Saratov JOURNAL of Medical and Scientific Research

№2, 2018, volume 14

Hemostasis test parameters in patients requiring revision knee arthroplasty

Year: 2018, volume 14 Issue: №2 Pages: 266-271
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Girkalo M.V., Shakhmartova S.G., Shpinyak S.P., Mandrov A.V., Kozadaev M.N., Puchinyan D.M.
Organization:
Summary:

Objective: comparative analysis of the blood coagulation system in patients requiring revision arthroplasty of the knee joint in connection with the developed infectious and aseptic complications after total arthroplasty. Material and Methods. 37 patients with complications of total knee replacement were examined. Patients were divided into 2 groups: 1st — with signs of suppuration (n=19); 2nd — withsigns of aseptic instability of the endoprosthesis components (n=18). The control group consisted of 22 conditionally healthy people. Studied screening coagulation: activated partial thromboplastin time, prothrombin time, fbrinogen concentration, thrombin time, antithrombin III, protein C, the content of soluble fbrin-monomer complexes and D-dimers. Results. There was an increase in activated partial thromboplastin time in patients of group 2, prothrombin time — in patients of groups 1 and 2 compared with the data obtained in the control group (p<0.001). An increase in the content of soluble fbrin- monomer complexes and D-dimers was recorded in the blood plasma of patients of the 1st and 2nd groups compared to their level in the control group (p<0.001). Conclusion. The data of local coagulogram tests in patients requiring revision arthroplasty of the knee joint refect the signs of maladaptation in the hemostatic system at the preoperative stage of examination. It is worth noting the lack of information content of the screening coagulogram, as its basic tests do not refect changes in the whole system of homeostasis, the search for new informative research methods remains relevant today.

Keywords:

Dynamics of prevalence of diseases of the digestive system among the population of different age groups in conditions of social stress

Year: 2018, volume 14 Issue: №2 Pages: 345-348
Heading: Gerontology and geriatrics Article type: Original article
Authors: Tyultyaeva LA, Denisova TP, Lipatova TE, Kovalev EP.
Organization: Saratov State Medical University n.a. V.I. Razumovsky Research Institute of Cardiology
Summary:

Objective: to analyze the prevalence of digestive diseases during social stress among the population of different age groups (young, mature, elderly / old). Material and Methods. We studied data from the official statistical reports of the health Committee of the city of Saratov and the logs of incoming and departures / deaths of patients in the surgical and gastroenterology clinics of the city for 1990-2006. Social stress was considered as a factor in the breeding population system from the equilibrium state. Linear regression analysis, odds ratio, and analysis of the speed characteristics of the dynamics of the studied parameters in time were applied. The number of time moments when the sign of the rate of change in the prevalence of the studied parameters changed to the opposite was estimated. Results. The change in the sign of the rate of prevalence of acute pathology of the digestive system was most often observed during the period of maximum severity of social stress, which emphasizes the importance of the social component in the emergence and development of digestive pathology. The increase in the prevalence of diseases of the digestive system in all age groups was revealed. The increase in the prevalence of individual nosological forms, as well as the greatest number of times when the sign of the rate of prevalence of the pathology changed to the opposite, were most often registered among the population of young and elderly / senile age. The population of the mature age was characterized by greater stability of the studied parameters, that is, higher resistance to social stress. Conclusion. The prevalence of diseases of the digestive system during the period of social stress varied among the population of different age groups asynchronously: the most significant changes in the studied parameters were observed among the population of two extreme age groups: young and elderly / old people. These groups of people need closer attention of the doctor than patients of mature age, because they have a higher risk of developing diseases of the digestive system.

Keywords: age

A method of improving clinical work with patients with peptic ulcer of stomach and duodenum

Year: 2018, volume 14 Issue: №2 Pages: 334-337
Heading: Gerontology and geriatrics Article type: Original article
Authors: Lipatova T.E., Tyultyaeva L.A., Nazarov M.M., Semenov S.V.
Organization: Saratov Regional Hospital for Veterans of Wars
Summary:

Objective: identification of risk groups for development of complications of ulcerous disease of stomach and duodenum.Material and Methods. We used data from the official statistical reports of the health Committee of the city of Saratov and the logs of incoming and departures/deaths of patients in the surgical and gastroenterology clinics of the city (1976-2006). The parameters of the prevalence of gastric ulcer and duodenal ulcer and its complications in the population of different age groups are analyzed. Linear regression analysis, odds ratio, and analysis of the speed characteristics of the dynamics of the studied parameters in time (mean, minimum, maximum speed, range of the dynamics of the studied parameters, the number of changes in the sign of the speed of change in the prevalence of the studied parameters) were applied. Results. It was found that the probability of complications of the disease is higher among those age groups, which are characterized by a frequent change in the sign of the rate of change in the prevalence of the pathology. The necessity of age accounting in stratification of the risk of complications of gastric ulcer and duodenal ulcer and the multiplicity of medical observation of persons of different ages with this pathology, taking into account the analytical parameters of the disease. Conclusion. The scheme of determining the multiplicity of dispensary examinations of patients with gastric ulcer and duodenal ulcer is proposed.

Keywords: risk, prevalence, complications

Comparative "portrait" of a hospital patient in Saratov Regional Hospital for Veterans of Wars in 2005 and 2017

Year: 2018, volume 14 Issue: №2 Pages: 349-351
Heading: Gerontology and geriatrics Article type: Original article
Authors: Tyultyaeva L.A., Lipatova Т.Е., Bulychev S.V., Kovalev Е.Р., Alipova L.N.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov State Medical University
Summary:

Objective: to analyze the number of patients, patients' opinions about the work of the medical institution in 2005 and 2017. Material and Methods. The data of the survey of patients of the Saratov Regional Hospital for Veterans of Wars in 2005 and 2017 are analyzed. Results. From 2005 to 2017, there was a change in the sex (decrease in the proportion of hospitalized men) and age (increase in the proportion of hospitalized patients over the age of 60 years) composition of hospital patients. The increase of the general educational level of patients, the increase of the share of patients who are in this hospital not for the first time is revealed. The share of patients satisfied with medical work and work of the power supply unit in this hospital has increased. The preference of paternalistic style of interaction between a doctor and a patient, typical for both patients in 2005 and patients in 2017, was revealed. Conclusion. Despite the increase in the educational level of patients and the increase in satisfaction with the work of the hospital, patients of this medical institution prefer a paternalistic style of interaction with the doctor.

Keywords: doctor, inpatienttreatment, patient

Erythrocyte system in elderly: ageing aspects

Year: 2018, volume 14 Issue: №2 Pages: 341-345
Heading: Gerontology and geriatrics Article type: Original article
Authors: Malinova L.I., Denisova Т.Р., Lipatova Т.Е., Khvostikova D.E., Yegorova A.V.
Organization: Saratov State Medical University
Summary:

The purpose of the study was an assessment of erythrocyte system age-dependent characteristics in elderly population dwelling in the same territory during the time period equal to the average life span in the region. Material and Methods. We perform the compare of hematological parameters of 800 patients with hypertension and coronary heart disease hospitalized during 25-years period. Results. In senile patients, red blood cells and hemoglobin levels signifi- cantly decrease, but platelet characteristics remain intact. Revealed differenced are similar during all 25-year period of observation. Conclusion. Over the past 25 years, the trend of age-related decline in the number of red blood cells and hemoglobin has been preserved. The average hemoglobin content in erythrocyte (MCH) during the aging process tends to decrease, which has become statistically significant in recent years. The principal difference of the obtained data from the results of obtained 25 years ago is the absence of an age-related increase in the volume of erythrocytes and a higher level of the average concentration of hemoglobin in the erythrocyte.

Keywords: ageing, erythrocytes, platelets

The structure of the "acute abdomen" in a period of social stress in a large industrial center

Year: 2018, volume 14 Issue: №2 Pages: 338-341
Heading: Gerontology and geriatrics Article type: Original article
Authors: Lipatova Т.Е., Tyultyaeva L.A., Semenov S.V., Kovalev Е.Р.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov State Medical University
Summary:

Purpose: to analyze the prevalence of acute abdominal pathology in the period of social stress. Material and Methods. The data of official statistical reports of the Saratov city health Committee and the logs of patients admitted and discharged / deceased in the surgical clinics of the city were studied. The prevalence of acute appendicitis, acute cholecystitis, acute pancreatitis, acute intestinal obstruction, gastrointestinal bleeding, perforation of ulcers during 1990-2006 among the population of different age groups (young, mature, elderly /old) was investigated. The significance of differences between the groups was assessed using white's T-test. Results. A decrease in the prevalence of acute appendicitis, an increase in the prevalence of acute pancreatitis and gastrointestinal bleeding. Differences in the prevalence of acute abdominal diseases in patients of different age groups were found: an increase in the prevalence of acute pancreatitis mainly in the young population. There is a tendency to gradual Erasure of sexual differences in acute cholecystitis and acute pancreatitis in this period. Conclusion. The analyzed time interval was characterized by changes in the structure of the "acute abdomen", which may be associated with social changes in society during this period.

Keywords: "acute abdomen", age, social stress, the dynamics of indicators

Healthy ageing and regional health care system of the Great Patriotic War veterans

Year: 2018, volume 14 Issue: №2 Pages: 330-334
Heading: Gerontology and geriatrics Article type: Author's opinion
Authors: Denisova Т.P.,Lipatova Т.Е., Shuldyakov V.A., Kovalev E.P., Alipova L.N.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov Ministry for Public Health
Summary:

The term of "Healthy Ageing" is about creating the environments and opportunities that enable people to be and to do what they value throughout their lives. Healthy ageing require multipurpose policy framework with biological, social, economic, cultural and ecological aspects. The long-term experience of Saratov Regional Hospital for War Veterans in development and management of competencies required for healthy ageing programs is generalized in the article. Science evidence base of healthy ageing was formulated including results of the original studies with veterans of Great Patriotic War involved.

Keywords: healthy ageing, health care

Clinical diagnosis in terms of insurance medicine

Year: 2018, volume 14 Issue: №2 Pages: 327-330
Heading: Gerontology and geriatrics Article type: Author's opinion
Authors: Denisova Т.Р., Lipatova Т.Е., Malinova L.I., Tyultyaeva L.A., Kovalev Е.Р., Alipova L.N., Vakhlyueva O.G.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov State Medical University
Summary:

Medical institutions in the conditions of insurance medicine are faced with not always justified interference of insurance companies in the structure of diagnosis and diagnostic process, whose violate the essence of the concepts of clinical classifications and statistical coding of diagnoses provided by ICD-10. Such a situation ultimately harms the patient and society, makes it difficult both to monitorthe adequacy of the ongoing treatment activities, and to protect the patient's rights to receive qualified medical care and doctor's rights.

Keywords: clinical classifications, diagnosis, diagnostic nomenclature, insurance medicine

Interaction of atherosclerosis and ageing: is there any discussion questionable?

Year: 2018, volume 14 Issue: №2 Pages: 322-327
Heading: Gerontology and geriatrics Article type: Author's opinion
Authors: Denisova Т.Р., Lipatova Т.Е., Alipova L.N., Yegorova A.V.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov State Medical University
Summary:

Age-related diseases and their link to involutionary processes in human organism remain as one of the burning problems in internal medicine. The article focuses on the discussable questions of the most common mechanisms of atherogenesis and ageing, their similarity and difference. Both processes mutually burdens each other, bringing the "fading" of the organism closer.

Keywords: ageing, atherosclerosis

Professor Valeriy Vladimirovich Shchukovsky (to the 70th anniversary)

Year: 2018, volume 14 Issue: №2 Pages: 309-311
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Ulyanov V.Yu., Grishin S.E., Puchinyan D.M., Fedonnikov A.S., Shchukovsky N.V., Norkin I.A.
Organization: Saratov Socio-Economic Institute of Plekhanov Russian University of Economics, Saratov State Medical University
Summary:

The article illustrates the life of Professor Valeriy Vladimirovich Shchukovsky and his scientific contribution into the development of separate branches of emergency medicine, namely intensive care of patients with embolism and acute thromboses of large vessels, severe thermal traumas, endotoxemia and multiorgan dysfunction syndrome, traumatic disease of spinal cord and its visceral complications in acute and early periods, reperfusion visceral injuries following its transplantation and patients with coagulopathic hemorrhage.

Keywords: critical care medicine, history of medicine, professor V.V. Shchukovsky