Perm State Medical University Research Articles

Application of a Standard Simulation Module as a Tool for Professional Development of Higher Education Teachers

The cycle of advanced training of the faculty on the basis of the Federal Accreditation Center of Perm State Medical University was created to form the professional competencies of students and the work functions of teachers. To introduce practical classes into the programs of clinical disciplines, a standard simulation module (SIM) was used, which is becoming a mandatory basis for the educational process at the University. The analysis of 106 SIM showed the use of simulation equipment and identified problems that are the basis for further development of the course.

Possibilities of Simulation Training in Improving Obstetric Care Using the Perm Region as an Example

In the context of solving the problem of reducing cases of critical obstetric conditions and maternal mortality, employees of the Perm State Medical University, on behalf of the Minister of Health of the Perm Territory, developed a comprehensive training program for employees of medical organizations of the obstetric and gynecological profile and chief physicians of the Perm Territory. Over the course of the year, work was carried out to organize on-site training and training for heads of specialized departments.

On the occasion of the 90th anniversary of professor Alexander Alekseevich Shutov`s birth

The life and professional path of Alexander Alekseevich Shutov, the Doctor of Medical Sciences, Professor, the head of the Department of Neurology and Medical Genetics of E.A. Vagner Perm State Medical University, are described in the article, as well as his scientific achievements, contribution to the organization of the university’s work, success in training of scientists, educators and neurologists of the Perm Region.

Issues of adaptation of medical simulation training specialists

TThe article discusses issues of adaptation of medical simulation training specialists. When forming an adaptation system, one of the main tasks is the development of personnel adaptation regulations. For future regulation of the process of adaptation of the center’s specialists, types of adaptation in content, methods and activities, used in the Federal Accreditation Center of E. A. Wagner Perm State Medical University, a survey of specialists from simulation centers is planned. In the course of analyzing the responses received and previously identified methods and activities, a document will be prepared regulating the process of adaptation of medical simulation training specialists, which will further speed up the adaptation process and make it more effective for each party in the labor relationship.

Tribute to the memory of Zarivchatsky Mikhail Fedorovich - surgeon, organizer of health care, professor of Perm State Medical University

Zarivchatsky Mikhail Fedorovich - surgeon, Honored Doctor of the Russian Federation, Academician of the Academy of Natural Sciences, former Vice-Rector for academic work, head of the Department of Surgical Diseases of Medical Faculty of Prevention, Perm State Medical University named after Academician E. A. Wagner, Doctor of Medical Sciences, Professor Aim to highlight the life path, the biography of the great doctor Zarivchatsky Mikhail Fedorovich and his contribution to the development of surgery, science and healthcare of the Udmurt Republic Materials and research methods. To achieve this goal, it was carried out a theoretical analysis and generalization of literature data on the topic.

Experience in the Treatment of Dry Eye Syndrome in Students with Myopic Refraction

Objective: to study the effectiveness of the hypromellose-based medicine Artificial Tears®, eye drops, in the treatment of dry eye syndrome in students with myopic refraction. Patients and methods. A total of 147 students of Academician E.A. Wagner Perm State Medical University with different types of clinical refraction were examined. Among them 63 students with myopic refraction of various degrees in 110 eyes were included in the study (mean age — 22.6 ± 0.16 years, 49 (78 %) women, 14 (22 %) men). Dry eye syndrome was detected in 49 (78 %) participants in 82 eyes (74.5 %). According to the myopia correction method, 3 groups were formed: Group 1 — students with eyeglasses; Group 2 — students constantly using soft contact lenses; Group 3 — students who had excimer laser correction by LASIK method. The remaining students (n = 14) had no dry eye syndrome. The study was conducted in two stages: at baseline and then repeated after 4 weeks in students with dry eye syndrome who used daily the medicine Artificial Tears®. Subjective assessment was based on the Ocular Surface Disease Index (OSDI) questionnaire. Оbjective assessment included function tests, characterizing the precorneal tear film stability and total tear production level. Results. In the process of treatment a good tolerance of the given medicine was reported. Analysis of the overall results showed that the mean OSDI score decreased statistically significantly from 26.92 to 20.29 seconds (p ≤ 0.0001). The mean tear film break-up time increased from 7.95 to 11.25 (p ≤ 0.0001). The mean Schirmer’s test score was slightly changed: from 13.98 to 14.07 mm due to the presence of increased tear production in some students, which is characteristic of the dry eye syndrome initial manifestations. Conclusion. The medicine Artificial Tears® in the form of eye drops is well tolerated and is sufficiently effective in eliminating the dry eye syndrome manifestations after only 4 weeks of use. The treatment with the medicine Artificial Tears® showed a statistically significant reduction in the disease severity (according to the OSDI questionnaire data) and an increase in the tear film break-up time. The received results allow us to recommend the medicine Artificial Tears® for medical use in patients with various degrees of myopic refraction, regardless of the myopia correction method used.

Anthropomorphic Dental Robot Patient as an Element of a Digital Platform

The educational complex is a “dental anthropomorphic robot”, equipped with elements of artificial intelligence with original hardware solutions based on the intellectual developments of Smart-jaw and Smart-teeth, developed by a group of scientists from a consortium of three universities (Academician E. A. Wagner Perm State Medical University, PNIPU, MGMSU) within the framework of the program of scientific events of the world-class Perm NOC with the creation of multifunctional service software modules, with a database of clinical cases in the “doctor-patient” system based on Robo-C, which is a modern digital system.

Priority Manual Skills Required when Training Future Surgeons

To increase the effectiveness of teaching manual surgical skills, we identified surgical techniques, the mastery of which allows us to develop the widest possible range of skills. These included intestinal, vascular and intracorporeal endoscopic sutures. The training was carried out on the basis of the Department of Faculty of Surgery No. 2 and the Federal Accreditation Center of Academician E. A. Wagner Perm State Medical University. The operations were performed using biological preparations. 14 students were trained in these skills. Training in the three leading manual skills allowed students to raise their skills to a high level.

A colossus of Perm endocrinology: dedicated to the 90th anniversary of the birth of professor I.V. Tereshchenko

Irina Vladimirovna Tereshchenko is a Doctor of Medical Sciences, an Honoured Professor of Academician E.A. Vagner Perm State Medical University, Correspondent Member of the Russian Academy of Natural Science, founder of Perm School of Endocrinology. More than 60 years of her life, she devoted to medicine including 47 of them to Perm Medical University. Irina Vladimirovna is a remarkable person, doctor, scientist, researcher and a talented teacher, founder of Perm School of Endocrinology. Having graduated from school with a silver medal, she entered the Medical Faculty of Nizhny Novgorod Medical Institute. Since that time, medicine became her fate. After graduating from medical institute, Irina Vladimirovna worked as a therapeutist at the hospitals and polyclinics of the city of Gorky and in 1960 began to work in the Unit of Endocrinology of Gorky Regional Hospital. In 1968 Irina Vladimirovna defended her candidate thesis, and in 1987 doctoral thesis. Both theses concerned the issue of pubertal dispituitarism. The etiology, pathogenesis, clinical picture, treatment and prevention of this disease were studied in details and the developed method of bitemporal inductothermy is very effictive. In 1970, Irina Vladimirovna came to Perm and began to work as an Assistant and since 1974 an Associate Professor at the Department of Hospital Therapy of Perm Medical Institute. From 1976 to 1988, she worked at the Department of Hospital Therapy № 2 and then she headed the Department of Therapy of Medicoprophylactic Faculty. Afterwards, Irina Vladimirovna worked at the Department of Endocrinology and Clinical Pharmacology of Perm Medical Academy. Irina Vladimirovna is the author of 4 monographs and more than 550 papers. Professor Tereshchenko is a Correspondent Member of the Russian Academy of Natural Science. All her scientific works greatly contribute to theoretical and practical endocrinology.

Dental simulator based on a robotic complex with an integrated smart jaw

The study reflects the current trends in the digital format of educational technology in dentistry, which is a new paradigm in the training of medical personnel. The new-generation dental simulator is presented as an innovation in the educational process. The authors propose technically combining the accumulated positive solutions in this area using a single hardware and software environment, i.e., an anthropomorphic robot, whose hardware platform is expanded with additional specialized sensors and actuators. To increase the practical competencies of dental students and dentists when honing practical skills, the use of a dental simulator based on a robotic complex in the educational process is the most optimal way by creating a fully functional anthropomorphic dental robot, especially with integrated modules Smart-Jaw and Smart Teeth and supporting the communicative function through artificial intelligence. Currently, a fully functional prototype of the anthropomorphic robot simulator Promobot-Ct with a set of educational cases has been utilized, which is used to train dentists at Perm State Medical University, which was named after Academician E.A. Vagner.

Irina Petrovna Koryukina – a physician, teacher, scientist, talented organizer: to the 70-th anniversary of her birth (1953–2020)

Koryukina Irina Petrovna was a doctor, teacher, Honored Scientist of the Russian Federation and a talented leader. She was born in the family of a doctor. Her childhood, youth and professional activity are connected with our city Perm. Having graduated from the Medical Faculty of Perm State Medical Institute (now Perm State Medical University) with honors degree in 1976, she continued her training in the residency (19761978), and then in the postgraduate courses (19781981) at the Department of the Faculty of Pediatrics. Afterwards, she became the assistant of the department (1981), defended her Candidate's thesis (1982). During the period of 1985-1992, she was an Associate Professor, and since 1992 the Head of the Department of Pediatrics of the Physicians Advanced Training Faculty. In 1993, Irina Petrovna received the title of professor. From 2002 to 2005, she was Deputy Rector for Academic Activity. From 2005 to 2020, she was the Rector of Perm State Medical University. Irina Petrovna started her scientific work studying the problem of treatment and prevention of acute stenotic laryngotracheites in children, then she was engaged in the problem of diagnostics and prevention of iodine deficiency in Perm Region. Later, she conducted research on the prevention of allergic diseases, minimally invasive methods of bronchial asthma diagnostics, and improvement of regional outpatient care. Irina Petrovna loved her work and was ready to devote all her free time to it. Her professional activity resulted in more than 900 scientific papers published; she prepared 59 Candidates of Medical Sciences and 19 Doctors of Medical Sciences. Under a wise leadership of Irina Petrovna, the collective of Perm State Medical University was twice acknowledged by the President of the Russian Federation (2007, 2017).

Connection of individual typological features of personality with nature of dreams

Objective. To study the influence of the temperament, anxiety level, intro-extraversion index, the nature of emotions, the level of happiness and the presence of pathologies of sleep physiology in the individual on the frequency of dream production and their figurative content.
 Materials and methods. The research involved 100 respondents students of E.A. Vagner Perm State Medical University, the average age was 22.5 4.5 years. The study was conducted through anonymous questionnaires using the following personality questionnaires and psychological tests: Eysenck Personality Questionnaire, Comprehensive Sociometric Test: Emotions, Oxford Happiness Questionnaire (OHQ), Comprehensive Test for Detection of Sleep Disorders.
 Results. It was found that in 37,7 % of cases out of 100,0 %, the imaginative content of dreams and the frequency of their production directly depend on the temperament of the individual, the level of anxiety affects dreams only in 50,0 % of cases out of 100,0 %. The intro-extraversion index has a significant impact on the nature of dreams and manifests its effect in 61,6 % out of 100,0 %. The complete dependence of the imaginative content of dreams on the quality of emotions is observed in 57.0 % of cases; inversely proportional dependence is noted in 43.0 % of cases. It was determined that the level of happiness has a natural effect on dreams in 66.0 % of cases. Sleep disorders can affect both negatively and positively the imaginative content of dreams and their quantitative production. Assessment of the multifactorial influence of the students' psycho-emotional state showed that the most important role in the cumulative effect on sleep and dreams is played by the level of anxiety and temperament.
 Conclusions. Changes in the parameters of dreams are a consequence of the multifactorial interaction of individual psychoemotional characteristics and typological characteristics of the personality. Determination of temperament and registration of the level of anxiety of the individual can contribute to the prediction of the overall picture of dreams for use in psychological and psychiatric practice.

Peculiarities of Teaching Manual Surgical Skills at the Stages of Training a Surgeon at Academician E.A. Wagner Perm State Medical University

In the training of experienced surgeons, one of the priority and difficult to master areas is teaching manual skills. The classical training system does not allow you to repeatedly repeat certain manipulations that allow you to consolidate manual skills. At the moment, in order to increase the effectiveness of the educational process in teaching the manual skills of surgeons, it is necessary to use simulation training technologies, and it is necessary to clearly divide the educational process into training stages depending on the subject being studied and the level of the surgeon’s training.

Provision of practical direction of educational process on the discipline «Epidemiology»

Objective. The article presents various forms of interaction between Academician E.A Vagner Perm State Medical University and authorities and institutions of healthcare as well as Rospotrebnadzor to ensure practical orientation of the educational process at the undergra-duate and postgraduate levels of training the discipline "Epidemiology".
 Materials and methods. The most significant directions of educational process are described, which allow students to acquire the necessary skills and abilities for future professional activities.
 Results. Practical training permits to form a number of universal and general professional competences among students.
 Conclusions. Involvement of highly qualified specialists of practical healthcare and Rospotrebnadzor in educational process allows making the learning process not only fascinating and informative, but also improves the quality of training students.

How to minimize infectious health risks for elderly people (based on focus group data)

This literature review focuses on practices aimed at mitigating infectious health risks for elderly people in acute care inpatient hospitals with multiple specializations. We revealed a necessity to create medical information centers; common reference centers for PCR diagnostics, sequencing, plasmid analysis, and MULDI-TOF; as well as to provide support and further development of bacteriological and hygienic service in medical and preventive organizations. Our review also dwells on theoretical solutions to issues related to minimizing infection risks in nursing homes and prospective approaches to providing infectious safety at home. A focus group was organized on May 20, 2021 at the E.A. Wagner’s Perm State Medical University of the RF Public Healthcare Ministry with its aim being to implement theoretical approaches into practices of minimizing infectious health risks for elderly people in Perm region within the “aging in place” paradigm. The sociological explication made it possible to fix the regional agenda on minimizing infectious heath risks for elderly people as per three basic directions: by improving living conditions, by improving care provided for elderly people at home, and by making elderly people’s lives more active as a way to support their immunity. All the discussion participants unanimously agreed both on assigning the primary role to the strengthened immunity as a way to minimize infectious health risks and on obvious absence of any drugs which would be able to resolve the issue. Experts believe adherence to conventional recommendations on how to improve elderly people’s immunity to be fundamental for infection risk mitigation. We should remember that some elderly people live in improper housing which should be renovated and adapted to basic needs of an elderly person. It is also important to develop the city environment taking into account elderly people’s habits and needs (they should be provided with a special place in the yard where they can communicate with each other, play board games or do physical exercises). Financial support should be given to “Inpatient hospital at home” program and to developing tools used to promptly minimize infection risks, for example, telemedicine which allows detecting certain alerting symptoms typical for communicable diseases (fever, complaining about cough and running nose, pains in the lumbar spine, decreased diuresis etc.)

К проблеме минимизации инфекционных рисков здоровью пожилых людей (по материалам фокус-группы)

This literature review focuses on practices aimed at mitigating infectious health risks for elderly people in acute care inpatient hospitals with multiple specializations. We revealed a necessity to create medical information centers; common reference centers for PCR diagnostics, sequencing, plasmid analysis, and MULDI-TOF; as well as to provide support and further development of bacteriological and hygienic service in medical and preventive organizations. Our review also dwells on theoretical solutions to issues related to minimizing infection risks in nursing homes and prospective approaches to providing infectious safety at home. A focus group was organized on May 20, 2021 at the E.A. Wagner’s Perm State Medical University of the RF Public Healthcare Ministry with its aim being to implement theoretical approaches into practices of minimizing infectious health risks for elderly people in Perm region within the “aging in place” paradigm. The sociological explication made it possible to fix the regional agenda on minimizing infectious heath risks for elderly people as per three basic directions: by improving living conditions, by improving care provided for elderly people at home, and by making elderly people’s lives more active as a way to support their immunity. All the discussion participants unanimously agreed both on assigning the primary role to the strengthened immunity as a way to minimize infectious health risks and on obvious absence of any drugs which would be able to resolve the issue. Experts believe adherence to conventional recommendations on how to improve elderly people’s immunity to be fundamental for infection risk mitigation. We should remember that some elderly people live in improper housing which should be renovated and adapted to basic needs of an elderly person. It is also important to develop the city environment taking into account elderly people’s habits and needs (they should be provided with a special place in the yard where they can communicate with each other, play board games or do physical exercises). Financial support should be given to “Inpatient hospital at home” program and to developing tools used to promptly minimize infection risks, for example, telemedicine which allows detecting certain alerting symptoms typical for communicable diseases (fever, complaining about cough and running nose, pains in the lumbar spine, decreased diuresis etc.)

ИЗМЕНЕНИЕ ПОЛОЖЕНИЯ И РАЗМЕРОВ НИЖНЕЙ ЧЕЛЮСТИ ПРИ ЛЕЧЕНИИ ПАЦИЕНТОВ С РЕТРО- И МИКРОГНАТИЕЙ НИЖНЕЙ ЧЕЛЮСТИ

The beneficial orthodontic treatment should be focused on functional and aesthetic optimum results in dentofacial system achievement. The aim of the study is to evaluate on-treatment changes of mandible size and position in patients with mandibular micrognathia and retrognathism in different periods of dentofacial system evolving. Methodology: the research base of prospective clinical study was Pediatric Dentistry and Orthodontics Department of E.A. Vagner Perm State Medical University. The object of the study were 102 patients aged 6 to 16 years with distal malocclusion and mandibular micrognathia and retrognathism. All patients were under orthodontic treatment. Study data is lateral cephalograms, recorded before and after orthodontic treatment. Results: orthodontic treatment was most effective in mixed dentition when skeletal effects expressed in total normalization of mandible sagittal position and its significant expansion. In permanent dentition period mandible expansion considerably decreased in CS4 cervical vertebrae stage maturation and was clinically insignificant in CS5 cervical vertebrae stage maturation. Correction of distal malocclusion in permanent dentition had dental effects in clockwise occlusion plane rotation and inclination changing of upper and lower incisors. Conclusions: skeletal effects are leading in treatment of patients with distal malocclusion and mandibular micrognathia and retrognathism in dentofacial system high growth potential cases; dental effects are leading in dentofacial system low growth potential cases.

For the 100th anniversary of the Department of neurology in Perm

October 2021 marks the 100th anniversary of the founding of the Department of neurology and medical genetics at the Perm State Medical University. The article presents a historical perspective, the main clinical and research achievements, and development prospects for the department.

Body dysmorphic disorder: some diagnostic approaches

Objective. Dysmorphophobis (body dysmorphic disorder, BDD) is a mental disorder characterized by excessive preoccupation with any imaginary or mild physical defect that causes significant discomfort, distress in the social sphere and other important areas of human activity.
 The aim was to analyze the possibilities of foreign validated methods for detecting body dysmorphic disorder in a Russian-speaking audience.
 Materials and methods. Two questionnaires have been translated into Russian, BDDQ-DV and DCQ. The survey was carried out in three samples: patients of a somatic hospital (55 women), clients of a plastic surgeon (71 women) and senior students of the Perm State Medical University (31 women).
 Results. A positive answer to the question about the presence of a defect in appearance was given by the majority of the survey participants. Most of them described in detail those defects of their appearance that bother them. More than half of them think a lot about the defects. A question with a request to describe the "defect" allows the doctor to clarify the indications for its correction. If the medical correction is not indicated, the physician of the somatic profile can refer the patient for psychological correction. Answers regarding the severity of feelings about the defect, about disorders in social and professional life, about how long it takes to think about a defect and attempts to hide it, as well as whether the respondents have previously consulted about it with a doctor, and what were the results of consultation, allow us to suspect the presence of BDD and refer the respondent to a profile specialist. The analysis of internal consistency demonstrated the possibility of using these questionnaires in scientific research (Cronbach's alpha 0.820.84).
 Conclusions The presented Russian-language versions of the DCQ and BDDQ-DV questionnaires can be recommended for scientific research as a screening tool for detecting body dysmorphic disorder among females of different age groups. However, their implementation in practice requires a deeper adaptation to the Russian-speaking audience.

Анализ фактического питания женщин молодого репродуктивного возраста, как этапа прегравидарной подготовки

Objective of the study: to assess the actual nutrition of women of young reproductive age, as a stage of pregravid training. Materials and methods. A survey was conducted of 114 female students / pupils of higher and secondary specialized educational institutions of Perm, who applied to the polyclinic of the Perm State Medical University. Academician E. A. Wagner (polyclinic) for the purpose of a preventive examination. Results and its discussion. The study revealed a deficiency in the consumption of the following nutrients: vitamin D3 (Me = 1.27 μg / day, Q1-Q3: 0.6-3.0), zinc (Me = 6.46 mg / day, Q1-Q3: 4.9-8.4), iron (Me = 13.15 mg / day, Q1-Q3: 9.9-16.5), selenium (Me = 24.8 mg / day, Q1-Q3: 13, 6-42.3), iodine (Me = 59.0 mg / day, Q1-Q3: 41.0-97.3). Conclusions. The study demonstrates that a comprehensive assessment of the component composition of nutrition should become the basis for drawing up an individual plan for the consumption of vitamins, macro- and microelements at the stage of pregravid preparation.