No 74 (2018)

Articles
THE ROLE OF THE DEPARTMENT OF FACULTY THERAPYIN THE IMPROVEMENT OF TRAINING OF FUTURE DOCTORS
Provotorov V.M.
Abstract
The program of the Department of faculty therapy forms the 4th year students clinical thinking due to work at the patient's bed and in the simulation training center, allowing the student to master the complex actions during resuscitation. When writing a medical card of a hospital patient there is the development and consolidation of specific skills of clinical thinking and its logical structure. Good psychological contact of the student with the patient determines the reliability of anamnestic data. The teacher should explain to students that the clinical diagnosis is formed on the basis of National recommendations for the diagnosis and treatment of the disease, approved by the Ministry of health of the Russian Federation. Great importance is attached to improving the lecture activities of experienced professors and associate professors. The lectures emphasize the role and importance of discoveries and achievements made by domestic clinicians. Of great importance is the work of the student scientific club for curious and hardworking students.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):3-7
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PROFESSOR S.S. SERGIEVSKY - AT THE ORIGINS OF THE PSYCHIATRIC SERVICE OF THE VORONEZH REGION AND CHECHEN-INGUSHETIA
Akhmadov T.Z., Akhmadova L.T.
Abstract
The article presents a little-known life and career of one of the first professional organizers of the psychiatric service of the Voronezh region and Chechen-Ingushetia, professor S.S. Sergievsky. To date, unknown biographical information of 1932-1949 is given.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):8-12
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ANALIZ TABAKOKURENIYa KAK FAKTORA RISKA KhRONIChESKIKh NEINFEKTsIONNYKh ZABOLEVANIY
Babkin A.P., Romanova M.M., Pisareva N.A., Khanin E.A., Golovko T.V.
Abstract
The article is devoted to the study of the features and structure of Smoking among patients of the therapeutic area of the city clinical clinic. According to the data obtained, the frequency of patients with nicotine dependence and the index of smoker among men is higher than in women in a separate section of the city polyclinic. In the structure of tabakokurenie changes ladyt person age category of 41 to 60 years. With the aim of reducing consumption of tobacco products and prevention of diseases correlated with tobacco Smoking, further legal, or-ganization and health measures at the state level, gra-moty in scientific terms, and an optimal, practical approach to solving this problem.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):13-17
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NEKOTORYE OSOBENNOSTI ANEMIChESKOGO SINDROMA U PATsIENTOV GORODSKOY POLIKLINIKI
Babkin A.P., Romanova M.M., Kislyak I.D., Muravitskaya M.N., Vazhenina T.N.
Abstract
An urgent task in clinical practice is the early appearance, adequate correction of risk factors, effective therapy of chronic non-infectious diseases, including in the framework of clinical examination of the adult population of the country. The article presents the results of a study on the prevalence and structure of anemic syndrome in patients on an outpatient basis. According to the obtained data, in the therapeutic area of the city polyclinic anemic syndrome was detected mainly in women (80%) of middle age (405.7 years) in most cases by accident (78.4%). The most frequent causes of anemic syndrome were gynecological (46.6%) and oncological (30%) pathologies. Prevailed patients with normochromic, normalfree anemia mild (68.3 per cent). The data obtained, in our opinion, should be taken into account when conducting clinical examination, prevention and rehabilitation of patients in outpatient settings.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):18-22
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THE IMPORTANCE OF PSYCHOSOCIAL STRESS, ALARM AND DEPRESSION IN PREVENTION OF CARDIOVASCULAR DISEASES IN YOUNG PEOPLE
Esina E.Y., Zuikova A.A., Krysenkova N.A.
Abstract
Psychosocial stress, anxiety and depression are independent risk factors for cardiovascular disease development, progression and death. 58 patients with somatoform dysfunction of the autonomic nervous system were examined in men aged 22.9 ± 1.6 years. The prevalence of risk factors in male patients was studied, including: psychosocial stress, anxiety, and depression. Patients had an average level of psychosocial stress and subclinical anxiety. The average level of psychosocial stress and subclinical anxiety were observed in patients with somatoform dysfunction of the autonomic nervous system with the studied leading risk factors for cardiovascular diseases. Revealed a strong correlation between stress and anxiety, moderate - between anxiety and depression, stress and depression.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):23-26
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THE ROLE OF THE PRIMARY HEALTH CARE LINKIN PALLIATIVE AID PROVISION
Zuykova A.A., Dobrynina I.S., Hanina E.A., Pusakova E.K.
Abstract
The study and evaluation of palliative care at the outpatient stage for women with metastatic breast cancer, for which the possibilities of special treatment methods were exhausted, were conducted. The patients consisted of IV clinical group ancochea. The nature and volume of pain therapy, as well as the effect of anesthesia on the quality of life of women were studied. Assessment of pain intensity was performed on the scale YOUR evaluation of the status of the cancer patient on a scale ECOG. It is shown that an adequate choice of pharmacotherapy allows to control pain and significantly improve the quality of life of patients. In the course of the work the importance of primary health care in improving the quality of life of cancer patients through adequate pharmacotherapy of pain syndrome in order to improve the provision of palliative care to the population.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):27-32
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THE ROLE OF THE PRIMARY HEALTH CARE LINK IN PALLIATIVE AID PROVISION
Zuykova A.A., Dobrynina I.S., Hanina E.A.
Abstract
The article deals with the prevalence and severity of urinary incontinence syndrome in women at the outpatient stage of medical care. It was found that among the patients who applied for help, the syndrome of incontinence was detected in approximately every 6 patients. Also, the most frequent comorbid conditions in this syndrome have been established. The leading factors affecting the occurrence of urinary incontinence in women were determined and the type of incontinence was determined. The level of influence of this condition on the quality of life and daily activity of the examined patients was revealed. The study identified the most common pathologies associated with the syndrome of incontinence: pathology of the cardiovascular system, respiratory system, diseases of the urinary system, gynecological pathology.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):33-39
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THE ANALYSIS OF THE STRUCTURE OF RESPIRATORY DISEASES IN OUTPATIENT CLINICS
Muravitskaya M.N., Zuikova A.A., Posmeteva O.S., Khanina E.A., Romanova M.M., Kovaleva L.P., Antipova E.I.
Abstract
This study analyzed the рrevalence of respiratory diseases, taking into account the sex, age of patients at the outpatient stage. A group of patients with acute and chronic diseases of the bronchopulmonary system was formed by random sampling, the structure of respiratory diseases was studied, priority acute and chronic non-infectious diseases were identified at the outpatient stage. The study revealed that the structure of respiratory diseases is dominated by chronic pathology over acute. In the structure of chronic respiratory diseases the first place in prevalence belongs to chronic obstructive pulmonary disease (38%), the second - bronchial asthma (24%), the third place is chronic bronchitis (18.5%). Acute and chronic diseases of the bronchopulmonary system were observed more often in men than in women - in 86 men (54.8%), the average age of which was 58±1.2 years and 71 women (45.2%), the average age of which was 56±1.3 years. Acute and chronic respiratory diseases were the cause of temporary disability in 107 (68.2%) patients.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):40-43
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THE POSSIBILITY OF OPTIMIZING REHABILITATION PROGRAMS OF PATIENTS WITH ACUTE CEREBROVASCULAR DISORDERS IN PRIMARY CARE
Ostroushko N.I., Chekmareva A.A., Romanova M.M., Zuikova A.A.
Abstract
This article deals with the problems of rehabilitation of patients with acute disorders of cerebral circulation (onmc) in outpatient practice. According to the data obtained from the examined patients with stroke, are under medical supervision, identifies affective disorders and disorders of chronoligical sleep-Wake. The main part of the examined patients with a history of cancer suffers from minor and clinically expressed insomnia, others need medical correction of sleep disorders. Development of individual programs of rehabilitation measures taking into account the violations of the psycho-emotional sphere in patients with ommc in history, achieving compliance between the doctor and the patient can reduce the severity of sleep disorders, improve the quality of life of patients.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):44-47
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BURNOUT SYNDROME IN GENERAL MEDICAL PRACTICE
Ostroushko N.I., Romanova M.M., Posmetieva O.S., Potapenko A.O.
Abstract
In modern conditions of optimization of practical health care the relevance of the problem of professional burnout, its early detection and prevention is increasing, especially for its primary level, for clinics, for General medical practice. The article presents the results of a study on the characteristics of burnout syndrome among medical workers of General medical practice in the conditions of primary health care. According to the data obtained, more than two thirds of 2/3 of medical workers experience symptoms of burnout syndrome in General medical practice among doctors and nurses. In the formed form, emotional burnout syndrome was revealed in more than half of the examined patients. Nurses are more prone to burnout than doctors. In view of the above, in the primary level of practical health care, early detection and effective correction of burnout syndrome in medical workers is necessary.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):48-53
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ANALYSIS OF COGNITIVE IMPAIRMENT IN PATIENTS WITH DYSCIRCULATORY ENCEPHALOPATHY
Khanina E.A., Zuikova A.A., Muravitskaya M.N., Posmeteva O.S., Romanova M.M., Bolysheva O.E.
Abstract
In this paper, we analyzed questionnaires of the Montreal cognitive assessment scale (MoCA) and out-patient charts of patients diagnosed with cerebrovascular disease, dyscirculatory encephalopathy (DEP) to identify the presence of cognitive impairment. Also in the study of patients was determined the severity of cognitive impairment depending on gender, age, stage of disease and the presence of other comorbidities (hypertension stage I, II, III, acute cerebrovascular disease, diabetes). In the course of the work it was found that cognitive disorders were observed in patients with this pathology, but more pronounced in patients with the diagnosis of DEP stage III, hypertension stage III, with an acute violation of cerebral circulation in the anamnesis, the older the greater the degree of cognitive impairment.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):54-58
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COMORBID DISORDERS IN OUTPATIENTS
Posmeteva O.S., Strepetov D.O., Muravitskaya M.N., Romanova M.M., Khanina E.A., Alkhasov A.I.
Abstract
The study is devoted to one of the most relevant problems of modern medicine - assessment of comorbidity in outpatient practice. The paper analyzes the data of 100 outpatient cards of patients of the General practice of the city polyclinic. The study found that the most common in patients combined diseases of the gastrointestinal tract and diseases of the joints and connective tissue, diseases of the circulatory system and diseases of the nervous system, diseases of the circulatory system and the gastrointestinal tract. The leading comorbid combinations were osteoarthritis and gastric ulcer, coronary heart disease and chronic gastritis, hypertension and the consequences of acute violation of cerebral circulation, hypertension and retinopathy. In patients, iatrogenic and complicated types of comorbidity were established, which requires special attention of the primary health care physician when assessing the condition and choosing the tactics of management of patients with combined pathology.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):59-65
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IMPROVEMENT OF DISPENSARY OBSERVATION OF PATIENTS WITH COPD BASED ON THE PATIENT-SPECIFIC PHENOTYPE APPROACH
Prozorova G.G., Burlachuk V.T., Tribuntceva L.V., Kozhevnikova S.A., Yur’eva M.Y., Fateeva O.V.
Abstract
Questions of clinical, laboratory, functional features of patients with a phenotype of chronic obstructive pulmonary disease (COPD) with frequent exacerbations are studied; the patient-specific algorithms of dispensary observation for patients with use of the retrospective questionnaire by on identification of COPD exacerbations are developed. It is shown that the level of pro-inflammatory cytokine (interleukin-8, TNF-α), C-reactive protein, fibrinogen is correlated with disease exacerbation frequency. The efficiency of clinical questionnaires use for retrospective identification of COPD exacerbations is estimated.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):66-70
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THE STRUCTURE OF SLEEP AND QUALITY OF LIFE PATIENTS WITH ESSENTIAL HYPERTENSION
Romanova M.M., Babkin A.P., Blinova E.A., Sharapova Y.A.
Abstract
In recent years, emotional and cognitive disorders, sleep disorders in various chronic non-communicable diseases have been actively studied in the scientific medical environment and in practical health care. The article presents the results of a study on the relationship of sleep structure and quality of life in patients with hypertension. Among the examined patients with hypertension, a high prevalence of sleep disorders was revealed. The most common sleep disorders were found in patients with hypertension of the second degree, with obesity of the first degree. In the study of the quality of life of both women and men, the physical and mental health component is limited. The data obtained, in our opinion, should be taken into account in further studies, as well as in the formation of preventive, therapeutic and rehabilitation measures for patients with hypertension in outpatient settings.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):71-75
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LOW PHYSICAL ACTIVITY:TRY TO RELIABLE ESTIMATE THE PHYSICAL ACTIVITY LEVEL
Ctankevich R.S., Tribuntceva L.V., Kozhevnikova S.A., Burlachuk V.T.
Abstract
The results of periodic health examinationof adult population certain groups of health locality are presented in the article, risk factors are revealed, the assessment of physical activity levels at patients of the II group of health is carried out, the reliable way of assessment, control and correction of physical activity level in compliance with the principle of "10 000 steps" is picked up.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):76-83
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CASE HISTORY OF MULTICYSTIC KIDNEYS. IS IT POSSIBLE TO SLOW DOWN THE CHRONIC KIDNEY DISEASE PROGRESSING?
Ctankevich R.S., Tribuntceva L.V., Kozhevnikova S.A., Burlachuk V.T.
Abstract
The case history of the patient with multicystic kidneys is presented. In spite of disadvantage diagnostic of rural outpatient clinic and regional hospital the diagnosis has been in time established and the treatment was appointed to the patient. On the example of this disease it was follow up the chronic kidney disease progressing to development of end-stage kidney failure. Considering of the disease hereditary nature it was revealed the multicystic kidneys in consanguinity of the patient and to sent them to the examination in time to early chronic kidney disease risk identification.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):84-92
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THE INFLUENCE OF REMOTE DISPENSARY OBSERVATION ON ARTERIAL HYPERTENSION COURSE
Tribuntceva L.V., Burlachuk V.T., Kozhevnikova S.A., Krysenkova N.A., Mamontova N.V.
Abstract
Arterial hypertension is the leading risk factor of cardiovascular accidents of the globe. The number of the patients informed on presence of the elevated blood pressure is annually enlarged, but there is low a percent of the persons which reached the objective blood pressure still. The last years much attention is paid to diseases preventive and rising of patient retention to treatment. The purpose of investigation was the assessment of distant dispensary observation influence on arterial hypertension current. Methods: The research included 342 patients with arterial hypertension follow-up dispensary observation by general practice doctor. There were 2 groups: the 1st group was 141 patients of active remote control, the 2nd group was- 201 patients without active remote control. It was comparison group. In the 1st group there was daily blood pressure self-checking, dates were communicate to attending medical doctor by phone or by e-mail. If necessary to find the antihypertensive therapy, the information about blood pressure communicated once a day, after this - once a week. Comparison group patients were observed according to health ministry Russian Federation dispensary observation guidelines. Results: During observation in the 1st and 2nd groups there was statistically significant difference in ambulance calls-out, admissions, time on sick leave. In 12 months in the 1st group 92,2% patients succeeded to reach the objective blood pressure, in 2nd group only 43,3% patients succeeded to reach the objective blood pressure. Conclusion. The active dispensary observation of patients with arterial hypertension leads to rising of patient’s number who reached the objective blood pressure, rising of treatment patient compliance, reduction of incapacity for working and patient’s hospitalization.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):93-101
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ANALYSIS OF THE INCIDENCE OF CARDIOVASCULAR PATHOLOGY IN THE OUTPATIENT RECEPTION
Hanina E.A., Nemtseva A.A., Dobrynina I.S., Zuykova A.A., Bolysheva O.E.
Abstract
In this work, the study of outpatient charts of patients with various rhythm disturbances and concomitant cardiological pathology (hypertension and coronary heart disease) in the presence of chronic heart failure IIA FC (I,II,III, IV) and concomitant type 2 diabetes was carried out, the quality of life of patients with chronic heart failure was assessed, clinical manifestations were analyzed, the data of the obtained methods of examination and prescribed drug therapy. Also, the features of the course and the type of various cardiac arrhythmias and conduction in patients with type 2 diabetes are considered. During the work it was found that the presence of type 2 diabetes mellitus aggravates the course of chronic heart failure and various types of heart rhythm disorders, increases the functional class and worsens the prognosis for the lives of these patients.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):102-107
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EVALUATION OF THE RISK FACTORS OF CARDIOVASCULAR DISEASES BASED ON THE RESULTS OF OBSERVATION RESEARCH
Chesnokova I.V.
Abstract
The results of the clinical examination of a limited contingent of the population of the Kominternovsky district of the city of Voronezh (the number of 630 people surveyed) are analyzed. It is established that the body mass index (BMI), which is higher than the norm, is the leading risk factor (RF) in this population and increases the multiple risk of developing cardiovascular diseases (CVD). The revealed regularity of the dependence of increased BMI on age and sex is the basis for the development of a target program for the prevention of CVD, taking into account gender patterns.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):108-112
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CLINICAL MANIFESTATIONS OF DISORDERS AFFECTIVE SPHERE AND QUALITY OF LIFE PATIENTS WITH COMORBID SOMATICPATHOLOGY IN GENERAL MEDICAL PRACTICE
Shlykova E.A., Romanova M.M., Zuikova A.A., Posmetjeva O.S., Barkovskaya L.N.
Abstract
The article deals with the problems of chronic non-infectious diseases, comorbidity of somatic and mental pathology in outpatient practice. According to the data obtained, patients with diabetes and obesity have anxiety and depressive disorders of different severity and changes in quality of life. The relationship between the degree of severity of affective disorders, the severity of diabetes, the degree of obesity and the quality of life of patients was established. The prospects of prospective studies in this direction from the standpoint of the development of ways to optimize the tactics of management of patients with comorbid pathology are demonstrated.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):113-116
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IMPLEMENTATION ADRAGOGICAL LEARNING PRINCIPLES IN CONTINUING PROFESSIONAL EDUCATION
Avdeev A.I., Zolotukhin O.V., Madykin Y.Y., Kochetov M.V.
Abstract
The specificity of training of the adult contingent of students is determined by the social and psychological characteristics of students. The formed persons cannot be trained effectively by means of traditional pedagogical technologies, methods and forms [2]. An important andragogical principle is the principle of systematic training. This principle determines the formation of the goal, the development of forms and methods of training. The andragogical model is characterized by readiness of students to determine their needs in studying of the interesting subject for the solution of concrete problems. The student plays a leading role in the formation of motivation and determination of learning goals. Contextnode training involves the implementation of joint activities obeysekara and teacher in terms of language teaching goals, and implementation and evaluation of the learning process [8]. Modernization of medical education, as well as the development of modern education system, involves training with a high level of independence with the leading role of the student's personality. The organization of continuing professional education requires an understanding of the motivation system and should be based on the principles of andragogical training, which contribute to the formation of students ' needs for self-continuous acquisition of professional knowledge and skills.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):117-121
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CONSTRUCTIVE PREVENTION OF PROFESSIONAL BURNOUT SYNDROME IN ANESTHESIOLOGIST-REANIMATOLOGISTS
Struk Y.V., Yakusheva O.A., Volkov V.K., Vahtina E.B.
Abstract
The article presents the features of the professional burnout syndrome in anesthesiology and resuscitation, the basics of constructive psychology and pedagogy, absolute human values, the content of the holistic health education of anesthesiology and resuscitation physicians. It is shown that a constructive approach can significantly increase the resilience of anesthesiologists-reanimations to professional burnout. It is concluded that it is advisable to include holistic health education in the training program for specialists.
Научно-медицинский вестник Центрального Черноземья. 2018;(74):122-127
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