Journal «MEDICINA» 4/2018

An analytical review of the existing rankings of universities is performed. The ranking methodology and the principal foreign and domestic ratings are considered. Medical universities listed as a part of general university rankings have been investigated. The place of medical universities in the domestic higher education is shown. Comparison of the first ten medical universities according to eight main ratings allowed to determine the best universities present in most ratings. The analysis of the dynamics of changes in positions of the best medical schools in the general university ranking in terms of the quality of admission has revealed the established stability of the reputational characteristics of leading medical schools. The necessity of creating specialized ratings for medical universities and specialties, considering their specific features is shown.

Key words: ranking, university, medical school, analysis, specialized ranking, analytical review

Binocular vision disorder is an important problem in ophthalmology. Disbinocular disorders occur not only in strabismus (even previously operated), but also in anisometropic amblyopia. We performed a comparative analysis of the efficacy of treating patients with operated strabismus, who in addition to standard orthoptics received home training, using a computer program «Little magician», and patients with anisometric amblyopia treated with lasers of red and green speckles. Despite the different etiopathogenetic factor, both groups showed positive dynamics in the development of binocular functions, with the prevalence of group I.

Key words: ophthalmology, strabismus, orthoptics, laser pleoptics, binocular vision, amblyopia, computer software

In the article authors present the case report of late diagnostic and treatment of 6 mm insulinoma located in the head of pancreas in 60 years old female patient. The disease manifested as an acute cerebrovascular disease and proceeded atypically. None of the imaging studies, including selective angiography combined with hepatic venous sampling for insulin after intra-arterial calcium administration has given an idea of an unambiguous disposition of a tumor. Intraoperative pancreas exploration by palpation ended in wrong localization of insulinoma. Contradictory data of topic diagnostics have caused the inadequate volume of primary surgical treatment causing the necessity of repeated surgery. Long-term persistent hypoglycemia induced encephalopathy and multiple organ failure resulted in lethal outcome although the source of insulin excess has been liquidated. This clinical case emphasizes need of vigilance concerning insulin-producing tumors at patients with clinical picture of stroke in combination with a hypoglycemia.

Key words: tumor of pancreas, insulin, beta-cells

The article discusses the possibility of organ-preserving operations in severe placental abruption. The application of the algorithm of the bilateral ligation of the uterine vessels with placental abruption allowed to reduce the volume of blood loss and save the uterus in 72 cases. This algorithm limits placental-fetal perfusion in placental abruption and is a safe and simple method of stopping bleeding, which is available at the level of regional institutions.

Key words: placental abruption, uterine vessels ligation, organ-preserving operations

The article presents the results of experimental studies on the development of the optimal composition and technology for production of capsules with dry extract of astaxanthin from seaweed Haematococcus pluvialis, for medicamental prevention and complex treatment of glaucoma. The resulting capsules meet the requirements of the State Pharmacopoeia (XIII edition) for the dosage form.

Key words: astaxanthin, granulate, wet granulation, solid gelatin capsules, glaucoma

The important criterions, defining the prospects of vital activity for teenagers are the level and the structure of their sickness rate. For the purpose separate classes of diseases are defined, based on the analysis of healthcare encounters in teenagers. Author analyses general, primary and health examination related sickness rates in teenagers of Krasnoyarsk region for the period 2016-2017. Based on complex assessment of these indexes (by the sum of ranks and coefficient of the relative significance) priorities of separate classes of diseases are determined. Principal (rated by specific significance) are diseases of an eye and its annexal structures, osteomuscular system and connecting tissues, mental and behavioral disorders, diseases of the digestive system, endocrine system, nutrition and metabolic disorders, diseases of respiratory organs, circulatory, nervous and urinogenital systems making 93,0% of total. That is significant for perfection of preventive, medical and diagnostic technologies.

Key words: incidence of teenagers, complex assessment, the quantitative significance of classes of diseases

Assessment of physical development in children requires universal method. That will provide for timely solution of healthcare and prevention, as well as vocational and athletic guidance in organized children groups. The aim of the study is to determine actual methods of studying and estimating children growth and development for identification of modern secular trend. The article provides analysis of national and foreign scientific reports from 2011 to 2018, determining the main tendencies in children’s physical development. The methods of estimation were systematized. Perspectives for finding and implementing the most effective and informative methods of diagnostics of health problems, prevention and correction of development deviations and forecasts of potential changes in human biology have been presented.

Key words: estimation of physical development, children and teenagers, secular trend

Objective – to establish the connection of the vascular tonus in veins of the lower extremities with arterial hypertension (AH). Materials and methods. A comparative analysis of the total femoral vein tone was performed in 60 men with hypertension and in 27 men with normal blood pressure. The tone was assessed by the orthostatic dynamics index in the prone and vertical positions, calculated on the results of the ultrasonic examination of the vein. Results. Under orthostasis in both groups an increase in the cross-sectional area of the vein by 2.8 times was recorded, compared with the baseline, but the differences in the orthostatic dilatation index between the groups were not detected. Results. There was no difference in vein tone between men with hypertension and with normal arterial pressure, probably due to the gender characteristics of patients, insufficient informative value of the method for determining tonus basing on the common femoral vein.

Key words: arterial hypertension, venous tone of the lower extremities, men

A description of the clinical case is given in a 46-year-old patient with diabetes mellitus type 2 and a number of associated diseases. The stages of the performed diagnostic search are presented with the verification of the clinical diagnosis and the tactics of the prescribed pharmacotherapy.

Key words: diabetes mellitus type 2, polymorbidity, polypragmasy

The effect of valprazolamide, a new antiepileptic agent from the group of amide derivatives of valproic acid, on the exploratory behavior of mice in «open field» test and a «dark/light transition» test was studied. As a result of the experiment, it was revealed that the new antiepileptic drug valprazolamide, when used in doses of 75 mg/kg and 150 mg/kg, hadn’t a significant effect on the orienting-exploratory behavior of mice. With a single intraperitoneal injection at a dose of 300 mg/kg, individual manifestations of rodent research activity increased (horizontal locomotor activity when tested in the open field), and at a dose of 450 mg / kg, it had a depressing effect on the orientation reflexes in rodents.

Key words: valproates, antiepileptics, exploratory behavior

In the context of the global financial crisis, there is a shortage of budget resources, which exacerbates the problem of meeting the social needs of Russian citizens, including in medical services. Currently, there is an active reform of audit activities associated with changes in the system of international relations, integration processes, restructuring of the institutional structures of business entities in the country and their assets. The principal problem in these conditions is the further development of the organization and methodology of audit activities and its methodological reference to business entities of different organizational and legal forms. Purpose: to analyze the current situation on the audit of medical organizations and justify the need to create a methodology for its implementation. Method of research. The paper used methods of content analysis, monographic, analytical.

Key words: medical organization, audit, methodology, quality