Підвищення якості підготовки лікарів через використання сучасних освітніх програм та інформаційно-телекомунікаційних технологій

The work substantiates the proposal for the introduction into the educational process of the higher medical establishments of the II-IV accreditation levels and intern doctors of the institutions (faculties) of postgraduate education of the progressive educational program of the American College of Cardiology «Electrocardiography Self-Assessment Program» (edited by Richard P. Lewis, MD, Colombus, OH, 1995) using information and telecommunication technologies

Research competency at the undergraduate level of higher education

Метою роботи є обґрунтування виділення окремого поняття «дослідницька компетентність» та висвітлення шляхів формування дослідницької компетентності у студентів закладу вищої медичної освіти на прикладі роботи студентського наукового товариства на базі кафедри внутрішньої медицини 3 Державного закладу «Дніпропетровська медична академія Міністерства охорони здоров’я України». У статті на основі існуючого законодавства України та вимог сьогодення обґрунтовано необхідність імплементації дослідницької компетентності у навчання студентів закладу вищої медичної освіти. З позицій власного досвіду та даних літератури наведено бажані цілі навчання з урахуванням можливості засвоєння «дослідницької компетенції». Проаналізовано роботу студентського наукового товариства (СНТ) клінічної кафедри, як один із можливих шляхів набуття дослідницької компетентності. Наведено аспекти роботи студентів у СНТ, які сприяють набуттю бажаної компетентності, а також ті, які можуть перешкоджати оволодінню нею. Дослідницька робота – це потужний поштовх до мотивації навчатися, оскільки спрямовує студентів на науковий пошук. Під час відвідування СНТ студенти розвивають навички літературного пошуку, критичного засвоєння інформації та оцінки існуючої первинної дослідницької літератури; формулювання наукової проблеми, що потребує вирішення; розробки та використання відповідних методів дослідження, що допоможе у вирішенні цієї проблеми; розуміння статистики та обробки даних із наступним представленням їх до літературних наукових джерел. Робота в СНТ виховує та формує професіонально необхідні якості, включаючи командну роботу, можливості управління часом та навантаженнями, розуміння медичної етики та ряд комунікативних навичок, що сприяє випускникам бути більш конкурентоспроможними на сучасному ринку праці. На сьогодні робота в СНТ залишається одним із оптимальних існуючих варіантів впровадження дослідницької компетентності у процес навчання магістрів медичного профілю, але він не забезпечує повне охоплення усіх здобувачів вищої освіти, як того вимагає закон України. The aim of the article is to provide a justi cation for the introduction of “research competency” concept and to describe the ways of its formation among students of higher medical institution, based on the experience of the Students' Scienti c Society (SSS) work at the Department of Internal Medicine 3 of State Institution “Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine”. The need to implement the research competency in the medical students training is substantiated in this article on the base of current legislation of Ukraine and today's requirements. A SSS work at a clinical department is analysed as one of the possible ways of the research competency acquisition, with the aspects that contributes to the development of the desired skills as well as those that may impede its mastery. Research work is a powerful impetus to the motivation to learn, as it directs students to scienti c research. During working at SSS, students learn how to make a literary search, critically assimilate and assess of primary research literature and formulate a scienti c problem, which require solution. At next step, they choose and apply the appropriate research methods that could be used in solving this problem. And nally, participants comprehend the statistics and process the obtained data followed by their scienti c papers presentation in literary scienti c sources or conferences. The work at SSS helps graduates be more competitive in today's job market as it brings up and cultivates professionally required qualities, including teamwork, ability to manage time and workload properly, an understanding of medical ethics and a range of communication skills. Currently, working in a SSS remains one of the best available options for introduction of the research competency in the training of the medical students, but it does not provide complete involvement of all undergraduate students, as required by the law of Ukraine

Treatment of patients with chronic heart failure and anemia or iron deficiency

Anemia and iron deficiency is widespread among patients with chronic heart failure (CHF) and is associated in such patients with reduced ability to exercise, a deterioration in the quality of life and a worse prognosis, regardless of the presence of anemia, so correction of iron deficiency is an actual issue in the context of the treatment of patients with CHF. This work presents review of literature about treatment of anemia and iron deficiency in patients with chronic heart failure. Clinical studies of intravenous iron therapy in patients with symptomatic CHF and decreased left ventricular ejection fraction demonstrate that correction of iron deficiency is associated with significant increase in exercise tolerance, decrease in symptoms and hospital admissions, improvement in the quality of life. The use of iron carboxymaltosate in patients with CHF decompensation prevents subsequent decompensations. As for oral therapy with iron preparations, which are often used as the first line of therapy for iron deficiency in patients with CHF. Treatment with such a dosage form does not have sufficient clinical data to confirm its effectiveness. Анемия и дефицит железа широко распространен среди пациентов с хронической сердечной недостаточностью (ХСН) и ассоциирован у таких пациентов со сниженной способностью к физическим нагрузкам, ухудшением качества жизни и худшим прогнозом, независимо от наличия анемии, итак коррекция дефицита железа – актуальный вопрос в контексте лечения пациентов с ХСН. В данной работе представлен обзор литературы, посвященной лечению анемии и дефицита железа у пациентов с хронической сердечной недостаточностью. Клинические исследования внутривенной терапии железом пациентов с симптомной ХСН и сниженной фракцией выброса левого желудочка демонстрируют, что коррекция дефицита железа ассоциировано со значительным увеличением толерантности к физической нагрузке, уменьшением симптомов, улучшением качества жизни и снижением частоты госпитализаций. Использование железа карбоксимальтозата у пациентов с декомпенсацией ХСН позволяет предупредить последующие декомпенсации. Насчет пероральной терапии препаратами железа, которые часто используется как первая линия терапии дефицита железа у пациентов с ХСН – лечение такой лекарственной формой не имеет достаточных клинических данных, которые подтверждали ее эффективность

Doxorubicin-Induced Cardiomyopathy in Rats: Behavior of the Animals in the Open Field

Under conditions of the open field test, 30 control Wistar rats and 30 rats with experimental cardiomyopathy (CMP) were examined with recording of four behavioral indices, (i) number of crossed squares (intensity of locomotion), (ii) number of rearings (vertical stands), (iii) number of examined holes in the arena, and (iv) number of grooming episodes, within a 28-day-long observation period. The CMP state was induced by five i.p. injections of 5.0 mg/kg of doxorubicin with one-week-long intervals. As was found, all behavioral indices of control rats demonstrated considerable (sometime statistically significant) variations within the observation period (this fact has probably attracted insufficient attention in analogous experiments with long-lasting observation periods). The development of doxorubicininduced CMP resulted in considerable suppression of all types of behavioral activity, relatively moderate within the first week of observation and dramatic within late phases of the observation period. The dynamics of the numbers of rearings and grooming phenomena were complex, with noticeable increases on days 3 and 14. The dynamics of the numbers of rearings and inspection of the holes in both experimental groups were significantly dissimilar, which indicates that these behavioral phenomena are related to different aspects of the research/orientatinal activity. In general, a state of increased anxiety followed by the development of a depression-like state was observed in CMP rats. These negative shifts in behavioral activity are believed to result from general CMP-induced insufficiency of blood supply of the brain and development of hypoxia in the latter; specific direct effects of doxorubicin on some cerebral structures seem to be unlikely

Prevalence and Pathogenesis of Anemia in Chronic Heart Failure

Anemia is often associated disease in patients with chronic heart failure, which reduces exercise tolerance, quality of life and worsens the prognosis in the patients. The recommendations of the leading associations of cardiology include the correction of iron deficiency and anemia in the context of the treatment of patients with chronic heart failure. Such influence and modern recommendations determine the relevance of knowledge of the prevalence and pathogenesis of anemia and iron-deficiency conditions in chronic heart failure. The purpose of the study was to review the literature illustrating current data about prevalence and pathogenesis of anemia and iron deficiency in patients with chronic heart failure. Materials and methods. This work presents review of literature about prevalence and pathogenesis of anemia and iron deficiency in patients with chronic heart failure, based on a search of English-language articles in the PubMed database for the last 20 years, by keywords – anemia, iron deficiency, chronic heart failure, pathogenesis, prevalence. Results and discussion. The frequency of anemia that patients with chronic heart failure ranges have are from 4% to 30-70% of cases, according to several studies. Such a variety of data is associated with different degrees of severity of heart failure in different studies, but they unanimously confirm the information about the significant prevalence of this condition in the studied population cohort. Iron deficiency is an important comorbid condition that patients with heart failure have and is observed in an average of 30-50% of cases, according to some data, the frequency reaches a maximum of 70-83%. Iron deficiency is the most common cause of anemia, but it is particularly interesting that approximately 46% of patients with iron deficiency do not have anemia. The following 6 factors that can be the cause of anemia individually or in combination that patients with chronic heart failure have, have been identified: iron deficiency, inflammation, erythropoietin level, medications, hemodilution, medullary dysfunction. The causes of absolute iron deficiency are anorexia, cachexia, malabsorption of iron due to intestinal edema and hepcidin-induced suppression of iron transporters, such as ferroportin, functional – chronic inflammatory state, which leads to an increase in the level of pro-inflammatory cytokines, such as interleukin-1, interleukin-6, interleukin-18, tumor necrosis factor-, which, in turn, induces the synthesis of hepcidin and, accordingly, decreases the expression of ferroportin with a decrease in the transition of iron into the state of circulation and stimulation of sequestration in macrophages of the reticuloendothelial system. Conclusion. Better understanding of the pathogenesis of these conditions that patients with chronic heart failure have, will allow the development of new methods of treatment

Role of biomarkers in diagnostics, stratification of risk and prognosis of heart failure

Heart failure occupies one of the leading places in the structure of the causes of adult mortality in the world. The issues of timely diagnosis and prognosis of the outcomes of this disease do not lose their relevance due to the high heterogeneity of clinical manifestations and absence of absolutely pathognomonic symptoms. The development of the multimarker diagnostic strategy for management of patients with heart failure is a progressive approach .The review focuses on the synthesis of known evidence data on the role of biomarkers in diagnostics and risk stratification