№2, 2016, volume 12

The article describes the experience of the organization of Olympiad in Internal medicine at the medical university for senior students and clinical residents. The paper presents the possibility of Olympiad in Internal medicine at the medical university is a modern educational technology that increases interest to the disciplines and motivation to professional development and formation of professional competencies. Such type of Olympiad helps future therapeutics to improve in their specialty and to form a personal reserve for the future work in the medical and research team, promotes continuity between students and postgraduate trainers in higher professional medical education.

The field of medicine facing the issues of diagnosis and treatment of spine diseases and injuries requires training of specialists in vertebrology taking into consideration the modern standards of higher professional education and medical care conditions. The article deals with the training of the specialists using a competency-based model

The article presents the analysis of empirical data of foreign and domestic medical and social research on the problem related to the features of health preservation among medical students. It was revealed that all the researchers recognized the importance of health preservation for future doctors in the context of perspective patients counseling on healthy lifestyle. It was determined that the academic sphere of a medical school, on the one hand, promotes formation of health preserving practices among students and, on the other hand, resists these practices implementation due to the specificity of training process of future doctors. It was noted that students' perception of health preservation varied at different stages of training process in a medical school.

The demand for psychiatric services in modern health care system will increase due to the growth in number of mental diseases. The role of nurses in prevention, treatment and rehabilitation of mental illness has a number of features. These features are related to care of patients with high level of aggressiveness, behavioral deviations, and problems in self-service. Differences in procedure practice and communicative space specialize and make narrower the nurses' professional practice in psychiatry and determine appearance of specific mechanisms and norms bound up with the necessity of supervision of patients while respecting their rights. Personnel's oversight functions, deviant behavior of patients, high degree of closure of psychiatric medical institutions — are the reasons for specialization of nurses' professional group in psychiatry, forming special mechanisms of maintaining tolerance to patients in professional sphere of this community.

The analysis of the institutionalization of palliative care trends in contemporary Russian is given by the authors in the methodological plane of the system of social and structural functions (AGIL), proposed by Talcott Parsons. The medicalization of palliative care in Russia is considered by the authors from the perspective of the dysfunctional practices. It is noted that the legislative documents adopted in Russia define palliative care as palliative medical care. The organization of palliative care in Russia takes place simultaneously with the improvement of legal acts, which significantly slows down the process of becoming of palliative care to population and predetermines the limit of its availability. The principle of an integrative approach to the organization of palliative care was not reflected in the process of formation of the normative base. The interdisciplinary view on the organization of palliative care and increase of its availability will allow to verify and to overcome the dysfunctions in the organization of palliative care to the population.

The research goal: to carry out the retrospective analysis of results of repeated antireflux interventions at the recurrent hernias of an esophageal opening of a diaphragm (HEOD). Material and methods. Results of surgical treatment of 38 patients with recurrence of HEOD in various terms after operation are studied. Results. At the most part of patients at repeated operations anatomic prerequisites to formation of recurrence of HEOD — migration of a fundoplication cuff, insolvency, an excessive tension of tissues when forming the gastric coupling, violation of technology of imposing of a cuff come to light. In this regard, proceeding from these references and the analysis of own research, it has been considered that plasticity of local tissues at recurrent HEOD, is insufficient for reliable elimination of a gastroesopha-geal reflux. Conclusion. The analysis of the results of antireflux surgical treatment of HEOD with a reflux-esophageal phenomenon has shown high efficiency of no tension plasticity, with use of a synthetic artificial limb. The fundoplication technique in antireflux surgery with no tension plasticity may be used as an operation of choice at recurrent hernias of an esophageal opening of a diaphragm.

Aim: to estimate functional status of coxarthrosis in patients requiring total hip replacement of the two hip joints. Material and methods. The biomechanical examination of 94 patients with bilateral primary coxarthrosis before and after total hip replacement was performed using clinical stabilometric software complex. The ability to perceive the mechanical load during standing and walking was evaluated at different stages of the treatment. The difference between the samples was estimated with the use of Mann — Whitney U-test. The rank correlation of biomechanical parameters was measured by Spearman coefficient. Results. It was revealed that the most responsive indicators are the transfer period, the first and second periods of double support and the deviation of the center of pressure relative to the average position in the frontal plane. Conclusion. After surgical treatment there was observed some improvement: the-left-and-right-step asymmetry decrease, rhythm rate increase, improved ability to maintain body balance, jog reactions increase.

The aim of the research is to study the indices of cellular immunity in patients before and after hip joint endoprosthesis. Materials and methods. The indices of cellular element of immunity (quantitative and qualitative composition of T-lymphocytes (CD3+), T-helpers (CD3+CD4+), cytotoxic T-lymphocytes (CD3+CD8+), B-lymphocytes (CD3-CD19+), natural killers (CD3-CD16+CD56)) in 20 patients with post-traumatic osteoarthrosis of III grade preoperatively and in the dynamic follow-up on the 3rd, 7th and 21st day post-surgically. Results. Patients with osteoarthrosis showed expressed immunological impairments both before and after endoprosthesis mostly affecting T-cellular immunity element and manifesting in immunoregulatory subpopulations imbalance as well as in T-suppressors decrement, T-helpers increment and NK-cells enlargement in patients after endoprosthesis. Conclusion. Patients with osteoarthrosis showed expressed immunological impairments both before and after joint endoprosthesis. Surgical intervention resulted in the aggravation of the pre-surgical disturbances in immunodeficiency.

In the course of the study the foreign and native publications concerning total hip replacement have been analyzed. The data from National Registers of various countries are presented in the study. They highlight some issues upon total hip replacement, technologies of surgical intervention advancing and most important risk factors for endoprosthetic ball dislocation.

The morbidity of depressive disorders and their role in the formation of different human pathologies emphasize the actuality of searching for new approaches in the prophylaxis and treatment of depressions. The modification of gut microbiota may be a perspective direction of clinical investigation. Development in this area is based on the review of trials which confirm the significance of gut microflora composition in regulation of mental functions in particular mood and behavior as well as the role of diet in the development of depressions. The hypothesis of the role of gut microbiota in the development of depressive conditions was discussed.