Vol 4, No 2 (2019)

Internal medicine

Coagulation profile depending on ABО blood group system

Gusyakova O.A., Gilmiyarova F.N., Ereshchenko A.A., Kuzmicheva V.I., Borodina I.A., Potyakina E.E.

Abstract

Objectives – to compare the parameters of hemostasis in representatives of various blood groups using the ABО system.

Material and methods. The study involved 51 people (mean age 19.8±0.5 year). The parameters of the coagulation, anticoagulation and fibrinolytic systems were determined for all the examined persons. The following hemostasis parameters were investigated: coagulation factors (II, VII, VIII, IX, X, XI, XII), APTT, prothrombin time, plasminogen, antiplasmin, antithrombin III, protein C.

Results. The obtained results indicate the presence of biological variation of blood coagulation parameters depending on the antigenic affiliation of the blood group according to the ABО system, which is manifested in a change in the concentration and activity of a number of coagulation factors. The revealed tendencies made it possible to form a coagulation profile depending on the group of blood in the ABО system.

Conclusion. The study of variability of coagulation parameters, depending on the group of blood in the ABО system, is an important step towards the formation of personalized approach in laboratory research.

Science and Innovations in Medicine. 2019;4(2):4-8
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Gastroenterology

Functional gastrointestinal disorders: a review of the main provisions of the Rome IV consensus

Osadchuk A.M., Davydkin I.L., Gritcenko T.A., Kurtov I.V.

Abstract

Objectives – the review presents the analysis of the main changes in Rome IV. The subsequent Rome IV consensus focused on the etiology, pathogenesis, diagnosis and differential diagnosis of the functional gastrointestinal disorders. It updated some definitions of the functional gastrointestinal disorders; opioid-induced constipation was set as a separate disorder; functional abdominal distention was considered specific for functional abdominal bloating as both disorders are often combined and do not replace each other. The functional gastrointestinal disorders still remain of the high medico-social importance as they are endemic, refractory and cause long-term disability.

Science and Innovations in Medicine. 2019;4(2):9-15
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Gerontology and geriatrics

Alzheimer’s disease as the cerebral cortex disorder

Volobuev A.N., Romanchuk P.I., Bulgakova S.V.

Abstract

Objectives – to highlight the structure, function and localization of Alzheimer’s disease and to specify cognitive impairments related to it.

Material and methods. The anatomic data of human brain structure were used.

Results. The patterns of memory formation in the brain cortex are investigated. The brain cortex is presented as a type of syncytium consisting of elementary neural structures – cyclic neuronal circuits – memory elements. All cyclic neuronal circuits in a brain cortex are functionally interconnected. The connections between the neuronal circuits can be determined (imprinted) and stochastic (random). The intensity of stochastic communications defines the person's potential for creativity. The impairment of cyclic neuronal circuit connections results in either Alzheimer’s disease or in senile dementia of Alzheimer’s type.

Conclusion. In case the cortex is considered as the syncytium, the memory storage element, it can be the reason of the human creativity. It is shown that the failure of the information transfer in the cortex syncytium or neurons destruction in the neuronal network results in Alzheimer’s disease or in senile dementia of Alzheimer’s type.

Science and Innovations in Medicine. 2019;4(2):16-20
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Age-specific involutive characteristics of cognitive functions

Simerzin V.V., Fatenkov O.V., Panisheva Y.A., Galkina M.A., Gagloev A.V.

Abstract

The review article reflects the specific features of involutive cognitive functions in elderly people. Furthermore the basis of these changes is the natural physiological process of morphofunctional remodeling of the human body in general and of the central nervous system in particular. As a result, the elderly and senium people have cognitive decline, and in the presence of provoking medical and social factors and comorbid diseases they may have transient cognitive dysfunction.

Science and Innovations in Medicine. 2019;4(2):21-26
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Involutive curable cognitive disorders in elderly people

Fatenkov O.V., Simerzin V.V., Krasovskaya M.A., Sytdykov I.K.

Abstract

The review article describes the characteristics of curable involutive cognitive impairment in the elderly. It is noted that mild cognitive impairment is predominantly neurodynamic in nature, but over time it can transform into a syndrome of moderate cognitive impairment, which, sometimes, is a precursor of dementia. Special attention is given to the clinical manifestations of mild and moderate cognitive impairment, diagnostic criteria, the course of the disease, and its medical and social impact.

Science and Innovations in Medicine. 2019;4(2):27-31
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Occupational medicine

Occupational chronic kidney disease: differential diagnosis and expert evaluation

Strizhakov L.A., Babanov S.A., Garipova R.V., Arkhipov E.V., Lebedeva M.V., Fomin V.V.

Abstract

This review focuses on kidney diseases resulting from exposure to chemical agents in production environment; special attention is given to diseases' classification, prevalence rate, specificity of clinical representation and diagnosis. The frequency of occupational renal diseases is underestimated due to poor manifestation of the symptoms and the influence of environmental factors; thus this problem requires further investigation.

Science and Innovations in Medicine. 2019;4(2):32-37
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Diseases of the nervous system

Nonblinded study of immersive virtual reality efficacy for motor rehabilitation in patients with acute ischemic stroke: results presented

Zakharov A.V., Khivintseva E.V., Kolsanov A.V., Poverennova I.E., Pyatin V.F., Chaplygin S.S., Kalinin V.A.

Abstract

Objectives – to evaluate the efficacy of the immersive virtual reality (VR) as a supplementary method of the motor function restoration in the lower extremities of the patients with acute ischemic stroke in the carotid territory. Berg balance scale dynamics was used for patients assessment.

Material and methods. The study included 33 patients with acute ischemic stroke in the carotid territory. The patients were randomized into two groups: the control group received the conventional treatment; the experimental group additionally received VR therapy with a sensory impact. The VR therapy included 10 sessions of 15 minutes duration each.

Results. On the 6th day of VR treatment, the static-locomotor function index on Berg balance scale was significantly improved in patients in the experimental group (p=0.03). On the last day of rehabilitation, the difference between the study groups in the static- locomotor function demonstrated the improvement on 23 points (95% CI 13–27 points) in the experimental group, the Berg balance scale improvement reached 7 points (95% CI 2–13 points).

Conclusion. The study revealed the positive input of the immersive VR sessions in static-locomotor function rehabilitation in patients in the acute period of ischemic stroke. The method demonstrated its safety and acceptability in this category of patients. Deeper immersion through the use of an explicit interaction with the VR objects could increase the efficiency of this rehabilitation method in static-locomotor function restoration.

Science and Innovations in Medicine. 2019;4(2):38-42
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Public health and health service

Social portrait of the patient with newly diagnosed tuberculosis

Borodulina E.V.

Abstract

Rationale. The incidence of tuberculosis in the Samara region, despite a significant decrease, is still higher than the national average. Thus, according to Rospotrebnadzor’s statistics, for 2018 the number of tuberculosis cases is 44.3 per 100 thousand of the population of Samara region, compared to 38.5 cases per 100 thousand of the population in Russia.

Objectives – to study the clinical and anamnestic data of patients with newly diagnosed tuberculosis to create their social portrait and to identify the areas for improving the detection of tuberculosis, as it is a powerful tool to combat the spread of the disease.

Material and methods. The study included 485 patients with newly diagnosed tuberculosis: 312 patients were diagnosed during fluorographic examination and 173 patients were diagnosed on the addressing for medical care.

Results. Men are affected 1.8 times more often than women. The peak of tuberculosis incidence is revealed in the age group of 35–44 years. The most important risk group is HIV-infected patients, accounting for one third of all newly identified. 58.5% of patients had no fluorographic examination for more than 2 years.

Conclusion. Sex and age composition, clinical and anamnestic data, medical and social characteristics of patients with newly diagnosed tuberculosis in Samara were studied. The priorities for TB control activities of primary care physicians were recommended.

Science and Innovations in Medicine. 2019;4(2):43-47
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Patient-focused medical care techniques in a hospital

Suslin S.A., Vavilov A.V., Ginnyatulina R.I.

Abstract

Objectives – to improve the organizational processes in the municipal hospital.

Material and methods. The study was conducted in Samara City Clinical Hospital №1 named after N.I. Pirogov. The methods of organizational modeling and statistical analysis were applied.

Results. The following patient-centered care techniques were introduced in the large multi-facility hospital: special logistics in the hospital admissions unit; models of "comfortable patient admission" and "friendly environment"; integrated information exchange with the emergency medical setting; modern equipment; new landscape; updated security and quality management systems. Routing in the admissions unit is organized according to a "3H" triage system – patients with different severity of conditions are sorted to "red', "yellow" and "green" zones. The "red" zone is intended for patients in extremely serious condition, with impaired vital functions. The "yellow" zone receives patients who are in a serious condition or in a state of moderate severity, with a violation of independent movement. The "green" zone accumulates patients whose health condition is not life threatening. The hospital's quality management system complies with the international standard ISO 9001:2015.

Conclusion. Implemented patient-focused care techniques set the best level of quality, costs and time of medical care thus ensuring the persistent development of the institution. The international quality management standards contribute to the wide dissemination of new principles of hospital management – focus on the patient, on the quality of care.

Science and Innovations in Medicine. 2019;4(2):48-52
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Morbidity with temporary disability among the working population of the Samara region: status and structure analysis

Tarasova T.N., Suslin S.A., Barinova Z.V., Bochkareva M.N.

Abstract

Objectives – to analyze the incidence and structure of morbidity with temporary disability among the working population of the Samara region in the period of 2013–2018.

Material and methods. The assessment of the temporary disability was carried out according to the scale " Estimation of morbidity with temporary disability (MTD) rate according to E.L. Notkin", which estimates the "proportion of sick persons" in the total number of working people.

Results. The rate of the morbidity with temporary disability was assessed in terms of quality, including the data on the variations of frequency and duration of temporary disability during the study period.

Conclusion. The analysis of the incidence rate with temporary disability allows to develop a set of measures for its prevention and reduction, not only in an individual area, but in the whole territory.

Science and Innovations in Medicine. 2019;4(2):53-57
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Lifestyle and health-care adherence in infertile women of late reproductive age

Tyumina O.V., Kuzmichev K.A., Chertuhina O.B.

Abstract

Objectives - to evaluate the health-care activity and lifestyle in infertile women of late reproductive age. Material and methods. The study concentrated on the representative group which included 650 women of the Samara region, aged 35-44 years (mean age 37.01+1.74) suffering from infertility. The control group included 300 women of the average age of 37.04+2.09 year, who have given birth to a child in the age over 35 years; that was the main inclusion criteria for the control group. Results. The most influential risk factors in women in the experimental group are weak health-care adherence (Q=0.576, p<0.05); body weight deviation from its optimal level (Q=0.542, p<0.05); low-level physical activity (Q=0.454, p<0.01); smoking (Q=0.448, p<0.05); malnutrition (Q=0.398, p<0.01). Conclusion. The study proved that infertile women of late reproductive age have unfavorable socio-hygienic status. It results in their poor health and requires a complex medical and social aid for its improvement.

Science and Innovations in Medicine. 2019;4(2):58-61
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Phthisiology

Predictors of the local forms of tuberculosis in children with HIV infection

Eryomenko E.P., Borodulin B.E., Borisova O.V.

Abstract

Objectives – to study the characteristics of pulmonary tuberculosis in children with HIV infection.

Material and methods. The 26 children with a combined pathology of HIV / tuberculosis have been examined in comparison with 50 children with tuberculosis and a negative HIV test.

Results. The general patterns of tuberculosis development are revealed, the leading risk factor in both groups is the social factor.

Conclusion. The main risk factor is proven to be a contact with a patient with tuberculosis (bacterium excreta). The children with HIV infection have had a detected contact two-times more frequent than in the control group – 80.76% and 42% respectively. Maternal diseases during pregnancy such as chronic viral hepatitis "B" and "C", urogenital infections were common in children with HIV infection. Opportunistic infections accounted for 69.23% in the children with HIV (compared to 2% in the control group).

Science and Innovations in Medicine. 2019;4(2):62-65
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Surgery

Cardioprotection in abdominal aortic aneurysm surgical repair

Vachev A.N., Gryaznova D.A., Dmitriev O.V., Tereshina O.V., Italyantcev A.Y., Chernovalov D.A., Kozin I.I.

Abstract

Objectives – to evaluate the efficacy of different types of risk reducing cardioprotection preceding the open surgery on the abdominal aorta.

Material and methods. The study analyses the treatment outcomes in 262 patients with abdominal aortic aneurysm. In all the patients the operation of prosthetics of abdominal aorta was performed. The patients were divided in two groups depending on the method of preoperative cardioprotection. The first group included 158 patients who received the intensive medicamentous preparation for the surgery. The second group of 104 patients additionally to drug treatment underwent the stress EchoCG; the coronarography was performed in patients with the positive test result. If the coronarography revealed the significant impairment of the coronary artery, the preliminary cardioprotective operations were performed: myocardial revascularization in 24 patients, CABG in 5 patients and coronary stenting in 19 cases.

Results. In spite of the intensive medicamentous preoperative preparation, in the first group the rate of myocardial infarction and acute coronary syndrome outcomes was significantly higher than in the second group of patients, who received the different preliminary myocardial revascularization according to individual requirements.

Conclusion. The individual approach to the choice of cardioprotection method before abdominal aortic aneurysm surgery significantly reduces the adverse cardiac events rate.

Science and Innovations in Medicine. 2019;4(2):66-69
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