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Pacific Medical Journal

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No 2 (2007)
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EDITORIALS

5-10 262
Abstract

The materials to the anniversary report on an academic council of the Vladivostok state medical university, devoted to the 25-anniversary of the department of postgraduate education. The history of development of postgraduate education in high school is submitted, the normative documents regulating training and retraining of specialists are resulted. It is marked, that general strategy of the state regarding personnel selection of public health is maintenance of quality of education and high level of the professional competence of physicians that is possible only at education «through the whole life». These positions, according to the modern concept of development of public health of the Russian Federation, are considered as a basis for the high level of medical help to the population.

LECTURES

10-13 369
Abstract

The lecture devoted to a modern condition of system of high education in Russia and abroad. It is emphasized, that no country of the world have the perfect education system, each of them has merits and demerits. Bologne process - one of the forms of co-operation of the countries in reforming of the high school. The main goal is to serve the interests of mankind in all activities.

14-22 303
Abstract

The development of the theoretical and methodological basis of heuristic training of specialists has allowed to determine its forms and methods in postgraduate education. The submitted forms and methods of heuristic training are closely interconnected and correlated, making the basic lecture-seminar and practical system. Heuristic training of specialists is provided with the most significant heuristic forms (individual and group training, individually collective systems of training) and methods (cognitive, creative, and organizational).

REVIEWS

23-27 195
Abstract

The review of the literature devoted to etiology, pathogenesis and classifications of aneurismatic aorta. The history of studying of this pathology and expediency of existing classifications is discussed from the point of view of the follow-up and tactics of treatment. The attention is given to the clinical features, the most typical complications, the causes of death.

28-33 342
Abstract

The review of the literature devoted to a balanced diet of cardiological patients, especially after surgery. The importance of preoperative exam and some biochemical and anthropological parameters is emphasized. It is concluded, that inclusion in medical programs of cardiological patients additional enteral feeding and certain nutrients with the purpose of reduction in effects of circulatory hypoxia will allow to support a homeostasis on more optimum level and favorably influence the clinical course.

ORIGINAL RESEARCHES

34-36 239
Abstract

The clinical course of myocardial infarction in 172 women in the age from 34 till 78 years old is investigated. Some features of risk factors are revealed in comparison with men: more often arterial hypertension and metabolic syndrome, early menopause and smoking in the age before 55 years old, diabetes in advanced age. More than half of patients had various psychopathic reactions. The level of nitrogen oxide in blood did not depend on the form of a coronary syndrome and reduced in all variants. The markers of immune activation have been correlated with the form of a coronary syndrome and depend on age.

37-41 306
Abstract

Modern views on pathogenesis, diagnostics and treatment of the nephrogenic hypertension at children are shown. The necessity of wide introduction for practical medicine of screening by centile tables to reveal early the increased arterial pressure is shown. The results of own research of risk factors of arterial hypertension are shown for chronic pyelonephritis; the active role of the nitrogen oxide in regulation of physiological functions of kidneys in norm, in chronic inflammatory process, and also in renal hypertensions is confirmed. The detailed algorithm of children' exam is stated, the attention is paid to the differentiated approach to antihypertensive medications.

41-44 305
Abstract

The paper is dedicated to the analysis of 150 medical charts in Pediatric City Hospital No. 1 of Vladivostok. Medical mistakes occurred in the pharmacotherapy of children in neurological, surgical, urology departments and in the intensive care unit. The increase of medical mistakes number results in growing of side effects. Among revealed medical mistakes the administration of low evidence drugs by doctors was most frequent — 24.7%, polypragmazia — 21.3%, complex pharmacotherapy without drug interaction considerations was registered in 12% of cases, counter indications to drugs were not noted in 6.8%, etc. Authors conclude that practical doctors must consider effectiveness and drug safety as most important principle of pharmacotherapy.

45-48 302
Abstract

The changes in functional condition of vascular endothelium at 30 hypertonic patients are investigated at Qunapril treatment. During the treatment the increase of endothelial-dependent vasodilatation, decrease in vasoconstriction, increase in the plasma metabolites of the nitrogen oxide and reactivity of the nitroxid-ergic system, big reduction in a level of the endothelin1 in plasma and liability endothelin1-producing system, the increase in atrombogenic properties of the endothelium cells has been marked. The changes of values of integrated indexes of functional activity of vascular endothelium confirm endothelium modulating effect of Qunapril.

48-51 300
Abstract

The research is devoted to study of interrelation of parameters of quality of life and haemodynamic at the patients with high blood pressure. 177 patients in the age of from 47 till 82 years were surveyed. The data were grouped to a sexual attribute and on presence of chronic intimate insufficiency. The quality of life was estimated with the help of approved questionnaires САН (state of health, activity, mood), "a Special scale of activity", "Minnesota a questionnaire of quality of life of the patients by chronic intimate insufficiency" and technique DASI (The Duke Activity Status Index). The parameters central and intimate haemodynamic estimated on the data echocardiography. Was revealed, that the patients of a female and patients with chronic intimate insufficiency estimated a subjective condition worse in comparison with the men and patients without chronic intimate insufficiency. The questionnaires, used in research, have appeared high-sensitivity and should be more widely applicable in practical medicine.

51-53 298
Abstract

It is necessary to search for "sources" of diseases of heart and vessels at childhood. ECG was done to 923 children and teenagers, living in Primorsky Krai. The electrocardiogram without deviations was typical for 7—9 (44,5%) and 13—15 (67.7%) years old. The delay of depolarization in ventricle myocardium is typical for children of the senior school age. Moderate sinus arrhythmias prevailed in all age groups, more often at 1—3 y.o. (72.2%). The syndrome of supra-ventricular elevation was marked in the age of 10—12 years old (31.0%), and incomplete right blockade in the age of 4—6 years old (18.0%). The received data is recommended to specialists of functional diagnostics and pediatric cardiologists for practical use.

54-56 243
Abstract

We investigated effects product CPP on the 26 men, 30—50 years, with first stage abdomen obesity in a polyclinic in Vladivostok without clinical indications of cardiovascular diseases. The characteristics lipid and carbohydrates and gormon metabolism were allow to determine metabolic syndrome at them. Complementary introduction in ration CPP to be back to normal body mass and have increased metabolic and energy balance along with intensifity effect of gormons.

57-60 205
Abstract

The clinical and immune features of the allergic diseases (bronchial asthma, allergic rhinitis, atopic dermatitis) at children in Primorsky Krai were studied. The complex research of immune pathogenesis and cytokine structure was done. It is shown, that system changes in cytokine and immune status have been unidirectional, depend on severity of process and therapy.

60-63 229
Abstract

In the Department of faculty surgery for last 5 years endovideosurgical methods were used in 140 patients with the complicated forms of the cholecysto-cholangiolithiasis in the age from 18 till 90 years old. In 19 cases at mechanical jaundice and in 3 at ductogenic destructive pancreatitis the first stage was ERCP, papillosphincterotomy, concrements extraction. Conversion was in 5 cases. Postoperative complications are marked at 6 patients. One patient has died. Thus, nowadays, at presence of the specialists endovideosurgical treatment should have the priority in the treatment of the complicated forms of the cholecysto-cholagiolithiasis.

63-65 244
Abstract

The results of research of levels of endothelin1, fibrinogen and C-reactive protein, and also lipid spectrum of venous blood in women with II type diabetes are submitted. Increase of concentration of endothelin1 — one of markers of endothelial dysfunction and a risk factor of heart diseases is found. The interrelation of abdominal adiposity and insulin-resistance with parameters of lipid profile, inflammation and dysfunction of vascular endothelium is shown, and also their influence on processes of coagulation.

66-68 439
Abstract

The prevalence and structure of life-threatening arrhythmias in children till 18 years of age in Primorsky Krai is described. 1127 children with heart diseases are examined. Arrhythmias are revealed in 22.1% of cases. It is shown, that life-threatening bradiarrhythmias, in most cases - the syndrome of sinus node weakness —were typical at male teenagers. For clarifying the character of arrhythmias the 24-hours monitoring of the electrocardiogram is recommended.

68-70 246
Abstract

The analysis of 100 case records and accompanying sheets of the first help of patients with infarct myocardial for the period 2005—2006. All patients were divided into 2 groups. In 1 group have come 50 patient, whom at a pre-hospital stage therapy Alteplase by a method accelerated infusion in a doze of 100 mg was carried out trombolytic. As 2 group considered 50 patients identical on a floor, age, risk factors, which therapy Alteplase was not carried out. It is established, that application accelerated infusion Alteplase at a pre-hospital stage allows to achieve early a painful syndrome, slows down distribution of an ischemia, formation of the center necrosis, reduces death rate of patients. Alteplase it is well transferred by patients, it is seldom accompanied by specific effects (reperfusion arrhythmia, hypotensia, hemorrhage complications) and can be recommended for the further application at a pre-hospital stage.

PEDAGOGY

70-72 293
Abstract

In article the basic clinical and organizational-methodical aspects of education on a specialty «clinical pharmacology» on postgraduate stage at the Vladivostok state medical university are reflected. The basic forms of postgraduate training on faculty of clinical pharmacology are analyzed; the new distance form of postgraduate training is suggested. Value of a specialty «clinical pharmacology» in optimization of medical process, medications maintenance, and increase of efficiency and safety of pharmacotherapy, formation of protocols and standards of medical therapy is shown.

73-75 227
Abstract

The priorities of the national project "Health" and tasks of its realization at the Vladivostok state medical university are considered. It is marked, that in 2006 VSMU as the direct participant of the project has adequately coped with the tasks assigned to it, according to the network schedule and the state contract on postgraduate education of primary physicians of the Primorsky Krai and the Sakhalin area. For 2007 VSMU has got plan on specialties "therapy", "pediatrics" and «general medical practice». Professional retraining for internists and general practitioners is also. planned The plan schedule of 15 additional cycles is developed for the subjects completely answering the pressing needs and directed on liquidation of "bottlenecks" at primary help.

76-78 235
Abstract

The experience of pedagogical work of faculty of infectious diseases of VSMU on general practitioners and other specialists training is described. The importance of knowledge on infectious pathology in modern conditions is emphasized. Stages and methods of training are shown. The special attention is given to introduction in pedagogical process of modern information technologies.

78-81 230
Abstract

Postgraduate education is provided in categorical internship and residency training on 19 and 28 specialties respectively. The comparative analysis of two forms of postgraduate studies has been done. The advantages of each form have been specified. The horizons of further development and perfection of postgraduate education have been outlined.

82-84 211
Abstract

In the given article are reflected positions of new state educational standard of 2005 years, defining modern system of educating a general practitioner. Shown organizining role and action, undertake by the kathedra of polyclinic, allowing optimize a teaching general physician practice.

84-86 224
Abstract

The principles of training of manual medicine at the Vladivostok state medical university are stated. The 8-lelels system of the specialist training is described from which four levels are before graduation. The role of scientific researches in the system formation of the clinical physician is emphasized.

86-87 223
Abstract

This article is the report on teamwork of the Vladivostok state medical university and department of public health of Administration of Primorsky Krai on postgraduate training of specialists. Normative documents are quoted; the increased dynamics in number of the physicians trained on the basis of VSMU in 1982-2006 is shown.

88-90 229
Abstract

Despite of reforming, prophylaxis faculty of VSMU has kept strong connections with the new system of institutions of Federal service in sphere of protection of the rights of consumers and well-being of the person in Far East federal district. Prophylaxis faculty not only answers the state order on specialists training, but also actively cooperates with the Center of hygiene and epidemiology in Primorsky Krai in new organizational and educational technologies at a postgraduate stage of specialists training.

90-92 301
Abstract

The article is devoted to a history of creation of faculty of marine medicine. The basic directions of scientific activity of faculty are shown, as well as the questions of educational-methodical and medical work. It contains brief autobiographical data on the first Head of the faculty, the outstanding scientist — Professor A.F. Malyshev.

93-94 218
Abstract

The article — report on teamwork of the Vladivostok state medical university and department of public health of Administration of the Sakhalin area on postgraduate training of physicians. It is marked, that existing for the long period of time relation allow to support a high level of education of specialists in difficult economic conditions.

HISTORY

94-95 215
Abstract

The article devoted to the 25-anniversary of postgraduate faculty of the Vladivostok State Medical University. The review of the history pediatric school, hospital bases, scientific directions are given. It is emphasized, that today the paediatric postgraduate chair is the center on teaching and re-training of paediatrics in the territory of Primorsky region.

96-97 255
Abstract

The history of the organization and development of faculty of occupational diseases is shown. The analysis of activity on perfection of teaching of occupational diseases on postgraduate level is carried out. The basic directions of training are formulated in view of realization of the priority national project "Health". The ways of the effective decision of a problem of improvement of quality of medical help to the people working in harmful conditions are shown.

97-100 282
Abstract

The historical article devoted to work of the one of the first faculties of the Department of postgraduate education of the Vladivostok state medical university. The basic directions of educational-methodical and scientific activity of faculty, stages of development of system of training and retraining of specialists are described. The faculty provides training on therapy and cardiology both on own base, and in other cities of Primorsky Krai and the Sakhalin area. Active research work on a theme «Clinical pathophysiology of the cardio-respiratory system» is conducted which results influence the practical public health.

100-101 288
Abstract

In the article the questions of development of faculty of anesthesiology and ICU of the Vladivostok state medical university are reflected. The basic sections of work are shown: educational-methodical, scientific, medical, organizational - methodical. The data on dynamics of qualitative and quantitative growth of scientific and pedagogical structure of faculty are resulted. The submitted data testify to the successful decision of the problems traditional for clinical faculties, and also on significant potential of staff.

PRACTICE OBSERVATIONS

102-103 305
Abstract

Case from practice. The way of diagnostics and endoscopic cut of the prepyloric membrane with an aperture at the girl of 1 year 8 months old is described. Electro coagulation sphincterotomy and balloon dilatation were used. Follow-up was within one year, results are satisfactory.

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ISSN 1609-1175 (Print)