№2, 2015, volume 11

The aim of the study was to examine the degree of influence of the complex of factors on adherence to long —term drug therapy. Material and Methods. The survey of hospitalized patients with diseases of cardiovascular system has been performed in the therapeutic department of the district hospital of the Saratov region. The questionnaire included socio-demographic indicators, the presence of comorbidity. After 6 months follow-up calls to patients were performed. The relationship between the characteristics were analyzed using one-factor analysis. Results. 100 patients (54% of those invited to the study) completed the survey. After 6 months 86 (80%) patients has managed to be in contact, 44 (51 %) — continue taking drugs after discharge. Continued drug therapy patients, who considered theoretically correct constant mode of therapy (p<0,01), with hypertensive crises in history (p<0,01), with higher education (p<0,01), pre-domina (p<0,01), satisfied therapy (p<0,01) that define the disease as "lifestyle" (p<0,01) receiving information about the disease from the attending physician (p<0,01) having a "friendly" relationship with the physician (p<0,01). Conclusions. 6 months after discharge, the recommendations should be followed by the half of the patients. Those patients who are aware of the importance of continuous treatment, chronically ill, not previously terminating treatment often continue therapy. The predominant model of the relationship doctor-patient is paternalistic.

Objective: to evaluate the nature of unilateral spinal anesthesia using various modes of administration of low doses of hyperbaric bupivacaine. Materials and Methods. Prospectively, the randomized study included 56 patients undergoing knee arthroscopy. In the control group bupivacaine of 5mg was administered simultaneously, in the main group — fractionally by 2.5 mg. The development of thermal and pain blocks from different sides was investigated. The data were statistically processed. Results. In the control group, the positioning of the patient usually began after the entire dose of anesthetic had been administered. In the case of temperature paresthesia in the area of the sacral segments of the full anesthesia throughout underlying limb was not always achieved. In 6 cases of block was not sufficient. In the main group patient positioning was performed after the administration of 2.5 mg of anesthetic and evaluate temperature paresthesia and in 2 cases the total dose was increased to 7.5 mg. The successful development of sensory block at fractional administration was significantly higher than in the single-step introduction. Conclusion. Temperature paresthesia occurs within the first minute and is an early predictor of developing spinal anesthesia. The area of arising paresthesia shows preferential distribution of the anesthetic. In the application of low dose local anesthetic the desired upper level of anesthesia via the patient positioning and dose adjustment may be achieved.

In acute physical exercise, there is a change in oxygen delivery working tissues, blood gas transport function and efficiency of the use of oxygen by cells in the process of metabolism, which is the basis for compensation for physical activities. Lipid metabolism plays an important role in the energy supply of muscle activity. The aim of our research is to study the effect of a single submaximal exercise capacity by changing the lipid profile of peripheral blood. Materials and Methods. The study was performed on 18 white rats. Model of acute exercise: animals swam 4 minutes with a load weighing 20% of body weight. Blood sampling was performed by intracardiac way, right after exercise. The blood lipid profile was determined. Results. In the experiment reported an increase in triglycerides, total cholesterol, very low-density lipoproteins, but the atherogenic ratio is maintained at the control values, due to a significant increase in the level of high-density lipoprotein. Conclusion. Acute submaximal exercise capacity by untrained body has an atherogenic effect. Working muscles during physical activity is a major consumer of free fatty acids, which are the source of atherogenic lipoprotein form of the very low and low density.

Objective: differentiation of age-dependence indices of aorta, carotid, brachial, femoral arteries and drawing the mathematical model for forensic age determinations on their basis. Material and methods. Objects were: aorta, fragments of right and left carotid, brachial and femoral arteries taken in a complex of 186 male and female corpses, died at the age of 17-94. Research methods consisted of organometrical, histological, micrometrical, correlative and regressive analysis. The Results. Correlative and regressive analysis of 35 indicators of aorta, carotid, brachial and femoral arteries was conducted. All material was divided into figures with a significant correlation with age and performance of age-independent. The mathematical model was composed for calculation of age. Conclusion. Indicated involution of arterial wall and compiled on the basis of a mathematical model for determination the age could be taken as the basis for forensic method of age determination.

Objective: to identify the microscopic features of the structure of the thyroid gland in different forms of its pathology. Materials and Methods. The study is based on the thyroid glands of 199 patients of both sexes aged 21 to 74 years. Results. At the micro-macrofollicular nontoxic goiter was found flattened thyroid epithelium with flattened normochromic nucleus, the small size of cells and nuclei, low nuclear-cytoplasmic index, intrafollicular moderate epithelial proliferation, homogeneous colloid and moderate diffuse lymphoid infiltration. At the micro-macrofollicular toxic goiter detected cubic epithelium with rounded normochromic kernel, smallest size of cells and nuclei, nuclear-cytoplasmic minimum index intrafollicular focal proliferation of the epithelium, colloid mesh boundary with severe vacuolization, focal lymphoid infiltration and hemorrhage. When diffuse toxic goiter detected cubic form cells of medium size with a fairly high nuclear-cytoplasmic index, rounded normochromic kernel, rare intrafollicular epithelial proliferation, homogeneous colloid with an edge vacuolization. With the prevalence of autoimmune thyroiditis was observed flattened epithelium with rounded normochromic nucleus, the small size of cells and nuclei, found the average nuclear-cytoplasmic index, homogeneous colloid and extensive lymphoid infiltration with light propagation centers. Adenoma of the thyroid gland epithelium was found with a cubic cell shape, round hyperchromatic nucleus, the large size of cells and nuclei, high nuclear-cytoplasmic index intrafollicular diffuse proliferation of epithelial and dense colloid. When thyroid cancer found the prevalence of papillary structures with short broad papillae formed polymorphic cells with round hyperchromatic nucleus, there is the largest size of cells and nuclei, nuclear-cytoplasmic maximum index expressed intrafollicular diffuse proliferation of the epithelium. Conclusions. Each form of thyroid disease, along with well-known typical microscopic manifestations is a characteristic regional feature of the microstructure.

Цель: оценить воздействие однократного внутривенного введения покрытых полиэтиленгликолем золотых наностержней на молекулярные маркеры межклеточного взаимодействия и показатели перекисного окисления в сыворотке крови четырех групп крыс: интактных, с аллоксановым диабетом, с перевитым раком печени; с перевитым раком печени на фоне аллоксанового диабета. Материалы и методы. Активность перекисного окисления липидов оценивалась по показателям гидроперекисей липидов, малонового диальдегида и молекул средней массы с использованием общепринятых спектрофотометрических методов, исследования молекулярных маркеров — фактора некроза опухоли TNF-a, инсулиноподобного фактора роста IGF-1, васкулоэн-дотелиального фактора роста VEGF-C проводились в сыворотке крови методом иммуноферментного анализа. Результаты. Выявлено, что при однократном внутривенном введении золотых наностержней не происходит значительного изменения количества маркеров межклеточного взаимодействия и показателей перекисного окисления липидов. в периферической крови. Заключение. Полученные результаты позволяют рекомендовать использование покрытых полиэтиленгликолем золотых наностержней в экспериментальной онкологии.

Stroke and cerebral infarction in particularly are important medical and social problems. The article describes the historical changes of legal acts regulating medical care for patients with stroke and observes recent researches dealing with the law enforcement in this sphere. Content analysis revealed the lack of correspondence between the legal framework and clinical guidelines for cerebral infarction. Particular attention is paid to the low level of scientific research results concerned with the stroke outpatient medical care.

Purpose: the study of trends in overall morbidity and primary hypertension in the Saratov region over the period from 2002 to 2013. Materials and methods. The official statistics Ministry of Health and the Federal State Statistics Service were used, which is processed using analytical and statistical methods. Results. The article has been providing the analysis of total and primary arterial hypertension morbidity of the population of the Saratov region, which is in accordance with the degree of the Government of the Russian Federation from December 1, 2004, N 715 to the group of socially significant diseases. During the period from 2002 to 2013 in the Saratov region, as well as in the Russian Federation in Volga Federal district, the tendency of growth of the overall incidence and the decrease in the primary incidence of arterial hypertension. Conclusion. The dynamics of incidence of hypertension suggests the need for careful analysis and optimization of medical care for patients with hypertension

Objective: to identify ways to use ICT in some areas of work of the territorial authority of Roszdravnadzor. Materials and Methods. We used a questionnaire survey of 50 employees of territorial bodies of Roszdravnadzor, 50 employees of the licensing bodies of the three subjects of the Russian Federation (the Republic of Tatarstan, Samara and Saratov region), 50 license applicants in the territory of the Samara region (a total of 150 respondents). For statistical processing of the results we used the criterion ("Chi-square") K. Pearson. Results. The analysis of the survey results reliably indicates a broad support for the subjects of licensing relations the introduction of modern ICT in the work of the relevant public authority. Conclusion. The study results of the views of the staff of the licensing authorities and applicants of licenses for medical activities on introduction of modern information and communication technologies in the work of the licensing authority have been presented. As possible methods it has been suggested the use of special (special programmes) and general (content site) groups.

Purpose: analysis of the present state of the system of professional training of nursing personnel and of the need for nursing personnel at the regional level. Methods. The indicators of availability of nursing staff in the Saratov region and the parameters of activity of nursing professional education institutions in the region have been analyzed. Results. Problems of nursing personnel provision of the healthcare system and the main trends of training of nursing personnel were identified. Conclusion. Optimization of personnel maintenance of healthcare and nursing personnel training system is possible by creating conditions for the professional realization of nursing personnel and adaptation of young professionals at the workplace.