Vol 22, No 1 (2019)
- Year: 2019
- Articles: 23
- URL: https://new.vestnik-surgery.com/index.php/2070-9277/issue/view/74
Articles
ASSESSMENT OF COGNITIVE IMPAIRMENT IN PATIENTS WITH DIABETES TYPE II AND THEIR IMPACT ON ADHERENCE TO THERAPY
Abstract
The study of cognitive functions in patients with type II diabetes mellitus (type II diabetes. at the outpatient stage was carried out. A total of 44 patients with type II diabetes who applied for outpatient admission were examined. The mean age of patients was 64.68±1,52 years. In the course of the work the influence of cognitive impairment on the level of patient compliance was studied. The contribution of comorbid pathology, micro - and macrovascular complications of diabetes mellitus, the duration of the disease to the level of cognitive deficit was also evaluated. It was found that the increase in cognitive dysfunction is accompanied by a decrease in the level of compliance in the study cohort of patients, as well as an increase in anxiety-depressive traits examined. The obtained data once again emphasize the importance of timely diagnosis and competent correction of possible cognitive impairment in patients with diabetes mellitus within the outpatient link.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):4-9



THE POSSIBILITY OF EXAMINATION TO IDENTIFY RISK FACTORSCHRONIC NON-COMMUNICABLE DISEASES
Abstract
The article considers the role of clinical examination in identifying risk factors for chronic non-infectious diseases. The data of reports of medical organizations of the Orenburg region on medical examination of the adult population in 2017 are analyzed. It is established that early detection of risk factors for chronic non-communicable diseases in the framework of medical examination should lead to a decrease in the prevalence and mortality from non-communicable diseases and improve the demographic situation in the country. It is necessary to carefully fix the risk factors during the medical examination and regular monitoring of indicators. Equally important is the conscious attitude of citizens to medical examination and follow-up after identifying their risk factors for chronic non communicable diseases.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):10-13



FEATURES OF SLEEP DISORDERS AT PATIENTS OF THE THERAPEUTIC SITE OF CITY POLICLINIC
Abstract
The article is devoted to the problem of sleep disorders among patients in the practice of district therapist. According to the obtained results, according to the results of the study, a low risk of OSA was encountered in 24% of cases, an average risk - in 28 %, a high risk - in 48% of patients; excessive daytime sleepiness was absent in 35% of patients, moderate daytime sleepiness - in 52% of patients, significant daytime sleepiness - in 13%. Given the wide prevalence of OSA, it is necessary to diagnose it in a timely manner and to treat and prevent it; to prevent recommended weight loss and maintaining ideal weight, quitting Smoking and alcohol, maintenance of stable sleep, exercise to exercise the muscles of the nasopharynx, avoiding sleep in the supine position.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):14-19



CHANGE OF COGNITIVE FUNCTIONS AT PATIENTS OF A GERONTOLOGICAL PROFILE
Abstract
In the article the interrelation of the emergence of cognitive violations, maintaining a certain way of life and presence of a syndrome of a senile adynamy at patients of a gerontological profile and also their communication is estimated with age. The research is based on results of questioning "Healthy lifestyle", the questionnaire "Age is not a hindrance" and testings of "SAGE" which took place 54 persons. As a result the existence of cognitive violations was revealed at the most part surveyed that directly depends on maintaining a healthy lifestyle and a syndrome of a senile adynamy which is also highly widespread among surveyed. Need of identification of initial signs of cognitive violations at an out-patient stage of inspection and also providing recommendations to the population about maintaining a healthy lifestyle and physical activity for prevention of development of dementia is emphasized
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):19-23



ANEMIC SYNDROME IN AN OUTPATIENT PATIENT
Abstract
The article is devoted to the problem of anemic syndrome in an outpatient patient, which, along with other chronic non-infectious diseases, requires early detection during dispensary and diagnostic measures in the primary health care, adequate appointment of a complex of therapeutic and preventive measures. According to the results, anemic syndrome in the therapeutic area of the city polyclinic was more often detected in women, persons in the age range over 55 years, anemia of mild severity was detected in patients, the predominant cause of the anemia syndrome is chronic blood loss.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):24-28



ANALYSIS OF PATIENTS ' QUALITY OF LIFE WITH PAIN SYNDROME ON THE BACKGROUND OF MUSCULOSKELETAL DISEASES SYSTEMS IN OUTPATIENT PRACTICE
Abstract
This paper presents a comparative analysis of the quality of life of patients with pain syndrome on the background of diseases of the musculoskeletal system (osteochondrosis, arthrosis, rheumatoid arthritis) and healthy individuals in outpatient practice. Sexual and gender features of patients with diseases of the musculoskeletal system were studied. The prevalence and structure of diseases of the musculoskeletal system were determined, the effectiveness of the treatment was evaluated. Assessment of the quality of life of patients with disease s of the bone-muscular system and healthy individuals was about conducted by using a General questionnaire of quality of life MOS SF-36, a brief questionnaire who to assess quality of life (WHOQOL)-BREF, a 5-point verbal rating scale of pain. In the course of the study it was established that women were more likely to seek medical care with pain syndrome against the background of pathology of the musculoskeletal system at the outpatient stage than men, the average age of which was 55.86±1.96 for men and 52.94±1.47 for women, respectively. The most common cause of treatment for pain was osteochondrosis. The quality of life of patients with pain syndrome on the background of musculoskeletal pathology in comparison with the quality of life of healthy individuals is worse in the following indicators: physical and psychological well-being, self-education, micro-social support and social well-being.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):29-34



ANALYSIS OF THE EFFECTIVENESS OF THE MANAGEMENT OF PATIENTS WITH PAIN SYNDROME IN OSTEOCHONDROSIS IN OUTPATIENT PRACTICE
Abstract
We analyzed the effectiveness of management of patients with pain in various forms of spinal osteochondrosis, on the basis of work with outpatient cards, evaluation of the scale "Visually Analog Scale", survey and examination of patients. Also, the sex and age of patients and the effectiveness of the therapy were determined. In the course of the work it was found that more women prevailed in the handling of pain syndrome, the age range was 31-50 years and 51-70 years, the pain localization in the first place is the lumbosacral region, on the scale "Visually Analog Scale" the intensity of pain syndrome in women the pain threshold is higher than in men. It was also found that drug therapy in the form of NSAIDs and muscle relaxants, prescribed to the studied patients for the purpose of relieving pain in osteochondrosis, led to a significant reduction in pain.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):35-40



ASSESSMENT OF COGNITIVE IMPAIRMENT IN PATIENTS CARDIOVASCULAR DISEASES (HYPERTENSION DISEASE AND CORONARY HEART DISEASE) IN OUTPATIENT PRACTICE
Abstract
This article presents the assessment of cognitive disorders in patients with cardiovascular diseases (hypertension disease, coronary heart disease) in outpatient practice. Was evaluated the prevalence of memory disorders in patients with hypertension and coronary heart diseases (CHD) using a questionnaire self-assessment of memory McNair and Kahn. A comparative analysis of the incidence of cognitive impairment in patients with hypertension and coronary heart diseases, depending on gender and age on the scale of assessment of cognitive functions MMSE. The interrelation between the degree of cognitive dysfunction and the stage of hypertension was revealed. The degree of severity of cognitive impairment in patients with various forms of ischemic heart disease was determined. In the course of the study it was found that memory disorders were more common in patients with hypertension than in patients with coronary heart disease. In patients with cardiovascular diseases, dementia of varying severity was diagnosed in every fourth woman and every third man. The prevalence of cognitive impairment in male and female patients with hypertension disease and CHD increased with age. In patients with hypertension, the degree of cognitive impairment increased with increasing stage. The degree of severity of cognitive impairment is greater in patients with coronary heart disease, progressive angina than in patients with other forms of coronary heart disease.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):41-47



THE RELATIONSHIP OF DEPRESSION, COGNITIVE IMPAIRMENT AND FRAILTY IN ELDERLY PATIENTS ON THERAPEUTIC AREA
Abstract
50 patients of elderly and senile age, observed at the district therapist of the district polyclinic, were examined. The assessment of cognitive impairment using The mini-Cog test, the severity of symptoms of depression on the geriatric scale of depression, the presence of frailty. 100% of the subjects showed signs of dementia, signs of mild and moderate depression were diagnosed in 78% of patients, the diagnosis of frailty was established in 82% of patients. Women are characterized by a greater severity of depressive disorder in comparison with men. Significant dependences of the increase in the degree of cognitive impairment, the severity of depression and frailty with an increase in the age of patients, as well as the mutually aggravating effects of the syndrome of frailty, cognitive impairment and depression in elderly patients were revealed.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):48-53



OBESITY IN PATIENTS WITH ANGINA PECTORIS: ASSESSMENT OF QUALITY OF LIFE, ANXIETY, DEPRESSION AND COMPLIANCE TO THE TREATMENT
Abstract
The research objective was to estimate quality of life, anxiety and depressive frustration and compliance to the treatment in patients with angina pectoris depending on existence of the accompanying obesity. 50 patients with coronary heart disease, including 28 with obesity are examined. Besides standard clinical laboratory inspection, at surveyed the quality of life according to the questionnaire SF-36, an anxiety and a depression on HADS and a compliance on a scale Moriski-Green was estimated. In group of patients with the accompanying obesity the quality of life is lower, than in group without him. In group of patients with obesity the frequency of occurrence and extent of anxiety and depression is higher, than in patients with coronary heart disease without obesity. In structure of frustration at patients with coronary heart disease and obesity frustration prevail anxiety. The compliance of patients with obesity was significantly lower, than in group of comparison. It was the most frequent cause of the admission of intake of medicine feeling sick at the previous reception of pills. With increase of BMI, functional class of angina pectoris, existence of anxiety and depression frustration patients have less motivation to adhere to the appointed treatment.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):54-61



RISK FACTORS OF INSOMNIA AMONG THE ELDERLY:DETECTION AND CORRECTION
Abstract
The article deals with the risk factors of insomnia among the elderly. In order to identify the risk factors of insomnia in the elderly, a survey of patients who applied for an appointment with a General practitioner in the Department of General practice №1 of the city of Saratov was conducted. The questionnaire included 39 questions and did not cause difficulties in patients when filling out. The study involved 100 elderly people. The study allowed to establish the risk factors of insomnia in elderly patients. On the basis of the obtained results, the methods of correction of the identified risk factors are developed. The defining conditions of prevention were: refusal to watch TV before going to bed, Smoking and taking caffeine drinks in the afternoon, timely treatment of the underlying disease, the symptom of which is a sleep disorder.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):62-65



SYNDROME OF EMOTIONAL BURNOUT AMONG HEALTH CARE WORKERS IN AMBULATORY CARE
Abstract
2Voronezh city policlinic № 1 The working day of medical workers takes place in the context of interaction with a large number of people: patients and their relatives, work colleagues. The burnout syndrome in the form of partial or complete elimination of the emotional factor in response to the action of traumatic agents is a psychological defense mechanism. 14 doctors and 14 medical workers, middle managers aged from 23 to 75 years were examined. The average work experience of doctors was 15.7 ± 11.7 years, nurses - 11.1 ± 10.3 years. Used: MBI questionnaire, adapted by N.Е. Vodopyanova, test V.V. Boyko and hospital scale anxiety and depression (HADS). An average level of emotional exhaustion, depersonalization and reduction of personal achievements was revealed, as well as emotional burnout at the formation stage, both among doctors and nurses. Outpatient doctors had subclinical anxiety and depression. Nurses only had subclinical anxiety.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):66-70



FEEDING BEHAVIOR OF THE PERSON DEPENDING ON THE TYPE OF TEMPERAMENT
Abstract
The article is devoted to the current topic-eating behavior, it discusses the idea of the relationship between the eating behavior of man and his type of temperament through a survey of an independent group of persons.the Work is interdisciplinary, written at the intersection of the collision of psychological, gastroenterological and cardiac spheres. After statistical processing of the obtained data, the regularities were revealed and the results were analyzed, the conclusion was made about the direct influence of the type of temperament on food behavior, the relationship between the main features of temperament and eating disorders. The study revealed the proportion of rational nutrition. The problem of the influence of psychological factors on human physiology is one of the leading and requires further study.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):71-75



EVALUATION OF THE EFFECT OF MELOXICAM ON BLOOD PRESSURE RESPONSE IN RELATION TO HIS PROHYPERTENSIVE EFFECT
Abstract
The influence of Meloxicam on the level of blood pressure was evaluated among patients suffering from hypertension and getting antihypertensive therapy, as well as among patients without diseases of the cardiovascular system, in relation to its pro-hypertensive effect. Through the retrospective analysis of medical histories, we studied levels of blood pressure, measured by the Korotkov’s method, before and after 3 months of taking Meloxicam in a dose of 7.5 mg / day. It was found that long-term medication of Meloxicam led to an increase of blood pressure indicators, both in patients without established diseases of the cardiovascular system, and in patients with the hypertension and an average total cardiovascular risk, who are regularly taking antihypertensive pills to achieve target blood pressure. In these cases, preference should be given to drugs that have the least effect on blood pressure indicators, such as Naproxen and Celecoxib (in the absence of IHD). Dihydropyridine calcium channel blockers should be considered as the mediсation of choice for the hypertension in patients who need long-term NSAID therapy.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):76-80



SUDDEN BRIEF LOSS OF CONSCIOUSNESS IN THE PRACTICE OF GENERAL PRACTITIONER
Abstract
20 patients with syncope history were examined, among whom were 7 men and 13 women aged from 18 to 75 years. The types of syncope and their causes were studied in patients depending on age. Older women were diagnosed with cardiogenic and orthostatic syncope, in 60% and 40% of cases, respectively. All men of old age had fainting of cardiogenesis. The causes of cardiogenic syncope in patients with elderly men were: dysfunction of the sinus node and AV block III, in 2 (66.7%) and 1 (33.3%) cases, respectively. AV-block III and supraventricular tachycardia were detected in 2 (40.0%) and 1 (20.0%) sick women, respectively, as a cause of sudden short-term loss of consciousness. Timely diagnosis and differential diagnosis of a sudden short-term loss of consciousness by a primary care physician will save health care resources associated with the cost of hospitalization of patients.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):81-85



PECULIARITIES OF SOMATIC DISEASES IN WOMEN AT MENOPAUSE
Abstract
The paper studies the prevalence and characteristic features of the course of chronic non-infectious diseases in different decades of menopause in women. 68 patients aged 40 to 85 years who applied for outpatient admission (mean age - 53.97 ± 1.41 years) were examined. With the help of clinical methods of examination, assessment of the severity of menopause using the Cooperman index, study of the quality of life of the SF36 questionnaire and the level of comorbidity were established characteristic for different periods of menopause features of the course of somatic pathology in the examined cohort of women. The study established a multidisciplinary somatic abnormalities developing against the background of hormonal imbalance at the stage of menopause. These circumstances require the joint efforts of doctors of various specialties to manage women during this period, including a special role in identifying and correcting these disorders should belong to the district service.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):86-93



THE QUALITY OF THE ORGANIZATION OF PROPHYLACTIC MEDICAL EXAMINATION OF ADULT POPULATION IN THE ORENBURG REGION
Abstract
The article deals with the issues of medical examination of the adult population in the Orenburg region. the number of citizens of the Orenburg region who passed the first stage of medical examination in 2017 amounted to 91.3% of the plan. 29.9% were sent to the second stage of medical examination, 98.5% of them completed it. As can be seen from the indicators of coverage of the population in both stages of medical examination, they were close to 100%. At the second stage, 5.3% were examined by a neurologist and 0.9% by a proctologist. The study of indicators of quality of medical examination of the adult population in the Orenburg region showed that there are reserves for their improvement. CCP should reduce the likelihood of each individual developing dangerous chronic non-communicable diseases, and in persons already suffering from such diseases, significantly reduce the severity of the course.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):94-97



THE COGNITIVE STATUS IN PATIENTS WITH CORONARY HEART DISEASE WITH THE VARIOS COMORBIDITY LEVEL
Abstract
The research objective was to estimate the cognitive status in patients with the coronary heart disease (CHD) depending on comorbidity level. Inspection of 30 patients with CHD became a material for the research. Besides a standard clinical laboratory tests all patiens were examed by MMSE test for the assessment of cognitive dysfunction. More then that the Charlson comorbidity index was calculated. During a research it had been revealed that patients with CHD have decrease in the cognitive status. A considerable part of the patients has moderate cognitive violations. Level of cognitive decrease has feedback with age, the body mass index, level of glucose, cholesterol, triglycerides, a hereditary factor, existence in the anamnesis of brain strokes, heart attacks, degree of arterial hypertension, risk of cardiovascular complications, a functional class and a stage of CHF, a functional class of CHD, CHD experience, existence duration at sick CHF. Violation of the highest brain functions increased at increase in the index of a comorbidity. Timely recognition of violations of cognitive function at sick CHD and their correction is necessary that can significantly help to improve the forecast.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):98-105



FALLING IN OLD AGE: RISK AND PREVENTION
Abstract
This article discusses the issue of falls in old age. The main purpose of the study was to assess the incidence of falls in elderly patients and the arrangement of their apartments, as a factor affecting the fall. Senile asthenia was detected in 31.8%, preasthenia - in 54.5% of patients 60 years and older, and the presence of a positive correlation of senile asthenia and falls indicates the need for close attention to this category of patients, because they are at high risk of falls and subsequent complications. In 50% of patients when assessing the arrangement of apartments there were more than 10 factors that increase the risk of falls.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):106-110



THE PREVALENCE OF PERIPHERIAL OCCLUSIVE DESEASES IN PATIENTS WITH CORONARY HEART DESEASE
Abstract
This article is devoted to the study of the prevalence of peripheral occlusive diseases in patients with manifestations of coronary heart disease, identifying common risk factors. In order to achieve the goals that were set, a questionnaire was surveyed for patients. The study involved 56 people over the age of 60, 28 men and 28 women. According to the results of the survey, it was concluded that 40% of respondents had a combined lesion of the coronary arteries and arteries of the lower extremities, risk factors for patients with CHD, and with a combination of CHD and POAD are common (hypertension, dyslipidemia). In all patients, clinical manifestations of POAD occurred on average after 6 years in men and 10 years in women after the first symptoms of CHD. An analysis of the history of the development of diseases led to the conclusion that POAD for a long time proceeds in a latent, asymptomatic form, and, being lately recognized, lead to surgical intervention.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):111-115



THE RELATIONSHIP OF SMOKING AND SOMATIC DISEASES IN AMBULATORY PATIENTS
Abstract
The paper analyzes the data of 1634 outpatient cards of patients of the therapeutic area to assess the prevalence of smoking (taking into account the gender factor) and the frequency of diseases associated with smoking: chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD), laryngeal cancer, lung cancer, lip skin cancer. A comparison of the prevalence and severity of this pathology in the group of smokers in comparison with the equivalent in number group of non-smokers was made. It was found that 22.6% of the patients attached to the site are smokers, males predominate among smokers (92.7%), among smokers the prevalence of COPD, coronary artery disease, lung cancer is much higher in comparison with non-smokers. Cancer of the larynx, cancer of the skin, the lip srin cancer were identified only in smokers. Smoking patients had a more severe course of COPD and lung cancer in comparison with non-smokers.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):116-120



ANALYSIS OF SLEEP DISTURBANCES IN OUTPATIENTS WITH VARIOUS STAGES AND COURSE OF HYPERTENSIVE DISEASE
Abstract
In this paper, we determined the relationship between the presence of sleep disorders in patients with hypertension and the control group (other nosologies), using questionnaires "detection of sleep disorders", compiled on the basis of International criteria of sleep disorders (ICSD-3), as well as through the collection of complaints, medical history, examination data, analysis of outpatient patient records. During the work it was found that the duration of sleep in persons with hypertension is 0.8 hours less than in the control group, the frequency of daytime sleep is higher in the group of patients with hypertension. Also, the analysis of sleep duration depending on the stage of hypertension was carried out, and the higher the stage of hypertension, the duration of sleep is less and there is a disorder of the night sleep.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):120-125



RECEIVING TABLETS FROM POWDER OF THE APPLE RESIDUE AND ASSESSMENT OF THEIR SORPTION PROPERTIES
Abstract
The unsuccessful state of environment affects health of the population. A noninvasive method of efferent therapy is the enterosorbtion. The purpose - development of the tableted sorbent form on the basis of powder of an apple residue and assessment of its sorption properties. Methods: Technical characteristics on powder defined in accordance with GOST 12597-67 (humidity) and OFS.1.4.2.0016.15 (a pressuyemost and degree of flowability). As excipients used starch and a kaolin. Tablets received by method of stamp pressing. Determined by a photocolorimetric method sorption activity of dosage forms (powder, tablets) in relation to methylene blue, to gelatin and cyanocobalamine. Results: It is established that powder from an apple residue has flowability - 20.0 ± 0.3 with / 100, the corner of a natural slope - 40.0º ± 1.0, bulk volume - 1.4 ± 0.2, and can be pressed without granulation. However, the tablet from this powder weighing 1.00 g with height relation to diameter of 38.46% meeting requirements of industry standard 64-072-89 did not conform to requirements OFS.1.4.2.0009.15, was fragile with erose edges. The tablet of structure of 0.50 g of an apple residue, 0.25 g of starch and 0.25 g of a kaolin corresponded to all process parameters. It is established that the received dosage form is capable to occlude methylene blue, gelatin and B12, sorption activity makes 192.6 ± 4.2 mg/g, 167.3 ± 3.9 mg/g and 89.3 ± 5.1 mg/g, respectively. The received sorbent does not concede, and sometimes and surpasses the registered medicines in sorption activity: Карбосорб (MS - 243.68 ± 1.3 mg/g; gelatin - 40.5 ± 1.3), Polisorb (MS - 47.7 ± 2.9 mg/g; gelatin - 328.2 ± 3.3 mg/g), Polifepan (MS - 28.9 mg/g, gelatin - 32.5 mg/g, B12 - 1 mg/g) and Smekta (MS - 125 mg/g, gelatin - 113 mg/g, B12 - 1.2 mg/g). Conclusion: The structure of a tablet at which it was succeeded to reach its compliance on pharmatsevtiko-process parameters is defined: 0.5 g of an apple residue, 0.25 g of starch and 0.25 g of a kaolin. It is established that the offered medicine has the high sorption activity which is not conceding to the registered medicines: Карбосорб and Polisorb concerning toxins and metabolites of the proteinaceous nature, low-molecular and high-molecular substances.
Applied Information Aspects of Medicine (Prikladnye informacionnye aspekty mediciny). 2019;22(1):126-131


