Saratov JOURNAL of Medical and Scientific Research

№2, 2017, volume 13

Computer analysis of epiretinal membrane parameters

Year: 2017, volume 13 Issue: №2 Pages: 350-358
Heading: Ophtalmology Article type: Original article
Authors: Daurov S.K., Dolinina O.N., Kamenskikh T.G., Batischeva Yu.S., Kolbenev I.O., Andreychenko O.A., Potemkin S.A., Proskudin R.A.
Organization: Yuri Gagarin State Technical University of Saratov, Saratov State Medical University
Summary:

Objective: to develop algorithms of processing of video images of optical slices of the eye retina to quantify the degree of folding of the epiretinal membranes and of the central fossa. Material and methods. The object of the study was the video image of the retina obtained by optical coherence tomography. To develop methods of determining the degree of folding epiretinal membrane was formed mathematical model of the profile consisting of a base profile (low frequency component) and folding (high frequency part). Results. There had been developed two alternative methods of estimation of folding epiretinal membrane: retinal-averaging method and the method using the wavelet transform. The algorithm of geometrical parameters of the central fossa: the height, width and line shape. These algorithms are implemented in a software system. Conclusion. The practical application of the developed system showed its adequacy, as well as an introduction into medical practice the use of quantitative estimates of some parameters of the retina condition.

Keywords: video image, optical coherent tomography, epiretinal membrane

Fluorescent angiography and optical coherence tomography with angiography of the ocular fundus in patients with "the wet" form of an age-related macular degeneration.

Year: 2017, volume 13 Issue: №2 Pages: 345-349
Heading: Ophtalmology Article type: Original article
Authors: Virsta A.M., Kamenskikh T.G., Nugaeva N.R., Kolbenev I.O., Gileva E/V.
Organization: Saratov State Medical University
Summary:

Purpose: to investigate the informative value of fluorescent angiography (FA) and optical coherence tomography with fundus angiography (angio-OCT) in the diagnosis of "wet" form of age-related macular degeneration (AMD). Material and methods. The present study included 20 patients (20 eyes) diagnosed with degeneration of macula and posterior pole of the eye, the "wet" form (late stage age-related macular degeneration, AREDS category 4). The study used machines: optical coherence tomography, Spectralis HRA+OCT (Heidelberg Engeneering, Germany), optical со- herence tomography-angiography CIRRUS HD-OCT MODEL 5000 (Carl Zeiss, Germany). Results. When conducting the FA, in 11 patients found the ill-defined zone of small leakage of dye in 7 patients revealed a clearly defined area of hyperfluorescence in the early phase, and marked leakage of dye in the late phase, 2 patients — uncertain indices. In connection with the received data questionable PHAGE in 11 patients, all were held angio-OCT, to clarify the localization of choroidal neovascularization (CNV). When performing angio-OCT in 11 patients revealed that "wet" form of AMD with occult choroidal neovascularization. In 7 patients there had been discovered classic CNV in 2 patients combined. Conclusion. Angio-OCT gives a clearer picture about the presence of a choroidal neovascular membrane that plays a significant role in determining the course of treatment of patients with wet age-related macular degeneration.

Keywords: age-related macular degeneration, fluorescent angiography of eyeground vessels, optical coherence tomography with fundus angiography

Combined approach to the surgical treatment of patients with prolifera-tive stage of diabetic retinopathy

Year: 2017, volume 13 Issue: №2 Pages: 338-345
Heading: Ophtalmology Article type: Original article
Authors: Bikbov M.M., Fayzrakhmanov R.R., Kalanov M.R.
Organization: State Budgetary Institution "Ufa eye research institute of the Academy of Sciences of the Republic of Bashkortostan"
Summary:

Purpose: to evaluate the effectiveness of combined surgical treatment in patients with proliferative stage of diabetic retinopathy. Material and Methods. 52 patients with advanced stage of proliferative diabetic retinopathy who were divided into 2 groups were examined. Group 1 consisted of 30 patients with a preliminary intravitreal injection of ranibi-zumab, followed by vitrectomy In group 2, 22 patients underwent vitrectomy without anti-VEGF therapy. Visual acuity in the 1st group before treatment was 0.04±0.02, in the second 0.05±0.03. The thickness of the retina in the foveolar zone of the 1st group was 358±34 urn, in the second 378±44 urn. Height of the complex "PHM with fibro-glial proliferation — retina" 670±38 and 710±30, respectively. Results. The visual acuity after treatment increased 4.2 times (group 1), in comparison with the results of the second group by 2.5 times. In patients of the 1st group intraoperative hemor-rhagic manifestations were observed in 36.6% of cases, in the 2nd group in all patients. An increase in the height of the complex "PHM with fibro-glial proliferation — retina" was noted in 83.3% in patients of the 1st group one month after the injection. The height of the complex increased on average to 153±25 urn, which in 76.6% increased the traction effect on the retina. The neovascularization regression occurred 4-8 days after ranibizumab injection in group 1 patients. The retinal thickness of the central zone 10 months after vitrectomy decreased to 220±10 urn in the 1st group and to 273±14 urn in the 2nd group, respectively. Conclusion. The use of inhibitors of angiogenesis, in particular ranibizumab, as a preoperative preparation of patients with proliferative stage of diabetic retinopathy reduces the risk of intra- and postoperative hemorrhagic complications, which facilitates the implementation of vitrectomy, avoids additional vitreo-retinal interventions, in connection with which a positive functional result remains.

Keywords: vitrectomy, ranibizumab, proliferative diabetic retinopathy, posterior hyaloid membrane, angiogenesis inhibitors

The efficiency of modern methodics of laser refractive surgery according to the clinical experience of the Ophthalmology Clinic of the Saratov State Medical University.

Year: 2017, volume 13 Issue: №2 Pages: 334-338
Heading: Ophtalmology Article type: Original article
Authors: Barabanova L.S., Kamenskikh T.G., Belousova T.V., Gileva E.M.
Organization: Saratov State Medical University
Summary:

The purpose of study is to compare an effectiveness of different refractive laser surgery methods. Material and methods. 72 LASIK patients (141 eyes) and 21 TransPRK patients (39 eyes) were analyzed. Among them there were 42 women and 50 men. The age of patients at the operation moment was from 18 to 46 years. Patients were divided into 3 groups, according to myopia rate. The research method is descriptive statistics. Results. A differentiated approach to the choice of surgery gives the maximum possible and stable functional result. Confocal corneal microscopy data show a decrease in the corneal epithelium of the number of cells with large nuclei (markers of hypoxia) in operated patients, in contrast to patients using contact lenses. This confirms the advantage of laser correction in comparison with contact correction of myopia. Conclusion. High and stable recuperated vision sharpness at all patients attests eximer-laser correction efficiency and safety under any myopia rates.

Keywords: LASIK, Saratov State Medical University n.a. V. I. Razumovsky, TransPRK

Cutting edge eye care at the Clinic of Eye Diseases of the Saratov State Medical University

Year: 2017, volume 13 Issue: №2 Pages: 329-334
Heading: Ophtalmology Article type: Original article
Authors: Tsipyashchuk A.F., Kamenskikh T.G., Reshnikova L.B., Polozova N.A.
Organization: Saratov State Medical University
Summary:

The purpose of study is to analyze the results of providing patients with the high-tech medical care at the Clinic of Eye Diseases of the SSMU. Material and methods. Analysis of laws and regulations of the Ministry of Health of the Russian Federation, statistical data, accounting documents of the Clinic of Eye Diseases of the SSMU and a number of other medical institutions that provide patients with the high-tech medical care. A retrospective analysis of original medical records, outpatient medical records, medical charts was carried out. The methods of research that are used in this work include socio-hygienic, retrospective, system analysis, statistical. Results. The implementation of the National Project "Health" by the Clinic of eye diseases of the SSMU is made available through the providing residents of the Saratov region and other 29 regions of the Russian Federation with the high-tech ophthalmic care for. According to the statistical data 3,284 patients were provided with the high-tech medical care in 2014, 2015, 2016. Refractive, vitreoretinal, reconstructive-plastic and optico-reconstructive surgeries, optical through keratoplasty, cross-linking, glaucoma surgery are carried out at the Clinic. The largest number of patients provided with high-tech medical care in 2014-2016 had vitreoretinal surgeries. Conclusion. There is a significant increase in the functional results of patients' treatment, increasing accessibility and quality of high technologies in ophthalmology. Successful providing patients with the high-tech medical care was facilitated by the creation of a special commission of identifying the patients required the high-tech medical care, concerted efforts of the physicians and nurses, state-of-the-art diagnostic and therapeutic equipment.

Keywords: the Clinic of Eye Diseases of SSMU, the high-tech medical care

A doctor, a scientist, a teacher and a health care manager — Lev Grigoryevich Gorchakov (to the 100-th birth anniversary)

Year: 2017, volume 13 Issue: №2 Pages: 313-316
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Yerugina M.V., Astafieva N.G., Zavyalov A.l., Abyzova N.V.
Organization: Saratov State Medical University
Summary:

The aim of the article is to present biographical data of Professor L. G. Gorchakov describing his scientific and practical contribution to the development of Russian Medicine, to the public health organization in Saratov and to the training of medical staff at Saratov Medical Institute.

Keywords: biography, doctor, health care organizers, L.G. Gorchakov, scientist

Portrait of V.I. Razumovsky: to the 160th anniversary of the birth of the first rector of Saratov State Medical University

Year: 2017, volume 13 Issue: №2 Pages: 309-313
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Popkov V.M., Kochetkova T.V., Chernenkov Yu.V., Bugaeva I.O., Yerugina M.V.
Organization: Saratov State Medical University
Summary:

Saratov Journal of Medical Scientific Research 2017; 13 (2): 309-313. The article is devoted to the role of professor V. I. Razumovsky in the development of Saratov University and the development of medical science in the Saratov province.

Keywords: rector, surgery, V.I. Razumovsky

Organization of educational process at the department of human anatomy of Saratov State Medical University n.a. V. I. Razumovsky

Year: 2017, volume 13 Issue: №2 Pages: 306-308
Heading: Pedagogics and Education Article type: Short message
Authors: Bugaeva I0, Aleshkina OYu, Chernenkov YuV, Bikbaeva TS., Zagorovskaya TM.
Organization: Saratov State Medical University
Summary:

Human anatomy is one of the basic disciplines in the system of medical education. Knowledge in this area is necessary for the development of related theoretical subjects and constitutes a basis for studying clinical disciplines. Therefore the priority task of department of human anatomy is qualitative training of students at the modern level using classical and innovative pedagogical and computer technologies, being based on competence-based approach to training. In the article the features of organization of educational process at department of Human Anatomy of Saratov State Medical University n.a. V. I. Razumovsky, within the Federal state educational standard of the 3rd generation which key differences are considered: acquisition by students of cultural and professional competences.

Keywords: innovative technologies, human anatomy, competence

Multimedia presentation as a form of E-learning resources in the educational process

Year: 2017, volume 13 Issue: №2 Pages: 303-305
Heading: Pedagogics and Education Article type: Short message
Authors: Bizyaev АА, Konnov VV, Bizyaeva ND, Krechetov SA, Pospelov AN.
Organization: Moscow City Teacher Training University, Saratov State Medical University
Summary:

The article describes the features of the use of multimedia presentations as an electronic learning resource in the educational process, reflecting resource requirements; pedagogical goals that may be achieved. Currently one of the main directions in the educational process is the effective use of teaching computers. Pressing issue implementation of information and communication technologies in education is to develop educational resources with the aim to increase the level and quality of education.

Keywords: educational process, electronic educational resources, multimedia presentation

An elderly person in the attitudes of medical students and medical residents: an ethical aspect

Year: 2017, volume 13 Issue: №2 Pages: 300-302
Heading: Sociology of Medicine Article type: Original article
Authors: Fakhrudinova E.R., Vashchenko I.S., Andriyanova E.A., Alenin P.N., Ermolaeva E.M.
Organization: Saratov State Medical University
Summary:

The objective of the study: to identify the attitudes towards elderly among the students and residents of SSMU n.a. V. I. Razumovsky. Material and Methods. Students of 3d and 6th courses and interns of 1st and 2d years (N=85) enrolled in the SSMU n.a. V. I. Razumovsky were involved in the research. The average age of respondents was 21 ±1.8 years. We used the technique of unfinished sentences, which allowed us to measure emotional load of the semantic field of the phenomenon of old age. Results. Among the respondents, most commonly old age is associated with responsibilities in the upbringing of grandchildren, wisdom and pension. The main reasons that hamper the interaction with the elderly respondents emphasized the conflict of older people and a decrease in cognitive functions. Conclusions. In the researched population there is mainly a positive image of old age. Medical students should be prepared to work with older people and a tolerant attitude to old age should be formed

Keywords: elderly patients, medical personnel training, the image of old age