[The rise of attractiveness of specialty "General Practice" for graduates of medical universities].

The choice of specialty by graduate of medical university can be promoted by particular social, demographic and personal characteristics. Purpose of the study is to investigate demographic, social and personal characteristics of students in residency on specialty "General Medical Practice" in the Russian Federation. The sociological, statistical and analytical methods are applied. The sampling for survey consisted of 81 respondents. The specialty "General Medical Practice" is chosen mainly by women residing in city, non-married and without children. They are not characterized by participation in public life and they are characterized by the presence of hobbies (hobbies). The choice is conditioned by multidisciplinary nature of medical care and scope of professional horizons. They are attracted by treatment work and are less interested in pedagogy and science. In perspective, 80% of female respondents are going to get another specialty. More than 70% of respondents plan to work in out-patient conditions and predominantly in state sector of health care. For women, main goals of further professional training are improvement in main and adjoining specialties and career promotion. And in educational program, internal diseases are of greatest interest. The preferred forms of training are internships and e-learning. The main direction of improving educational process is increasing of scope of practical training. The comparative analysis of study results with data of previous publications was implemented. The factors influencing commitment to specialty are revealed. The proposals increasing attractiveness of general medical practice for graduates of medical universities and keeping in specialty after residency are formulated.

[The effectiveness of the use of non-drug treatment complexes and their impact on quality of life indicators, the psychosomatic status of patients with residual brucellosis with lesions of the musculoskeletal system]. / Effektivnost' primeneniya kompleksov nemedikamentoznogo lecheniya i ikh vliyanie na pokazateli kachestva zhizni, psikhosomaticheskii status patsientov s rezidual'nym brutsellezom s porazheniem oporno-dvigatel'nogo apparata.

Secondary focal lesions of the musculoskeletal system that occur with residual brucellosis are characterized by a variety of localizations and simultaneous damage to several groups of joints, a deterioration in the quality of life and a high percentage of disability in people of working age. At present, there are many different schemes for the treatment and rehabilitation of developed residual brucellosis, in which, in addition to the "basic" course, including systemic anti-inflammatory therapy, much attention is paid to physiotherapeutic procedures, but the choice of the most effective treatment tactics remains an unresolved problem. PURPOSE OF THE STUDY: To determine the effectiveness of the use of options for non-drug methods of treatment in the complex rehabilitation of patients with residual brucellosis with lesions of musculoskeletal system. MATERIAL AND METHODS: Study included 140 patients treated for osteoarthritis of brucellosis etiology, who were divided into three groups matched by age, gender, average duration and stage of the disease, place of residence. Patients of all groups received standard medical treatment and different sets of physiotherapeutic procedures: in the 1st group (45 patients) - electrophoresis of novocaine on the knee joints, therapeutic massage of the cervical-collar zone; in the 2nd group (45 patients) - magnetotherapy on the area of the knee joints, sinusoidal modulated currents (SMC) on the shoulder joints, decimeter wave therapy of the lumbosacral zone (DMW-therapy); in the 3rd group (50 patients) - magnetic laser therapy on the shoulder, elbow, knee joints, therapeutic massage of the lumbosacral zone. Complaints, clinical symptoms, goniometry results, and blood parameters were assessed: ESR, C-reactive protein, fibrinogen, before the start of treatment, immediately after the course of rehabilitation, and after 6 and 12 months. At the same time, testing was carried out according to the SF-36 Health Status Survey questionnaire to monitor the quality of life. RESULTS: The applied scheme of drug treatment in combination with magnetic laser therapy and therapeutic massage in the 3rd group made it possible to achieve a significant reduction in arthralgic syndrome, a statistically significant increase in the range of motion in the joints, positive dynamics of laboratory data and an improvement in the psychological state and quality of life of patients compared to other observation groups. CONCLUSION: The results of the study indicate the high efficiency of magnetic laser therapy in the complex treatment of patients with residual brucellosis with lesions of the musculoskeletal system.

[Change of immune status parameters, clinical symptoms and health related quality of life patients with postmastectomy syndrome depending on the used rehabilitation complexes]. / Izmenenie pokazatelei immunnogo statusa, klinicheskikh simptomov i kachestva zhizni patsientok s postmastektomicheskim sindromom v zavisimosti ot primenyaemykh kompleksov reabilitatsii.

Regardless of the chosen methods of breast cancer treatment, more than 85% of patients develop postmastectomy syndrome (PMES) after a course of therapy, which significantly worsens their quality of life and psychological state. Relatively recently, physical factors began to be used in the conservative treatment of PMES and the results of the use of various rehabilitation therapy complexes were evaluated. OBJECTIVE: To assess the effectiveness of the use of some physiotherapy methods in the rehabilitation of patients with PMES according to clinical parameters, markers of endothelial dysfunction, and the results of a questionnaire. MATERIAL AND METHODS: 185 patients suffering from PMES were examined. They were divided into 4 groups: in the 1st group (control, 61 patients) basic treatment was used (physiotherapy exercises, photomatrix therapy, manual lymphatic drainage massage of the affected upper limb, pneumatic compression); in the 2nd group (43 patients) - basic treatment + sinusoidal modulated currents to the area of the muscles of the thoracic girdle; in group 3 (42 patients) - basic treatment + electrostatic therapy of the upper limb on the side of the operation; in the 4th group (39 patients) - basic treatment + SMC therapy + electrostatic therapy. Before and after the rehabilitation course, clinical symptoms, blood counts for interleukins (IL) 6, 8, 10, homocysteine were assessed, testing was carried out according to the SF-36 (Short Form Medical Outcomes Study) questionnaire, WAM (Well-being, activity, mood) questionnaire, Hamilton depression scale. RESULTS: There was a tendency to a decrease in the quantitative parameters of the immune status: the mediators of the acute phase of inflammation - pro-inflammatory interleukins (IL-6, IL-8), homocysteine and anti-inflammatory interleukin (IL-10). A statistically significant decrease of length of circumference of the affected upper limb was recorded in patients of groups 3 and 4, which electrostatic therapy was used in the rehabilitation program. Lymphatic edema of the upper limb was decreased statistically significant by 33.25% in the 3rd group, by 35.45% in the 4th group. According to the data of the Mirage multicenter study, parameters of the physical and mental components of health of the SF-36 questionnaire after a course of rehabilitation therapy ware significantly approached to the average population parameter in all groups. There was an objective improvement in the general well-being of the patients, an increase in activity and mood according to the data of the WAN questionnaire and psychological state according the Hamilton scale. CONCLUSIONS: Inclusion of electrostatic therapy procedures, sinusoidal modulated currents in the rehabilitation program, significantly enhances the therapeutic effect, promote to reduce the edema of the upper limb, increase the range of motion of the shoulder joint, which has a positive effect on the quality of life andemotional state of patients. The level of IL-6, IL-8 tends to decrease, which indicates the absence of tumor growth and systemic inflammatory reactions. Decrease of the level of IL-10 and homocysteine confirms the safety of the use of physical factors in the treatment of PMES.

[Dynamics of the profile of biochemical markers of arterial hypertension in the elderly patients under exposure to a physical load]. / Dinamika profilia biokhimicheskikh markerov arterial'noi gipertenzii u pozhilykh patsientov pri vozdeistvii fizicheskoi nagruzki.

BACKGROUND: The elderly age is an independent, non-modifiable risk factor for the development of cardiovascular diseases, including arterial hypertension (AH). One of the causes attributable to the increase in the number of cardiovascular diseases (including hypertension) is a decrease in the level of the motor activity in humans under the modern living conditions. In connection with this, the modern society is actively looking for various means that could contribute to the prolongation of active human longevity. The regular physical activity can and should be the most important among such means. AIM: The objective of the present work was to study the biochemical markers of arterial hypertension in the elderly patients and the influence of physical activity on their dynamics. MATERIAL AND METHODS: The study involved the elderly patients including 148 ones at the age from 60 to 74 years who underwent examination and/or treatment for stage I-II arterial hypertension (AH I-II) based at the medical facilities of the city of Stavropol. 30.4% of these patients were men and 69.6% women. All of them were asked to take the drugs needed to treat hypertension during a period of 12 months. The patients were divided into two groups. The first group (the main group) consisted of 72 patients (48.6%) who receivedregular sessions of medical physical training, in addition to conventional drug therapy. The patients who received only medication were referred to the second group comprised of 76 subjects (51.4%). RESULTS: The results of the study give evidence that the combination of the physical exercises with standard drug therapy in the elderly and senile patients presenting with AH I-II promotes considerable improvement in the overall health status of the treated patients including red blood indices (p<0.05). The more pronounced influence of the treatment on the biochemical indices of endothelial dysfunction (the homocysteine level) and lipid metabolism (total cholesterol) was documented in the group of the patients who practiced exercise therapy (p<0,05) than in those comprising the group of comparison treated in the absence of exercise therapy (p=0). The greatest effect was observed after 6 months from the beginning of the exercise therapy. CONCLUSIONS: The investigation into the biological markers of arterial hypertension in the elderly patients with this pathological condition has demonstrated that the regularly practiced moderate physical exercises (exercitation, walking) leads to a significant decrease of the homocysteine level as well as the normalization of lipid metabolism and indices of the red blood.

[The development of diagnostics of abdominal form of ischemic heart disease in primary health care].

The systematization and stratification of clinical, physical, laboratory and instrumental methods of testing was carried out. The research permitted to formulate the algorithm of comprehensive diagnostics of patient and to determine the role and significance of modern additional techniques in examination of patients with atherosclerotic abdominal ischemic heart disease on the level of primary health care.

[Dopamine levels in the gastric and duodenal mucosa, blood and urine in patients with duodenal ulcer]. / Soderzhanie dofamina v slizistoi zheludka i dvenadtsatiperstnoi kishki, krovi i moche u bol'nykh s duodenal'noi iazvoi.

A study was made of the dopamine (DA) level in the gastric and duodenal mucosa, blood and urine of 54 patients with duodenal ulcer and 19 healthy persons. An increase in the DA level in the duodenal mucosa, blood and urine during exacerbation of disease was noted. The DA level in the gastric mucosa was normal. Reverse correlation between the DA content in the gastric mucosa and blood, on the one hand, and criteria of acid production, on the other hand, was established. An increase in the activity of chromaffin cells was interpreted as a compensatory reaction ensuring the reduction of catecholamine metabolism, a decrease in gastric secretion, a rise of the rates of reparative regeneration in the duodenal mucosa.