The article presents a review of the literature on the current problem of medicine-depressive disorders among medical students. The need to study the problem of depressive disorders among students of medical higher educational institutions is due to their high frequency and negative impact on the quality of life of students.

Возможности повышения объективности оценки выполнения практических навыков на экзамене по дисциплине «Пропедевтика внутренних болезней»Н. Ю. Шимохина, Е. И. Харьков, Е. В. Таптыгина, Н. А. Балашова Красноярский государственный медицинский университет имени профессора В.Ф.Войно-Ясенецкого, Красноярск 660022, Российская Федерация Цель исследования.В 2018 году в ФГБОУ ВО «Красноярском государственном медицинском университете имени профессора В.Ф.Войно-Ясенецкого» Минздрава России (далее -КрасГМУ) впервые практический экзамен по дисциплине «Пропедевтика внутренних болезней» у студентов третьего курса лечебного факультета проведен в два этапа.Целью настоящего исследования стала оценка уровня овладения практическими навыками студентами третьего курса лечебного факультета КрасГМУ по дисциплине «Пропедевтика внутренних болезней», а также возможности повышения объективности их оценивания.Материал и методы.Демонстрация практических навыков оценивалась на первом экзаменационном этапе у 402 студентов, на втором -у 411 человек.Статистический анализ полученных данных осуществляли с использованием пакета прикладных программ Statistica 7.0 (StatSoft Inc., 2004).Результаты.Первый этап практического экзамена проводился на кафедре пропедевтики внутренних болезней и терапии.Второй этап выполнялся впервые на кафедре -центре симуляционных технологий КрасГМУ.Экзаменационные практические навыки включали обязательные разделы: обследование органов дыхания, обследование сердечно-сосудистой системы, обследование пищеварительной системы.Предлагалось продемонстрировать практические навыки по эндокринной, мочевыделительной и другим системам.На втором этапе практического экзамена могли быть предложены для демонстрации еще три дополнительных практических навыка

ОПЫТ ПРОВЕДЕНИЯ ДВУХЭТАПНОГО ПРАКТИЧЕСКОГО ЭКЗАМЕНА ПО ПРОПЕДЕВТИКЕ ВНУТРЕННИХ БОЛЕЗНЕЙ У СТУДЕНТОВ ТРЕТЬЕГО КУРСА ЛЕЧЕБНОГО ФАКУЛЬТЕТАШимохина Н.Ю. 1 , Харьков Е.И. 1 , Балашова Н.А. 1 , Цибульская Н

В данной статье представлен клинический случай диссеминированного поражения легочной ткани, выявленного на последней стадии заболевания у пациентки с раком поджелудочной железы.

To explore the possibility of developing a mathematical prediction of the risk of developing hypertension in men based on data from the anthropometry and somatometry surveyed 102 people with arterial hypertension and 49 people with normal levels of blood pressure. The examination included clinical, instrumental, functional and laboratory methods of examination and anthropometry with subsequent somatotropine. It was found that obtained by the results of mathematical modeling predictive nomograms can be used to determine the risk of developing hypertension. The use of prognostic nomograms allows with a probability of 70 % and above to predict the possibility of developing hypertension and highlight the leading factors that determine the presence of the subject at high risk, and acting on them, to prevent development of the disease. Forecast of development of arterial hypertension in patients with different levels of blood pressure using the method of restructuring and analysis of different types of statistical data, more than adequate based on the data anthropometry and somatometry.

The article presents the results of placebo-controlled research of the effectiveness of magnetic infrared laser therapy (MIL-therapy) of patients with psoriasis with malabsorption syndrome. The methods of treatment (traditional method, method with the use of magnetic infrared laser therapy and placebo control) were compared. The results of study showed that the group of patients who were treated with use of magnetic infrared laser therapy had more significant positive dynamics.

To study the frequency and gravity of disturbing-depressive disorders and their relationship to quality of life in the hearing impaired migrants Extreme North in the period of re-adaptation to new climate conditions, were examined 80 patients of both sexes who had previously resided in the Far North and moved further on permanent residence in Central Siberia, with arterial hypertension, the average age 64,1 years. Conducted a comprehensive audiological examination. Using special questionnaires were evaluated the severity of anxiety-depressive disorders and determined the levels of quality of life. It is established, that in the structure of sensorineural hearing loss more than a third of patients had a sensorineural hearing loss of the II degree. On a scale HADS anxiety symptoms were detected in more than 43% of the surveyed patients with sensorineural hearing loss, and depression symptoms more than half 51%. A summary indicator of quality of life in the hearing impaired migrants Far North totaled -5,24±0.67 points that correspond to the moderate decline in the quality of life, while among persons with clinically severe anxiety, and depression met the greatest number of patients with significantly reduced quality of life.

The article presents the results of placebo-controlled research of the effectiveness of magnetic infrared laser therapy (MIL-therapy) of patients with psoriasis with malabsorption syndrome. The methods of treatment (traditional method, method with the use of magnetic infrared laser therapy and placebo control) were compared. The results of study showed that the group of patients who were treated with use of magnetic infrared laser therapy had more significant positive dynamics.

С целью изучения частоты и выраженности тревожно-депрессивных расстройств и их взаимосвязи с качеством жизни у мигрантов Крайнего Севера с артериальной гипертонией в период реадаптации к новым климатическим условиям было обследовано 145 пациентов обоего пола, проживавших ранее на Крайнем Севере и переехавших в дальнейшем на постоянное место жительства в Центральную Сибирь, средний возраст 64,1 ± 0,9 года. Обследование включало: общий клинический осмотр, регистрацию ЭКГ, анкетирование, двукратное измерение АД, биохимическое определение липидов и глюкозы крови. С помощью специальных опросников оценивалась тяжесть тревожно-депрессивных расстройств и определялись уровни качества жизни. Установлено, что симптомы тревоги выявлялись более чем у 42,7 % обследуемых мигрантов Крайнего Севера, а симптомы депрессии более чем у половины – 53,1 %. Суммарный показатель качества жизни у мигрантов Крайнего Севера составил 5,27 ± 0,39 балла, что соответствовало умеренному снижению качества жизни, при этом среди лиц с клинически выраженной тревогой и депрессией встречалось наибольшее количество пациентов со значительным снижением качества жизни.

To study the adherence to treatment of arterial hypertension among elderly women were surveyed 969 women, Krasnoyarsk aged 20 to 79 years, mean age 38,0±0,4 years. The proportion of the target over the age of 60 years was 8,4%. The examination included: General clinical examination, questionnaires, blood pressure measurement, ECG registration. Adherence to hypertension treatment was assessed by the conventional method Morisky-Green. Criteria of efficiency of treatment of hypertension (control), was the achievement of target levels of blood pressure less than 140/90 mm rt. art. Among patients in the older age group is more common arterial hypertension 2, 3 degrees and isolated systolic hypertension in comparison with the young. Awareness and adherence to treatment in this group of patients is higher than among young women, however, the achievement of target levels of blood pressure remains at a low level. The greatest commitment to treatment were detected in elderly patients with a high level of education.

To study the features of influence components of a metabolic syndrome on the clinical course of coronary heart disease at men taking into account components of body weight and a somatotip, 137 men, residents of Krasnoyarsk (middle age of 54,9±1,4 years) with an arterial hypertension and coronary heart disease are examined. Inspection included clinical, tool, functional and laboratory methods of research, and also anthropometry with the subsequent somatotipirovaniye. It is established that among men the metabolic syndrome met coronary heart disease at 10,8% examined. Patients with coronary heart disease in combination with the accompanying arterial hypertension had higher levels of a glycemia, an insulinemiya and lipids, than at patients with coronary heart disease without the accompanying arterial hypertension. Indicators of carbohydrate and lipidic exchanges at patients with coronary heart disease with a myocardial infarction in the anamnesis are higher in comparison with patients with coronary heart disease without the postponed myocardial infarction. Among the examined men somatotipa met with considerable development fatty components most more often.

To study re-adaptation to new climatic conditions, depending on the length of stay in the Far North. The study involved 2,137 men organized population of the city of Norilsk aged 30 54 years, mean age 45,8±1,3 years, the examinees were divided into groups depending on the length of stay in the Far North (10 years and over 10 years). Use of modern methods of epidemiological studies according to the WHO recommendations, we measured hemodynamic parameters, conducted a statistical analysis. The prevalence of hypertension in an organized newcomer populations of men aged 30-54 years was 35.6%, and those living in the region for less than 10 years 22.7%, more than 10 years, 44.2% (р=0,023). Observation of the Far North migrants who have come to a new place of residence, in the central part of Eastern Siberia, showed that the severity of hypertension during rehabilitation more often for longer stays 10 years and over. The cause of hypertensive crises, frequent angina was caused by the same high neuroticism, the socio-economic factors.

We studied the efficacy and safety of phenazepam administration as a component of combination therapy in 60 patients with coronary artery disease and acute myocardial infarction (AMI) complicated by cardiac arrhythmias. Our data showed that standard cardiotropic drug therapy combined with phenazepam administration in a daily dose of 1 mg led to significant decrease in the number of supraventricular and ventricular extrasystoles, decrease in the levels of anxiety and depression, and improvement in sleep quality in AMI patients. In contrast, we did not find significant improvement in above mentioned parameters in the control group of AMI patients who did not take phenazepam.