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The Scientific Notes of the Pavlov University

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Vol 23, No 3 (2016)
View or download the full issue PDF (Russian)
https://doi.org/10.24884/1607-4181-2016-23-3

REVIEWS AND LECTURES

6-11 1119
Abstract

Due to the fact that acquired myasthenia gravis is an autoimmune disease, so rational treatment of these patients includes the symptomatic therapy (acetylcholinesterase inhibitors, potassium supplements, potassiumsaving diuretics), short-term immunotherapy (intravenous immunoglobulin, methods of extracorporeal hemocorrection), longterm immunotherapy (glucocorticosteroids, cytotoxic agents, targeted therapies), thymectomy, as well as a number of new promising therapeutic agents. The choice of effective therapy depends on identifying the clinical forms of myasthenia gravis and a complete analysis of autoimmune mechanisms underlying the disease because of similar clinical forms of myasthenia gravis may respond to similar therapies.

11-15 1227
Abstract
The necessity of search of the effective individual programs for rehabilitation in patients with neuromyelitis optica spectrum disorders (NMOSDs) is recognized by majority of authors. Clinical and laboratory features of these patients which could impact on the rehabilitation prognosis were provided in this article. The possible methods for evaluation of the neurological deficit and disability because of NMOSDs were described. The literature data devoted to priority tasks of rehabilitation programs for this category of patients were given.

HEALTH CARE ORGANIZATION

16-17 1815
Abstract
A feature of a multidisciplinary approach to national health care system is the lack of nursing staff in the brigades, which reduces their clinical and costeffectiveness. A nurse implements problemoriented nursing process, basing on the patient’s level of adaptation to opportunities changed in accordance with the main FIC domains. Traditionally nurses take over the functions of patients’ social adaption. The article presents the data of sociological research of nurses, engaged in rehabilitation departments. The main evident problem of rehabilitation is a fundamental change of the role functions of nurses, which is associated with the transformation into the scientific discipline of centuriesold experience of nursing care, the integration of international experience in the practice of national health care.
18-20 1254
Abstract
The specialty «Rehabilitation nursing care» was introduced by the order of the Ministry of Health and Social Development of Russian Federation of 30.03.2010 № 199н, but became really demanded due to government ordinance of Russian Federation № 291 of 16.04.2012 «Medical practice licensing». Rehabilitation assumes a particular paradigm of clinical thinking, where special professional competences are forming. It is the only study program, where nursing process application is a matter of legislative regulation, and diagnostics is based on FIC (ICF). A nurse is not just a doctor’s precept executor, but the whole therapeutic environment (including recommended motion and epidemic regimes, diet therapy, leisure and complex sequel prevention) organizer as well. Professional organization and restorative care implementation allow concentrating all the patient’s and medics’forces on the recovery of lost opportunities, activity normalization and retrieval of the person to an everyday life.
21-23 851
Abstract
The most important question of the modern organization of medical rehabilitation system are the issues of quality and patient satisfaction, therefore, we carried out a sociological study, which was attended by 309 parents and legal guardians of children who were on rehabilitation in the clinic of the Institute of children’s infections. The analysis of respondents answers showed that 28.5 per cent were awaiting the commencement of rehabilitation treatment of a child less than one week; 40.1 percent – from 1 to 2 weeks; 25.9 per cent for 3–4 weeks, and 5.6 percent – more than a month. 75.6% of respondents were satisfied with the rehabilitation process in the clinic. In the opinion of the vast majority (87.4%, other) status of their children after rehabilitation was improved, including 43.7 percent reported a significant improvement. Most parents are almost completely satisfied with the organization, quality and efficiency of rehabilitation of children in the basic clinic, and a significant part of the suggestions for improving the organization of the rehabilitation process expressed by respondents are reduced mainly to the organization of domestic activities (61,5%) and only 15.4% – are aimed at improving directly the rehabilitation process.

ORIGINAL PAPERS

24-28 1825
Abstract
The study was conducted on the basis of the SaintPetersburg’s children’s polyclinic (TMO №114 of Primorski district). Total quantity of the children was 105 of the age from 1 to 12 months. 51 children were included in main group and 54 children were included in control group. The efficiency of the application of the proposed method of physical rehabilitation to correct existing violations and improve the level of health in children under one year was proved during the study.
28-31 1041
Abstract

The results of biomechanical analysis of the motor function of the arm of poststroke patient in the process of neuroreha bilitation with exoskeleton of the hand controlled by brain – computer interface are presented in this paper. At the beginning and end of the course it was registered the kinematic portrait of the patient– isolated random movements for each of the seven degrees of freedom as the paretic and intact arms.
Angular accelerations were taken as an assessment of muscle forces, the number of reverse movements was taken as an assessment of joint spasticity, and the kinematic content of the movement as a description of pathological synergy arising after stroke. These parameters give an objective numerical asses sment of motor function as well as of rehabilitation technology effectiveness.

32-34 900
Abstract
The article presents the results of comparison of different methods of rehabilitation in patients undergoing acute ischemic stroke, including those with cognitive disorders.
35-39 883
Abstract
The greatest weight neurodystrophic process develops in traumatic spinal cord injury, appears as neurotrophic decubitus (bedsores). There is a high risk of wound infection in the event of pressure ulcers. Surgical repair of the skin integrity in spinal patients of 3 and 4 grade is a basic prerequisite for the further complex of the rehabilitation measures. Work objective: to develop the concept of innovative technologies of treatment of local physical impacts and to implement it in surgical system of rehabilitation of patients with spinal cord lesion with neurotrophic decubitus of 3 and 4 grade. Clinical studies subjected 49 (100%) patients with spinal cord lesions and neurotrophic decubitus of 3 and 4 grade. All patients were divided into two groups: 1– (study group 1) 29 patients; 2 – (control group 2) 20 patients. The managed negative pressure system S042 NPWT VivanoTec (Hartmann), a method of ultrasonic cavitation (Sonoca%180), the system for the hydro surgery Versajet Smith and Nephew were used in the 1%st group. Traditional dressings for the preparation of a plastic closure of the wound defect neurotrophic decubitus of the grade 3%4 were used in the 2nd group. Statistical analysis was performed using package of Microsoft Excel%97 Statistica for Windows 6.0, SPSS 10.0 for Windows. The study showed that the use of complex methods of vacuum therapy, ultrasound cavitation and hydro surgical in the 1st group significantly reduces the duration of treatment compared with conservative methods in the 2nd group. In group 1, the mean duration of treatment was 19.9±13.9 days, in group 2 (comparison group) – 40.0±28.2 days (p<0.05). The usage of physical methods (managed negative pressure system, ultrasonic processing method, hydro surgical system) local treatment is a highly effective method of preparation neurotrophic decubitus grade 3 and 4 to the early recovery of the skin. Physical methods of local treatment have a positive effect on tissue regeneration and reduces periods of maturing granulation tissue. Axial flaps allow adequately perform the restoration of the skin in case of neurotrophic decubitus grade 3 and 4.
40-43 1405
Abstract
The study of quality of life for families in which lives the patient with a disability has revealed the phenomenon of «family disability.» All members of the family of invalid were diagnosed with depressive disorders of varying severity. The depression in relatives of children is severe than in relatives of adults with disabilities. There is a marked dependence between the severity of depression in relative and level of selfservice and mobility in invalid. The lower selfservice and mobility of the patient with disability, the depression in family members is severe.
44-46 907
Abstract
This research is focused on studying the types of education, parental attitudes and characteristics of defending strategies in families with pediatric asthma. Families with pediatric asthma have discovered a rigid system of family functioning and an existence of strict familiarly rules and roles. Based on the study results, where the factor analysis was applied, three groups of families with pediatric asthma were defined depending on to what degree the family functioning is violated. The correlation has been found between the characteristics of family functioning and severity of pediatric asthma.
47-51 864
Abstract
The study was conducted to evaluate the activity parameters of local and systemic inflammation in women suffering from bronchial asthma (BA). 119 women with asthma were studied, and 48 with a regular menstrual cycle and 71 in menopause; 38,7% of BA was mild, 61,3% – moderate severity. All patients were examined in the remission phase of the disease. On the background of normal values of conventional indicators of inflammation it was showed a significant increase of IL 1 alpha and IL 8 more in the group of women with regular menstrual cycles and normal body weight, IL1 alpha amounted to 489±80 pg/ml and IL8 – 631±122 pg/ml (p<0.05), which emphasizes the role of hormonal status of patients, and also the necessity of using the basic anti-inflammatory therapy during remission of BA.
51-55 839
Abstract
Frequent epileptic seizures and side effects of drugs have a significant negative impact on the quality of life. The main goal in the treatment of such patients is not only to decrease the number of attacks and their severity, but also to improve social adaptation. Surgical treatment for some forms of pharmacoresistant epilepsy improves prognosis and enhances the quality of life of patients, and the result depends on the duration of the disease. The main task of the preoperative examination is the most accurate localization of the epileptogenic zone. In the case of proximity or the overlapping of the epileptogenic zone with functionally significant parts of the crust, additional surveys to determine the latter are conducted. The survey may be conducted using non-invasive techniques, such as MRI, functional MRI, positron emission tomography (PET), single photon emission computed tomography (SPECT) and extracranial electrical stimulation or invasive direct electrical stimulation of the cortex.
56-59 832
Abstract
The article presents the results of the evaluation of the state of the ocular surface in patients with involutional lower eyelid malpositions of atopic type. In the group with eyelid malposition was marked a statistically significant reduction in the time gap of the tear film and marked damage of the surface of the cornea and conjunctiva. According to the questionnaire, the index reflecting the damage to the ocular surface tissues in patients with malposition eyelids more pronounced clinical manifestations of dry eye syndrome. Therefore, involutional lower eyelid malpositions lead to the defeat of the ocular surface tissue, mainly due to the violation of the tear film stability and enhance its evaporation.
60-64 1172
Abstract
In this work we studied the interrelations of violation regional hemodynamics and microcirculation of a fabric blood groove of a mucous membrane of a mouth in 70 patients with the chronic heart failure (CHF) and inflammatory diseases of a parodontium. The microcirculatory bed is a peculiar model of the regulatory processes happening in vessels of various calibers. The received results show that patients with initial stages of chronic heart failure have a decrease in haemodynamics indicators of speed of a fast and slow blood filling in the pool of internal sleepy are followed by increase of linear speed of a bloodgroove, increase in an index of a pulsation and peripheral resistance in the field of a transitional fold of the sky and interdental nipples of fabrics of a parodontium. The microcirculatory bed is a peculiar model, the regulatory processes happening in vessels of various calibers. The received results reflect mechanisms of regulation and compensation for maintenance of microcircula tion of a fabric bloodgroove of a parodontium in patients with CHF.
64-67 843
Abstract
The problem of estimation of students’ professional competence level in “Physical education” is a difficult task to solve. The RWD complex corresponds the demands of the modern pedagogical evaluation and is the universal means of formation of quantitative evaluation of competencies. Analysis of the results shown by students in certain types of tests indicates a relatively weak preparedness for passing the standards of the RWD complex. To create the most favorable conditions for the formation of competence in the discipline “Physical education”  during the development of the educational program it is necessary to include types of the RWD complex among credit requirements and evaluate them in accordance with the score-rating system.

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ISSN 1607-4181 (Print)
ISSN 2541-8807 (Online)