Formation and improvement of clinical thinking in medical students. Кhaniukov O., Kozlov S., Yehudina Y., Sapozhnychenko L., Kozlova Yu., Somilo O. Introduction and purpose of the study: high requirements for graduates of higher medical establishments facilitate the search, implementation and improvement of modern teaching methods in order to optimize the development of clinical thinking in medical students. In the the course of the work, a big volume of information was used, which was worked out using such methods as historical and literary synthesis, structural and logical analysis, abstract thinking and personal experience taking into account the principles of systemic approach and analysis. To improve the quality of medical students' training it is necessary to use the innovative teaching methods. Presence of the personal clinical archive, with allow to use archival material in the training process (for example, to use case-method), in the analysis of a clinical case and the use of data in the scientific work. The article presents an example of a clinical problem and emphasizes the importance of the case-method in teaching students in higher educational institutions. Formation of clinical thinking takes place over the course of direct work with the patient, with an independent attempt to resolve a specific clinical situation in real conditions. Case method allows to reveal and form the necessary personal qualities and abilities of medical students, necessary for the further work. Modern methods and means of information technology must be purposefully implemented into clinical practice and educational process for the development of professional skills, formation of clinical thinking, accumulation of clinical experience.
stiffness and pulse wave velocity / Aorta and carotid arteries 137 (0.94 to 1.01) p = 0.096; Obesity OR = 0.47 (0.29 to 1.77) p = 0.003 and Diabetes OR = 2.41 (1.15 -5.05) p = 0.020. Conclusions: According to the results obtained, genetic polymorphisms variables were not in the multivariate analysis equation to determine the increase of the PWV, which can be explained either by being included in the selected variables such as hypertension, or on the other hand, they may not have enough strength to remain in the equation. So, according to this study, PWV has much more to do with behaviors and traditional risk factors than the genetic heritage.P883 Endothelial dysfunction, pulse wave velocity and augmentation index are correlated in subjects with systemic arterial hypertension?
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
9. Menou A, et al. Human airway trypsin-like protease, a serine protease involved in respiratory diseases.
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