ВОПРОСЫ СОВЕРШЕНСТВОВАНИЯ УЧЕБНОГО ПРОЦЕССА
The article deals with the concept of pedagogical professionalism and its components. The characteristic of levels of pedagogical professionalism with the recommended tactics of the chief to the specialists having a different level of professional experience is given.
TO HELP THE MILITARY DOCTOR
Modern methods of diagnosis and treatment of iron deficiency anemia are presented in the article, and alsо questions of prevention and dispensary dynamic monitoring are considered.
The article analyzes the information content of the application questionnaire for workers exposed to harmful production factors on the physicians involved in the conduct of mandatory medical examinations. The analysis of the information obtained through questionnaires, allowed to form groups at high risk of developing NCDs, which gives the possibility of personalized approach to these groups during the mandatory periodic medical examinations.
ORIGINAL SCIENTIFIC PUBLICATIONS. Medical and preventive questions
A method for predicting the risk of purulent-septic complications in patients with destructive pancreatitis has been suggested, based on the assessment of the levels of four parameters of the aspirate obtained by transcutaneous puncture of local cystic fluid formations. The sensitivity, specificity and accuracy of the method were studied in comparison with the results of microbiological evaluation of the transcutaneous aspirate.
Data are presented on the study of the prevalence of visceral pathology in 628 patients in the neurological department with lumbosacral pain syndrome. Based on the analysis of clinical data, laboratory and instrumental methods of research and testing, the relationship between the pathology of internal organs and the manifestation of pain syndrome was determined. Application of the innovative technology of the multidisciplinary approach to diagnosis and therapeutic correction of the pain syndrome made it possible to reduce the frequency of diagnostic errors for lumbargia by 47.0%, lumboschialgia by 37.0%, radiculopathy by 25.9%, duration of inpatient treatment by 20.0%. A significant improvement in the quality of life of patients was achieved, and a significant economic effect was achieved.
Cognitive functioning plays an important role as a predictor of the formation of alcohol dependence, and can also have a significant effect on the effectiveness of remissions and ongoing preventive measures. The article presents the results on the study of the influence of cognitive and psychomotor reactions, the attention functions on the effectiveness of group and short-term psychotherapy in people with alcohol dependence. A total of 230 male patients with AD and a control group of 121 were examined. The basic group was randomized into 4 subgroups depending on the type of psychotherapy used (short-term or group therapy) and the results of treatment (presence of annual remission or absence). To assess the neuropsychological status, the following tests were used: "Schulte tables"; RTI and MOT from CANTAB. It is established that the high efficiency of mental performance is a predictor of the choice of short-term psychotherapy in the treatment of alcohol dependence.
The article presents the results of studying the effect of spatial working memory functions on the choice and effectiveness of group and short-term psychotherapy in individuals with alcohol dependence. A total of 230 male patients with AD and a control group of 121 were examined. The basic group was randomized into 4 subgroups depending on the type of psychotherapy used (short-term or group therapy) and the results of treatment (presence of annual remission or absence). To assess the neuropsychological status, the SWM test (spatial working memory) was used. It has been established that SWM application allows to define some neuropsychological criteria (cognitive flexibility, social cognition, working memory, attention) for determining the effectiveness of application and choice of short-term and group psychotherapy methods in the treatment of alcohol dependence.
Dental examination of 97 children with phenylketonuria aged from 2 to 18 years was carried out; the increasing intensity of tooth decay, dynamic changes in the condition of oral hygiene as well as periodontal status were assessed during dental treatment and 2-year preventive measures implementation in this group of children.
The data were analyzed by means of the program Statistica 10.0 utilizing the χ2-test, U-Mann-Whitney and t-Student test. As a result of dental treatment and preventive measures in children with phenylketonuria, the main indicators of dental status significantly improved: the increase in the intensity of dental caries in the children of the preventive group was significantly lower than that of patients in the test group. The level of oral hygiene and the condition of periodontal tissues in children who followed all the recommendations of a dentist, have significantly improved in 24 months after the onset of observation, the level of dental care exceeded up to 90%.
A comprehensive study to assess the effectiveness of peridural therapeutic blockades with diprospane in 70 patients with neurological manifestations of lumbar osteochondrosis who were in treatment in the 2nd and 4th neurological departments of the State Institution 9th City Clinical Hospital in Minsk was conducted. It was found that the therapeutic blockades with diprospane reduce pain syndrome effectively (р < 0,05) and elevate scale of vitality in patients with neurological manifestations of lumbar osteochondrosis. The main method of research is statistical.
The article deals with the possible connection between smooth eye tracking movement and symptoms of schizophrenia. The authors draw attention to the fact that the oculomotor function by many scientists is considered as a possible biomarker of the schizophrenic process, or as part of the phenotype of this disease. The temporal parameters of smooth follow-up movement of the eyes in a sample of 198 patients (93 men and 105 women) with paranoid schizophrenia and 46 patients with the risk of first psychosis of males were studied using video-histogram. In patients with the leading disorganization syndrome, a significant disturbance of smooth follow-up movements of the eye was observed at low signal velocities, which suggests a possible conjugated connection of eye tracking mechanisms and disorganization of thinking in schizophrenia. The authors approach the theoretical substantiation of the results obtained from the point of view of the theory of efferent copies.
The study included 31 patients with infection of a synthetic prosthesis after arterial reconstructions in the pathology of the aorto-femoral segment. 9 patients (29%) after removal of the infected prosthesis, revascularization was performed by means of a non-anatomic shunting using synthetic material and 21 (67.7%) restoration of blood flow in the lower extremities was performed using donor arterial grafts. In one case (3.2%), the infected prosthesis was not removed. In the main group, using donor arteries, a positive result of 66.7% was achieved. The results allow us to conclude that the use of biological materials (donor arterial allografts) for repeated reconstructive interventions under conditions of a purulent-septic process is more effective and allows improving the results of treatment of this category of patients.
ORIGINAL SCIENTIFIC PUBLICATIONS. Military epidemiology and hygiene
The extent of changes in the expression of pattern-associated receptors and molecules similar in function by peripheral blood neutrophils and monocytes under the influence of inactivated gram-positive and gram-negative bacteria and its components was studied. It was established that even in the minimum concentration, the studied bacteria and its components exerted a significant influence on the expression of the CD11b, CD32, CD35, CD62L, CD64 and CD88 molecules by blood neutrophils and monocytes, which supports its application in the development of a method for differential diagnosis of the bacterial and viral etiology of acute infections. Comparative analysis of cell activation index allowed to choose the most promising biomarkers, to determine using clinical samples.
The aim of the study was a multipurpose assessment of the dynamics of cadets’health levels during studing on the indicators of the fat component of the body, the index of functional changes in the circulatory system, the complex index of physical fitness, Stange's test and personal anxiety. As a result, it has been established that while the continuating of study at the university, the most of the studied indicators are improved, but they are not sufficient for a qualitative increase of heath levels in the collectivity as a whole. The optimization of cadets nutrition can be one of the promising areas of this activity.
ORIGINAL SCIENTIFIC PUBLICATIONS. Hygiene and physiology of military labor
There are many stressful factors which influence cadets of military educational institutions, such as factors of educational process and the long-lived exercise stress, that can adversely affect their state of health. We carried out the analysis of morbidity of cadets of the state educational establishment «Institute for Command Engineers» of the Ministry for Emergency Situations of the Republic of Belarus and definition of morphometric indexes and main somatic type. Respiratory diseases take the main place in structure of morbidity. It demands holding the improving and hardening procedures which needs to be selected taking into account constitutional features of an organism. Thus, before introduction of the hardening procedures it is necessary to perform medical examination of cadets following the results of which to determine adaptation potential and somatic type. These indexes are necessary for the choice of the mode of exercise stresses and hardening, well-timed correction of the revealed violations.
The aim of the study was hygienic evaluation of the health condition of the flying staff according to basic indices of the nutrition status. Screening of the flying staff with the determination of basic informative indices characterizing the body structure, functional and adaptive body possibilities, as well as the condition of personal anxiety has been performed. It was shown that the majority of the examined military men had increased nutrition status especially in the elderly age group. This was caused by an excess in the consumed energy with food as compared with average daily energy losses of the body.
ORIGINAL SCIENTIFIC PUBLICATIONS. New technologies in medicine
A method for predicting the risk of purulent-septic complications in patients with destructive pancreatitis has been suggested, based on the assessment of the levels of four parameters of the aspirate obtained by transcutaneous puncture of local cystic fluid formations. The sensitivity, specificity and accuracy of the method were studied in comparison with the results of microbiological evaluation of the transcutaneous aspirate.
A new method of bone autografts in the surgical treatment malunion of the distal radius has been developed. The latter was used in 6 patients treated at the City Clinical Center of Traumatology and Orthopedics of the 6th Clinical Hospital in Minsk for the period from 2010 to 2016. A comparison was made with a group of patients who underwent a surgical correction using standard bone allograft.
Corrective osteotomy of the distal radius was performed in all cases with fixation of fragments by the plate and screws and closure of the defect with bone auto- or allografts. The results were evaluated by quantitative measurements of the amplitude of movements in the wrist joint (flexion / extension, pronation / supination, radial / ulnar deviation), and also a qualitative evaluation produced by the results of the DASH-scale.
It has been provided a method for predicting of disease progression after radical surgical treatment of gastric cancer, that includes evaluation of the methylation status of RECK gene primary tumor and in the peritoneal washings after lymph node dissection in combination with the assessment of the degree of metastatic involvement of regional lymph nodes.
The aim of the study was to Determine the condition of microcirculation in fabrics of the first interdigital interspace brush for diseases of vital organs.
Method of edemometry defined parameters of microcirculation in the tissues of the first interdigital interspace brushes in 15 patients 27–83 years in diseases of the brain (3), lung and pleura (4), heart (4), liver (2) kidney (2). The work was of a searching nature, so each group had only 2–3 patients.
It is established that when the transferred cerebral stroke, Parkinson's disease, myocardial infarction, heart failure, lobar pneumonia, pleural empyema, liver cirrhosis and acute renal failure, impaired microcirculation in the tissues of the hand. Problems have happened in those cases, when the disease manifested morphological and functional lesions of the organ. With this increased hydration of the tissues, changes the integral of the microcirculation and tissue pressure and diastolic blood pressure. The regularity of the microcirculatory environment – disruption of the microcirculation develops with the defeat of vital organs and is registered with anemometry in the tissues of the folds of the first interdigital interval of the brush. This phenomenon can be explained by the reaction of the entire system of microcirculation to the emerging “ failure”. The data justify the necessity of special study search results.
REVIEWS AND LECTURES
Currently, inflammatory diseases and wound infection are common in obstetrics and are most common in women with infertility and in the postpartum period. Despite of large number of studies on the pathogenesis, diagnosis and treatment of inflammatory diseases, their frequency does not tend to decrease. In the light of modern achievements in medical science, special attention is paid to the role of lipid peroxidation (LPO), inflammation and activity factors of phospholipase A2, apoptosis processes in the pathogenesis of infectious inflammatory pathology. It is systematized information about the cellular and molecular mechanisms of LPO, inflammation and apoptosis, shoed the modern views on the multicomponent and interrelated pathogenetic mechanisms of inflammatory diseases at this article. The results of actual studies on this problem in the field of obstetrics are presented and the need for an integrated approach to solving problems on diagnosis and correction of pathobiochemical disorders in patients is convincingly demonstrated.
ОРГАНИЗАЦИЯ МЕДИЦИНСКОГО ОБЕСПЕЧЕНИЯ ВОЙСК ЗАРУБЕЖНЫХ СТРАН
The article analyzes the legislative and regulatory acts that relate to pharmaceutical assistance to the population in emergency situations of civil and military time. The expediency of the development and operation of pharmacies in adapted premises with the right of extemporal manufacture of medicines in emergency situations is justified. The need for the development and implementation of a set of normative and methodological solutions aimed at improving the material and technical base of pharmacies and preparing pharmaceutical personnel for sustainable operation in extreme emergency situations is substantiated.
It is a review of the literature about the structure and organization of health care in the armed forces of Lithuanian Republic. There is specified the structure of health service, stated the basic principles of medical personnel training and specifics of staffing.
CASE FROM PRACTICE
BRIEF MESSAGES
The using a method of immunohistochemistry allowed to determine an expression of laminin in abdominal part of an aortic media in normal in age groups from 1 to 70 years at men and women was determined. The laminin expression in different age groups at men and women was studied and the nature of its changes in normal in different age groups was established. Indicators of the specific area of laminin in aortic media on border from an aneurysm was studied. The comparative analysis of changes of an expression of laminin in normal and in a zone, bordering with aneurism, was carried out. On the basis of the obtained quantitative data the regression analysis was carried out.
HISTORY OF MILITARY MEDICINE
The article presents historical events connected with the creation of the Airborne Troops and their sanitary (medical) service in the structure of the Red Army and the Armed Forces of the USSR and the events connected with the creation of special forces in the Armed Forces of the Republic of Belarus Operations as a kind of troops and in their composition of the MTR Command as a body of military command with all its structural units, including the medical service.