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ORIGINAL RESEARCH
Lexical analysis automated system: main methods and approaches. Berseneva E.A., Sedov A.A. P. 7
The problem of wound healing in ear surgery and the ways to resolve it. Ognetov S.Yu. P. 43
ORGANIZATION OF HEALTHCARE
Enterprise development in the national health system. Zudin A.B. P. 58
HELP FOR PRACTITIONER
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ORIGINAL RESEARCH
UDC 61:81`322.2:004.912
DOI: 10.20969/VSKM.2017.10(2).7-12
LEXICAL ANALYSIS AUTOMATED SYSTEM: MAIN METHODS AND APPROACHES
BERSENEVA EVGENIA A., D. Med. Sci., Head of Higher and supplementary professional education department of N. Semashko National Research Institute of Public Health, Russia, 105064, Moscow, Vorontsovo Pole str., 12/1, bld. 1, tel. +7-916-216-84-59, e-mail: eaberseneva@gmail.com
SEDOV ALEXANDER A., junior research worker of Higher and supplementary professional education department of N. Semashko National Research Institute of Public Health, Russia, 105064, Moscow, Vorontsovo Pole str., 12/1, bld. 1. tel. +7-903-624-64-51, e-mail: gd@seber.ru
Abstract. Topical issues of the medical document lexical analysis automated system creation are considered in the article. Aim. Medical document lexical analysis automated system creation. Material and methods. Customized methods of indistinct counterpart and borrowings detection, scaly algorithm, relational and situation-dependent model, non-uniform semantic networks and multi-stage linguistic analysis. Results and discussion. The new approach to Russian medical texts processing that includes a complex of methods, both: well checked in similar problem solving in other areas as well as perspective approaches, such as search taking into account semantic syntactical sentence structures, medical terminology and specific vocabulary, was investigated in terms of the project. Conclusions. The system developed allows to perform an assessment of medical documents of different types (examination protocols, discharge summaries, etc.). Interaction between the users and system is carried via the interface for expert and analytical operation with the use of semantic analysis algorithms created. The algorithms applied are based on the medical and non medical vocabularies created within the project.
Key words: medical documentation quality, lexical analysis system, semantic analysis, information technologies, medical organization complex automated information systems.
For reference: Berseneva EA, Sedov AA. Lexical analysis automated system: main methods and approaches. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 7—12. DOI: 10.20969/VSKM.2017.10(2).7-12.
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2. Osipov GS. Priobretenie znanij intellektual’nymi sistemami [Acquisition of knowledge intellectual systems]. Moskva: Nauka; Fizmatlit [Moscow: the science; Fizmatlit].1997: 109 p.
3. Sochenkov IV. Metod sravnenija tekstov dlja reshenija poiskovo-analiticheskih zadach [Method of texts comparison for the solution of search and analytical tasks]. Iskustvennyj intellekt i prinjatie reshenij [Artificial intelligence and decision-making]. 2013; 2; 95-106.
4. Mbajkodzhi Je, Dral’ AA, Sochenkov IV. Metod avtomaticheskoj klassifikacii korotkih tekstovyh soobshhenij [Method of automatic classification of short text messages]. Informacionnye tehnologii i vychislitel’nye sistemy [Information technologies and computing systems]. 2012; 3: 93-102.
UDC [616.13-004.6:616-008.939.155]-07
DOI: 10.20969/VSKM.2017.10(2).13-18
DAVLYATSHINA NURFIYA Z., postgraduate student of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-900-333-92-51, e-mail: nurfiya.20@mail.ru
MAYANSKAYA SVETLANA D., D. Med. Sci., professor of the Department of internal medicine of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-905-316-99-66, e-mail: smayanskaya@mail.ru
MUHAMETGALIEVA ALIYA R., student of the Department of biochemistry and biotechnology of Kazan Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, tel.+7-960-087-09-14, e-mail: aliya_rafikovna@mail.ru
MAYKOVA EVGENIYA V., C. Biol. Sci., assistant of professor of the Department of biochemistry and biotechnology of Kazan Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, tel.+7-917-917-28-63, e-mail: kazan.gen@gmail.com
KRAVTSOVA OLGA A., C. Biol. Sci., associate professor of the Department of biochemistry and biotechnology of Kazan Federal University, Russia, 420008, Kazan, Kremlevskaya str., 18, tel. +7-905-312-99-80, e-mail: okravz@yandex.ru
Abstract. Aim. Evaluation of the gene expression level related to the class of scavenger-receptors in different clinical forms of atherosclerosis was performed. Material and methods. Gene expression analysis of scavenger-receptors CD36, CD68, MARCO, MSR1, SCARB2 of the monocytes and macrophages was performed on 150 people. Among those there were 48 patients with confirmed diagnosis of multifocal atherosclerosis (group 1). Group 2 consisted of patients with coronary heart disease complicated with acute coronary syndrome (46 persons). The 3rd group consisted of patients without clinical evidence of atherosclerotic vascular lesions, but with the presence of risk factors of cardiovascular disease (47 people). Gene expression analysis was performed in peripheral blood in multifocal atherosclerosis patients and in atherosclerotic plaques in addition. Control group was represented by a population sample of 9 people without family history, risk factors or clinical manifestations of cardiovascular disease. Results and discussion. The study of gene expression revealed the differences of scavenger-receptor CD36 in peripheral blood and atherosclerotic plaques in patients with multifocal atherosclerosis. MSR1 receptor gene expression was seen only in atherosclerotic plaques. It was absent in peripheral blood of those patients. Gene Expression of scavenger-receptor CD68 in blood was significantly higher in patients with multifocal atherosclerosis irrespective of its degree. The highest figures of SCARB2 were observed in multifocal atherosclerosis group and the least performance — in acute coronary syndrome group. Сonclusion. The results allow assessing gene expression of scavenger-receptors, which is an important marker of atherosclerotic vascular lesions. This difference in gene expression levels in patients with varying disease severity can be used both as diagnostic and prognostic indicators of atherosclerotic lesions of the vascular wall.
Key words: gene expression of scavenger-receptors monocyte and macrophage, multifocal atherosclerosis, risk factors, atherosclerotic plaques.
For reference: Davlyatshina NZ, Mayanskaya SD, Muhametkalieva AR, Maykova ЕВ, Kravtsova OA. The features of monocyte and macrophage scavenger-receptors gene expression in different clinical forms of atherosclerosis. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 13—18. DOI: 10.20969/VSKM.2017.10(2).13-18.
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UDC [616.441-008.64:616.12-005.4]-085.357.441:616.15-07
DOI: 10.20969/VSKM.2017.10(2).18-24
DOLBIN IGOR V., D. Med. Sci., associate professor, consultant, cardiologist of City Clinical Hospital № 38, Russia, 603000, Nizhny Novgorod, Chernyshevsky str., 22, e-mail: dolbina.olesya20@yandex.ru
EKIMOVSKIKH ANTON YU., physician of City Clinical Hospital № 38, Russia, 603000, Nizhny Novgorod, Chernyshevsky str., 22, e-mail: aranel07@mail.ru
Abstract. Aim. We have studied the effects of levothyroxine replacement therapy on systemic inflammation markers in primary subclinical hypothyroidism patients. Material and methods. 130 patients have been examined. Group 1 comprised 43 stable angina and subclinical hypothyroidism patients; group 2—35 acute coronary syndrome patients; group 3—17 stable angina patients and group 4 (control group) consisted of 35 people. All the subjects were tested for levels of interleukin 6, interleukin 8, interleukin 10, thyroid-stimulating hormone, free thyroxin, and thyroperoxidase antibodies. In the experimental groups 1—3 tests for interleukins were carried out twice: after confirming subclinical hypothyroidism stability before prescribing replacement therapy and 6 months after. Results and discussion. Interleukin 6 content in group 1 happened to be 4,3 times (р=0,005) higher than in group 2; 28 times higher than in group 3 (р<0,001) and control group (р<0,001). Interleukin 8 content in group 1 did not differ significantly from group 2 (р=0,13). It was 5 times higher than in group 4 (р<0,001). Interleukin 10 content in groups 1 and 2 was equitable (p=1,0). In group 1 it was higher than in group 3 (р<0,001) and control group (р<0,001). While receiving levothyroxine replacement therapy Interleukin 6 level (р<0,001), Interleukin 8 (р<0,001) were significantly reduced in group 1 whereas Interleukin 10 (р<0,001) level has increased. Conclusion. Subclinical hypothyroidism as an outcome of chronic autoimmune thyroiditis may negatively affect coronary heart disease course resulting from changes in lipid and cytokine profiles with a distinct atherogenic effect. Levothyroxine replacement therapy results in decrease in inflammatory and increase in anti-inflammatory interleukins.
Key words: hypothyroidism, atherosclerosis, coronary heart disease, dyslipidemia, interleukins.
For reference: Dolbin IV, Ekimovskikh AYu. Levothyroxine replacement therapy effect on systemic inflammation markers in patients with primary subclinical hypothyroidism and coronary heart disease. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 18—24. DOI: 10.20969/VSKM.2017.10(2).18-24.
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7. Bondar’ TP, Cogoeva TV. Issledovanie etapov vospalenija u bol’nyh s ostrym koronarnym sindromom s pomoshh’ju opredelenija citokinov [Research stages of inflammation in patients with acute coronary syndrome by determining the cytokine]. Novosti «Vektor–Best» [«Vector–Best» news]. 2005; 4 (38): 9-13.
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13. Shal’nev VI. Dinamika soderzhanija interlejkina–8 v plazme krovi bol’nyh ostrym koronarnym sindromom. Immunomodulirujushhij jeffekt rannej terapii statinami [The dynamic changes of interleukin–8 level in blood plasma in acute coronary syndrome setting. The immunomodulating effect of early statin therapy]. Skoraja medicinskaja pomoshh’ [Emergency]. 2011; 2: 67-72.
14. Halvorsen B, Waehre T, Scholz H, Clausen OP, von der Thüsen JH, Müller F, Heimli H, Tonstad S, Hall C, Frøland SS, Biessen EA, Damås JK, Aukrust P. Interleukin-10 enhances the oxidized LDL-induced foam cell formation of macrophages by antiapoptotic mechanisms. J Lipid Res. 2005; 46: 211–219.
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17. Oganov RG. Nacional’nye klinicheskie rekomendacii [National clinical guideline]. Moskva [Moscow]: Silitseya-Poligraf. 2011; 528 p.
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19. Kuharchuk VV, Konovalov GA, Susekov AV et al. Diagnostika i korrekcija narushenij lipidnogo obmena s cel’ju profilaktiki i lechenija ateroskleroza; Rossijskie rekomendacii; V peresmotr [Diagnosis and correction of lipid disorders for the prevention and treatment of atherosclerosis; Russian recommendations; V revision]. Rossijskij kardiologicheskij zhurnal [Russ Card J]. 2012; 4 (96): 2-32.
20. Glazanova TV, Bubnova LN, Trunin EM. Produkcija nekotoryh citokinov u bol’nyh s autoimmunnymi zabolevanijami shhitovidnoj zhelezy [Production of some cytokines in patients with autoimmune thyroid diseases]. Problemy jendokrinologii [Problems of Endocrinology]. 2004; 3: 29-32.
UDC 616.248-057-02:614.253.5:519.254
DOI: 10.20969/VSKM.2017.10(2).25-29
ITERATIVE ALGORITHM OF PROFESSIONAL ASTHMA RISK ASSESSMENT
DUDINTSEVA NATALIA V., C. Med. Sci., assistant of professor of the Department of nursing of Samara State Medical University, Russia, 443099, Samara, Chapaevskaya str., 89, е-mail: natalidudinceva@mail.ru
ZHESTKOV ALEXANDER V., D. Med. Sci., professor, Head of the Department of microbiology, immunology and allergology of Samara State Medical University, Russia, 443099, Samara, Chapaevskaya str., 89
LOTKOV VYACHESLAV S., D. Med. Sci., professor of the Department of occupational diseases and clinical pharmacology of Samara State Medical University, Russia, 443099, Samara, Chapaevskaya str., 89
STULIN VLADIMIR V., C. Tech. Sci., associate professor of the Department of mathematics and practical informatics of Samara State Technical University, Russia, 443100, Samara, Molodogvardeyskaya str., 244
Abstract. Aim. Assessment of occupational asthma risk factors was performed taking iterative algorithm in a group of nurses as an example. Material and methods. The group of health care providers with the largest number of occupational diseases — 222 (Group of nurses) has served as experimental group in our study. Simulations based on iterative algorithm developed by employees of Samara State Technical University called approximation-optimization approach (POA) were conducted in order to choose optimal strategy for occupational diseases. The algorithm is based on the principle of risk factor maximum variability. A group of professional allergies (asthma) was selected for simulation. Results and discussion. Sanitary hygienic characteristics analysis of working conditions of nurses was conducted. Presence of significant amount of production risk factors for development of occupational asthma was revealed. The following indicators have been identified: penicillins, Grippol vaccine, disinfectants (with and without chlorine), latex gloves and mycelia fungus. Conclusion. Iterative algorithm application makes it possible to predict occupational bronchial asthma progression in order to develop preventative programs.
Key words: bronchial asthma risks, processing of medical information, statistical methods.
For reference: Dudintseva NV, Zhestkov AV, Lotkov VS, Stulin VV. Iterative algorithm of professional asthma risk assessment. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 25—29. DOI: 10.20969/VSKM.2017.10(2).25-29.
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8. Stulin VV, Zipaev DV, Zimichev AV. Verojatnostnaja model’ ocenki vlijanija faktor-parametra na lokal’nuju harakteristiku serii ekstremal’nyh eksperimentov [Probabilistic model for estimating the influence of the factor-parameter on the local characteristic of a series of extreme experiments]. Vestnik SamGTU: Serija matematicheskaja [SamSTU Messenger: Mathematical Series]. 2008; 2 (8): 112-133.
UDC 616.34-008.314.4-022.6-053.2
DOI: 10.20969/VSKM.2017.10(2).30-33
CLINICAL AND IMMUNOLOGICAL FEATURES OF VIRAL DIARRHEA IN CHILDREN
ZAYTSEVA LUDMILA YU., С. Med. Sci, associate professor of the Department of pediatrics Kursk State Medical University, 305004, Russia, Kursk, K. Marks str., 3, e-mail: luda201235@yandex.ru
KHMELEVSKAYA IRINA G., D. Med. Sci, professor, Head of the Department of pediatrics, vice-rector of Kursk State Medical University, 305004, Russia, Kursk, K. Marks str., 3
KALUTSKIY PAVEL V., D. Med. Sci, professor, Head of the Department of microbiology, vice-rector of Kursk State Medical University, 305004, Russia, Kursk, K. Marks str., 3
Abstract. Aim. Determination of the etiological structure, clinical and laboratory features of viral diarrhea and detection of changes in humoral immunity in children with acute intestinal infections caused by Rota- and Noroviruses in Kursk. Material and methods. 60 patients of the Department of intestinal infections hospitalized in 2015—2016 were under our observation. In addition to the standard investigation Astro-, Noro- and Rotavirus RNA detection in feces was carried out via polymerase chain reaction. Immunologic study included serum total immunoglobulin M and G level determination as well as serum IgA concentration in coprofiltrates. Interleukins 6 and 10 were determined via immunoenzymatic essay. Results and discussion. The main clinical and laboratory features of viral diarrhea course in children were shown. The longer course of the disease in children with unspecified etiology of the disease was identified. The study of cytokine status has showed significant increase in the content of IL-6 in patients with unidentified origin of intestinal infection. At the same time significant differences (p<0,05) in IL-6 content were revealed between this group of children and patients with infections caused by Norovirus and Rotavirus. Conclusion. The most common cause of intestinal infection of viral etiology is Rotavirus, while Astroviruses were not detected. Major changes in immunological parameters were recorded in patients with undetected etiological agent. Described clinical and laboratory signs, as well as the impossibility of pathogen identification by routine methods allows to assume high probability of anaerobic flora participation in development of pathological process in intestine.
Key words: viral diarrhea, children, Rotavirus, Norovirus, immunoglobulins, cytokines.
Forreference: Zaytseva LYu, Khmelevskaya IG, Kalutskiy PV. Clinical and immunological features of viral diarrhea in children. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 30—33. DOI: 10.20969/VSKM.2017.10(2).30-33.
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UDC 616.233-002.1-053.2-085.322
DOI: 10.20969/VSKM.2017.10(2).34-39
ZAKIROVA ALFIYA M., C. Med. Sci., associate professor of the Department of pediatrics of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, e-mail: azakirova@gmail.com
MOROZ TATYANA B., C. Med. Sci., Head of Pediatric hospital of Central Clinical Hospital № 18, Russia, 420073, Kazan, Richard Zorge str., 2a, e-mail: azakirova@gmail.com
RASHITOV LENAR F., C. Med. Sci., associate professor, Head of the Department of emergency medicine and medical simulation of Institute of Fundamental Medicine and Biology, Kazan (Volga) Federal University, Russia, 420018, Kazan, Kremlevskaya str., 18, e-mail: rashlen@gmail.com
FETISOVA TATYANA G., neonatologist of University clinic of Kazan (Volga) Federal University, Russia, 420018, Kazan, Kremlevskaya str., 18, e-mail: tatiananeon@mail.ru
Abstract. Nowadays, due to increasing pathogen resistance to synthetic medications (in particular, to antibiotics) and also due to often adverse drug reaction development, the attention of doctors and patients is being dragged to plant extract based medications. Aim. To trace the therapeutic effect and tolerability of the inhalation technique with «Abisil», which is a set of terpens, in children for acute bronchitis treatment with respect to the dynamics of clinical and laboratory symptoms of the inflammatory process. Material and methods. 50 children with acute bronchitis aged from 1 to 7 years (inclusive) hospitalized to the children department of the State Sanitary Epidemiologic Service of the Central Clinical Hospital № 18 in Kazan were placed under observation. Inhalations were carried out daily 2 times a day for 10—15 minutes with a course of 7 days via steam inhaler by «B. Well». 8 drops of «Abisil» were used for each inhalation. Results and discussion. The effectiveness of the inhalations with the use of the drug «Abisil» (a complex of natural terpenoids of Siberian fir) in the complex treatment of infants with acute bronchitis was studied. Conclusion. Versatile properties of «Abisil», as well as the results of clinical observations confirm multidirectional therapeutic effect and safety of the drug, which allows us to recommend it for widespread use in treatment of acute bronchitis in children.
Key words: children, acute bronchitis, terpenoid, steam inhalations.
For reference: Zakirova AM, Moroz TB, Rashitov LF, Fetisova TG. Plant extract based medication «Abisil» administration experience in children with acute bronchitis. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 34—39. DOI: 10.20969/VSKM.2017.10(2).34-39.
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UDC 616.12-018.2-007.17-085.2/.3
DOI: 10.20969/VSKM.2017.10(2).39-43
COMBINED DRUG THERAPY OF CONNECTIVE TISSUE DYSPLASIA CONCURRENT WITH INSULIN RESISTANCE
KOROL INNA V., assistant of professor of the Department of endocrinology of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7-918-414-44-19, e-mail: innakorol1@mail.ru
IVANOVA LYUDMILA A., D. Med. Sci, professor, Head of the Department of endocrinology of Kuban State Medical University, Russia, 350063, Krasnodar, Sedin str., 4, tel. +7-988-242-13-90, e-mail: endocrinkgmu@mail.ru
Abstract. Aim. Effectiveness of combined drug therapy in patients with connective tissue dysplasia in combination with insulin resistance was studied. Material and methods. The study included 69 patients [mean age (31,1±2,8) years] with connective tissue dysplasia in combination with insulin resistance. They were divided into main (n=42) and control (n=27) clinical groups. During 6 months the patients of the main group were taking magnesium orotate (2000—3000 mg/day) and thioctic acid (600 mg/day). The patients from control group were receiving Magnesium orotate (2000—3000 mg/day). We have studied the effect of therapy on the course of autonomic dysfunction syndrome, the frequency of arrhythmias and heart conduction and rate disorders as well as dysplasia markers. Vegetative status evaluations, standard electrocardiogram at rest, echocardiography as well as laboratory tests were performed at baseline and after 6 months of treatment. Results and discussion. The patients with connective tissue dysplasia combined with insulin resistance presented with significant decrease in the incidence and severity of autonomic dysfunction syndrome, heart rhythm disorders, as well as heart dysplasia markers revealing after 6 months of treatment with magnesium orotate and thioctic acid comparing to the baseline. Conclusion. Combined therapy with magnesium orotate and thioctic acid can be recommended for the patients with connective tissue dysplasia in combination with insulin resistance in order to assure endocrine and connective tissue disease correction.
Key words: connective tissue dysplasia, insulin resistance.
For reference: Korol IV, Ivanova LA. Combined drug therapy of connective tissue dysplasia concurrent with insulin resistance. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 39—43. DOI: 10.20969/VSKM.2017.10(2).39-43.
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UDC 616.28-089.168.1:616-003.9
DOI: 10.20969/VSKM.2017.10(2).43-47
THE PROBLEM OF WOUND HEALING IN EAR SURGERY AND THE WAYS TO RESOLVE IT
OGNETOV SERGEY YU., C. Med. Sci., assistant of professor of the Department of otorhinolaryngology of Izhevsk State Medical Academy, 426000, Russia, Izhevsk, Communar str., 281, e-mail: ognetovlor@rambler.ru
Abstract. Aim. Study and comparison of the modern methods of wound healing in ear surgery. Suggestion of the personal method of cavity epithelization obtained in the course of canal wall down mastoidectomy. Material and methods. The article highlights the problem of wound healing in ear surgery as well as the ways to resolve it. The этаadvantages and disadvantages of the methods were discussed. The literature data is presented. We propose a method, which assumes the use of epidermal growth factor. The essence of the method is that on the 7 day after canal wall down mastoidectomy after removal of the tampon from the ear, the postoperative cavity is being treated with epidermal growth factor (ointment «Ebermin»). According to the prescription the ointment is being applied once in two days. The study involved 87 patients: 47 men and 40 women aged 15 to 64 years. The control group (comparison) consisted of 88 patients. The results of cavity epithelialization were evaluated by ear microscopy («OPMI Sensera» microscope). Results and discussion. Complete epithelialization of post-operative cavity obtained during mastoidectomy was achieved in all cases. Conclusion. The problem of wound healing in ear surgery is still relevant. The abundance of wound healing problem solution proposals in ear surgery confirms the lack of effectiveness of each. Epidermal growth factor can be used for post-operative cavity epithelization in patients undergoing canal wall down mastoidectomy.
Key words: wound healing, epidermal growth factor.
For reference: Ognetov SYu. The problem of wound healing in ear surgery and the ways to resolve it. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 43—47. DOI: 10.20969/VSKM.2017.10(2).43-47.
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UDC 616-089.5:615.33:546.46
DOI: 10.20969/VSKM.2017.10(2).47-53
FISHER VASILIY V., C. Med. Sci., associate professor of the Department of anesthesiology, intensive care and emergency medical care of Stavropol State Medical University, Russia, 355017, Stavropol, Mir str., 310, e-mail: vvfisher26@gmail.com
YATSUK IVAN V., assistant of professor of the Department of anesthesiology, intensive care and emergency medical care of Stavropol State Medical University, Russia, 355017, Stavropol, Mir str., 310, e-mail: yatsukiv@gmail.com
BATURIN VLADIMIR A., D. Med. Sci, professor, Head of the Department of clinical pharmacology, allergology and immunology of Stavropol State Medical University, Russia, 355017, Stavropol, Mir str., 310, e-mail: prof.baturin@gmail.com
VOLKOV EVGENY V., C. Med. Sci., assistant of professor of the Department of anesthesiology, intensive care and emergency medical care of Stavropol State Medical University, Russia, 355017, Stavropol, Mir str., 310, e-mail: volkov26@mail.ru
Abstract. Aim. The effectiveness of supplementary anesthetic pharmacological patient protection from surgical stress from inclusion of sedative drug «Magnesium Sulfate» was studied. Material and methods. The study included 60 patients (30 persons in control group and 30 ones in main group) of maxillofacial surgery department without significant comorbidities. The values of intracellular magnesium, calcium and circulating endothelial cells were evaluated one day prior to surgery, during surgery, 3 and 5 days after surgery. Results and discussion. It was established that at the time of surgery the number of circulating endothelial cells began to grow and reached a maximum on the 5th day of the postsurgical period. After surgery and during postsurgical period the increase in calcium in erythrocytes was shown comparing to presurgical values. Intracellular calcium levels were the highest during the surgery, and on the 3rd day after. While in erythrocytes raising magnesium levels were detected during the surgery. There was a gradual decline after. On the 5th day after the surgery magnesium content was lower than initial, while the calcium level was significantly increased. Adding MgSO4 solution to the anesthesiology aid protocol was accompanied by less significant changes in the number of circulating endothelial cells and intracellular levels of calcium and magnesium. It might indicate stress-protective properties of magnesium sulfate. Conclusion. Using the solution of MgSO4 as a component of sedation may become an additional factor protecting patients from the surgical stress.
Key words: surgical stress, calcium, magnesium, premedication, magnesium products, circulating endothelial cells.
For reference: Fisher VV, Yatsuk IV, Baturin VA, Volkov EV. The effect of surgical stress on endothelial dysfunction and magnesium-calcium balance in case of inclusion of magnesium sulfate solution in premedication. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 47—53. DOI: 10.20969/VSKM.2017.10(2).47-53.
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UDC 61:378.4(560).091.212:303.62
DOI: 10.20969/VSKM.2017.10(2).53-57
ADAPTATION OF THE MEDICAL ACHIEVEMENT SELF-EFFICACY SCALE (MASS) INTO TURKISH
TURAN SEVGI, MSc, PhD, Associate Professor of Medical Education, Hacettepe University Faculty of Medicine, Department of Medical Education and Informatics, Sihhiye Campus, Turkey, 06100, Ankara, e-mail: sturan@hacettepe.edu.tr
ELCIN MELIH, MD, MSc, CHSE, Professor of Medical Education, Hacettepe University Faculty of Medicine, Department of Medical Education and Informatics, Sihhiye Campus, Turkey, 06100, Ankara,
DERESE ANSELME, MD, PhD, Associate Professor of Family Medicine and Medical Education, Ghent University Faculty of Medicine, Department of Family Medicine and Primary Health Care, De Pintelaan 185, 6K3, 9000, Ghent, Belgium
Abstract. Aim. Curriculum innovators are eager to evaluate the overall effects of curriculum changes. In a Belgian-Turkish collaboration we developed a scale, for content validity based on the competency frameworks of CanMEDs and The Five Star Doctor, to measure self-efficacy changes in undergraduate medical students. In this study, the reliability and construct validity of Medical Achievement Self-efficacy Scale (MASS) among Turkish medical students were examined. Material and methods. The MASS contains 18 items, to be rated on a five-point Likert scale. The study was conducted with undergraduate medical students at Hacettepe University (n=547). The Turkish form of the scale was examined for content validity by five experts. Cronbach’s alpha was calculated for reliability of the scale. Item-total correlation was calculated and the scores of lowly and highly performing groups were compared by means of a t-test. Exploratory factor analysis was conducted to determine the construct validity. Results and discussion. The content validity of the Turkish MASS was considered appropriate. The reliability of the scale was high (Cronbach’s a=0,89). Item-total correlation coefficients of the Turkish MASS ranged from 0,53 to 0,70. Lower and upper score groups were compared as an indicator of the discriminant validity. All items discriminated significantly between lowly and highly performing students. Factor analysis showed that the scale has a one factor structure which explains 37,89% of the variance. Factor loadings ranged from 0,56 to 0,73. Conclusions. The study showed the reliability and delivered evidence about the construct validity of the Turkish adaptation of the MASS.
Key words: academic self-efficacy, medical students, scale development.
For reference: Turan S, Elcin M, Derese A. Adaptation of the Medical Achievement Self-efficacy Scale (MASS) into Turkish. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 53—57. DOI: 10.20969/VSKM.2017.10(2).53-57.
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ORGANIZATION OF HEALTHCARE
UDC 614.39(470+571):334.012.32
DOI: 10.20969/VSKM.2017.10(2).58-63
ENTERPRISE DEVELOPMENT IN THE NATIONAL HEALTH SYSTEM
ZUDIN ALEXANDER B., C. Med. Sci., Director of the Institute of biomedical problems, of Russian University of peoples’ friendship, Russia, 117198, Moscow, Miklukho-Maklay str., 6, e-mail: zudin@nptemp.ru
Abstract. Aim. The purpose of the study is implementation of the methods of strategic planning and foresight into the process of effective reform of the health care system of the Russian Federation. We have studied the entreprise development experience in the national health care system. Material and methods. Review of publications, theoretical and system analysis methods, classification, quantitative and qualitative methods of sociological research were applied. Results and discussion. Entrepreneurship in the field of paid medical service rendering in the national health care system is still in its infancy at present. In a great measure it depends on the level of infrastructure development. Russian market of medical services does not have developed market infrastructure because of the fragmentation of business structures. However, entrepreneurship in the sphere of providing paid medical services has a good future, but its achievement is connected to the policy of rational correlation of market principles in health care with the elements of state regulation. The lag in its development was built from the inception of the country on military sample of architect and subordination. Division of health into state, municipal and private systems preserves hierarchical pattern of the first two and cannot be applied on the last. So that private medicine has a lack not only in subordination, but also in the infrastructure. Creation of market infrastructure is a government task. Conclusion. It was established that transition to market economy implies the use of mainly economic methods of management. Most of economists are focused on profit as an ultimate goal of entrepreneurship. The key tasks of the state regulation of enterprise activity in national healthcare were highlighted.
Key words: entrepreneurship, medical services, development, quality, demand.
For reference: Zudin AB. Enterprise development in the national health system. The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 58—63. DOI: 10.20969/VSKM.2017.10(2).58-63.
REFERENCES
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UDC 616.12-008.331.1-085.225.2:616.1(470.41-22)
DOI: 10.20969/VSKM.2017.10(2).64-71
KITAEVA ENDZHE A., C. Med. Sci., Head of the Department of neurology of Rybnaya Sloboda Central District Hospital, Russia, 422650, Rybnaya Sloboda district, set. Rybnay Sloboda, Sosnovaya str., 6, tel. +7-927-033-78-41, e-mail: kitaevaenge@mail.ru
KITAEV MANSUR R., C. Med. Sci., Chief physician of Rybnaya Sloboda Central District Hospital, Russia, 422650, Rybnaya Sloboda district, set. Rybnay Sloboda, Sosnovaya str., 6, tel. (843-61) 2-21-63, e-mail: Mansur.Kitaev@tatar.ru, e-mail: mz.rsloboda_crb@tatar.ru
SUETINA TATYANA A., C. Econ. Sci., associate professor of the Department of process dynamics and management of A.N. Tupolev Kazan National Research Technical University — KAI, Russia, 420034, Kazan, K.Marx str., 10, tel. +7-960-037-73-89, e-mail: suetinat@mail.ru
SALYAHOVA LILIYA YA., C. Med. Sci., associate professor of the Department of health management of Kazan State Medical University, Russia, 420012, Kazan, Butlerov str., 49, tel. +7-987-297-06-30, e-mail: saljakhova.l@gmail.com
VAFIN ADEL YU., C. Med. Sci., associate professor of the Department of health management of Kazan State Medical University, the Minister of Health of the Republic of Tatarstan, Russia, 420012, Kazan, Butlerov str., 49, tel. 8(843)-236-02-72, e-mail: Adel.vafin@tatar.ru
Abstract. Aim. The article is devoted to current problem related not only to the health care, but to society in general which is cardiovascular diseases. The aim of the study is the analysis of modern data on the topic of cardiovascular disease prevention in rural areas. Material and methods. Review of literature of native and foreign authors was carried out. Primary and secondary cardiovascular disease prevention organization experience aiming to eliminate risk factors (excess body weight, hypertension, dyslipidemia) as well as behavioral ones were studied (unhealthy diet, addictions, physical inactivity etc.). The experience of the Stroke schools organization was described. Results and discussion. On the basis of the studied data we proposed a method of combined effect on patients aiming to develop compliance to drug treatment in rural area patients: 1) team work of the general practitioner and doctor’s assistant of medical and obstetrical center — active medical and medical assistant’s observation (during the first 6 months since the moment of inclusion into research the frequency of the visits to the doctor and to the doctor’s assistant of medical and obstetrical center is once a month). For example, visits to the doctor are in the beginning of the month, a visit to the doctor’s assistant is in the middle of the month; 2) regular training at Stroke school is once a month; 3) daily keeping «Diary of blood pressure self-check»; 4) introduction of the system of free hypotensive drug distribution during the first 6 months since the inclusion into research; 5) introduction of the high-tech method Automatic call-down through the Unified State Information System for the purpose of rising patient commitment to medicinal therapy. Conclusion. The use of comprehensive program aiming to develop drug therapy compliance will allow reducing the risk of cardiovascular diseases and their complications in patients living in rural areas.
Key words: stroke, Stroke school, stroke prevention, compliance.
For reference: Kitaeva EA, Kitaev MR, Suetina TA, Salyahova LYa, Vafin AYu. Implementation of patient oriented program aiming to develop compliance in rural area patients (in terms of Rybnaya Sloboda district of the Republic of Tatarstan). The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 64—71. DOI: 10.20969/VSKM.2017.10(2).64-71.
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HELP FOR PRACTITIONER
UDC 616.153.922-056.7
DOI: 10.20969/VSKM.2017.10(2).72-79
DIAGNOSIS AND TREATMENT OF FAMILY HYPERCHOLESTEROLEMIA (russian guidelines)
EZHOV MARAT V., D. Med. Sci., professor, leading research worker of the Department of atherosclerosis issues of Russian Cardiology Research and Production Complex, president of the National Society for the research on atherosclerosis, Russia, 121552, Moscow, 3th Cherepkovskiy str., 15a, e-mail: marat_ezhov@mail.ru
SERGIENKO IGOR V., D. Med. Sci., professor, leading research worker of the Department of atherosclerosis issues of Russian Cardiology Research and Production Complex, director of the National Society for the research on atherosclerosis, Russia, 121552, Moscow, 3th Cherepkovskiy str., 15a
ROZHKOVA TATIANA A., C. Med. Sci., researcher worker of the Department of atherosclerosis issues of Russian Cardiology Research and Production Complex, director of the National Society for the research on atherosclerosis, Russia, 121552, Moscow, 3th Cherepkovskiy str., 15a, e-mail: rozhkova.ta@mail.ru
KUKHARCHUK VALERY V., D. Med. Sci., professor, Corresponding Member of Russian Academy of Sciences, Head of the Department of atherosclerosis issues of Russian Cardiology Research and Production Complex, editor-in-chief of the journal «Atherosclerosis and Dislipidemia», Russia, 121552, Moscow, 3th Cherepkovskiy str., 15a, e-mail: v_kukharch@mail.ru
KONOVALOV GENNADY A., D. Med. Sci., professor, research head of the Center for Diagnostics and Innovative Medical Technologies of Clinical and diagnostic center «MEDSI» on Belorusskaya, academician of the International Academy of Sciences, Russia, 123056, Moscow, Gruzinsky lane, 3a, e-mail: konovalov@medsigroup.ru
MESHKOV ALEXEY N., C. Med. Sci., Head of the Laboratory of molecular genetics of State Research Center for Preventive Medicine, Russia, 101990, Moscow, Petroverigsky lane, 10, bld. 3, e-mail: meshkov@lipidclinic.ru
ERSHOVA ALEXANDRA I., C. Med. Sci., senior research worker of the Department of clinical and molecular genetics of State Research Center for Preventive Medicine, Russia,101990, Moscow, Petroverigsky lane, 10, bld. 3, e-mail: alersh@mail.ru
GUREVICH VIKTOR S., D. Med. Sci., professor, Head of the Department of atherosclerosis of Scientific Clinical and Educational Center «Cardiology» of the Medical Faculty of the St. Petersburg State University, vice president of the National Society for the research on atherosclerosis, Russia, 99034, St. Petersburg, Universitetskaya banking, 7-9, e-mail: vktrgurevich@gmail.com
KONSTANTINOV VLADIMIR O., D. Med. Sci., professor of the Department of internal medicine of I.I. Mechnikov North-West State Medical University, Russia, 191015, St. Petersburg, Kirochnaya str., 41, e-mail: atherosclerosis@mail.ru
SOKOLOV ALEXEY A., D. Med. Sci., professor of the Department of nephrology and efferent therapy of S.M. Kirov Military Medical Academy, executive director of National Council of Experts on Rare Diseases, Russia, 194044, St. Petersburg, Academik Lebedev str., 6, lit. J, e-mail: dr.sokolov@list.ru
SHCHERBAKOVA MARINA YU., D. Med. Sci., professor of the Department of pediatrics of N.I. Pirogov Russian National Research Medical University, Russia, 117997, Moscow, Ostrovityanov str., 1, e-mail: shcherbakova_m@rsmu.ru
LEONTIEVA IRINA V., D. Med. Sci., professor, chief research officer of the Department of congenital and acquired diseases of the cardiovascular system of Academician Yu.E. Veltischev Scientific Research Clinical Institute of Pediatrics of N.I. Pirogov Russian National Research Medical University, Russia, 125412, Moscow, Taldomskaya str., 2, e-mail: lirina2006@mail.ru
BAZHAN STEPAN S., C. Med. Sci., senior researcher of the Department scientific and innovation, research of Institute of Therapy and Preventive Medicine, Russia, 630089, Novosibirsk, Boris Bogatkov str., 175/1, e-mail: stepan_bazhan@yahoo.com
VOEVODA MIKHAIL I., D. Med. Sci., professor, academician of the Russian Academy of Sciences, Director of the Scientific Research Institute of Therapy and Preventive Medicine, vice president of the National Society for the research on atherosclerosis, Russia, 630089, Novosibirsk, Boris Bogatkov str., 175/1, e-mail: mvoevoda@ya.ru
SHAPOSHNIK IGOR I., D. Med. Sci., professor, Head of the Department of internal medicine of South Ural State Medical University, Russia, 454092, Chelyabinsk, Vorovsky str., 64, e-mail: shaposhnik@yandex.ru
Abstract. Family hypercholesterolemia is a monogenic autosomal dominant disease accompanied by significant increase of blood cholesterol, and as a result, premature development and progressive course of atherosclerosis, usually at young age. Even in case of the absence of diseases caused by atherosclerosis the patients with family hypercholesterolmia belong to the high-risk group and to a group of a very high risk of cardiovascular complications development if relevant. Aim. These practical recommendations are developed for physicians and represent the definition, diagnostic criteria and modern approaches to the treatment of family hypercholesteremia. Material and methods. The recommendations contain the stages of providing medical care to this group of patients, depending on the age and sex. Results and discussion. Possible types of medical care were indicated for each stage. An algorithm of identification, management and treatment of patients with family hypercholesterolemia were presented. Conclusion. The main principles of methodological recommendations presented for the organization of medical care for patients with family hypercholesterolemia in the subjects of the Russian Federation are intended for general practitioners, pediatricians and cardiologists, as well as for physicians of other specialties.
Key words: family hypercholesterolemia, low-density lipoprotein cholesterol, prevention, atherosclerosis, treatment.
For reference: Ezhov MV, Sergienko IV, Rozhkova TА, Kuharchuk VV, Konovalov GA, Meshkov AN, Ershova AI, Gurevich VS, Konstantinov VO, Sokolov AA, Shcherbakova MYu, Leontieva IV, Voevoda MI, Shaposhnik II. Diagnosis and treatment of family hypercholesterinemia (russian guidelines). The Bulletin of Contemporary Clinical Medicine. 2017; 10 (2): 72—79. DOI: 10.20969/VSKM.2017.10(2).72-79.
