Статьи журнала - Saratov Medical Journal
Все статьи: 92
Статья научная
Objective: to evaluate the role of soluble fms-like thyroxine kinase-1 (sFlt-1) and anti-endothelial cell antibodies (AECA) in patients with acute coronary syndrome (ACS) in the post-COVID era. Materials and Methods. The study included 118 patients (including 57 women, 61 men) with ACS and a history of novel coronavirus infection (NCI). All patients were measured for the levels of sFlt-1and AECA in the blood. The comparison group consisted of 121 patients with ACS without NCI. Results. Elevated levels of sFlt-1 and AECA were more often detected in the ACS group and group with a history of NCI vs. the comparison group: relative risk (RR)=2.768 [95% confidence interval (CI): 2.0810-3.681], p<0.001; and RR=1.554 [95% CI: 1.216-1.987]; p=0.002), respectively. In the group of patients with ACS and a history of NCI, a more severe course of ACS was also observed: arrhythmia was observed more often (RR=1.372 [95% CI 1.005-1.784]; p=0.032), along with rehospitalization in the first 14 days for cardiovascular diseases (RR=1.475 [95% CI: 1.100-1.977]; p=0.032) and in-hospital mortality (RR=1.610 [95% CI: 1.160-2.233]; p=0.042). Conclusion. Levels of AECA and sFlt-1 are associated with the risk of developing a severe course of ACS in patients who have previously undergone NCI.
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Статья научная
The objective of our study was to reveal the morphofunctional interactions between allografts and the recipient nervous system from the experimental model of the mimetic musculature reinnervation. Materials and Methods. The experiments were conducted on Chinchilla rabbits (n=36). All animals were subjected to the facial nerve transection. No other manipulations were performed in the Control Group (n=9). In Treatment Group 1 (n=12), an autograft fragment of the masseter muscle with a neurovascular bundle was attached to the denervated buccinator. In Treatment Group 2 (n=15), allogeneic biomaterials – specifically, Regeneration Stimulator and Vasculogenesis Stimulator, were inserted between specified muscles. The animals were removed from the experiment on days 10, 30, 60 and 180. Tissue pieces from the operation zone were analyzed using transmission electron microscopy. Results. It was established that compensatory and restorative processes in the Control Group and Treatment Group 1 end with scarring of the boundary zone and contracture of mimetic muscles. In Treatment Group 2, we observed revascularization of mimetic musculature, as well as axonal ingrowth into the buccinator and restoration of neuromuscular synapses. Conclusion. Allogeneic biomaterial transplantation creates adequate conditions for the restoration of the organ vascular bed and the innervation apparatus of denervated mimetic muscles. The results of our experiments could be regarded as an example of restoring the interlevel relations in the human body following the use of allogeneic biomaterials.
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Статья научная
Objective: to examine the possibility of reducing the severity of organ dysfunction and inflammatory response with the L-17 compound in a model of acute post-manipulation pancreatitis (APMP). Materials and Methods. APMP was modeled on 40 rats. Laboratory rats were distributed among control (n=20, without treatment) and experimental (n=20, with the introduction of the L-17 compound) groups. The daily dose of the compound was 40 mg/kg of rat body weight. Results. APMP developed in all animals. In the control group, persistent organ dysfunction and inflammatory response corresponded to a severe course of acute pancreatitis with a mortality rate of 70%. In the experimental group, there was a decrease in the severity of organ dysfunction and inflammatory response, with a decrease in mortality down to 30%. Conclusion.Administration of the L-17 compound reduced the severity of organ dysfunction and inflammatory response in experimentally modeled APMP.
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Статья научная
Objective: to conduct an experimental study on the properties of three different types of synthetic polyester matrices, to carry out their comparative assessment, and to identify the optimal carrier for the cultivation and transplantation of limbal stem cells while eliminating limbal insufficiency. Materials and methods. Transparency, mechanical properties (strength, relative elongation at break, and elastic modulus), biocompatibility with corneal cell cultures were assessed, and duration of matrix biodegradation in vivo were studied. Results. In the course of our study, the optical and mechanical properties of matrices, made of polylactide-glycolide (PLG), polylactide-caprolactone (PLC) and poly-E-caprolactone (PCL), were studied. It has been experimentally shown that limbal stem cells of humans and rabbits, as well as human corneal epithelial cells, adhered to the surface of all types of the studied matrices. During the cultivation process, they retained the typical structure of the actin cytoskeleton, along with the ability to proliferate and migrate. Differences in the interaction of different cell cultures with different types of carriers were revealed. The biodegradation time of 5 μm thick PLC matrices was about 30 days. Conclusion. Our results obtained implied the possibility of using 5 μm thick PLC matrices as a carrier for cultured limbal stem cells.
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Статья научная
Objective: to study the effect of the targeted delivery system of tannic acid (TA) in silver alginate microcapsules on the state of gum microvasculature in rats with intact periodontium vs. experimental periodontitis. Materials and Methods. The study was conducted on 90 white rats, distributed among six groups: the control group, two groups with intact periodontium and single application of gel with microcapsules loaded/not loaded with TA, experimental periodontitis group, and two groups of animals with periodontitis and repeated application of gel with microcapsules loaded/not loaded with TA. We assessed gingival perfusion and blood flow modulation mechanisms in rats via laser Doppler flowmetry. Results. Applying gel with silver microcapsules to an intact gum in rats caused 7.5% transient increase in perfusion and activation of microcirculation modulation. Loading microcapsules with TA reduced the severity of transient microcirculatory changes. Using gel with TA-loaded capsules in rats with periodontitis allowed achieving a more pronounced normalization of perfusion and mechanisms of microcirculation modulation vs. using gel containing microcapsules without active components. Conclusion. Loading alginate microcapsules with silver ions and TA yielded reduction of the irritating effect on gingival mucosa accompanied by an increase in the effectiveness of correcting microcirculatory disorders in periodontitis.
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Статья научная
Objective: to evaluate echocardiographic changes in patients with acute coronary syndrome (ACS) combined with post COVID-19 syndrome (PCS). Materials and methods. The study included 118 patients (61 men and 57 women) with ACS+PCS. All patients were subjected to the echocardiography (EchoCG) on the first day, in addition to coronary angiography and general clinical examination methods. The comparison group included 121 patients with ACS but without PCS. Results. In the ACS+PCS group, the following parameters were statistically significantly more frequently recorded than in the ACS group: elevated blood pressure (risk ratio, RR 2.327; 95% confidence interval, CI 1.582-2.699), tachycardia (RR 2.067, 95% CI 1.415-3.730), dyspnea (RR 2.022, 95% CI 1.495-2.736), weakness (RR 4.077, 95% CI 2.946-5.643), and insomnia (RR 1.893, 95% CI 1.519-2.358); p<0.001. According to EchoCG results, in the ACS+PCS group of patients, an increase in the mean pulmonary artery pressure, expansion of its diameter, and mitral valve regurgitation were noted (p<0.001). Of the cardiac complications, the most common were left ventricular apical thrombus (RR 1.785, 95% CI 1.304-2.444), left ventricular aneurysms (RR 1.736, 95% CI 1.234-2.443), along with hypokinesis and akinesis (development of myocardial infarction) (RR 1.673, 95% CI 1.275-2.196; p<0.05). Conclusion. Patients who experienced ACS in combination with PCS exhibited more pronounced EchoCG changes vs. patients without PCS.
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Features of erythrocyte electrophoretic mobility in programmed hemodialysis patients
Статья научная
Objective: to analyze the electrophoretic properties of erythrocytes in patients receiving programmed hemodialysis treatment. Materials and Methods. The study included 100 patients with an established diagnosis of stage 5D chronic kidney disease, receiving programmed hemodialysis treatment. The control group included 17 healthy blood donors. The following indicators of erythrocyte electrophoretic activity were evaluated: oscillation amplitude, percentage of motile cells, ellipticity, and aggregation index. Results. Compared with the control group, we revealed significant changes in the amplitude of oscillations and the percentage of motile cells (p-0.001). No significant gender-dependent differences were observed (p-0.05). Statistically significant differences between young and senile age groups (p=0.048) were observed in the average oscillation amplitude, whereas ellipticity differed significantly in middle-aged vs. senile patients (p=0.040) and elderly vs. senile subjects (p=0.035). As for the effect of hemodialysis treatment duration, a reduction in the oscillation amplitude was observed when comparing maximum with minimum duration: less than 1 year (p=0.029) and 1 year (p=0.035). Aggregation index values were the highest in the groups with the minimum (p=0.044) and maximum (p=0.035) dialysis duration. Conclusion. In hemodialysis patients, the oscillation amplitude of erythrocytes was significantly reduced, with assumed tendency for further decrease associated with duration of hemodialysis treatment.
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Статья научная
Objective: to determine the features of intercellular interaction of platelets with neutrophils expressing adhesion molecules in psoriasis patients. Material and Methods. The study included 82 patients 20-60 years of age with a plaque psoriasis or pustular psoriasis. As a control group, 50 virtually healthy individuals 20-60 years old were examined. The study of the adhesion molecules spectrum on neutrophils was carried out on a Beckman Coulter FC-500 flow cytometer (USA) using monoclonal antibodies. The platelet-neutrophil aggregates were determined sensu the method by Yu.A. Vitkovsky et al. (2006). Results. In patients with psoriasis, compared with the control group, few intercellular contacts of neutrophils with platelets were revealed. Low values of platelet-neutrophil aggregates with 3, 4, and 5 lobes in the nucleus were observed. The formation of aggregates statistically significantly correlated with the expression of LFA-1 and PECAM-1 adhesion molecules by mature neutrophils. Conclusion. Low rates of intercellular interaction of platelets with three-, four-, and five-lobed neutrophils in psoriasis were indicative of their augmented migration from the peripheral blood to the epidermis. The adhesion molecules LFA-1 and PECAM-1 play a key role in the migration of platelet-neutrophil aggregates.
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Features of microcirculatory responses in experimental wound area in white rats
Статья научная
Objective: to examine changes in the microcirculatory bed parameters via laser Doppler flowmetry in the course of wound healing and the possibility of their use for upgrading the technology of evaluating the effectiveness of wound healing agents. Materials and Methods. The studies were performed on 25 white rats distributed between two groups: 10 control animals (intact rats) and 15 animals with a full-thickness experimental skin defect. The microcirculation parameters in the skin of experimental wound edges in rats were evaluated using laser Doppler flowmetry, and histological preparations of tissues in the wound area were analyzed. Results. Changes in skin microcirculation at the wound edges were characterized by inflammatory hyperemia manifested by an increase in the perfusion index by 27% and augmented normalized amplitudes of myogenic, respiratory and cardiogenic oscillations. Changes in microcirculation were verified by the morphological picture of inflammation, which reflects an increase in the number of vessels fully filled with arterial and venous blood, as well as in leukocyte infiltration of the wound edges and bottom. Conclusion. Monitoring of microcirculatory disorders occurring in the area of skin wounds allows assessing the dynamics of the reparative process, which could be used for developing and evaluating the effectiveness of existing medicamentous and non-medicamentous methods of stimulating regeneration.
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Functional prognosis of acute ischemic stroke patients from their neuropsychological features
Статья научная
The objective was to evaluate the relationship between the patient neuropsychological condition and recovery of his/her motor activity disorder due to acute cerebrovascular accident. Materials and Methods. The study involved 103 patients with ischemic stroke in the pools of middle and anterior cerebral arteries. We carried out clinical and neurological assessments of the patient condition, and conducted neuropsychological testing via Beck Hopelessness Scale (BHS), Montreal Cognitive Assessment (MоCA), SF-36, and Visual Analog Scale (VAS). The examination was performed on three occasions: during the acute phase of cerebral circulatory disorders, after two weeks and within the range of 24-36 months. After the long-term follow-up, all patients were distributed among two groups: with a favorable outcome and with unfavorable outcome. We attempted to identify the most typical values of above-mentioned scales for each group. Results. The general physical health (GPhH) indicators based on the results of SF-36 (p=0.007), BHS (p=0.003 and 0.002), and VAS (p=0.025), collected after acute ischemic stroke, were prognostically significant. In both groups, the most important indicators for the stroke prognosis were MоCA (p=0.038), BHS (p=0.009) and SF-36 (GPH) (p=0.002), regardless of the stroke phase. Conclusion. The connection between the patient neuropsychological condition and restoring the motor functions after the stroke was revealed. The investigated questionnaires can be included in the multivariate forecast model of the stroke prognosis among other criteria for the outcome of this disease.
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Статья научная
Objective: assessing the association of sequence variants rs8192678, rs1801282, rs9939609, rs7799039 and rs1137101in PPARGC1A, PPARG2, FTO, LEP and LEPR genes, respectively,with non-alcoholic fatty liver disease (NAFLD) inyounger adults (18-44 years old) of the Russian Federation. Materials and Methods. Our case-control study encompassed 100 patients distributed between two groups: Group 1 (cases) with patients suffering from NAFLD (n=50) andGroup 2 (controls) with individuals without it (n=50). All subjects underwent a conventional sonography of their liver and shear wave elastography (Aixplorer®, France): both ultrasound examinations assessed the severity of liver steatosis and fibrosis. Results. We discovered two sequence variants associated with an increased risk of NAFLD in women: rs9939609 and rs7799039: A/A rs9939609 genotype (OR 5.33, 95% CI 1.14-24.90,p=0.041) and G/G rs7799039genotype (OR 7.5, 95% CI 1.04-54.12,p=0.026). Conclusion.The A/A genotype of the rs9939609 gene in younger women of the Russian population yielded the fivefold increase in the likelihood of NAFLD, whereas the G/G genotype of the rs7799039 gene resulted in a 7.5-fold likelihood ofNAFLD occurrence.
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Impact of bone marrow allotransplantation on functional state of mast cells in lymph nodes
Статья научная
Objective: to analyze the functional state of mast cells (MC) after bone marrow allotransplantation at the early stages of the experiment. Materials and Methods. The experiments were carried out on 40 outbred male mice, which were divided into 3 groups: Group 1 with intact animals (n=10); Group 2 with control animals injected with 0.85% sodium chloride solution (n=10); Group 3 with experimental animals (n=30) injected into their tail vein with a cell suspension from another mouse under ether anesthesia. The state of mast cells was evaluated by the method of staining with polychrome toluidine blue sensu P.G. Unna. Results. Forty minutes after the introduction of foreign bone marrow in the medulla, metachromatic MC were found near the vessels, and their proportion (60%) prevailed over orthochromatic MC (40%). MC were most often located in groups, especially near the vessels, in contact with each other. The morphometric parameters of MC were changing (diameter, 8.00-17.00 μm 6.00-12.00 μm vs in intact MC). Two hours after the experiment, in accordance with the degree of heparin sulfation, metachromatic mast cells were predominantly detected (92%), and extensively degranulated MC predominated (61%), p<0.05. The size of MC was changing (diameter: 3.00-9.00 μm; distance between cells: 29.00-53.00 μm). One-way analysis of variance established that there was a significant effect of the experiment duration on the change in the proportion of MC with metachromatic staining. Conclusion. An introduction of bone marrow transplant significantly changes the functional profile of mast cells.
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Impact of excess weight on surgical treatment of the ankle joint
Статья научная
Objective: to assess the possible effect of excess body weight on the results of surgical treatment outcomes of ankle osteoarthritis.
Materials and Methods.Our study sample included 134 patients with moderate to advanced ankle osteoarthritis who underwent supramalleolar osteotomy or ankle arthrodesis.Patients were distributed among four groups according to their body mass index values: A) underweight (BMI≤18.5kg/m2), B) normal weight (18.5
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Статья научная
Objective: to evaluate the effects of alginate microcapsules on morphological changes in periodontitis depending on silver nanoparticle concentration in them. Materials and Methods. The study was conducted on 30 rats distributed among three groups of 10 animals: the comparison group comprising animals with an experimental model of periodontitis and two experimental groups including animals with 5-week periodontitis, which were subjected to applications of the gel containing microcapsules with high (0.25 M, Group 1) and low (0.1 M, Group 2) concentrations of silver on the surface of their gums. To assess morphological changes, the mandible was sampled for subsequent examination. Results. In animals with periodontitis, changes in the supporting structure of the tooth took place, including defibration and perivascular edema in periodontal ligament of the tooth, and bone resorption via its replacement with connective tissue. The application of a gel containing microcapsules with silver nanoparticles led to a partial reduction of such disorders: particularly, it reduced bone resorption and its replacement with connective tissue. Destructive changes in periodontal tissues caused by gel with a high content of silver nanoparticles (0.25 M) were less pronounced than those caused by capsules with a low content of silver (0.1 M). Conclusion. Gels containing microcapsules with silver nanoparticles contributed to the reduction of destructive changes in the supporting structure of the tooth in periodontitis. The severity of the effects of the gel increased with an increase in the content of silver nanoparticles in alginate microcapsules.
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Indicators of antioxidant activity in unexplained infertility: A cohort study
Статья научная
Objective: to evaluate the levels of antioxidant protection markers in women with unexplained infertility vs. women who had at least one term birth of a live full-term fetus. Materials and Methods. We conducted a comparative retrospective cohort study, which included 52 women with unexplained infertility and 85 women without infertility. During the study, we examined standard biochemical parameters, along with antioxidant and peroxidase activity. Results. In women with unexplained infertility, the overall antioxidant activity was more pronounced than in women without infertility (2.21±0.312 and 1.970.312 ng/mL, respectively; p<0.001), while they exhibited a lower peroxidase activity (11.6±3.96% and 13.46.67%, correspondingly; p<0.001). Conclusion. Our study established that in women with unexplained infertility, the level of overall antioxidant capacity of serum was higher than in women who have executed their reproductive function, while peroxidase activity in the former was less pronounced.
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Instances of folliculogenesis in rat thyroid: The norm vs. the experiment
Статья научная
Objective: identification and characterization of the stages of new follicle formation, along with measuring the frequency of folliculogenesis in various parts of the thyroid in normal and experimental conditions. Materials and Methods. The experiment was performed on 36 mature white rats distributed among three groups: the control (Group I), 60-day exposure to sodium benzoate at a dose of 1,000 mg/kg (Group II), and administration of Mexidol at a dose of 50 mg/kg against the background of a 60-day exposure to sodium benzoate (Group III). The stages of folliculogenesis were studied using light microscopy followed by statistical analysis of its frequency. Results. The formation of a new follicle begins with the proliferation of thyrocytes on the cell wall of the mature follicle, after which a cavity is formed between the cells into which they secrete colloid. As the follicle grows, the height of the thyrocytes declines, and the size of their cavity and the amount of colloid increase. In Group II vs. Group I, on days 3 and 24 of the experiment, signs of folliculogenesis were detected 1.7 and 1.4 timesless frequently in the thyroid center, and 2 and 1.2 times less often in the thyroid periphery; while in Group III vs. Group II, these were observed1.3 and 1.6 timesmore often in the center of the organ, and 1.3 and 1.3 times more frequently in the thyroid periphery. Conclusion. During folliculogenesis in the thyroid, focal proliferation of thyrocytes develops in the cell wall of one of the follicles with further formation of the cavity of the newly formed follicle and its growth. Normally, the formationfrequency of new follicles is higher in the organcenter vs. the periphery and lower in both thyroid zones in the group of rats exposed to sodium benzoate. However, in the group of rats where sodium benzoate administration waspharmaceuticallycorrected by Mexidol, the frequency of the young follicleformation increased, albeitit did not reach the control values.
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Objective: to conduct a comparative analysis of the features of intracellular metabolism in polymorphonuclear leukocytes (PMN) in the peripheral blood of rats with inherited stress-induced arterial hypertension (ISIAH) vs. normotensive animals (NTA). Materials and Methods. In the leukocytes of rat blood (15ISIAH rats and 20 NTA), the indicators of carbohydrate and lipid metabolisms, the activity of a number of key enzymes reflecting the state of redox processes, and PMN functional activity level were determined using histochemical methods. Results. The study established that a stable increase in blood pressure was accompanied by hypertrophy of the left ventricle, degenerative changes in cardiomyocytes and a decrease in the density of the microvasculature. At the same time, the amount of intracellular glycogen in leukocytes decreased by 23% while the amount of intracellular lipids remained unchanged. The levels of activity of intracellular ATPase and myeloperoxidase decreased by 22% with a slight increase in the activity of succinate dehydrogenase (by 13%). The number of PMN with a positive hematocrit (НСТ) test was higher by 35% in ISIAH rats.Conclusion. Analysis of the studied PMN metabolism indicators revealeddisorders in the energysupplying and enzymatic processes of leukocytes in arterial hypertension.
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Malnutrition in hospitalized children
Статья научная
Objective: Our study aimed to determine the prevalence and grade of malnutrition in patients hospitalized for various indications and to examine its relationship with comorbidities and socio-demographic factors. Materials and Methods: This study enrolled children aged 1 month to 15 years old with a median age (Q25; Q75) of 1.8 (1.27–3.47) years, admitted to our hospital with various diagnoses between 1 January 2019 and 31 December 2019. Our study included 498 patients, 286 (57.4%) of which were male and 212 (42.6%) were female. Results: Of all patients, 40 (19.7%) with a median age of 2.25 (1.27–3.48) years had a weight z-score of less than –2SD. Of our patients, 47.2% (n=235) had malnutrition sensu the Waterlow classification. There were significant differences between the groups in socioeconomic level and C-reactive protein (CRP) content. Conclusion: Malnutrition is associated with a low socioeconomic status. It plays an important role in hospitalizations with various diagnoses.
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Статья научная
Objective: based on the Russian Federation multicenter registry data, to assess the comprehensiveness of medicamentous therapy in patients with stable coronary artery disease (CAD) from the perspective of 2018 European Society of Cardiology (ESC-2018) recommendations for myocardial revascularization and 2017 American Appropriate Use Criteria (AUC-2017) for the expediency of revascularization. Materials and methods. Anamnestic data of 1531 patients with stable CAD (average age: 61.7 ± 9.8 years; 76% men) were studied. The data source was the Russian Federation multicenter registry of patients with arterial hypertension, CAD, and chronic heart failure. We identified the prescription of optimal medical therapy (OMT) sensu ESC-2018, maximal anti-ischemic therapy (MAT) sensu AUC-2017, and compliance of drug therapy with ESC-2018 and AUC-2017 simultaneously. OMT included at least one anti-ischemic medication + antiplatelet agent + statin + short-acting nitrate + blocker of the renin-angiotensin system in the presence of hypertension, diabetes mellitus, or heart failure. MAT included at least two anti-ischemic pharmaceutical drugs. Compliance with these criteria was determined in the groups of patients who underwent, or did not undergo, myocardial revascularization, as well as among those, for whom invasive treatment was indicated as the first priority, as the second priority, or was not indicated at all, according to ESC-2018 and AUC-2017. Results. Among patients who received solely medicamentous therapy (n=924), OMT was prescribed in 18%, while in the revascularization group (n= 07), in 9% of cases (p <0.001). MAT was also prescribed more often in the conservative therapy group (34%) than in the revascularization group (24%): p = 0.001. OMT sensu ESC-2018 and AUC-2017 in the groups with, or without, intervention was prescribed in 3% vs. 7% of cases, respectively (p <0.001). Conclusion. According to the Russian Federation multicenter registry, medicamentous therapy of stable CAD complies with the provisions of European and American clinical guidelines for myocardial revascularization in a small proportion of patients, regardless of the chosen treatment tactics.
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Methodology of designing specialized medical information registries
Статья научная
The objective. Developing information exchange methodology by means of specialized registries among the core healthcare partakers in the course of provisioning medical assistance to traumatology and orthopedic patients. Materials and Methods. We conducted the analysis and systematization of functionality for 31 registers of traumatology- and orthopedics-related medical information from the databases of the Federal Institute of Industrial Property, European Patent Office and developers’ websites. The search depth has been set at 1979 and defined by the date of the earliest discovered information source. Results. The analysis of specialized registries revealed that majority of those (70.9%) were mono-nosologic, hence containing information about the diagnosis and treatment procedures provided at the level of a specific medical institution. We developed the methodology for evaluating the functionality of specialized medical information registries, containing the data on used medical devices, medications, medical technologies, rehabilitation programs, and assessment of medical treatment effectiveness. Such methodology was designed to operate on data from the information systems of major healthcare partakers. Conclusion. The proposed information exchange methodology defined the necessity of integrated, target-oriented registry development. Its implementation would allow increasing the quality of management decisions proposed by healthcare participants.
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