diagnostic value of the increased content of pro- and anti-inflammatory cytokines (IL-8, MCP-1, RAIL) in gingival fluid at patients with a chronic periodontal disease. Material and Methods: 60 patients with inflammatory periodontal diseases were surveyed. The concentration of the studied cytokines in gingival fluid has been defined. Results: At a periodontal disease the increased level of pro- and anti-inflammatory cytokines in gingival fluid has been noted. Conclusion: Definition of the MCP-1 and IL-8 levels in gingival fluid can be used as a criterion of the prognosis of the severity of inflammatory and destructive processes in the periodontal tissues.

Keywords: cytokines, gingival fluid, periodontal disease

Differential diagnostics of different nosological forms of the temporomandibular joint pain dysfunction syndrome

Year: 2014, volume 10 Issue: №3 Pages: 432-435
Heading: Stomatology Article type: Original article
Authors: Kameneva L.A., Potapov V.P., Tlustenko V.P., Potapov I.V., Maltceva A.V., Hatuntseva T.N.
Organization: Samara State Medical University
Summary:

Research objective: to carry out differential diagnostics of various nosological forms of a temporal and temporomandibular joint pain dysfunction syndrome. Material and methods. On clinical base of orthopedic odontology chair of SamSMU inspection of 244 patients with temporomandibular joint pain dysfunction syndrome was performed. Diagnostics was carried out according to the special card of inspection which was developed on orthopedic odontology chair of SamSMU and included subjective, objective and special methods of research. As a result of research it is taped: 71 — an occlusal-articulation dysfunctional syndrome, 44 — a neuromuscular dysfunctional syndrome, 76 patients have a hardly set dislocation of intra joint disk and 53 — a habitual dislocation and a subluxation of a temporomandibular joint. We used Yu.A. Petrosov's classification as it displays most precisely the processes happening at pathology of the intra joint relations. Conclusion: On the basis of the obtained data the table of differential diagnostics of various nosological forms of temporomandibular joint pain dysfunction syndrome has been made.

Keywords: temporomandibular joint, pain dysfunction syndrome