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danarTi 2

sarezidento programa

`bavSvTa nevrologia”

(xangrZlivoba 3 weli – 33 Tve)

MMmuxli 1. სპეციალობის აღწერილობა1. pediatriuli nevrologia evropaSi ukve 50 welze metia rac calke dargad

arsebobs. bavSvTa nevrologebis umetesoba gadamzadebuli pediatria, xolo zogierT qveyanaSi specializacias bavSvTa nevrologiaSi gadian mozrdilTa nevrologebi.

2. mimdinare programa asaxavs rezidenturis samwlian saswavlo kurss pediatriul nevrologiaSi. igi regularulad (yovel sam weliwadSi) unda ganicdides gadaxedvasa da adaptacias.

3. pediatriuli nevrologia (definicia) - pediatriuli nevrologia warmoadgens samedicino disciplinas, romelic moicavs centraluri nervuli sistemisa da periferiuli nerv-kunTovani sistemis rogorc normalur, aseve anomaliur ganviTarebas mucladyofnis periodidan mozrdilobis asakamde. igi moicavs aRniSnuli sistemebis daavadebaTa diagnostikas, mkurnalobas, kvleviT muSaobasa da Semdgomi unarSezRudulobis srulfasovan marTvas.

4. bavSvTa nevrologiis rezidenturis momzadebis programis kurikulumi unda moicavdes eqimis trenirebas da swavlebas damoukidebeli muSaobisaTvis bavSvTa nevrologiaSi. am momzadebiT rezidentma unda SeiZinos kompetenciebi qvemoTCamoTvlil eqvsive sferoSi. 5. pacientis movla:

ა) anamnezis srulyofili Segroveba;ბ) pacientis srulyofili nevrologiuri gasijva;გ) nevrologiuri niSnebis lokalizaciis dadgenis srulyofileba;დ) hospitalSi mosaTavsebeli pacientis diagnozis maRali sizuste;ე) hospitalSi moTavsebuli pacientis xarjTefeqturi marTva rogorc farmakologiuri, aseve arafarmakologiuri mkurnalobis meTodebiT;ვ) nevrologiuri da sxva samedicino problemebis amocnoba da prioritetebis mixedviT ranJireba;ზ) teqnikuri unarebis - mag.: lumbaluri punqciis warmoebis – srulyofa;თ) nevrologiuri pacientis xangrZlivi movlis srulfasovani da xarjTefeqturi dagegmva;ი) samedicino da qirurgiuli Carevebis nevrologiuri garTulebebis prevencia, amocnoba da drouli marTva;კ) hospitaluri movlis gaumjobeseba;ლ)pacientis movlisas eTikis normebis dacva da gulisxmieri damokidebuleba.

6. samedicino codna: ა) bazisuri nevrologiuri codnis gaumjobeseba;ბ) codnis gaRrmaveba gadaudebeli stacionirebis saWiroebebismqone nevrologiuri daavadebebis Sesaxeb, rogoricaa miasTenia, gafantuli sklerozis gamwvaveba, gilen-bares sindromi, mwvave gulyra an epilefsiuri statusi, Sakikis statusi, meningiti/encefaliti, pediatriuli insulti da sxva;

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გ) xSiri nevrologiuri daavadebebis Sefasebisa da diagnostikis gaumjobeseba;დ) laboratoriuli da diagnostikuri teqnologiebis codna, am teqnologiebis usafrTxo, efeqturi da ekonomikuri gamoyeneba;ე) daavadebisa Tu mkurnalobis mosalodneli garTulebebis drouli amocnobisa da marTvis unari;ვ) pacientis daavadebasTan dakavSirebuli samedicino informaciisa da samecniero mtkicebulebebis kritikuli Sefasebis unari.

7. interpersonuli da komunikaciuri unar-Cvevebi: a) pacientebsa da maT ojaxebTan efeqturi komunikaciis unari, rac moicavs pacientis da misi ojaxis wevrebis mosmenas da gagebas, kulturuli da religiuri Taviseburebebis gaTvaliswinebas da daZlevas;b) kolegebTan efeqturi komunikacia rogorc zepiri, aseve, werilobiTi;g) pacientis yvela momvlelTan da qronikul marTvaSi CarTul personalTan efeqturi komunikacia;d) pacientis Sesaxeb informaciis mkafiod gadmocemis unari rogorc zepiri Sefasebisas, aseve werilobiT;e) kolegebisa da studentebis efeqturi swavlebis unari.

8. პraqtikaze dafuZnebuli swavleba da gaumjobeseba:a) pediatriuli nevrologiuri daavadebis mqone hospitalizebul pacientTa daavadebis Sesaxeb sakuTari codnisa da unarebis deficitisa da susti mxareebis amocnoba da maT gaumjobesebaze muSaoba;b) pacientis movlis gasaumjobeseblad mecnieruli da praqtikuli literaturidan Tanamedrove informaciis mopoveba;g) praqtikuli muSaobis gasaumjobeseblad da Sesafaseblad Sesabamisi sistemebis Seswavla, maT Soris, pacientis mxridan Sefaseba da gamosavlis analizi; d) samedicino literaturis kritikuli Sefasebis unari;e) codnis gaumjobesebis zogadi da individualuri strategiis SemuSaveba.

9. profesionalizmi: a) gamoavlinos pativiscema, TanagrZnoba, erTianoba pacientsa da mis ojaxTan;b) iyos gulisxmieri da pativi sces pacientis asaks, kulturul Rirebulebebs, sqess, religiur mrwamss;g) daicvas eTikuri principebi, pacientis konfidencialurobis ufleba da aseve informirebuli Tanxmobis aucilebloba;d) profesiuli muSaobis procesSi iyos punqtualuri, sando, Tanmimdevruli, hqondes damoukidebeli swavlis da profesiuli ganviTarebis unari;e) pativi sces ufrosebs, kolegebs, studentebs da samedicino gundis yvela wevrs.

10. sistemaze dafuZnebuli praqtika:

a) jandacvis mTeli sitemis muSaobis codna, maT Soris, im praqtikuli gaidlainebisa da resursebisa, rac gaaumjobesebs pacientis cxovrebis xarisxs da gavlenas moaxdens pacientis movlis yvela aspeqtze;b) icnobdes da iyenebdes multidisciplinuri, gunduri midgomis principebs qronikuli pacientebis marTvis procesSi;g) saukeTeso movlis gamxorcielebisaTvis, samedicino gundis sxva wevrebTan axorcielebdes efeqtur kolaboracias;

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d) pacientis movlis procesSi iyenebdes mxolod mtkicebulebebze dafuZnebul, xarjTefeqtur strategiebs;e) aanalizebdes pacientis qronikuli movlis Soreul zegavlenas mis socialur-ekonomikur statusze;v) pacientis individualuri finansuri SezRudvebis pirobebSi xelmisawvdomi resursebis efeqturi gamoyeneba;z) jandacvis arsebuli sistemis farglebSi, praqtikuli medicinis samarTlebrivi sakiTxebis codna.

Mmuxli 2.saswavlo programis miznebi1. nevrologiuri darRvevebis mqone bavSvTa marTvis gaumjobeseba;

bavSvTa janmrTelobisa da keTildReobis uzrunvelsayofi yvela samedicino servisisa da masSi monawile samedicino personalis mxardaWera.

2. bavSvTa nevrologTa saTanado umaRlesi ganaTlebisaTvis aucilebeli Teoriuli codnisa da praqtikuli unar-Cvevebis standartebis dadgena.

3. pediatriul nevrologiaSi kvleviTi muSaobis ganviTareba da xelSewyoba.4. pediatriul nevrologiaSi sxvadasxva qveynis saswavlo programebis

harmonizacia da bavSvTa nevrologiis evropaSi არსებული maRali profesiuli standartebis mxardaWera.

Mmuxli 3. saswavlo programis Sinaarsi1. pediatriul nevrologiaSi eqimTa specializacia moicavs sxvadasxva

etapebs:a) bavSvTa nervuli sistemis normaluri da anomaliuri funqcionirebis bazisuri codna;b) bavSvTa da mozardTa asakis nevrologiur paTologiaTa farTo speqtris klinikuri Sefasebis uSualo gamocdileba;g) saswavlo kursis Catareba srulad aRWurvil ganyofilebaSi; d) mocemul bazaze zogierTi specifikuri aRWurvilobisa da gamocdilebis uzrunvelyofis SeuZleblobis SemTxvevaSi sxva hospitalSi individualuri trening-programis ganxorcielebis uzrunvelyofa; e) pediatriul nevrologiaSi praqtikuli moRvaweobisas warmoqmnili fsiqosocialuri da multidisciplinuri aspeqtebis saswavlo programaSi gaTvaliswineba;v) kvleviTi muSaobis araaucileblobis miuxedavad rezidentisTvis/saeqimo specialobis maZieblisaTvis kvleviTi muSaobis warmoebis uzrunvelyofa.

2. pediatriuli nevrologiis Teoriuli codna: a) pediatriuli nevrologiis bazisuri sferoebi:

a.a) normaluri ganviTarebis Sesaxeb detaluri informacia da anomaliuri ganviTarebis ZiriTadi aspeqtebi;a.b) tvinis antenataluri ganviTarebis ZiriTadi principebi, rogorc normaluri, ise anomaliuri;a.g) neonataluri nevrologia: mwvave da qronikuli, neonatalur periodSi manifestirebuli nevrologiuri daavadebebi; a.d) Semdegi mdgomareobebis epidemiologia, etiologia, paTogenezi, klinika, mkurnaloba da gamosavali:a.e) bavSvobis asakis nevrologiuri daavadebebi, maT Soris metaboluri genesis;a.v) ganviTarebis Seferxeba (mentaluri retardacia), daswavlis siZneleebi da swavlis specifikuri gaZneleba, metyvelebisa da komunikaciis kompleqsuri darRvevebi;

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a.z) genetikuri da unarSezRudulobis gamomwvevi nevrologiuri mdgomareobebi bavSvTa asakSi;a.T) bavSvobis asakis gavrcelebuli qceviTi darRvevebis arsi da manifestacia, maT Soris autisturi speqtris darRvevebis, yuradRebis deficitis/hiperaqtivobis, depresiis, SfoTvis, mozardTa fsiqozis da anorexia nervosa-s;a.i) gadaudebeli mdgomareobebi bavSvTa nevrologiaSi. mag.: epilefsiuri statusi an koma;a.k) neiroqirurgiuli daavadebebi bavSvTa asakSi, maT Soris cerebrospinaluri siTxis normaluri cirkulaciis darRveviT mimdinare darRvevebi;a.l) nevrologiur daavadebaTa urTierTkavSiri sxva organoTa sistemebis funqcionirebasTan, maT Soris zrdasa da kvebasTan, kvebis gaZnelebasTan, gastro-ezofagur refluqsTan da aspiraciasTan;a.m) pediatriuli orTopedia, orTozebis gamoyenebisa da bioinJineriis klinikuri aspeqtebi;a.n) genetikuri aspeqtebi, rogoricaa genealogiuri xis Sedgena, ganmeorebis riski, prenataluri diagnostika, genebis lokalizacia, impritingi da molekuluri genetikis principebi;a.o) profilaqtika pediatriul nevrologiaSi (ubedur SemTxvevaTa prevencia, fsiqoaqtiur medikamentTa moxmareba, imunizaciis programebi);a.p) bavSvTa dacvis samarTlebrivi sakiTxebi;b. diagnostikuri saSualebebi:b.a) nevrologiuri darRvevebis prenataluri diagnostika;b.b) bavSvTa nevrologiuri daavadebebis bioqimiuri da neirometaboluri kvlevebi;b.g) bavSvTa nevrologiuri daavadebebis genetikuri da imunologiuri kvlevebis meTodologia;b.d) qsovilTa biofsia, histologiuri anomaliebis interpretacia;b.e) neiroradiologia, nevropaTologia da klinikuri neirofiziologia, iseve rogorc nervuli sistemis funqcionirebisa da intrakraniuli wnevis monitoringisaTvis saWiro teqnologiebi;b.v) saTanado fsiqologiuri testebi da Sedegebis interpretaciis unari;b.z) funqcionirebis, unarSezRudulobisa da davadebaTa saerTaSorisoklasifikaciebi.g. mkurnaloba:g.a) yvela saxis nevrologiuri daRvevis mtkicebiTi mkurnalobis gegma da ganviTarebadi meTodebi;g.b) neirofarmakologia;g.გ) neirounarSezRudulobis mqone bavSvTa reabilitaciis principebi;g.დ) qceviTi darRvevebis marTvis principebi, farmakoTerapia, konsultacia da fsiqoTerapia;g.ე) mkurnalobisa da reabilitaciis procesSi gamoyenebuli saSualebebi, smenisa da mxedvelobis daqveiTebis dros damxare saSualebebi, sayrdeni da mobilurobis gasaumjobesebeli, komunikaciis damxmare saSualebebi, kompiuteri, orTozebi, damxmare ventilacia da a.S.;g.ვ) kvebis da gastrointestinuri aspeqtebi;g.ზ) alternatiuli da aratradiciuli mkurnalobis meTodika da maTi SesaZlo gamosavali;

d. multidisciplinuri marTva:4

d.a) nevrologiur darRvevaTa da unarSezRudulobis gunduri marTvisas bavSvTa nevrologis pasuxismgebloba, maT Soris fizikuri, okupaciuri da metyvelebis Terapevtebis, fsiqoTerapevtis, eqTnis, dietologis, fsiqologis, pedagogisa da socialuri muSakis;d.b) sxva medikosTa da paramedikosTa mier gamoyenebadi meTodebi;d.g) nevrologiuridarRvevebis mqone bavSvTa sazogadoebrivi marTva;d.d) nevrologiuri darRvevebis mqone bavSvTa swavla;d.e) mkurnaloba bavSvTa asakidan mozrdilTa servisze gardamaval etapze.3. arsebuli socialuri servisebi.

4. eTikuri aspeqtebi:a) klinikuri pediatriuli nevrologiis eTikuri aspeqtebi myari unarSezRudulobis da progresuli mdgomareobebis, maT Soris prenataluri diagnostikis sakiTxebi, sasicocxlo funqciebis SemanarCunebeli movla;b) bavSvTa asakSi kvleviTi saqmianobis warmoebis eTikuri aspeqtebi; informirebuli Tanxmoba;g) klinikuri kvlevebis CatarebisaTvis aucilebeli eTikis sakiTxebi da Tanxmobis miRebis uzrunvelyofa;d) qveyanaSi moqmedi sxva sakanonmdeblo aqtebi:

დ.a) saqarTvelos kanoni ,,janmrTelobis dacvis Sesaxeb”; დ.b) saqarTvelos kanoni ,,saeqimo saqmianobis Sesaxeb”; დ.გ) saqarTvelos kanoni ,,pacientis uflebebis Sesaxeb”. 5. pediatriuli nevrologiiT gaTvaliswinebuli unar-Cvevebi: a) klinikuri unar-Cvevebi:

a.a) samedicino istoriis adekvaturi warmoeba;a.b) nebismieri asakis bavSvisa da mozardis (0-dan 18 wlamde asakis) klinikuri gasinjva da ganviTarebis Sefaseba;a.g) klinikuri kvleva da analizi, romelic moicavs normalur da anomaliur ganviTarebas, TamaSs, motorul unarebs;a.d) saTanado diagnostikuri saSualebebis gamoyeneba pacientis klinikuri mdgomareobis interpretaciisaTvis, saTanado daskvnebis gamotana da saWiro mkurnalobis dagegmva;a.e) smenisa da mxedvelobis Sefaseba;a.v) sikvdilis faqtis konstantirebisaTvis nevrologiuri kriteriumebis gamoyeneba;a.z) kritikuli mdgomareobebis dros marTvis koordinacia: gadaudebeli nevrologiuri mdgomareobebis marTva da multisistemuri daavadebebis nevrologiuri aspeqtebi;a.T) SesaZlo nevrologiuri darRvevebis mqone pacientTa da maTi ojaxis wevrebis mimarT adekvaturi da efeqturi midgoma, maTi emociuri mdgomareobis Sefaseba. rTuli informaciis gadacemis saTanadod uzrunvelyofa, konsultirebis procesis saWiroebisamebr uzrunvelyofa, ufro gamocdili da/an sxva fsiqologis daxmarebis saWiroebis droulad gansazRvra;a.i) sxva pediatriuli konsultaciis uzrunvelyofa.b.) akademiuri unar-Cvevebi:b.a) literaturis mimoxilvisa da miRebuli klinikuri Sedegebis kritikuli Sefaseba;b.b) naSromis momzadeba;b.g) zepiri prezentaciebis momzadeba;b.d) aqtiuri kvleva an kvlevis mxardaWera;

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b.e) formaluri da araformaluri pedagogiuri muSaoba studentebsa da dabali kursis rezidentebTan/maZieblebTan.

Mmuxli 4. saswavlo programa

1. aRniSnuli programis gasavlelad saWiro periodi moicavs 3 wels. Ppirveli etapi moicavs zogad pediatrias (erTi weli), romelsac mosdevs saswavlo kursi pediatriul nevrologiaSi (ori weli). 2. dasawyisi, Cveulebriv, moicavs ganacxadis Setanas vakantur adgilze, romelic gamocxaddeba qveynis masStabiT da dadgenili wesiT. 3. saswavlo kursi Sedgeba Semdegi komponentebis kombinaciisagan: a) pacientTa klinikuri marTva zedamxedvelobis qveS; b) saswavlo programa, Semdgari leqcia-seminarebisagan; g) mecadineobebi araformaluri klinikuri da samuSao Sexvedrebis saxiT; d) biblioTekaSi muSaoba. 4. zogadi pediatriis saswavlo kursi: a) pediatriis kursi gulisxmobs swavlebis erT wels, rac aucileblad unda iTvaliswinebdes neonatologias, gadaudebeli da intensiuri Terapiis modulebs; b) swavlebam unda moicvas rogorc stacionaruli, aseve ambulatoruli pacientebi da pacientebis aqtiuri movla. pediatriuli nevrologiis momzadebis I weli – pediatria moicavs Semdeg modulebs: b.a) zogadpediatriuli stacionari – 5 Tve; b.b) samSobiaro bloki/axalSobilTa ganyofileba – 1 Tve; b.g) neonataluri stacionari – 1 Tve; b.d) bavSvTa gadaudebeli daxmareba – 2 Tve; b.e) bavSvTa reanimacia da intensiuri Terapia – 2Tve.

muxli 5. Mმoduli - zogad pediatriuli stacionari1. modulis xangrZlioba - 5 Tve;2. modulis mizani: Seaswavlos rezidents hospitalizebuli pacientis

damoukideblad gasinjva, mdgomareobis simZimis Sefaseba, wamyvani klinikuri sindromis gamovlena, diferencialuri diagnozi da marTva.

3. modulis amocanebi:a) pediatriuli stacionaris struqtura da muSaobis principebi;b) pediatriuli istoria; g) pediatriuli pacientis gasinjvis teqnika: inspeqcia, palpacia, perkusia, auskultacia. Sefaseba sistemebis mixedviT. klinikuri analizi. diferencialuri diagnozi. gamokvlevis gegmis dasaxva. mkurnalobis SerCeva;d) sasunTqi sistemis anatomiur-fiziologiuri Taviseburebebi bavSvTa asakSi. dazianebis semiotika;e) gul-sisxlZarRvTa sistemis anatomiur-fiziologiuri Taviseburebebi bavSvTa asakSi. dazianebis semiotika;v) kuW-nawlavTa sistemis anatomiur-fiziologiuri Taviseburebebi bavSvTa asakSi. dazianebis semiotika;z) Sard-sasqeso sistemis anatomiur-fiziologiuri Taviseburebebi bavSvTa asakSi. dazianebis semiotika;T) nervuli sistemis anatomiur-fiziologiuri Taviseburebebi bavSvTa asakSi. dazianebis semiotika;i) kanis, kanqveSa qsovilebis, limfuri jirkvlebis anatomiur-fiziologiuri Taviseburebebi bavSvTa asakSi. dazianebis semiotika;

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k) Zval-saxsrovani sistemis anatomiur-fiziologiuri Taviseburebebi bavSvTa asakSi. dazianebis semiotika;l) laboratoriuli kvlevis meTodebi: klinikuri, baqteriologiuri, serologiuri, bioqimiuri. Sedegebis interpretacia;m) instrumentuli kvlevis meTodebi: radiologiuri, sonografiuli, endoskopiuri, kompiuteruli tomografia, magnitur-rezonansuli kvleva. Sedegebis interpretacia;n) biofsia. morfologiuri kvleva;o) wamyvani klinikuri simptomebis diferencialuri diagnozi;ცxeleba;cxeleba lokaluri simptomatikis gareSe; ucnobi etiologiis cxeleba; gamonayari. limfadenopaTia; muclis tkivili; Rebinebisa da wamoqafebis sindromi; stridori; mstvenavi; xixini; xvela; cianozi; Suili; arTriti; anemia; krunCxva; hematuria; siyviTle; Tavis tkivili; diarea; yabzoba; meningialuri sindromi; raqiti da raqitismagvari daavadebebi; kvebis qronikuli moSla;

4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba წარმოდგენილია ცხრილის სახით:

profesiuli unar-Cvevebi raod. davalebapediatriuli pacientis anamnezis Sekreba, damoukideblad gasinjva da Sefaseba

50 rezidentma unda daweros TveSi erTi referati, sasurvelia gaakeTos prezentacia an moxseneba rezidentTa konferenciisaTvis

modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT da modulis bolos testuri CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT

sunTqvis sixSiris daTvla da Sefaseba 50guliscemis sixSiris daTvla da Sefaseba 50arteriuli wnevis gasinjva da Sefaseba asakobriv WrilSi

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xaxis daTvaliereba 50Termometria (aqsilaruli, reqtaluri, oraluri) 20kuWis amorecxva 10gamwmendi oyna, hipertonuli oyna 10kunTSi da venaSi ineqcia, venaSi infuzia 30inhalacia 20reqtaluri (TiTiT gasinjva) 5xaxis nacxis aReba 10sisxlis jgufis da rezusis gansazRvra 5sisxlis, Sardis, ganavlis mikroskopuli kvleva 15hematokritis gansazRvra 15kvebiTi statusis Sefaseba 20

muxli 6. Mmoduli - samSobiaro bloki/axalSobilTa ganyofileba1. modulis xangrZlioba - 1 Tve;

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2. modulis mizani: aswavlos rezidents fiziologiuri axalSobilis marTva samSobiaro saxlSi, pirveladi reanimaciis principebi samSobiaro blokSi, dedebis konsultireba movlis da kvebis meTodebTan dakavSirebiT.

3. modulis amocanebi: a) nayofis antenataluri ganviTareba. teratogenuli faqtorebis gavlenanayofze antenataluri ganviTarebis sxvadasxva periodSi; b) maRali riskis orsulebi da axalSobilebi:dedis mwvave da qronikuli daavadebebi. diabetiT daavadebuli dedis axalSobili. alkoholuri embriofetopaTia. teratogenuli medikamentebi.damZimebuli sameano anamnezi. oligo, polihidramniozi. tyupidan tyupze transfuziis sindromi. hestozebi. sanayofe garsebis mTlianobis naadrevi darRveva/mSrali mSobiaroba.placentis paTologia. naadrevi aSreveba. placentis winamdebareoba;g) axalSobilTa hestaciuri asaki. drouli, dRenakli axalSobili, axalSobilivadagadasuli orsulobidan. hestaciur asakTan SedarebiT mcire masis, Zalian mcire masis, didi masis axalSobili;d) axalSobilTa asfiqsia. axalSobilTa reanimacia samSobiaro blokSi. apgaris Skala. asfiqsiis adreuli da Soreuli garTulebebi.e) axalSobilTa respiraciuli distres-sindromi. mizezebi. manifestacia. mkurnalobisa da prifilaqtikis meTodebi. surfaqtantis gamoyenebis perspeqtivebi;v) samSobiaro travma. samSobiaro simsivne. cefalohematoma. sisxlCaqcevakoniuqtivaSi da retinaSi. zurgis tvinis dazianebis semiotika. intrakranialurihemoragia. mxris wnulis, diafragmis, qalas nervebis dazianebis niSnebi. motexilobebi. visceruli organoebis travma;z) axalSobilTa pirveladi tualeti da rutinuli movla. koniuqtivitisa da hemoragiuli sindromis profilaqtika. vitaminiKK.axalSobilTa Termoregulacia. gadacivebis niSnebi dagarTulebebi;T) axalSobilTa siyviTle;i) axalSobilTa imunizacia samSobiaro saxlSi;k) axalSobilTa skriningi metabolur daavadebebze;l) parafiziologiuri mdgomareobebi.4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba წარმოდგენილია ცხრილის სახით:modulis gavlis Semdeg rezidents unda SeeZlos

profesiuli unar-Cvevebi (minimaluri odenobis miTiTebiT)

davaleba

axalSobilis gasinjva hestaciuri asakis gansazRvra _10upirobo refleqsebis Semowmeba- 10

rezidentma unda daweros TveSi erTi referati, sasurvelia gaakeTos prezentacia an moxseneba rezidentTa konferenciisaTvis

axalSobilis piris da cxviris sanacia baloniT an eleqtroamomwoviT

axalSobilis piris da cxviris sanacia baloniT an eleqtroamomwoviT _ 5

ABCD reanimaciis principebi, daxmarebis gaweva neonatologisTvis axalSobilTa reanimaciis procesSi

8

modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT da modulis bolos testuri CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.

sunTqvis daTvla, guliscemis daTvla, kanis feris Sefaseba, centraluri da periferiuli cianozis diferencireba. apgaris SkaliT Sefaseba

sunTqvis daTvla _ 10guliscemis daTvla _ 10xaxis sanacia _ 5apgaris SkaliT Sefaseba. _ 10

gulis xelovnuri masaJis, niRbiT da tomriT ventilaciis da oqsigenoTerapiis principebi da reJimi. am RonisZiebebis gatareba eqim-reanimatologis meTvalyureobis qveS

gulis xelovnuri masaJi _ 2niRbiT da tomriT ventilacia _ 2 oqsigenoTerapia _ 5

Wipis takvis damuSaveba Wipis takvis damuSaveba _ 5

Tvalebis damuSaveba Tvalebis damuSaveba _ 5

axalSobilis awona da gazomva

axalSobilis awona da gazomva_ 10

pirveli kvebis ritualis Catarebasaubari dedasTan ZuZuTi kvebis mniSvnelobis Sesaxeb qalisa da bavSvis janmrTelobisaTvis.

konsultaciis gaweva ZuZuTu kvebis teqnikis, reJimis, xangrZliobis Sesaxeb_ 10

vaqcinacia samSobiaroSi. BCG da B-hepatitis sawinaaRmdego vaqcinacia _ 5

Mmuxli 7. moduli - neonataluri stacionari1. modulis xangrZlioba - 1 Tve.

modulis mizani: Seaswavlos rezidents axalSobilTa uxSiresi daavadebebis amocnoba da marTvis principebi hospitalis pirobebSi, sicocxlisaTvis saSiSi mdgomareobebis gamovlena da gadaudebeli daxmareba. 2. modulis amocanebi:a) axalSobilTa kanis daavadebebi (Tandayolili: teleangieqtazia. hemangioma. melanozi. ixtiozi. bulozuri epidermolizi. dune kanis sindromi. elers-danlosis sindromi; SeZenili arainfeqciuri daavadebebi: gamoyelva. ixtiozi. adiponekrozi. sklerema. skleredema. seboreuli dermatiti; SeZenili infeqciuri daavadebebi: stafilokokuri vezikulo-pustulozi. pemfigusi. riteris eqsfoliatiuri dermatiti figneris fsevdofurunkulozi. streptodermia. mastiti. nekrozuli flegmona);b) respiraciuli darRvevebi da daavadebebi (axalSobilTa respiraciuli distres_sindromi. klinika. marTva. garTulebebi (emfizema, pnevmomediastinumi, pnevmoToraqsi, bronqopulmonuri displazia, dRenaklTa retinopaTia) axalSobilTa tranzitoruli taqipnoe. filtvis pirveladi hipertenzia. apnoe. axalSobilTa pnevmonia);g) hematologiuri darRvevebi (hemolizuri daavadeba (jgufis, rezus SeuTavsebloba). klinikuri variantebi da marTva. sisxlis SenacvlebiTi Terapiis Cvenebebi. fotoTerapia.posthemoragiuli anemia (mwvave, qronikuli). hemoragiuli daavadeba. Policitemia);

9

d) axalSobilTa hiperbilirubinemia. laboratoriuli evaluacia da marTva. bilirubinuli encefalopaTia;e) axalSobilTa sefsisi (adreuli, gviani);v) metaboluri darRvevebi. hipoglikemia. Hipokalciemia;z) wylulovan-nekrozuli enterokoliti;T) Rebinebisa da wamoqafebis sindromi;i) perinataluri infeqciuri daavadebebi;k) axalSobilTa krunCxva;l) centraluri nervuli sistemis paTologia. posthipoqsiuri encefalopaTia. intrakranialuri hemoragia. Meningiti. 3. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba წარმოდგენილია ცხრილის სახით:modulis gavlis Semdeg rezidents unda SeeZlos


davaleba

axalSobilis gasinjva. wamyvani sindromis gamoyofa da diferencialuri diagnozi

hestaciuri askis Sefaseba _ 10



axalSobilTa hemolizuri daavadebis diagnostika da marTva

infuzuri Terapia _ 10

perinataluri imfeqciebze saeWvo axalSobilebis amocnoba

nazogastraluri zondis Cadgma _ 5

axalSobilTa siyviTlis diferencialuri diagnozi

fotoTerapia _ 3

sefsisis diagnostika da marTva

parenteraluri kveba _ 5

axalSobilTa krunCxvis marTva

neirosonoskopia. Sedegebis interpretacia _ 5

meningitis diagnostika lumburi punqcia _ 2antibiotikoTerapiis empiriuli SerCeva sefsisisa, meningitis, wylulovan-nekrozuli kolitis da sxva infeqciuri daavadebebis dros wamyvani infeqciuri agentebis gaTvaliswinebiT

kuWis amorecxva _ 5 gamwmendi oyna. _ 5

samedicino dokumentaciis gaformebaperinataluri da neonataluri sikvdilobis analizi

Mmuxli 8. Mmoduli - bavSvTa gadaudebeli daxmareba1. modulis xangrZlioba - 2 Tve.

10

2. modulis mizani: Seaswavlos rezidents avadmyofis gadaudebeli samedicino daxmareba prehospitalur etapze.

3. modulis amocanebi:a) gadaudebeli daxmarebis organizacia pediatriaSi. Etapurobis principi. daxmareba binaze, ambulatoriaSi, gadaudebeli daxmarebis departamentSi, reanimaciul ganyofilebaSi;

b) bavSvTa letalobis mizezebi; g) pediatriuli travma, rogorc bavSvTa sikvdilobis wamyvani mizezi; d) prehospitaluri daxmarebis principebi pediatriuli tramvis dros (swrafi Sefaseba ABCD principiT, imobilizacia, transportireba). pediatriuli tramvis Skala; e) pediatriuli tramvis principebi gadaudebeli daxmarebis departamentSi. pirveladi Sefaseba ABCD principiT modifikaciiT travmaze. triaJi anu avadmyofTa skriningi gadaudebeli daxmarebis gawevis rigiTobis gansazRvris mizniT. reanimacia. ganmeorebiT Sefaseba. postreanimaciuri monitoringi. რeabilitacia; v) Tavis tramva. qalasSida sisxlCaqceva. tvinis Seryeva. daJeJiloba. mentaluri statusis swrafi Sefaseba AVPU Skalis safuZvelze; z) zurgis tvinis tramva. imobilizaciis principebi; T) gulmkerdis travma. pnevmoToraqsi; i) muclis travma (Ria, daxuruli); k) elenTis, RviZlis, Tirkmlis, pankreasis travma; l) damwvroba. damwvrobis simZimis Sefaseba siRrmis ,farTis, lokalizaciis mixedviT. dazianebuli zedapiris farTis gamoTvla. marTva; m) Wriloba. Wrilobis damuSavebis principebi; n) motexilobebi; o) nakbenebi (ZaRli, kata, morieli, gveli, oboba, futkari); p) ucxo sxeulis aspiracia. pirveladi daxmareba CvilebSi, erT welze meti asakis bavSvebSi (heimlikis meTodi), ugono mdgomareobaSi myof bavSvebSi. ucxo sxeulis eqstraqcia stacionaris pirobebSi; J) mowamvlebi. (medikamenturi, sayofacxovrebo, qimiuri nivTierebebiT, SxamebiT, sokoTi); r) hiperTermiuli sindromi. febriluri gulyra; s) muclis mwvave tkivili. (naRvlis kolika, Tirkmlis kolika, mwvave muceli).


modulis gavlis Semdeg rezidents unda SeeZlos


davaleba

gadaudebeli mdgomareobis Sefaseba, adekvaturi strategiis SemuSaveba

periferiuli venebis punqcia da kaTeterizacia _ 15 arteriuli wnevis gasinjva. asakobrivi maCveneblebis gamoTvla _ 10


mentaluri statusis swrafi Sefaseba

pediatriuli travmis Skalis mixedviT Sefaseba _ 10

Tavis tramvis marTva pirveladi daxmareba krunCxvis dros _ 5

zurgis tvinis tramvis marTva

lumburi punqcia _ 3

gulmkerdis travmis marTva

plevris punqcia _ 2

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muclis travmis marTva peritonealuri punqcia _ 2Sardis buStis kaTeterizacia _ 3

pirveli daxmareba damwvrobis drosWrilobis damuSaveba.motexilobebis marTva

Wrilobis pirveladi damuSaveba _ 3imobilizacia _ 3

mowamvlebis marTva kuWis amorecxva _ 5gamwmendi oyna _ 5 hipertonuli oyna _ 5dehitrataciis xarisxis gansazRvra. rehidrataciis principebi. rehidrataciis ,,a”, ,,b” ,,g” gegmebi _ infuzuri Terapiis dagegmva wyal-marilovani cvlis daregulirebis mizniT deficitis, mimdinare danakargebis, sadReRamiso moTxovnilebis dajamebis safuZvelze _ 20

Mmuxli 9. Mmoduli - bavSvTa reanimacia da intensiuri daxmareba1. modulis xangrZlioba - 2 Tve.2. modulis mizani: kritikuli mdgomareobebis diagnostireba, poliorganuli

ukmarisobis sindromuli mkurnaloba. 3. modulis amocanebi:a) reanimaciuli ganyofilebis organizacia da muSaobis principebi;b) kardio-pulmonuri funqciis swrafi Sefaseba A (sasunTqi gzebis gamavloba), B (sunTqva), C (cirkulacia) midgomis safuZvelze kritikuli mdgomareobebis dros;g) mdgomareobebi, romlebic moiTxoven gadaudebel Carevas: kardiopulmonuri aresti. kardiuopulmonuri ukmarisoba. respiraciuli distresi/respiraciuli ukmarisoba;d) sunTqvis ukmarisoba. mizezebi, klinikuri da laboratoriuli niSnebi. marTva;e) Soki. Sokis tipebi. gamomwvevi niSnebi. klinikuri niSnebi. marTva;v) koma. glazgos komis Skala. glazgos Skalis modifikacia CvilebisaTvis. mizezebi. marTva;z) gadaudebeli daxmareba pulmonologiaSi.mwvave laringotraqeiti. epiglotiti. bronquli asTmis Seteva, asTmuri statusi. filtvis SeSupeba. bronqis ucxo sxeuli. pnevmoToraqsi, piopnevmoToraqsi;T) gadaudebeli daxmareba kardiologoaSi.gulis ukmarisoba.mwvave sisxlZarRvovani ukmarisoba (kolafsi,Soki). gulis ritmis darRveva (paroqsizmuli taqikardia, mocimcime ariTmia, morgan-adam-atoqsis sindromi). hipertonuli krizi;i) gadaudebeli daxmareba gastroenterologiaSi.sisxldena kuW-nawlavis traqtidan. RviZlis ukmarisoba. hepato-renuli ukmarisoba. portuli hipertenzia;

12

k) gadaudebeli daxmareba nefrologiaSi.mwvave oligo/anuria (prerenuli, renuli, postrenuli). Tirkmlis ukmarisoba. hemolitiko-uremiuli sindromi. hemasorbcia. hemodializi;l) gadaudebeli daxmareba endokrinologiaSi. Tirkmelzeda jirkvlis mwvave ukmarisoba. diabeturi koma. hipoglikemiuri koma;m) gadaudebeli daxmareba hematologiaSi. sisxldena. hemostazis principebi. sisxlZarRvSida Sededebis sindromi;n) gadaudebeli daxmareba nevrologiaSi.meningialuri sindromi.encefaluri reaqcia. krunCxva. krunCxviTi statusi;o) gadaudebeli daxmareba infeqciuri daavadebebis dros.sefsisuri Soki. dehidratacia/eqsikozi. hiperTermiuli sindromi; p) mwvave alergiuli reaqciebi. anafilaqsiuri Soki. kvinkes SeSupeba.urtikaria. Sratismieri daavadeba.4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba წარმოდგენილია ცხრილის სახით:

modulis gavlis Semdeg rezidents unda SeeZlos


davaleba

bavSvis mdgomareobis simZimis Sefaseba, reanimaciuli RonisZiebebis aucileblobis dasabuTeba, adeqvaturi strategiis SemuSaveba

centraluri venebis punqcia da kaTeterizacia _ 10



sunTqvis ukmarisobis diagnostika da marTva

lumburi punqcia. punqtatis mikroskopia. mikroskopuli, bioqimiuri da baqteriologiuri kvlevis Sedegebis interpretacia _ 5

Sokis diagnostika da marTva

traqeis intubacia _ 3

komis diagnostika da marTva

filtvebis meqanikuri ventilacia niRbiT da tomriT _ 5

zeda sasunTqi gzebis obstruqciiT mimdinaredaavadebebis marTva

filtvis xelovnuri ventilacia _ 2

ucxo sxeuli sasunTq gzebSi.

traqeobronquli sanacia _ 5

mwvave alergiuli reaqciebis marTva

oqsigenoTerapia _ 5

kolafsi, gulis riTmis darRveva

arteriuli gazebis da mJava-tutovani wonasworobis monacemebis Sefaseba _ 10

sisxldena. sisxlZarRvSida Sededebis sindromi.

parenteraluri kveba _ 10

dehidratacia / eqsikozi. infuzuri Terapia wyal-marilovani cvlis, mJava-tutovani wonasworobis, hematokritis koregirebis mizniT _ 20

13

krunCxviTi sindromi lumburi punqcia _ 3

Mmuxli 10. saswavlo kursi pediatriul nevrologiaSi1. swavlebis miznebi da safuZvlebi:

a) sruli nevrologiuri istoriis da yvela asakis bavSvisa da mozardis gasinjvis warmoebis unari;b) nevrologiuri niSnebis anatomiuri lokalizaciis gansazRvrisa da misi praqtikaSi gamoyenebis unari;

g) qveda da zeda motoneironis dazianebis diferencireba (tonusis garCeva Zalisagan, spastikis definicia); d) saxis nervis centraluri da periferiuli dazianebis garCeva; e) sensoruli deficitis diferencireba dazianebis donis mixedviT (radikulopaTia, neiropaTia, pleqsopaTia da sxva); v) komaSi myofi pacientis gasinjvisas diferencireba: v.a) decerebraciisa da dekortikaciis; v.b) gugebis paTologiis; v.g) okulo-vestibuluri refleqsis Catareba/Sefaseba; v.d) herniaciuli sindromebis codna.

2. sxvadasxva nevrologiur daavadebaTa kardinaluri gamovlinebis codna da am codnis demonstrirebis unari, maT Soris:

a) epilefsia; b) Tavis tkivili; g) Secvlili cnobierebis mdgomareobebi/travma; d) nervuli sistemis infeqciuri da postinfeqciuri daavadebebi; e) genetikuri/metaboluri daavadebebi; v) moZraobiTi aSlilobebi; z) nerv-kunTovani daavadebei; T) neiroganviTarebiTi daavadebebi; i) neirokutaneuli daavadebebi; k) malformaciebi; l) sxva paTologiebi.

მუხლი 11. ძირითადი მოდულები1.ZiriTadi მოდულები-სტრუქტურა წარმოდგენილია 2 ძირითადი nawiliT

mwvave pediatriuli nevrologia da neiroreabilitacia: ა) mwvave pediatriuli nevrologia-rezidenti muSaobs sertificirebul specialistTan. aRniSnuli periodis ganmavlobaSi iTvisebs saTanado codnas nevrologiuri daavadebebis mqone Cvilebis, bavSvebisa da mozardebis diagnostikisa da marTvis procesSi. uSualod monawileobs pacientTa marTvaSi axalSobilTa da intensiuri Terapiis ganyofilebebSi. modulma unda moicvas neiroqirurgiuli Carevis saWiroebis mqone pacientTa marTvac. modulis farglebSi rezidenti unda daeswros kvleviT Sexvedrebs (radiologiur, genetikur, paTomorfologiur da neirofiziologiurs), rac klinikuri marTvis aucilebel nawils warmoadgens. mwvave pediatriuli nevrologiis xangrZlivoba moicavs minimum 15 Tves;ბ) unarSezRuduloba–neiroreabilitacia-rezidenti/მაძიებელი muSaobs akreditirebul bavSvTa ნevrologiuri/reabilitaciis servisis mimwodebel dawesebulebaSi, romelic moicavs multidisciplinur gunds umaRlesi samedicino personalis paralelurad fsiqologis, okupaciuri Terapevtis, da

14

sxva specialistebis SemadgenlobiT. rezidenti eufleba unarSezRudulobis mqone yvela asakis bavSvTa diagnostikasa da marTvas. ხანგძლივობაა 5 თვე.2. SeniSvna: mwvave da unarSezRudulobis modulebi erTad unda Seadgendes sul 20 Tves. SesaZlebelia, maTi integracia. gaTvaliswinebulia rom specialistebis nawili SesaZloa fokusirdes mwvave nevrologiaze da am modulze gansazRvros 18 Tve, xolo sxva fokusirdes neirounarSezRudulobaze. pediatriuli nevrologiis modulebi (20 Tve):ა) pacientis nevrologiuri Sefaseba – 1 Tve;ბ) Tavis tkivili – 1 Tve;გ) intrakraniuli hipertenzia, koma da Tavis tvinis sikvdili – 1 Tve;დ) epilefsia, araepilefsiuri paroqsizmebi da Zilis darRvevebi – 2 Tve; ე) nervuli sistemis infeqciebi – 1 Tve;ვ) nervuli sistemis simsivneebi, malformaciebi da sisxlZarRvovani darRvevebi – 1 Tve;ზ) ataqsia da moZraobiTi darRvevebi – 1 Tve;თ) nervuli sistemis dazianebiT mimdinare genetikuri da metaboluri darRvevebi – 1 Tve;ი) Tavisa da zurgis tvinis travmuli da anoqsiuri dazianebebi – 1 Tve;კ) neiroganviTarebiTi darRvevebi – 1 Tve;ლ) neiroqceviTi darRvevebi – 1 Tve;მ) nerv-kunTovani daavadebebi – 1 Tve;ნ) avtonomiuri nervuli sistemis, neiroendokrinuli da sistemuri daavadebebis Tanmxlebi nevrologiuri darRvevebi – 1 Tve;ო) neonataluri nevrologia – 1 Tve;პ) neiroreabilitaciis safuZvlebi – 5 Tve.

მუხლი 12. Mmoduli - pacientis nevrologiuri Sefaseba1. xangrZlivoba - 1 Tve.2. modulis mizani - mwvave da qronikuli nevrologiuri darRvevebis mqone

pacientis Sefaseba: eqimis bavSvTan urTierTobis Taviseburebebis codna, yvela asakis bavSvis nevrologiuri gasinjva da am unar-Cvevebis praqtikaSi gamoyeneba. neirodiagnostikuri kvlevis ZiriTadi meTodebis da Cveneba - ukuCvenebebis codna, monacemTa swori interpretireba da klinikur praqtikaSi gamoyeneba.

3. modulis amocanebi - rezidentma unda icodes:ა) kortikospinaluri gzis da qveda motoneironis anatomiuri da funqciuri Taviseburebebi, dazianebis sindromebi;ბ) naTxemis anatomia, funqciuri dayofa da dazianebis niSnebi;გ) qerqqveSa kvanZebis anatomiur-funqciuri Taviseburebebi, hiper da hipokinezuri sindromebi;დ) Tavis tvinis nervebis anatomiur-funqciuri Taviseburebebi, dazianebis sindromebi;ე) mgrZnobelobis gzebi, saxeebi, dazianebis tipebi, topikuri diagnostika;ვ) cnobierebis moSlis saxeebi, Sefasebis skala;ზ) Tavis tvinis dazianebis fokaluri nevrologiuri sindromebi;თ) 1 wlis asakamde bavSvis ganviTarebis Taviseburebebi da Sefasebis skalebi.

4. nevrologiuri praqtikaSi gamoyenebuli specialuri kvlevis meTodebis Cveneba - ukuCveneba da SesaZleblobebi:

ა) sisxlis citologiuri, bioqimiuri da baqteriologiuri kvleva;15

ბ) liqvoris citologiuri, bioqimiuri da baqteriologiuri kvleva; გ) eeg;

დ) emg da nervis gamtarebloba; ე) smenis Sefaseba; ვ) mxedvelobis Sefaseba, mxedvelobis gamowveuli potencialebi;

ზ) citogenetikuri kvleva;თ) imunologiuri kvleva;ი) kani da kunTis biopsia;კ) ultrabgera, kt da mrt;ლ) metaboluri skrininguli da specifikuri kvleva;მ) prenataluri diagnostika;ნ) siarulis analizis principebi;

ო) intrakraniuli wnevis monitoringi;პ) Tavis tvinis sikvdilis dasadgeni testi.

5. modulis farglebSi gaTvaliswinebuli unar-Cvevebi rezidents unda SeeZlos:

ა) anamnezuri monacemebis Segroveba, mSoblis an pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT daavadebaze eWvis mitana;ბ) yvela asakis bavSvis nevrologiuri gasinjva, maT Soris: axalSobilobis periodSi, axalSobilobidan 2 wlis asakamde da 2 welze zeviT asakSi;g) monitorireba.6. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis

raodenoba წარმოდგენილია ცხრილის სახით:Teor. kursi profesiuli unar-Cvevebi raod-

badavaleba

bavSvis neiroganviTareba da nevrologiuri gasinjva

Tavis qalas garSemowerilobis gazomva da monacemis interpretireba

40 2 referati da 5 SemTxvevebis prezentacia

Rrma refleqsebis Sefaseba 40msxvili mtoruli funqciis Sefaseba 35naTxemis funqciis Sefaseba 35sensoruli sistemis Sefaseba 35martivi refleqsebis Sefaseba 25kunTTa tonusis da siarulis tipis Sefaseba 35glazgos komis gamoyenebiT pacientis cnobierebis donis Sefaseba

15

anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze saeWvo daavadebis gamoyofa da diagnozis dazustebisTvis saWiro kvlevis meTodebis SerCeva

35

sisxlis, liqvoris da Sardis citologiuri, bioqimiuri da baqteriologiuri kvlevis monacemta interpretireba

35

eeg kvlevis monacemTa interpretireba 40emg da nervis gamtareblobis kvlevis monacemTa interpretireba

20

smenis da mxedvelobis Sefasebis monacemebis interpretireba

20

smenis da mxedvelobis gamowveuli potencialebis monacemTa interpretireba

5

16

citogenetikuri kvlevis monacemTa interpretireba

15

imunologiuri kvlevis monacemTa interpretireba

20

kanisa da kunTis biofsiis monacemTa interpretireba

5

neirogamosaxviT kvlevaTa interpretireba 30metaboluri skrininguli da specifikuri kvlevis monacemTa interpretireba

20

prenataluri diagnostikis kvlevis monacemta interpretireba

20

7. modulis Sefasebis meTodebi: ა) rezidentma unda daweros 2 referati da gaakeTos 5 SemTxvevis prezentacia; ბ) modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT (დადებითი ან უარყოფითი შეფასება).

8. aucilebeli da rekomendebuli literaturis nusxa:ა) janeliZe m., klinikuri nevrologia, 2009, 724 gv.;ბ) tatiSvili n. gabunia m. bokeria i, bavSvTa nevrologiur daavadebaTa mkurnaloba, 2011.; გ) Volpe Joseph J.:Neurology of the Newborn, Fourth edition 912, 2001;დ) Berman Stephen, Pediatric Decision Making, Fourth Edition 895p,2003;ე) Barkovich A.James;Pediatric Neuroimaging, Rhied Edition,850, 1997;ვ) Swaiman Kenneth F. ; Stephen Ashwal , pediatric Neurology Principles and Practice,Third Edition, 1494,1999;ზ) Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes,Second Edition, 289 p, 2002;თ) Blume Warren T. and Kaibara Masako: Atlas of Pediatric Electroencephalography Second Edition, 391, 1999;ი) King M., Stephenson J., Handbook of Neurological Investigations, Mac Keith Press, 2009, 399 p.

მუხლი 13. moduli - Tavis tkivili da tkivilis sxva sindromebi1. xangrZlivoba - 1 Tve.2. Mმizani - Tavis tkivilis klasifikaciis, pacientis asakis da paTfiziologiuri

Taviseburebebis gaTvaliswinebiT Tavis tkivilis mqone pacientis Sefaseba, diagnostika da adekvaturi marTva. nocicepturi da neiropaTiuri tkivilis farmakologiuri da arafarmakologiuri marTva.

3. modulis amocanebi-rezidentma unda icodes:ა) Tavis tkivilis epidemiologia, klasifikacia, paTfiziologia;ბ) Tavis tkivilis mqone pacientis Sefasebis Taviseburebebi;გ) diferenciuli diagnozi, kliniko-laboratoriuli testebi;დ) Tavis tkivilis specifikuri sindromebi;ე) Sakiki da Sakikis variantebi;ვ) qronikuli progresirebadi da araprogresirebadi Tavis tkivili;ზ) Tavis tkivilis marTva, farmakologiuri Terapia;თ) pediatriuli tkivilis Sefasebis saSualebebi;ი) nocicepturi tkivilis meqanizmi da mkurnaloba;კ) neiropaTiuri tkivilis meqanizmi da mkurnaloba.

4. samuSaos moculoba da Casatarebeli manipulaciebis raodenoba17

Teoriuli kursi

profesiuli unar-Cvevebi manipulaciis raod-ba

davaleba

bavSvTa asakis Tavis tkivili da tkivilis sxva sindromebi

anamnezuri monacemebis Segroveba, mSoblis an pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT daavadebaze eWvis mitana;

30 1

referati

da

2 Sem

Txvevebis prezentacia

Tavis tkivilis mqone bavSvis nevrologiuri Sefaseba;

30

eeg kvlevis monacemTa interpretireba 30neirogamosaxviT kvlevaTa interpretireba 30pacientis mdgomareobis adekvaturi Sefaseba, diagnostika da marTva.

30

5. modulis Sefasebis meTodebi:

ა) rezidentma unda daweros 1 referati da gaakeTos misi prezentacia; ბ) modulis Sefaseba xdeba xelmZRvanelis mier modulis dasrulebis Semdeg zepiri gasaubrebiT, testuri CaTvliT (dadebiTi pasuxi testebis >75%) da unar-Cvevebis aTvisebis donis Semowmebis gziT.

6. aucilebeli da rekomendebuli literaturis nusxa:ა) janeliZe m., klinikuri nevrologia, 2009, 724 gv.;ბ) Berman S, Pediatric Decision Making, Fourth Edition, 895p,2003;გ) Barkovich A.J. Pediatric Neuroimaging, third Edition, 850p, 1997;დ) Swaiman Kenneth F, Ashwal S, Pediatric Neurology: Principles and Practice, Third Edition, 1494p,1999;

ე) Blume Warren T. and Masako Kaibara: Atlas of Pediatric Electroencephalography, Second Edition, 391, 1999;

ვ) King M., Stephenson J., Handbook of Neurological Investigations, Mac Keith Press, 2009, 399 p.;ზ) Lewis D. W., Ashwal S., G. Dahl, D. Dorbad, D. Hirtz, A. Prensky and I. Jarjour Neurology and the Practice Committee of the Child Neurology Society Report of the Quality Standards Subcommittee of the American Academy of Practice parameter: Evaluation of children and adolescents with recurrent headaches 2002;59;490-498 Neurology;თ) Lewis D., Ashwal S., A. Hershey, D. Hirtz, M. Yonker and S. Silberstein Society Standards Subcommittee and the Practice Committee of the Child Neurology and adolescents: Report of the American Academy of Neurology Quality Practice Parameter: Pharmacological treatment of migraine headache in children2004;Neurology 63;2215;ი) Hershey, A, et al. Headaches. Curr Opin Pediatr. 2007; 19: 663-669.

მუხლი 14. moduli - intrakraniuli hipertenzia, koma da Tavis tvinis sikvdili

1. ხangrZlivoba - 1 Tve. 2. მizani - komaSi myofi pacientis adekvaturi Sefaseba klinikuri gasinjvis,

glazgos komis skalis da neirodiagnostikuri kvlevis saSualebis

18

gamoyenebiT, tvinis sikvdilis diagnostika,intrakraniuli hipertenziis diagnostika, monitoringi da marTva.

3. modulis amocanebi - rezidentma unda icodes:ა) cnobierebis moSlis saxeebis definicia, klasifikacia, klinikuri niSnebi;ბ) cnobierebis Sefasebis skalebi;გ) cnobierebis SenarCunebis paTofiziologia, moSlis saxeebi;

დ) pacientis Sefaseba fizikuri da nevrologiuri gasinjvis mixedviT;ე) herniaciuli sindromebi;ვ) cnobierebis moSlis marTva da gamosavlis prognozireba;ზ) tvinis sikvdilis sixSire da etiologia;თ) tvinis sikvdilze saeWvo pacientis nevrologiuri Sefaseba da neirodiagnostikuri kvlevebis: eeg, cerebruli angiografia, transkraniuli dopleri, Tavis tvinis kt, pet, mrt da gamowveuli potencialebi, monacemTa swori interpretireba;ი) cnobierebis Secvlis Taviseburebebi axalSobilobis periodSi;კ) intrakraniuli wnevis warmoqmnis da liqvorodinamikis meqanizmi;ლ) intrakraniuli hipertenziis paTofiziologia, monitoringis meTodologia da gamoyeneba;მ) intrakraniuli hipertenziis klinikuri niSnebi da marTva;ნ) Pseudotumor cerebri, diabeturi ketoacidozis Tanmxlebi tvinis SeSupeba, gareTa hidrocefalia da kraniostenozi.


Teoriuli kursi

profesiuli unar-Cvevebi manipulaciis raod-ba

davaleba

intrakraniulihipertenziissindromebi, komebi, Tavistvinissikvdili

komatozuri an Secvlili cnobierebis mqone pacientis Sefaseba nevrologiuri gasinjvis da neirodiagnostikuri kvlevis meTodebis gamoyenebiT;

20 1

referati

da

2 Sem


glazgos komis skalis gamoyeneba; 30komatozuri an Secvlili cnobierebis mqone pacientis diagnostika da adekvaturi marTva;

20

tvinis sikvdilis diagnostika; 10intrakraniuli hipertenziis amocnoba, etiologiis dadgena, monitoringi da marTva.

30

5. modulis Sefasebis meTodebi: ა) rezidentma unda daweros 1 referati da gaakeTos 2 SemTxvevis prezentacia; ბ) modulis Sefaseba xdeba xelmZRvanelis mier modulis dasrulebis Semdeg zepiri gasaubrebiT, testuri CaTvliT (dadebiTi pasuxi testebis >75%) da unar-Cvevebis aTvisebis donis Semowmebis gziT.

6. aucilebeli da rekomendebuli literaturis nusxa:ა) Nishisaki A, Sullivan J, Steger B, Carey R. Bayer, Retrospective analysis of the prognostic value of electroencephalography patter obtained in pediatric in-hospital cardiac arrest survivors during three years, Pediatr Crit Care Med 2007; 8:10–17; ბ) Barkovich A.J, Pediatric Neuroimaging, third edition, 850p, 1997; გ) Berman S, Pediatric Decision Making, Fourth Edition 895p, 2003.;

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დ) Blume Warren T. and Kaibara Masako: Atlas of Pediatric Electroencephalography Second Edition, 391, 1999;ე) Wijdicks E.F.M., Hijdra A., Young G.B., Bassetti C.L., MD; and S. Wiebe, MD, Practice Parameter: Prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review), NEUROLOGY 2006;67:203–210;ვ) King M., Stephenson J., Handbook of Neurological Investigations, Mac Keith Press, 2009, 399 p;

მუხლი 15. moduli - epilefsia, araepilefsiuri paroqsizmebi da Zilis darRvevebi

1. xangrZlivoba - 2 Tve;2. mizani:ა) epilefsiuri gulyrebis amocnoba rogorc klinikuri, aseve eleqtrofiziologiuri maxasiaTeblebiT, epilefsiuri gulyrebis marTvisas medikamentebis gamoyeneba da sxva alternaciuli saSualebebis codna;ბ) araepilefsiuri paroqsizmebis amocnoba, Zilis fiziologiis codna, dissomniebis da parasomniebis amocnoba, sunTqvis Sekavebis Setevebis, refleqsuri anoqsiuri gulyrebis, sinkopes da sxva araepilefsiuri paroqsizmebis marTva.3. modulis amocanebi - rezidentma unda icodes:

ა) epilefsiis epidemiologia, paTfiziologia, epilefsiuri gulyrebis klasifikacia, normaluri eeg;ბ) generalizebuli gulyrebi, difdiagnozi, eeg, etiologia, mkurnaloba, prognozi;გ) gansakuTrebuli epilefsiebi-epilefsiuri encefalopaTiebi, difdiagnozi, eeg, etiologia, mkurnaloba, prognozi;დ) parcialuri gulyrebi, klasifikacia, etiologia, eeg, marTvis principebi, antikonvulsantebi, marTvis yvelaze xSiri Secdomebi, qirurgiuli mkurnaloba;ე) kogniciuri simptomebiT mimdinare epileftiformuli darRvevebi, etiologia, paTfiziologia, mkurnaloba;ვ) mioklonia da miokloniuri gulyrebi, klasifikacia, mkurnaloba;ზ) neonataluri periodis gulyrebis Taviseburebebi;თ) febriluri gulyrebi, epidemiologia, genetika, marTva;ი) epilefsiuri statusi, paTfiziologia, klasifikacia, epidemiologia, etiologia, marTva, prognozi;კ) antiepilefsiuri medikamenturi mkurnaloba, principebi, farmakokinetika, bavSvTa asakis Taviseburebebi, medikamentebis urTierTqmedeba, farmakodinamika, dozireba da miRebis gzebi, klinikuri da laboratoriuli monitoringi, gverdiTi movlenebi, wamlis SerCeva;ლ) ketogenuri dieta, efeqturoba, moqmedebis meqanizmi, kandidatebis SerCeva, Cveneba-ukuCveneba, garTulebebi;მ) epilefsiis mkurnalobis alternatuli meTodebi;ნ) epilefsiuri qirurgia, Cvenebebi, preoperaciuli Sefaseba, miznebi;ო) qceviTi, kogniciuri da socialuri siZneleebi epilefsiis dros;პ) sunTqvis Sekavebis Setevebis klinikuri niSnebi, paTofiziologia, genetika da mkurnaloba;ჟ) refleqsuri anoqsiuri gulyrebi, klinikuri niSnebi, paTofiziologia, laboratoriuli testebi, mkurnaloba;რ) sinkope, epidemiologia, saxeebi;ს) sxva araepilefsiuri paroqsizmebi;

20

ტ) Zilis fiziologia, Zilis darRvevebis mqone pacientis Sefaseba, dissomniebi da parasomniebi, maTi saxeebi.4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis


badavaleba

bavSvTa asakis epilefsiuri da araepilefsiuri paroqsizmebi, Zilis darRvevebi


60 2

referati

da

10

SemTxvevebis

prezentacia

anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze saeWvo daavadebis gamoyofa da zusti diagnostikisTvis saWiro kvlevis meTodebis SerCeva;

60

eeg kvlevis monacemTa interpretireba; 60neirogamosaxviTi kvlevebis monacemTa interpretireba;

65

epilefsiuri sindromebis klasificireba; 60epilefsiuri sindromis mqone pacientisTvis medikamentozuri mkurnalobis adekvaturi SerCeva da marTva;

60

araepilefsiuri paroqsizmebis, dissomniebis da parasomniebis amocnoba da adekvaturi marTva.

70

5. modulis Sefasebis meTodebi: ა) rezidentma unda daweros 2 referati da gaakeTos 10 SemTxvevis prezentacia; ბ) modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.

6. aucilebeli da rekomendebuli literaturis nusxa:ა) Barkovich A. J, Pediatric Neuroimaging, 4th Edition, 850 p, 1997; ბ) Berman Stephen, Pediatric Decision Making, 4th Edition, 895 p, 2003;გ) Blume Warren T. and Kaibara Masako: Atlas of Pediatric Electroencephalography, Second Edition, 391p, 1999;დ) Niedermayer E., EEG, 2005,1280p.;ე) Pellock J., B. Bourgeious, W. Dodson, Pediatric Epilepsy, 2008, 883p.;ვ) King M., Stephenson J., Handbook of Neurological Investigations, Mac Keith Press, 2009, 399 p;ზ) Privitera M., J.Cavitt, D.Ficker, Clinitians Guide to AED Use, 2006, 159p.;თ) Varelas P., Seizures in Critical Care, 2005, 395p.;ი) Swaiman Kenneth F. Ashwal Stephen, Pediatric Neurology: Principles and Practice ,Third Edition, 1494 p,1999.კ) Tatum W., A.Husein, S.Benbadis, Handbook of EEG Interpratation, 2008, 290p.;ლ) Friedman MJ. Seizures in Children. Pediatr Clin N Am 2006, 53:257-77;მ) Olson, D. Paroxysmal Events. Differentiating Epileptic Seizures from Nonepileptic Spells. Consultant for Pediatricians 2008; 461-69;ნ) Zupanc ML. Neonatal seizures. Pediatr Clin N Am 2004; 51:961-978.;ო) Breningstall GN. Breath-holding spells. Pediatr Neurol 1996;14:91-97;

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პ) Hirtz D et al. Practice parameter: Evaluating a first nonfebrile seizure in children. Neurol 2000;55:616-623;ჟ) Hirtz D et al. Practice parameter: Treatment of the child with a first unprovoked seizure. Neurol 2003;60:166-175;რ) Jarrar RG and Buchhalter JR. Therapeutics in pediatric epilepsy, part 1: the new antiepileptic drugs and the ketogenic diet. Mayo Clin Proc 2003;78:359-370.;ს) Practice Parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure. Pediatr 1996;97:769-772.;ტ) Baumann RJ and Duffner PK. Treatment of children with simple febrile seizures: the AAP practice parameter. Pediatr Neurol 2000;23:11-17.;უ) Summary of status epilepticus treatment protocolHolmes GL and Riviello JJ. Midazolam and Pentobarital for Refractory Status Epilepticus. Pediatr Neurol 1999;20:259-264;.ფ) Riveiello, J et al. Practice Parameter: Diagnostic assessment of a child with status epilepticus. Neurology 2006; 67: 1542-1550.;ქ) Hrachovy, R Infantile Epileptic Encephalopathy with Hypsarrhythmia (Infantile Spasms/West Syndrome). J Clin Neurophys 2003; 20(6):408-425.

მუხლი 16. moduli - nervuli sistemis infeqciebi1. xangrZlivoba - 1 Tve.2. mizani-nervuli sistemis virusuli, baqteriuli, sokovani, riketsiuli da

parazituli infeqciebis diagnostika, prognozireba da marTva.3. modulis amocanebi - rezidentma unda icodes:

ა) nervuli sistemis baqteriuli infeqciebis epidemiologia, klinikuri niSnebi, diagnostika, garTulebebi, paTogenezi, marTvis principebi, prognozi, prevencia, imunizacia:

ა.ა)mwvave baqteriuli meningiti;ა.ბ)Tavis tvinis abscesi;ა.გ)mikobaqteriuli infeqciebi: tuberkulozi, leprozi;ა.დ)spiroqetuli infeqciebi.

ბ) nervuli sistemis virusuli infeqciebis epidemiologia, klinikuri niSnebi, diagnostika, marTva:

ბ.ა)aseptikuri meningiti;ბ.ბ)encefaliti;ბ.გ)sxva nevrologiuri darRvevebi.

გ) nervuli sistemis sokovani, riketsiuli da parazituli infeqciebis epidemiologia, klinikuri niSnebi, diagnostikuri testebi, marTva.


Teor. kursi profesiuli unar-Cvevebi raod-ba

davaleba

bavSvTa asakis nervuli sistemis infeqciebi


25 1 referati da

6 Sem


yvela asakis bavSvis nevrologiuri gasinjva;anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze saeWvo daavadebis gamoyofa da zusti diagnostikisTvis saWiro

30

22

kvlevis meTodebis SerCeva;lumbaluri punqcia;sisxlis, liqvoris da Sardis citologiuri, bioqimiuri da baqteriologiuri kvlevis monacemTa interpretireba;

50


30

neiroinfeqciebis diagnostika da marTva. 25

5. modulis Sefasebis meTodebi:ა) rezidentma unda daweros 1 referati da gaakeTos 6 SemTxvevis prezentacia; ბ) modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.6. literaturis nusxa:

ა)Aicardi J., Diseases od Nervous System in Childhood, Mac Keith Press, 2009, pp 383-445;ბ)Baker LK, Long CJ, et al, editors. Red Book: 2006 Report of the Committee on InfectiousDiseases. 27th edition. ElkGroveVillageAmericanAcademy of Pediatrics; 2006. p. 310–8;.გ)Goodwin F., Kennedy C., Encephalitis, in Harvey S. Singer, Eric H. Kossoff, Adam L. Hartman O. Crawford, book Treatment of Pediatric Neurologic Disorders, 2005 by Taylor, pp 293-303;დ)Jones Ch, Meningitis, in Harvey S. Singer, Eric H. Kossoff, Adam L. Hartman,O. Crawford, book Treatment of Pediatric Neurologic Disorders, 2005 by Taylor, pp 287-293; ე)Kaplan SL. Clinical presentations, diagnosis, and prognostic factors of bacterial meningitis. Infect Dis Clin North Am 1999;13:579–94;ვ)King M., J.Stephenson, Handbook of Neurological Investigations, Mac Keith Press, 2009, 399p.;ზ)Lavoie FW, Caucier JR. Central nervous system infections. In: Marx JA, Hockberger RS,თ)Leen W G., Corry M. Weemaes, MD, PhD Marcel M. Verbeek, PhD Michèl A. Willemsen, MD, PhD, and Jan J. Rotteveel, MD, PhD;ი)Loring KE. CNS infections. In: Tintinalli JE,KelenGD, Stapczynski JS, editors. Emergency medicine: a comprehensive study guide. 6th edition. New York: McGraw-Hill; 2004. p. 1431–7.;კ)Maria B., J.Bale, Infections of Nervous System, in Menkes, John H.; Sarnat, Harvey B.; Maria, Bernard L. Child Neurology, 7th Edition 2006 Lippincott Williams & Wilkins;pp. 432-556;ლ)Scheld W.M., R.J. Whitley, C.M.Marra, Infections of CNS, Lippincott Williams, 2004, 921p.;მ)Sharon E. Mace, Acute Bacterial Meningitis, Emerg Med Clin N Am,38 (2008) 281–317;ნ)Somand D, Meurer W, Central Nervous System Infections, Emerg Med Clin N Am 27 (2009) 89–100;ო)Talati N J, Rouphael N, Krutika Kuppalli, Carlos Franco-Paredes, Spectrum of CNS disease caused by rapidly growing mycobacteria, Lancet Infect Dis 2008;8: 390–98;

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პ)Walls RM, et al, editors.Rosen’s emergencymedicine concepts and clinical practice. 6th edition. Philadelphia: Mosby Elsevier; 2006. p. 1710–25.

ჟ)Ziai WC. Advances in the management of central nervous systems infections in the ICU. Crit Care Clin 2006; 22(4):661–94.

მუხლი 17. moduli - nervuli sistemis simsivneebi, malformaciebi da sisxlZarRvovani darRvevebi

1. xangrZlivoba- 1 Tve;2. mizani:

ა) nervuli sistemis simsivneebis amocnoba klinikuri niSnebis da neirovizualizaciuri kvlevis monacemebis mixedviT da marTvis principebis codna;

ბ) cerebrovaskuluri daavadebebis diagnostika klinikuri da paraklinikuri monacemebis mixedviT da adekvaturi marTva.mucladyofnis periodSi nervuli sistemis normaluri ganviTarebis da ganviTarebis darRvevis sxvadasxva variantebis codna, klinikuri niSnebis da neirovizualizaciuri kvlevis monacemebis safuZvelze maTi diagnoscireba.

3. Amocanebi - rezidentma unda icodes:ა) Tavis tvinis simsivneebis epidemiologia, sixSire, histopaTologiuri da lokalizaciuri dayofa, diagnostika, marTvis ZiriTadi principebi, qirurgia, radiacia, qimioTerapia;ბ) zurgis tvinis simsivneebis tipebi, klinikuri niSnebi, diagnostika, marTva, garTulebebi;გ) cns-is dazianeba leikemiis da limfomis dros da misi marTva;დ) cns-is simsivneebis mkurnalobis mogvianebiTi efeqti da axali midgomebi mkurnalobaSi;

ე) bavSvTa asakis cerebrovaskuluri daavadebebis paTofiziologia, klinikuri niSnebi, risk-faqtorebi, radiologiuri niSnebi, mkurnaloba, gamosavali;

ვ) arteriuli iSemiuri insulti; ზ) sinovenozuri Trombozi; თ) ჰemoragiuli insulti – intracerebruli da subaraqnoiduli hemoragia; ი) vaskuluri malformacia;

კ) nervuli sistemis normaluri ganviTareba;ლ) nervuli sistemis malformaciebis etiologiuri Taviseburebebi;მ) nervuli lulis defeqtebi;ნ) proliferacia-deferenciaciis darRvevebi;ო) migraciuli darRvevebi;პ) naTxemis malformaciebi;ჟ) Tavis qalas da nakerebis Tandayolili anomaliebi;რ) am tipis darRvevebis epidemiologiuri monacemebi;ს) etiologia;ტ) paTogenezi;უ) paTologia;ფ) klinikuri niSnebi;ქ) marTva da gamosavali.



davaleba

24

bavSvTa asakis nervuli sistemis simsivneebi, malformaciebi da sisxlZarRvovani darRvevebi

anamnezuri monacemebis Segroveba, mSoblis an pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT cns-is simsivnis an cerebrovaskuluri darRvevis arsebobaze eWvis mitana;


yvela asakis bavSvis nevrologiuri gasinjva, anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze diagnostikisTvis saWiro kvlevis meTodebis SerCeva;

40

sisxlis, liqvoris da Sardis citologiuri, bioqimiuri da baqteriologiuri kvlevis monacemTa interpretireba;

40

eeg kvlevis monacemTa interpretireba; 20emg da nervis gamtareblobis kvlevis monacemTa interpretireba;

20

nervuli sistemis simsivnuri da vaskuluri daavadebebis amocnoba, diagostika da marTva.

20

neirogamosaxviTi kvlevebis monacemTa interpretireba;

30

centraluri nervuli sistemis malformaciebis amocnoba, klinikuri niSnebis da neirovizualizaciuri monacemebis saSualebiT;

20

centraluri nervuli sistemis malformaciebis darRvevebis mqone konkretuli pacientis xangrZlivi marTva.

20

5. modulis Sefasebis meTodebi:ა) rezidentma unda daweros 3 referati da gaakeTos 5 SemTxvevis prezentacia; ბ) modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.6. aucilebeli da rekomendebuli literaturis nusxa:

ა)Catherine Amlie-Lefond, Guillaume Sébire, Heather J Fullerton, Recent developments in childhood arterial ischaemic stroke, Lancet Neurol 2008; 7: 425–35;ბ)DeVeber Gabrielle, Kirkham Fenella, Guidelines for the treatment and prevention of stroke in children, the Lancet.com/neurology Vol 7 November 2008, p.983-85;გ)Hartman A.L, Lunney K.M, Serena J.E,Pediatric Stroke: Do Clinical Factors Predict Delays in Presentation?, J Pediatr 2009;154:727-32;დ)Janjua N, Nasar A, Lynch JK, Qureshi AI. Thrombolysis for ischemic stroke in children: data from the nationwide inpatient sample. Stroke 2007 38: 1850–54.ე)Monagle P, Chalmers E, Chan A, et al. Antithrombotic therapy in neonates and children: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest 2008; 133: 887S–968S.ვ)Roach ES, Golomb MR, Adams R, et al. Management of stroke in infants and children: a scientifi c statement from a Special Writing Group of the American Heart

25

Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke 2008; 39: 2644–91ზ)Satoshi Kuroda, Kiyohiro Houkin, Moyamoya disease: current concepts and future perspectives, Lancet Neurol 2008; 7: 1056–66;

მუხლი 18. moduli - ataqsia da moZraobiTi darRvevebi1. xangrZlivoba: 1 Tve2. mizani:

ა) ataqsiis mqone pacientis anamnezuri da klinikuri monacemebis Sefaseba, diagnostika da marTva; ბ) moZraobiTi darRvevebis amocnoba, diagnostika, moZraobiTi darRvevebiT mimdinare daavadebaTa diagnostika da marTva.

3. Amocanebi-rezidentma unda icodes:ა) naTxemis anatomia, funqciuri dayofa da dazianebis niSnebi;ბ) ataqsiis mqone pacientis anamnezuri, klinikuri da laboratoriuli monacemebis Sefaseba;გ) mwvave da qronikuli – spinocerebelaruli degeneraciebiT gamowveuli ataqsiebi;დ) moZraobiTi darRvevebis neiroanatomia, neirotransmiterebi, pacientis Sefaseba;

ე) qorea, aTetozi, distonia, tremori, balizmi, mioklonia, tikebi, maTi difdiagnostika;

ვ) moZraobiTi darRvevebiT Tanxlebuli bazaluri gangliebis daavadebebi.4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis

raodenoba წარმოდგენილია ცხრილის სახით:Teor. kursi profesiuli unar-Cvevebi raod

-badavaleba

bavSvTa asakis ataqsia da moZraobiTi darRvevebi

ataqsiis mqone pacientis adekvaturi Sefaseba; 10 2 referati da 2 Sem


moZraobiTi darRvevebis amocnoba da tipebis identificireba;

20

arsebuli darRvevis savaraudo etiologiis dadgena;

20

ataqsiis mqone pacientis marTva. 10moZraobiTi darRvevi mqone pacientis marTva. 20


ა)Affifi A., Bazal Ganglia, Neuronal Networks, Vol 10, No 1 (March), 2003: pp 3-10;ბ)Barkovich A.J. Pediatric Neuroimaging, Fourth Edition,850, 1997 გ)Berman S, Pediatric Decision Making, Fourth Edition, 895p,2003დ)Blume Warren T. and Masako Kaibara: Atlas of Pediatric Electroencephalography, Second Edition, 391p, 1999. ე)Caviness J., Pathophysiology of Myoclonus,Neurol Clin 27 (2009) 757–777;ვ)Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes, Second Edition 289 p, 2002

26

ზ)Pranzatelli M., Myoclonus in Childhood, Vol 10, No 1 (March), 2003: pp 41-51 თ)Swaiman K. F., Ashwal S., Pediatric Neurology: Principles and Practice, Third Edition, 1494,1999

მუხლი 19. moduli-nervuli sistemis dazianebiT mimdinare genetikuri da metaboluri darRvevebi

1. xangrZlivoba: 1 Tve2. mizani:

ა) memkvidreobiTobis molekuluri safuZvlebis, adamianis genomis organizaciis, klinikuri citogenetikis, memkvidreobiTobis tipis, qromosomuli anomaliebis codna, nevrologiuri darRvevebiT Tanxlebuli genetikuri daavadebebis amocnoba da marTva. ბ) Tandayolili metaboluri darRvevebis diagnostikis, klinikuri niSnebis da adekvaturi marTvis sakiTxebis codna da klinikur praqtikaSi gamoyeneba.

3. modulis amocanebi - rezidentma unda icodes:ა) memkvidreobiTobis molekuluri safuZvlebi;ბ) adamianis genomis organizacia;გ) memkvidreobiTobis qromosomuli safuZvlebi;დ) molekuluri genetikis teqnologiebi;ე) mutacia da normaluri variaciebi;ვ) klinikuri citogenetika;ზ) memkvidreobiTobis tipebi;თ) memkvidreobiTTbis araklasikuri paternebi;ი) adamianis genis ruqa;კ) populaciuri genetika;ლ) genetikuri riski;მ) aminoacidopaTiebi da organuli acidemiebi;ნ) amoniumis metabolizmis daavadebebi;ო) naxSirwylovani metabolizmis darRvevebi;პ) lizosomuri daavadebebi;ჟ) JangviTi metabolizmis darRvevebi;რ) mitoqondriuli daavadebebi;ს) peroqsisomuli darRvevebi.



davaleba

bavSvTa asakis nervuli sistemis dazianebiT mimdinare genetikuri da metaboluri darRvevebi

qromosomuli anomaliebis epidemiologiis da klinikuri niSnebis gaTvaliswinebiT sindromis amocnoba da adekvaturi marTva;

10 2

referati

da

2 Sem


citogenetikuri kvlevis monacemTa interpretireba;metaboluri skrininguli da specifikuri kvlevis monacemTa interpretireba;

10

prenataluri diagnostikis kvlevis monacemTa interpretireba;

10

mSoblebis da ojaxis wevrebisTvis genetikuri rCeva-darigebis micema;

10

memkvidruli darRvevebis amocnoba, kvlevis meTodebis SerCeva dea xangrZlivi marTva.

10

27


ა)Barkovich A.J; Pediatric Neuroimaging, Fourth Edition, 850p, 1997 ბ)Berman S, Pediatric Decision Making Fourth Edition, 895p,2003გ)Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes, Second Edition 289p, 2002დ)Ferreti P., Tikkey A.and D.Moore, Emgrios, Genes and births Defects,2006, 590p.;ე)Moeschler John B., Michael Shevel, and the Committee on Genetics, Clinical Genetic Evaluation of the Child With Mental Retardation or Developmental Delays, Clinical, J. Pediatrics, 2006, pp01006-1008;ვ)Swaiman K F. ; Ashwal S, Pediatric Neurology: Principles and Practice ,Third Edition, 1494,1999

მუხლი 20. moduli - Tavisa da zurgis tvinis travmuli da anoqsiuri dazianebebi

1. xangrZlivoba: 1 Tve2. mizani:

ა) Tavisa da zurgis tvinis travmuli dazianebebis amocnoba, klinikuri gasinjvis da neirodiagnostikuri kvlevis saSualebebis monacemebis mixedviT mdgomareobis Sefaseba, diagnostika, prognozireba da marTva; ბ) hipoqsiur-iSemiuri encefalopaTiis ganviTarebis meqanizmis da klinikuri paTofiziologiis codna, postanoqsiuri garTulebebis da prognozis gansazRvra da marTva.

3. modulis amocanebi -rezidentma unda icodes:ა)qala-tvinis travmis anatomiuri da paTogenezuri Taviseburebebi;ბ)Tavis tvinis travmuli dazianebis mqone pacientis nevrologiuri gasinjva, radiologiuri kvleva, lumbaluri punqcia;გ)Tavis tvinis travmis mqone pacientis marTva:

გ.ა)intrakraniuli hipertenzia;გ.ბ)posttravmuli epilefsia;გ.დ)Tavis tvinis SeSupeba.

დ) Tavis travmis klinikuri tipebi, maTi paTofiziologia:დ.ა)skalpis dazianeba;დ.ბ)difuzuri aqsonuri dazianeba;დ.გ)tvinis Seryeva da SeryevisSemdgomi sindromi;დ.დ)tvinis daJeJiloba;დ.ე)mwvave epiduruli da subduruli hematoma;დ.ვ)qvemwvave da qronikuli subduruli hematoma.

ე) Tavis tvinis mwvave travmis prognozi da gamosavali;ვ) zurgis tvinis dazianebis anatomiuri da paTogenezuri Taviseburebebi, nevropaTologia;ზ) zurgis tvinis dazianebis mqone pacientis Sefaseba nevrologiuri gasinjvis da radiologiuri kvlevis monacemebis mixedviT;თ) zurgis tvinis dazianebis klinikuri sindromebi da maTi marTva.ი) Tavis tvinis anoqsiuri dazianebis meqanizmi;

28

კ) klinikuri paTofiziologia;ლ)gulis gaCerebiT Tanxlebuli darRvevebi da maTi klinikuri gamosavali;მ)gulis gaCerebis Semdgomi nevrologiuri garTulebebi;ნ)anoqsiuri dazianebis gamosavlis prediqtorebi;ო)anoqsiuri dazianebis mkurnaloba da potenciuri Terapia.



davaleba

Tavisa da zurgis tvinis travmuli da anoqsiuri dazianebebi bavSvTa asakSi

anamnezuri monacemebis Segroveba, mSoblis an pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, bavSvis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT Tavisa da zurgis tvinis travmul dazianebaze eWvis mitana;


anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze zusti diagnostikisTvis saWiro kvlevis meTodebis SerCeva;

20

glazgos komis skalis gamoyeneba;lumbaluri punqcia;

20

sisxlis, liqvoris da Sardis citologiuri, bioqimiuri da baqteriologiuri kvlevis monacemTa interpretireba;

20


20

travmis mqone pacientis marTva rogorc mwvave periodSi, aseve mwvave periodis Semdeg;

20

postanoqsiuri encefalopaTiis Sefaseba nevrologiuri gasinjvis, eeg-s, gamowveuli potencialebis, bioqimiuri markerebis da neirogamosaxvis mixedviT;

20

anoqsiuri dazianebis prehospitaluri da hospitaluri marTva.

20

5. modulis Sefasebis meTodebi: ა)rezidentma unda daweros 1 referati da gaakeTos 2 SemTxvevis prezentacia; ბ)modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.6. aucilebeli da rekomendebuli literaturis nusxa

ა)Avarello Jahn T., Pediatric Major Trauma: An Approach to Evaluation and Management, Emerg Med Clin N Am 25 (2007) 803–836; Guideline commissioned by the National Institute for Clinical Excellence, 2003, 246p;ბ)Barkovich A.J; Pediatric Neuroimaging, Fourth Edition, 850p, 1997 გ)Berman S, Pediatric Decision Making, Fourth Edition, 895p,2003დ)Blume Warren T. and Masako Kaibara: Atlas of Pediatric Electroencephalography, Second Edition, 391p, 1999ე)Brain injuries after blunt head trauma. Ann Emerg Med 2003;42(4):492– 506.

29

ვ)Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes, Second Edition 289p, 2002ზ)Kopjar B, Wickizer TM. Age gradient in the cost-effectiveness of bicycle helmets. Prev Med 2000;30:401-406.თ)Palchak MJ, Holmes JF, Vance CW, et al. A decision rule for identifying childreი)Swaiman K F. ; Ashwal S, Pediatric Neurology: Principles and Practice ,Third Edition, 1494,1999კ)Thiessen Mary L., Woolridge Dale P., Pediatric Minor Closed Head Injury, Pediatr Clin N Am 53 (2006) 1 – 26.

მუხლი 21. moduli - neiroganviTarebiTi darRvevebi1. xangrZlivoba - 1 Tve.2. mizani:

ა) pacientis ganviTarebis Sefaseba, sxvadasxva asakis bavSvis ganviTarebis Sesafasebeli skalebis codna; motoruli, metyvelebis da gonebrivi ganviTarebis darRvevebis Sefaseba, prognozireba da marTva; ბ) neirodermaluri sindromebis (e.w. fakomatozebis) adreuli sadiagnostiko niSnebis mixedviT amocnoba da adekvaturi marTva; გ) TeTri da ruxi nivTierebis degeneraciuli daavadebebis paTofiziologiis, bioqimiis, klinikuri niSnebis da genetikis codnis safuZvelze am daavadebaTa amocnoba da marTva.

3. modulis amocanebi-rezidentma unda icodes:ა) ganviTarebis Seferxebis prenataluri, perinataluri, postnataluri da idiopaTiuri etiologia;ბ) ganviTarebis regresis mizezebi da Taviseburebebi;გ) metyvelebis darRvevebis klasifikacia, difdiagnozi, specifikuri sindromebi;დ) disleqsia, misi epidemiologia, etiologia, paTofiziologia, diagnostika, marTva;ე) mentaluri retardacia, misi epidemiologia, etiologia, diagnostika, marTva;ვ) Sefasebis skalebi;ზ) neirofibromatozis, tuberozuli sklerozis, Sturge-veberis sindromis, fon-hipel-lindaus daavadebis, ataqsia-teleangieqtaziis da sxva iSviaTi fakomatozebis klinikuri niSnebi, paTologia, genetika da neirovizualizaciuri korelatebi;თ) pirveladad ruxi nivTierebis degeneraciiT mimdinare daavadebaTa (menkesis sindromi, infantiluri progresirebadi poliodistrofia, retis sindromi, nervuli seroiduli lipofuscinoziebi) paTologia, bioqimia, klinikuri maxasiaTeblebi, genetika, laboratoriuli kvlevis monacemebi da marTva;ი) pirveladad TeTri nivTierebis degeneraciiT mimdinare daavadebaTa (gafantuli sklerozi, Silderis daavadeba, mwvave diseminirebuli encefalomieliti, hipo da madismielinizirebeli darRvevebi – peliceus-merzbaxeris daavadeba, kanavanis daavadeba, aleqsandres daavadeba da leikoencefalopaTiebi) paTologia, bioqimia, klinikuri maxasiaTeblebi, genetika, laboratoriuli kvlevis monacemebi da marTva.



davaleba

30

neiroganviTarebiTi darRvevebi

rezidentma unda SeZlos Seafasos: pacientis fizikuri ganviTareba, Tanmxlebi Tvalis, kanis, smenis, Tmis darRvevebi, hepatosplenomegalia, metaboluri acidozi da sxva darRvevebi; motoruli, gonebrivi da metyvelebis ganviTareba;


mdgomareobis prognozireba; 30sruli SefasebisTvis saWiro specialistTa da kvlevebis SerCeva;

30

ganviTarebis darRvevis mqone pacientis marTva;

30

uxSiresi neirodermaluri sindromebis amocnoba klinikuri da neirovizualizaciuri niSnebis mixedviT, simptomuri mkurnaloba da xangrZlivi marTva;

20

TeTri da ruxi nivTierebis degeneraciuli daavadebebis amocnoba, diagnostika da marTva;

20


6. aucilebeli da rekomendebuli literaturis nusxaა)Barkovich A.J; Pediatric Neuroimaging, Fourth Edition, 850p, 1997 ბ)Berman S, Pediatric Decision Making, Fourth Edition, 895p,2003გ)Chavarska K, Klin A, Volkmar F.R, Autism spectrum Disordres in Infants and Toddlers, The Guilford Press, 348 p, 2008.დ)Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes, Second Edition 289p, 2002ე)Coleman M, The Neurology of Autism, 2007.ვ)Filipek P. A., Accardo P. J., Ashwal S., Baranek G. T., E. H. Cook, Jr., G. Dawson, B. Neurology Society Standards Subcommittee of the AmericanAcademy of Neurology and the Child Practice parameter: Screening and diagnosis of autism: Report of the Quality, 2000;55;468-479 Neurology;ზ)Gupta VidyaBhushan, "AutisticSpectrumDisordersinChildren (PediatricHabilitation)", 2008.თ)Richman S, "Encouraging Appropriate Behavior for Children on the Autism Spectrum: Frequently Asked Questions", 2009.ი)Swaiman K F. ; Ashwal S, Pediatric Neurology: Principles and Practice ,Third Edition, 1494,1999კ)Volkmar Fred R."Handbook of Autism and Pervasive Developmental Disorders, Two Volume Set", 2006.

მუხლი 22. moduli - neiroqceviTi darRvevebi1. xangrZlivoba - 1 Tve.2. mizani-yuradRebis deficitis da hiperaqtiurobis sindromis, swavlebis

siZneleebis, tikebis, turetis sindromis da autisturi darRvevebis klinikuri 31

niSnebis, diagnostikuri kriteriumebis, prognozis da marTvis Taviseburebebis codna da klinikur praqtikaSi gamoyeneba.

3. modulis amocanebi-rezidentma unda icodes:ა) yuradRebis deficitis da hiperaqtiurobis sindromis klinikuri niSnebi, Tanmxlebi darRvevebi (swavlebis siZneleebi, SfoTviTi da bipolaruli darRvevebi, tikebi), maTi gamosavali, farmakoTerapia, arafarmakologiuri Terapia;ბ)t ikebi da turetis sindromi – neiroanatomiuri lokalizacia, neirofsiqologiuri problemebi, akademiuri moswrebis siZneleebi da maTi marTva;გ) autisturi darRvevebis klinikuri niSnebi, diagnostika, autizmis neiroanatomia, neirogamosaxviTi kvlevis monacemebi, neiroqimia, genetika da marTvis Taviseburebebi.



davaleba

neiroqceviTi darRvevebi

neiroqceviTi darRvevebiT mimdinare nevrologiuri daavadebebis amocnoba

30 1 referati da

2

SemTxve

vebis diagnostikuri kriteriumebis gamoyeneba 30marTva medikamentozuri da arafarmakologiuri mkurnalobis gamoyenebiT.

30

5. modulis Sefasebis meTodebi: ა) rezidentma unda daweros 1 referati da gaakeTos 2 SemTxvevis prezentacia; ბ) modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.6. aucilebeli da rekomendebuli literaturis nusxa

ა)Berman S, Pediatric Decision Making, Fourth Edition, 895p,2003ბ)Chavarska K, Klin A, Volkmar F.R, Autism spectrum Disordres in Infants and Toddlers, The Guilford Press, 348 p, 2008.გ)Clarke J.T.R.: A Clinical Guide to Inherited Metabolic Diseaes, Second Edition 289p, 2002დ)Coleman M, The Neurology of Autism, 2007.

ე)Filipek P. A., Accardo P. J., Ashwal S., Baranek G. T., E. H. Cook, Jr., G. Dawson, B. Neurology Society Standards Subcommittee of the AmericanAcademy of Neurology and the Child Practice parameter: Screening and diagnosis of autism: Report of the Quality, 2000;55;468-479 Neurology;

ვ)Gupta VidyaBhushan, "AutisticSpectrumDisordersinChildren (PediatricHabilitation)", 2008.ზ)Luna B, Garver KE, Urban TA, et al. Maturation of cognitive processes from late childhood to adulthood. Child Dev 2004;75:1357-1372.თ)Richman S, "Encouraging Appropriate Behavior for Children on the Autism Spectrum: Frequently Asked Questions", 2009.ი)Swaiman K F. ; Ashwal S, Pediatric Neurology: Principles and Practice ,Third Edition, 1494,1999კ)Volkmar Fred R."Handbook of Autism and Pervasive Developmental Disorders, Two Volume Set", 2006. ლ)Walkup JT, Labellarte MJ, Ginsburg GS. The pharmacological treatment of childhood anxiety disorders. Int Rev Psychiatry 2002; 14:135–142.

32

მ)Warren T.blume and Masako Kaibara: Atlas of Pediatric Electroencephalography, Second Edition, 391p, 1999

მუხლი 23. moduli-nerv-kunTovani daavadebebi1. xangrZlivoba - 1 Tve.2. mizani-nerv-kunTovani daavadebebis amocnoba, diagnostika,

eleqtroneiromiografiuli kvlevis monacemTa interpretireba, ojaxisTvis genetikuri rCeva-darigebis micema da marTva.

3. modulis amocanebi-rezidentma unda icodes:ა) normaluri kunTis anatomiuri da struqturuli Taviseburebebi, klinikuri bioqimia, eleqtroneirografia, kunTis biofsia;ბ) nerv-kunTovani daavadebebis epidemiologia, klasifikacia, klinikuri niSnebi, diagnostika, memkvidreobiToba, paTofiziologia, marTva da prognozi:ბ.ა) winarqovani daavadebebi;ბ.ბ) periferiuli neiropaTiebi;ბ.გ) mwvave da qronikuli mademielinizirebeli neiropaTiebi;ბ.დ) nerv-kunTovani kavSiris darRvevebi (miasTenia, lambert-itonis

miasTeniuri sindromi, botulizmi);ბ.ე) kunTTa distrofiebi (duSenis, bekeris, kidur-sartylovani, landuJi-

deJerinis, skapuloperonealuri, miotonuri, Tandayolili);ბ.ვ) Tandayolili miopaTiebi;ბ.ზ) metaboluri miopaTiebi;ბ.თ) anTebiTi miopaTiebi;

ბ.ი) miotoniuri darRvevebi da perioduli damblebi.4. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis


badavaleba

nerv-kunTovani daavadebebi



yvela asakis bavSvis nevrologiuri gasinjva;anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze saeWvo daavadebis gamoyofa da zusti diagnostikisTvis saWiro kvlevis meTodebis SerCeva;

30

emg da nervis gamtareblobis kvlevis monacemTa interpretireba;

30

citogenetikuri kvlevis monacemTa interpretireba;kunTis biofsiis monacemTa interpretireba;

30


30

nerv-kunTovani daavadebis arsebobis amocnoba, diagnostika da marTva.

30

5. modulis Sefasebis meTodebi:

33

ა)rezidentma unda daweros 2 referati da gaakeTos 3 SemTxvevis prezentacia; ბ) modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.6. aucilebeli da rekomendebuli literaturis nusxa:

ა)Grewal PK, Hewitt JE. Glycosylation defects: a new mechanism for muscular atropies,Hum Mol Genet 2003; 12:R259–R264;

ბ)Dubowitz V. Muscle Disorders in Childhood. 2d ed. Saunders, 1995;გ)Bushby K, Mellies U, Wallgren-Pettersson C. Ventilatory support in congenital neuro-muscular disorders. 117th ENMC Workshop, Naarden, The Netherlands 4–6th April2003. Neuromusc Disord 2004; 14:56–69;დ)Goebel HH. Congenital myopathies at their molecular dawning. Muscle Nerve 2003;27:527–548;ე)Darras BT, Menache CC, Kunkel LM. Dystrophinopathies. In: Jones HR, DeVivo DC, 2008;ვ)Darras BT, eds. Neuromuscular Disorders of Infancy, Childhood, and Adolescence—A Clinicians Approach. Amsterdam: Butterworth Heinemann, 2003:649–700.Hill, New York Myology. 2003;ზ)Mankodi A, Thornton CA. Myotonic syndromes. Curr Opin Neurol 2, 2009;თ)Wang C.,Bonnehmen C.,Rutkovski A. et al. Consensus Statement of Standart of Care Congenital Muscular Dystrophies, Journal of Child Neurology, 25 (12), 2010.p.1559-1581;ი)Bushby K., Fenkel G.,Birkrant D. et al. Diagnosis and Management of Duchene Muscular Dysthrophy, Lancet neurology, 11, 2009, p.1116-1174 .

მუხლი 24. moduli-avtonomiuri nervuli sistemis, neiroendokrinuli da sistemuri daavadebebis Tanmxlebi nevrologiuri darRvevebi

1. xangrZlivoba - 1 Tve.2. mizani:

ა) hipoTalamuri da hipofizis darRvevebis endokrinuli gamovlinebebis, avtonomiurinervuli sistemis sindromebis, Sardvisa da defekaciis darRvevebis diagnostika da marTva; ბ) revmatuli darRvevebis, mowamvlis, gulis da renaluri daavadebebis, kvebis deficitis, kuW-nawlavis daavadebebis da imunizaciis Tanmxlebi nevrologiuri darRvevebis diagnostika da marTva.

3. modulis amocanebi-rezidentma unda icodes:ა) neiroendokrinologiis anatomiur-fiziologiuri da kliniko-paTologiuri safuZvlebi, Tandayolili struqtureuli defeqtebis da nevrogenuli endikrinuli darRvevebis diagnostika, klinika, neirovizualizaciuri Taviseburebebi da marTva;ბ) avtonomiuri nervuli sistemis anatomiuri, bioqimiuri da farmakologiuri maxasiaTeblebi, klinikuri testebi, sindromebi da maTi marTva;გ) Sardvisa da defekaciis darRvevebis paTofiziologia, pacientis Sefaseba, diagnostika da marTva;დ)revmatuli darRvevebis (revmatoiduli arTriti, mwvave revmatizmi, laimis daavadeba, wiTeli mglura, sklerodermia, Sagrenis sindromi, kvanZovani poliarteriti, leikocitoklasturi vaskuliti, granulomatozuri angiiti, giganturujredovani arteriti) nevrologiuri gamovlinebebis klinikuri niSnebi, diagnostika, nevrologiuri gamovlinebebis mkurnaloba;

34

ე) mwvave da qronikuli mowamvlis mqone pacientis Sefaseba, diagnostika, marTva;ვ) gulis qirurgiis, mankebis da SeZenili gulis daavadebebis Tanmxlebi nevrologiuri darRvevebis diagnostika da marTva;ზ) renaluri problemebis da nevrologiuri darRvevebis kavSiri: uremiuli encefalopaTia, hipertenziuli encefalopaTia, dializis garTulebebi, uremiuli neiropaTia, transplantaciis garTulebebi, renul-nevraluri daavadebebi, maTi amocnoba da marTvis Taviseburebebi, nevrologiuri daavadebebis marTva Tirkmlis daavadebis dros;თ) kuW-nawlavis traqtis daavadebebis, kvebis darRvevebis da wyal-marilovani cvlis darRvevebis Tanmxlebi nevrologiuri problemebis amocnoba da marTva;ი) imunizaciis nevrologiuri garTulebebis diagnostika da marTva.



davaleba

avtonomiuri nervuli sistemis, neiroendokrinuli da sistemuri daavadebebis Tanmxlebi nevrologiuri darRvevebi

neiroendokrinuli, avtonomiuri nervuli sistemis, Sardvis da defekaciis darRvevebis mqone pacientTa Sefaseba, diagnostika da marTva;

30 2

referati

da

2 Sem


revmatuli darRvevebis, mowamvlis, gulis da renaluri daavadebebis, kvebiTi deficitis, kuW-nawlavis daavadebebis da imunizaciis Tanmxlebi nevrologiuri darRvevebis amocnoba, diagnostika da marTva.

30

5. modulis Sefasebis meTodebi:ა) rezidentma unda daweros 2 referati da gaakeTos 2 SemTxvevis prezentacia. modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos; ბ) zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.6. aucilebeli da rekomendebuli literaturis nusxa:

ა)Axelrod FB. Genetic disorders as models to understand autonomic dysfunction. ClinAuton Res 2002; 12(suppl 1);

ბ)Bos AP, van der Meche FG, Witsenburg M, van der Voort E. Experience with Guillain-Barre ´ syndrome in pediatric patients. Intensive Care Med 1987; 13:328–331;

გ)Ellies M, Rohrbach-Volland S, Arglebe C, Wilkins B, Lakawi R, Hanfeld F. Successful management of drooling with botulinum toxin A in neurologically disabled children. Neuropediatrics 2002; 33:327–330;დ)Gadoth N. Familial dysautonomia. Handbook of autonomic nervous system dysfunction. New York: Marcel Dekker Inc., 1995:95–115;ე)Lahat E, Goldaman M, Barr J, Bistrizer T, Berkovitch M. Intranasal midazolam as a treatment of autonomic crises in patients with familial dysautonomia. Pediatr autonomic nervous system.Ann Intern Med 2002; 137:753–763;ვ)Shatzky S, Moses S, Levy J, Pinsk V, Hershkovitz E, Herzog L, Shorer Z, Luder A, Parvari R. Congenital insensitivity to pain with anhidrosis (CIPA) in Israeli-Bedouins:genetic heterogeneity, novel mutations in the TRKA=NGF receptor gene, clinical findings and results of nerve conduction studies. Am J Med Genet 2000; 92:353–360;

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ზ)Stewart JM. Orthostatic intolerance in pediatrics. J Pediatr 2002; 40:404–411.Neurol2000; 22:19–22.

მუხლი 25. moduli-neonataluri nevrologia1. xangrZlivoba -1 Tve.2. mizani-axalSobilis adekvaturi nevrologiuri Sefaseba, neonataluri periodis

nevrologiuri daavadebebis amocnoba, diagnostika da marTva.3. modulis amocanebi-rezidentma unda icodes:

ა) axalSobilis nevrologiuri Sefasebis skalebi;ბ) axalSobilis eeg da neirovizualizaciuri Taviseburebebi;გ) axalSobilobis periodis nevrologiur daavadebaTa klinikuri Taviseburebebi, diagnostikuri sirTuleebi da marTvis ZiriTadi miznebi:გ.ა) Tavis tvinis hipoqsiur-iSemiuri dazianebebi;გ.ბ) intrakraniuli hemoragiebi;გ.გ) qalas meqanikuri travmiT gamowveuli dazianebebi;გ.დ) zurgis tvinis da mxris wnulis dazianebebi;გ.ე) kerniqterusi;გ.ვ)kunTis tonusis darRvevebi;გ.ზ)metaboluri darRvevebi;გ.თ) Tandayolili infeqciuri daavadebebi;გ.ი) baqteriuli meningiti;გ.კ) neonataluri gulyrebi.



davaleba

neonataluri nevrologia

axalSobilis Sefaseba nevrologiuri gasinjviT; 80 4 referati da 8 Sem


neonataluri eeg da neirovizualizaciuri monacemebis swori interpretireba;

80

neonataluri periodis nevrologiur darRvevaTa amocnoba/diagnostika;

80

neonataluri periodis nevrologiur darRvevaTa marTva.

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6. aucilebeli da rekomendebuli literaturis nusxa:ა)Aicardi J, Diseases of the nervous system in childhood, 3rd edition, 964 p, 2009.

ბ)Futagi Y, Suzuki Y, Toribe Y, Nakano H, Morimoto K. Neurodevelopmental outcome in children with posthemorrhagic hydrocephalus. Pediatr Neurol 2005;33:26-32; გ)Golomb MR, Garg BP, Williams LS. Outcomes of children with infantile spasms after perinatal stroke. Pediatr.Neurol 2006;34:291-295; დ)James J. Filiano, MD, Neurometabolic Diseases in the Newborn,Clin Perinatol 33 (2006) 411– 479; ე)King M.D. Stephenson B.P, A Handbook of neurological investigations in children, 399 p, 2009; ვ)Michael J. Noetzel, MD, Perinatal Trauma and Cerebral Palsy, Pediatr.Neurol 2006;34,120-128;

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ზ)Volpe Joseph J.:Neurology of the Newborn, Fourth edition, 912 p, 2001; თ)Yasuyuki Futagi, MD, Yasuhisa Toribe, MD, Kana Ogawa, MD, and Yasuhiro Suzuki, MD,Neurodevelopmental Outcome in Children With Intraventricular Hemorrhage,Pediatr Neurol 2006;34:219-224.

მუხლი 26. moduli- neiroreabilitaciis safuZvlebi1. xangrZlivoba - 5 Tve2. mizani:

ა) nevrologiur daavadebaTa reabilitaciis neiromecnieruli safuZvlebis codna; ბ) unarSezRudulobis mqone pacientis motoruli da gonebrivi funqciis Sefaseba; გ) neiroreabilitaciuri samedicino problemebis marTva.

3. modulis amocanebi-rezidentma unda icodes:ა) unarSezRudulobis da invalidobis saerTaSoriso klasifikacia;ბ) unarSezRudulobis epidemiologia;გ) reabilitologiis roli;დ) reabilitaciiis mecnieruli safuZvlebi;ე) motoruli kontroli da kunTTa plastikuroba; ვ) kognicia;ზ) aRdgenis biologiuri meqanizmi;თ) zogadi meqanizmebi;ი) eqsperimentuli miRwevebi;კ) pacientis Sefasebis Taviseburebebi;ლ) msxvili motoruli funqciis Sefasebis skala;მ) msxvili motoruli funqciis klasifikacia;ნ) cerebruli damblis simZimis klasifikacia;ო) aqtiuri moZraobis da Zalis skala;პ) kunTTa spastikurobis aSuortis skala;ჟ) yofiTunarianobis barTelis skala;რ) funqciuri damoukideblobis skala;ს) gonebrivi ganviTarebis Sefasebis skalebi asakis mixedviT;ტ)neiroreabilitaciuri mkurnalobis gunduri midgomis prioritetulobis safuZvlebi;უ) kunTTa spastikis paTofiziologia, Sefaseba, biomeqanikuri da eleqtrofiziologiuri teqnikebi, eleqtromiografiuli da kinematuri meTodebi, marTvis fizikuri saSualebebi, eleqtruli stimulacia, farmakoTerapia, qirurgiuli Careva;ფ) kontraqturebis tipebi, sakoreqcio varjiSebi da damxmare saSualebebi;ქ) nevrogenuli Sardis buStis paTofiziologia da marTva;ღ) nawlavTa disfunqciis paTofiziologia da marTva.



davaleba

neiroreabilitologia

unarSezRudulobis gamomwvevi nervuli sistemis daavadebaTa adreuli reabilitaciuri daxmarebis efeqrurobis gaTvaliswinebiTCarevis miznebis gansazRvra

60 6 referati da

24 Sem

Txvevis

pacientis unarSezRudulobis gamomwvevi ZiriTadi problemis gamoyofa, realuri miznebis dasaxva da mkurnalobis xanmokle da

37

xangrZlivi gegmis Sedgena; prezentaciaunarSezRudulobis mqone pacientebis mdgomareobis Sesafaseblad motoruli da gonebrivi funqciis Sefasebis skalebis gamoyeneba;

60

spastikis da kontraqturebis Sefaseba da marTva.

60

nevrogenuli Sardis buStis da nawlavTa disfunqciis Sefaseba da marTva.

30

5. modulis Sefasebis meTodebi:ა) rezidentma unda daweros 3 referati da gaakeTos 12 SemTxvevis prezentacia; ბ) modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.

6. aucilebeli da rekomendebuli literaturis nusxaა)Accardo PJ. Freud on diplegia: Commentary and translation. American Journal of Diseases of Children. 1982;136:452-456;ბ)Batshaw M. In: Children with disabilities. 5th ed. Baltimore: Brooks Publishing Co; 2002;p. 443-466;გ)Bennett F. Diagnosing cerebral palsy–the earlier the better. Contemporary Pediatrics. 1999;16:208-216;დ)Blair E, Stanley F. Interobserver agreement in the classification of cerebral palsy. Developmental Medicine and Child Neurology. 1985;27:615-622;ე)Boyle C, Decoufle P, Yeargin-Allsopp M. Prevalence and health impact of developmental disabilities in US children. Pediatrics. 1994;93:399-403;ვ)Clark SL, Hankins GD. Temporal and demographical trends in cerebral palsy–fact and fiction. American Journal of Obstetrics and Gynecology. 2003;188:628-633;ზ)Dormans JP, Pellegrino L. Caring for children with cerebral palsy. Baltimore: Brooks Publishing; 1998;თ)Fedrizzi E, Facchin P, Marzaroli M, Pagliano E, Botteon G, Percivalle L, et al. Predictors of independent walking in children with spastic diplegia. Journal of Child Neurology. 2000;15:228-234;ი)Futagi Y, Otani K, Goto M. Prognosis of infants with ankle clonus within the first year of life. Brain Development. 1997;19:50-54;კ)Gibson CS, MacLennan AH, Goldwater PN, Dekker GA. Antenatal cause of cerebral palsy: Associations between inherited thrombophilias, viral and bacterial infection, and inherited susceptibility to infection. Obstetrics Gynecology Survey. 2003;58:209-220;ლ)Grether J, Nelson K, Emory E. Prenatal and perinatal factors and cerebral palsy in very low birth weight infants. Journal of Pediatrics. 1996;128:407-414;მ)Han TR, Bang MS, Lim JY, Yoon BH, Kim IW. Risk factors of cerebral palsy in preterm infants. American Journal of Physical Medicine and Rehabilitation. 2005;81:297-303;ნ)Hutton J, Pharoah P. Effects of cognitive, motor, and sensory disabilities on survival in cerebral palsy. Archives of Diseases in Childhood. 2002;86:84-89;ო)Katz RT. Life expectancy for children with cerebral palsy and mental retardation: Implications for life care planning. NeuroRehabilitation. 2003;18:261-270;პ)Kuban K, Leviton A. Cerebral palsy. The New England Journal of Medicine. 1994;330:188-195;

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ჟ)Molnar G. In: Pediatric Rehabilitation. 2nd ed. Baltimore: Lippincott Williams & Wilkins; 1992;p. 492-500;რ)Molnar GE, Gordon SU. Cerebral palsy: Predictive value of selected clinical signs for early prognostication of motor function. Archives of Physical Medicine and Rehabilitation. 1976;57:153-158;ს)Morgan AM, Aldag JC. Early identification of cerebral palsy using a profile of abnormal motor patterns. Pediatrics. 1996;98:642-649ტ)Moster D, Lie RT, Irgens L, Bjerkedal T, Markest;ad T. The association of Apgar score with subsequent death and cerebral palsy: A population-based study in term infants. Journal of Pediatrics. 2001;138:798-803;უ)Pueyo R, Junque C, Vendrell P. Neuropsychologic differences between bilateral dyskinetic and spastic cerebral palsy. Journal of Child Neurology. 2003;18:845-850;ფ)Roberts G, Palfrey J, Bridgemohan C. A rational approach to the medical evaluation of a child with developmental delay. Contemporary Pediatrics. 2004;Retrived May 9, 2004, from www.comtemporypeds.com;ქ)Rosembaum P. Cerebral palsy: What parents and doctors want to know. British Medical Journal. 2003;326:970-974ღ)Rosenbaum PL, Walker SD, Hanna SE, Palisano RJ, Russell DJ, Raina P, et al. Prognosis for gross motor function in cerebral palsy: Creation of motor development curves. Journal of the American Medical Association. 2002;288:1357-1363.

მუხლი 27. mozrdilTa nevrologia1. rezidenti/მაძიებელი muSaobs mozrdilTa nevrologiis dawesebulebaSi

rogorc stacionarul, aseve ambulatorul pacientebTan. eswreba kvleviT Sexvedrebs (radiologiuri, genetikuri, paTomorfologiuri, neirofiziologiuri). moduli SeiZleba gaerTiandes pediatriuli nevrologiis modulTan da SesaZloa moicvas mozardebisTvis gankuTvnili klinika.

2. minimaluri xangrZlivoba - 2 Tve.3. mizani: mozrdili nevrologiuri pacientis gasingva, anamnezis Sekreba,

nevrologiuri statusis Sefaseba, mozrdilTa nevrologiuri daavadebebis kargi codna, pediatriul nevrologiuri daavadebebTan minmarTebaSi TaviseburebaTa codna.

4. modulis amocanebi. 5. rezidentma unda icodes:

ა) mozrdili nevrologiuri pacientis gasinjva;ბ) nevrologiuri statusis Sefaseba;გ) ცნობიერების დარღვევისთვის:

გ.ა) cnobierebis darRvevis Sefaseba, gabrueba, deliriumi, paTologiuri Zilianoba, sopori, koma; გ.ბ) nevrologiuri statusis Sefaseba cnobierebis darRvevis dros, Sesabamisi nevrologiuri kvlevebis warmoeba; გ.გ) cnobierebis daTrgunvis gamomwvevi ZiriTadi daavadebebeis amocnoba, diagnostika, mkurnaloba;

დ) Tavis tkiviliსთვის;დ.ა)Tavis tkivilis epidemiologia, klasifikacia, paTfiziologia;დ.ბ)Tavis tkivilis mqone pacientis Sefasebis Taviseburebebi;დ.გ)diferenciuli diagnozi, kliniko-laboratoriuli testebi;დ.დ)mwvave generalizebuli, mwvave lokalizebuli Tavis tkivili; დ.ე)mwvave morecidive Tavis tkivili /Sakiki, Sakikis variantebi;დ.ვ)qronikuli araprogresirebadi Tavis tkivili;დ.ზ)qronikuli progresirebadi Tavis tkivili;

39

დ.თ)sxvadasxvagvari Tavis tkivili;დ.ი)Tavis tkivilis sindromTa Taviseburebani mozrdilTa asakSi;დ.კ)Tavis tkivilis specifikuri sindromebi;დ.ლ)Tavis tkivilis marTva, farmakologiuri Terapia.

ე)inteleqtis darRvevისთვის:ე.ა) gonebrivi ganviTarebis CamorCena;ე.ბ) demencia;

ვ) Tavbruსთვის:ვ.ა) Tavbrus Sefaseba: vestibularuli Tavbrusxveva, sinkope da kolafsi, wonasworobis kargva, Tavbrusxvevis msgavsi gaurkveveli mdgomareobebi;ვ.ბ )vestibularuli Tavbrus klinikuri da paraklinikuri Sefaseba, kvleva;ვ.გ)vestibularuli TavbruTi da wonasworobis kargviT midinare uxSiresi daavadebebis diagnostika da mkurnaloba; ვ.დ)vestibuluri neironiti, keTilTvisebiani poziciuri Tavbru, posttravmuli Tavbru, menieris sindromi, labirinTiti, funqciuri Tavbru, tvinis Reros gardamavali iSemia, insulti da sxv.;

ზ)zurgis tkiviliსთვის:ზ.ა)malTaSua diskis Tiaqari; ზ.ბ)osteoqondrozi; ზ.გ)spondilolizi da spondilolistozi ;ზ.დ)xerxemlis sxva dazianebani: ankilozirebadi spondiloarTriti, pevmatoiduli arTriti, pejetis daavadeba ;ზ.ე)simsivnis metastazebi ;ზ.ვ)Zvlebis metaboluri dazianebani;

თ)epilefsiისთვის:თ.ა)epilefsiis epidemiologia, paTfiziologia, epilefsiuri gulyrebis klasifikacia, normaluri eeg;თ.ბ)generalizebuli gulyrebi, difdiagnozi, eeg, etiologia, mkurnaloba, prognozi;თ.გ)gansakuTrebuli epilefsiebi-epilefsiuri encefalopaTiebi, difdiagnozi, eeg, etiologia, mkurnaloba, prognozi;თ.დ)parcialuri gulyrebi, klasifikacia, etiologia, eeg, marTvis principebi, antikonvulsantebi, marTvis yvelaze xSiri Secdomebi, qirurgiuli mkurnaloba;თ.ე)kognitiuri simptomebiT mimdinare epileftiformuli darRvevebi, etiologia, paTfiziologia, mkurnaloba;თ.ვ)mioklonia da miokloniuri gulyrebi, klasifikacia, mkurnaloba;თ.ზ)epilefsiuri statusi, paTfiziologia, klasifikacia, epidemiologia, etiologia, marTva, prognozi;თ.თ)antiepilefsiuri medikamenturi mkurnaloba, principebi, farmakokinetika, bavSvTa asakis Taviseburebebi, medikamentebis urTierTqmedeba, farmakodinamika, dozireba da miRebis gzebi, klinikuri da laboratoriuli monitoringi, gverdiTi movlenebi, wamlis SerCeva;თ.ი)ketogenuri dieta, efeqturoba, moqmedebis meqanizmi, kandidatebis SerCeva, Cveneba –u kuCveneba, garTulebebi;თ.კ)epilefsiis mkurnalobis alternatuli meTodebi;თ.ლ)epilefsiuri qirurgia, Cvenebebi, preoperaciuli Sefaseba, miznebi;თ.მ)qceviTi, kogniciuri da socialuri siZneleebi epilefsiis dros;თ.ნ)sinkope, epidemiologia, saxeebi;თ.ო)sxva araepilefsiuri paroqsizmebi;

40

თ.პ)Zilis fiziologia, Zilis darRvevebis mqone pacientis Sefaseba, dissomniebi da parasomniebi, maTi saxeebi;

ი)tvinis sikvdiliსთვის:ი.ა)tvinis sikvdilis kriteriumebi; ი.ბ)qronikuli vegetatiuri mdgomareoba;

კ)cerebrovaskularuli darRvevebi: კ.ა)iSemiuri da hemoragiuli insulti; კ.ბ)sisxlis mimoqcevis gardamavali moSla; კ.გ)subaraqnoidaluri hemoragia; ლ)სimsivneebiსთვის: ლ.ა) Tavis tvinis simsivneebis epidemiologia, sixSire, histopaTologiuri da lokalizaciuri dayofa, diagnostika, marTvis ZiriTadi principebi, qirurgia, radiacia, qimioTerapia;

ლ.ბ)zurgis tvinis simsivneebis tipebi, klinikuri niSnebi, diagnostika, marTva, garTulebebi;ლ.გ)cns-is dazianeba leikemiis da limfomis dros da misi marTva;ლ.დ)cns-is simsivneebis mkurnalobis mogvianebiTi efeqti da axali midgomebi mkurnalobaSi;ლ.ე)avTvisebiani glioma;ლ.ვ)supratentorialuri astrocitoma da oligodendroglioma;ლ.ზ)cns pirveladi limfomebi;ლ.თ)meningiomebi;

ლ.ი)Svanoma; ლ.კ)hiofizis adenoma;ლ.ლ)metastazuri simsivneebi da sxv.;

მ)travma:მ.ა)Comocio, Contusion cerebri ;მ.ბ)epiduruli, subduruli, intracerebruli hemoragia;მ.გ)subaraqnoiduli hemoragia;

ნ)mademielinizebeli daavadebebi:ნ.ა)gafantuli sklerozi;ნ.ბ)optikuri nevriti;ნ.გ)mwvave diseminirebuli encefalomieliti;ნ.დ)mwvave transversiuli mieliti;

ო)toqsiuri da metaboluri darRvevebi:ო.ა)RviZlismieri encefalopaTia;ო.ბ)qronikuli hepatocerebruli degeneracia;ო.გ)vilsonis daavadeba;ო.დ)reies sindromi;ო.ე)uremiuli encefalopaTia;ო.ვ)uremiuli neiropaTia;ო.ზ)hemodializis nevrologiuri garTulebebi;ო.თ)Tirkmlis transplantaciis nevrologiuri garTulebebi;ო.ი)porfiria;ო.კ)mZime metalebiT intoqsikacia;ო.ლ)alkoholuri intoqsikacia, alkoholuri abstinencia;ო.მ)vernikes encefalopaTia;ო.ნ)barbituratebiT intoqsikacia;ო.ო)cns–ze damTrgunveli efeqtis mqone sxva nivTierebebiT intoqsikacia;ო.პ)amfetaminiT, salicilatebiT; ო.ჟ)antidepresantebiT intoqsikacia;

41

ო.რ)avTvisebiani neiroleptiuri sindromi;ო.ს)hipovitaminozebi;

პ)moZraobiTi darRvevebi:პ.ა)piramiduli, naTxemis, qerqqveSa birTvebis dazianeba;პ.ბ)medikamenturi eqstrapiramiduli darRvevebi;პ.გ)parkinsonis daavadeba;პ.დ)hentinqtonis daavadeba;პ.ე)torsiuli distonia, spastiuri kisermrudoba, paroqsizmuli qoreoaTetozi;პ.ვ)tikebi, tremori, mioklonusi;პ.ზ)mousvenari fexebis sindromi;

ჟ)nervkunTovani daavadebebi:ჟ.ა)miopaTiebi;ჟ.ბ)miotoniebi;ჟ.გ)poilimioziti;ჟ.დ)triqinelozi;ჟ.ე)ჟrabdomiolizi; ჟ.ვ)glikogenozebi;ჟ.ზ)paroqsizmuli mioplegiebi;ჟ.თ)miasTenia;ჟ.ი)botulizmi;ჟ.კ)tetanusi;ჟ.ლ)avTvisebiani hiperTermia da avTvisebiani neiroleptiuri sindromi;ჟ.მ)gien-bares sindromi;ჟ.ნ)qronikuli neiropaTiebi /hipovitaminozis, Sqaqriani diabetis, vegetatiuri, toqsiuri neiropaTiebi;ჟ.ო)arxovani neiropaTiebi;ჟ.პ)belis dambla;ჟ.ჟ)gverdiTi amiotrofiuli sklerozi;ჟ.რ)spinaluri amiotrofia.6. Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis


badavaleba

mozrdilTa nevrologia

anamnezuri monacemebis Segroveba, pacientis mier mowodebuli informaciis analizi, ZiriTadi Civilis gamoyofa, pacientis asakis da mdgomareobis mimdinareobis gaTvaliswinebiT daavadebaze eWvis mitana;

30 2 referati da

10 Sem


anamnezuri da nevrologiuri gasinjvis monacemebis safuZvelze saeWvo daavadebis gamoyofa da zusti diagnostikisTvis saWiro kvlevis meTodebis SerCeva;

30


35

eleqrtomiografiuli kvlevis Sedegebis interpretacia

30

laboratoriuli kvlevis monacemTa interpretireba 30pacientisTvis medikamentozuri mkurnalobis adekvaturi SerCeva da marTva;

30

42

7. modulis Sefasebis meTodebi:ა)rezidentma unda daweros 2 referati da gaakeTos 10 SemTxvevis prezentacia. ბ)modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.

8. aucilebeli da rekomendebuli literaturis nusxa:ა)janeliZe m., klinikuri nevrologia, 2009;ბ)Maurice Victor; Aiian H. Ropper; Princioles of Neurology. McGrowhill. 9th edition. 2009. 1572;გ)W. Michael Scheld; Richard J. Whitley; Cristina M. Marria; Infections of the Central Nervous System. Third edition. Lippincott Williams & Wilkins. 2004. p939;დ)M.J.Aminof, D.A.Greenberg, R.P.Simon, Clinical Neurology, Lange, 6th edition,2005, 401p;ე)Kenneth W. Lindsay PHD FRCS. Neurology and Neurosurgery Illustrated. Churchill Livingstone; 2005. 5th edition. p612;ვ)Lewis P. Rowland; Timothy A. Pedley MD. Merritt's Neurology. Lippincott Williams & Wilkins; 12 Har/Psc edition (2009). 1216 pages;ზ)Duglas Gelb MD; Introduction to Clinical Neurology. Oxford University Press, USA; 4th edition (2010). 528 pages;თ)Jose Biller MD, Practical Neurology. Lippincott Williams & Wilkins; 4 th Edition (2012). 748 pages.

მუხლი 28. მოდული - bavSvTa fsiqiatria1. moduli SesaZloa gavlili iqnas arasruli dRis grafikiT an SeTavsebuli iqnas

bazisur pediatriul an pediatr-nevrologiur modulebTan. igi moicavs zedamxedvelobis qveS fsiqiatriuli paTologiis mqone bavSvTa klinikur zedamxedvelobas zogad an neirofsiqiatriul ganyofilebaSi. moduli SesaZloa gaerTiandes sxva bavSvTa nevrologiur modulebTan.2. minimaluri periodi 1 arasruli dRe/kviraSi 6 Tvis manZilze an Sesabamisi eqvivalenti;3.xangrZlivoba: 2 Tve;

4. mizani:ა)bavSvTa asakis qceviTi da emociuri aSlilobebisa da socialuri problemebis safuZvlebis codna; ბ)mentaluri problemebis mqone bavSvis/mozardis da misi ojaxis Sefaseba; გ)fsiqotropuli medikamentebis Cvenebebisa da ukuCvenebebis codna;mentaluri problemebis aramedikamentozuri marTva.

5. modulis amocanebi – rezidentma/maZiebelma unda icodes:ა)mentaluri janmrTelobis perinataluri da adreuli bavSvobis asakis risk da dacviTi faqtorebi;ბ)bavSvTa da mozardTa qceviTi, emociuri da socialuri problemebis epidemiologia;გ)skolamdeli asakis bavSvis socialur-emociuri ganviTareba;დ)mentaluri problemebis, maT Soris:

ე)ganviTarebiTi darRvevebis: ე.ა)daswavlis problemebis;ე.ბ)enuresis;ე.გ)enkoprezis;ე.დ)autisturi speqtris aSlilobebis;ვ)qceviTi darRvevebis:

43

ვ.ა)yuradRebis deficitisa da hiperaqtiurobis sindromis;ვ.ბ)opoziciur-gamomwvevi qceviTi aSlilobis;ზ)guneba-ganwyobis aSlilobebis;ზ.ა)depresiis;ზ.ბ)bipolaruli aSlilobis;ზ.გ)suicidi da TviTdamazianebeli qcevis;ზ.დ)tikozuri aSlilobebis;ზ.ე)SfoTviTi aSlilobebis; ზ.ვ)kvebiTi aSlilobebis;ზ.ზ)somatoformuli aSlilobebis klinikuri gamovlinebebi, SeZlos diagnostika

da marTva multidisciplinur gundTan erTad;თ)fsiqometruli testirebis interpretireba; ი)bavSvTa fsiqiatriis gadaudebeli mdgomareobebis amocnoba da marTva;კ) mentaluri janmrTelobis neiromecnieruli safuZvlebi da misi gamoyeneba klinikur praqtikaSi.



davaleba

bavSvTa fsiqiatria

skolamdeli asakis bavSvis socialur-emociuri ganviTarebis skrininguli da sadiagnostiko Sefaseba

20 2 referati da

6 Sem

Txvevis prezentacia

pacientis da ojaxis problemebis identificireba, miznis gamoyofa, struqturirebuli kiTxvaris gamoyeneba, multidisciplinur gundSi muSaoba

10

qceviTi darRvevebis diagnostika da Terapiis saWiroebis da moculobis gansazRvra

10

autisturi speqtris aSlilobebis skriningi da diagnostika

10

qceviTi da emociuri aSlilobebis multidisciplinuri gunduri diagnostika da marTvis aramedikamenturi meTodebis, maT Soris qceviTi, fsiqoTerapiuli, xelovnebiT Terapiis gamoyeneba

10

7. modulis Sefasebis meTodebi:ა)rezidentma unda daweros ori referati da gaakeTos eqvsi SemTxvevis prezentacia. ბ)modulis Sefaseba xdeba xelmZRvanelis mier yoveli Tvis bolos zepiri gasaubrebis gziT, modulis testuri (dadebiTi pasuxi testebis >75%) CaTvlis da unar-Cvevebis aTvisebis donis Semowmebis gziT.

8. aucilebeli da rekomendebuli literaturis nusxa:ა)oqsfordis mokle saxelmZRvanelo fsiqiatriaSi, me-5 gamocema, maikl gelderi, pol harisoni, filip qoueni, globaluri iniciativa saqarTveloSi, Tbilisi, 2012;ბ)Fleischhacker WW and Brooks DJ, Neurodevelopmental Disorders, Springer Wien NewYork, 2005;გ)Klykylo WM, Kay J, Clinical Child Psychiatry, John Wiley & Sons, 2005;დ) Rey J. M. (editor) IACAPAP Textbook of Child and Adolescent Mental Health, IACAPAP, Geneva, 2012;

44

ე)http://www.medscape.com/resource/child-adolescent-psychiatryhttp://iacapap.org/publications

მუხლი 29. specialuri sferoebi

pediatriul nevrologiaSi zogierTi sfero saWiroebs sagangebo swavlebas. isini ar aris savaldebulo. rezidentma SesaZloa moindomos am sferoSi fokusireba pedagogTan SeTanxmebiT. qvemoT mocemulia zogierTi:

ა)pediatriuli neiroimijingi;ბ)pediatriuli neirofiziologia;გ)pediatriuli nevropaTologia;დ)neirogenetika;ე)pediatriuli neirometaboluri daavadebebi;ვ)pediatriuli neirointensiuri marTva;ზ)neonataluri nevrologia;თ)pediatriuli epileftologia;ი)pediatriuli da mozardTa neirofsiqiatria.

muxli 30. kvleviTi treningikvleviTi treningi pediatriul nevrologiaSi-mniSvnelovania rom rezidentebi/მაძიებლები CarTuli iyvnen kvlevaSi. rigi dawesebulebebi saTanadodaa aRWurvilia kvleviTi treningebis Casatareblad, kvlevis zedamxedvelobisa da kvleviTi jgufebis organizebisaTvis. kvlevis klinikuri nawili ganxilul unda iyos rogorc maTi klinikuri modulis nawili kursis xelmZRvanelTan SeTanxmebiT da qveynis kanonmdeblobis gaTvaliswinebiT;

muxli 31. pedagogebi1. saswavlo kurss xelmZRvanelobs pedagogiur da klinikur sferoSi gamocdili bavSvTa nevrologi. სasurvelia, mas hqondes bavSvTa nevrologiis sferoSi samecniero muSaobis gamocdileba. igi ecnoba yvela rezidents kursis dawyebisas, meTvalyureobs programas da afasebs rezidentTa swavlebas yovelwliurad;2. xanmokle periodis ganmavlobaSi TiToeuli rezidentis saqmianobas meTvalyureobs pedagogi. rezidenti awarmoebs dRiurs, romelSic asaxulia yvela misi aqtivoba;3. modulis warmatebiT dasruleba dasturdeba saTanado mowmobiT, romelic detalurad asaxavs rezidentis mier gaweul samuSaos da aTvisebul masalas.

muxli 32. saswavlo bazasaswavlo baza-swavleba mimdinareobs Sesabamis centrebsa da ganyofilebebSi, romelTa SerCeva warmoebs klinikuri da pedagogiuri SesaZleblobebis gaTvaliswinebiT da maTi SesabamisobiT modulebis moTxovnilebebTan.

muxli 33. swavleba1. swavleba - rezidentis swavlebis sakiTxebi unda iTvaliswinebdes Sesabamisi kompetenciebis specifikas:a) pacientis kontrolirebadi zrunva/movlis gamocdileba pasuxismgeblobis TandaTanobiTi matebiT, maT Soris ambulatoriuli da stacionaruli:

a.ა)anamnezis Segroveba pacientisa da misi ojaxis wevrebisgan an sxva naTesavebisgan;

45

http://iacapap.org/publications

http://www.medscape.com/resource/child-adolescent-psychiatry

a.ბ)fizikuri da nevrologiuri gasinjvis Sesruleba;a.გ)diferenciuli diagnostikis ganviTareba, maT Soris savaraudo nevrologiuri lokalizacia da/an genetikuri an metaboluri anomaliebi;a.დ)diagnostikisTvis laboratoriuli, radiologiuri da eleqtrofiziologiuri Sefasebis ganviTareba da implementacia;a.ე)testirebis Sedegebis interpretacia;a.ვ)Terapiuli gegmis ganviTareba da implementacia;a.ზ)pediatriul gundTan, kvebasTan, fizikur da okupaciur a.Terapiasa da jandacvis damxare sxva konsultantebTan SeTanxmebiT zrunva/movlis gegmis koordinireba

b) konsultireba pediatriuli gadaudebeli daxmarebis, neonataluri da pediatriuli intensiuri Terapiis ganyofilebebSi sicocxlisaTvis saxifaTo nevrologiuri darRvevis mqone pacientis marTvisas. nevrologiuri procedurebis kontrolirebadi Sesruleba palataSi, intensiuri Terapiis ganyofilebasa da klinikaSi, maT Soris: lumbaluri punqcia; kaloriuli cda; edrofoniumis testi.d) nevropaTologiur servisSi rotireba, sadac unda Seasrulos:

d.ა)Tavisa da zurgis tvinis avtofsiuri masalis momzadeba da saTanado Senaxva;d.ბ)pediatriul nevropaTologiur konferenciaze SemTxvevis prezentaciis momzadeba da wardgena; d.გ)mozrdilTa da pediatriul nevropaTologiur konferenciebze daswreba.

e) klinikur konferenciebSi aqtiuri monawileoba, maT Soris:e.ა)neiroradiologiur;e.ბ)klinikuri SemTxvevebis yovelkvireul;e.გ)pediatriul nevropaTologiur;e.დ)epilefsia/eeg-s konsensus-ganxilvebSi.

2. samedicino codna:a) klinikuri swavleba zeda kursis rezidentebis da eqimebis mier swavlebis kursis dros ambulatoriuli da stacionaruli servisebis ganxorcielebisas.b) klinikuri swavleba pediatriuli reabilitaciis, bavSvTa fsiqiatriis, epilefsiis, neirofiziologiis da pediatriuli nevrologiis qvespecialobebSi rotaciisas;g) SemTxvevaTa ganxilvebi nevrologiaSi, neiroradiologiaSi, nevropaTologiaSi da eeg/neirofiziologiaSi;d) didaqtiuri leqciebi klinikur nevrologiaSi da neiromecnierebebSi, maT Soris yovelkvireuli ganyofilebis Semovlebi;e) nabeWdi teqსtidan, Jurnalebidan da eleqtronuli resursebidan bavSvTa nevrologis ZiriTadi kurikulumis Sesabamisi masalis damoukideblad swavla;v) internetidan masalis moZieba klinikuri muSaobisa da swavlisTvis;z) saganmanaTleblo lokalur da qveynis masStabiT mimdinare kursebSi (maT Soris uwyveti samedicino ganaTlebis) monawileoba;

3. interpersonuli da komunikaciuri unar-Cvevebi:ა)monawileoba interdisciplinuri gundis muSaobaSi;ბ)pacientis marTvisas gamoyenebul sakonsultacio servisebTan komunikacia;გ)ojaxTan Sexvedrebis xelmZRvaneloba pacientis, marTvis gadawyvetilebis, sicocxlis bolo etapis gadawyvetilebis, servisis gagrZelebis gadawyvetilebis Sesaxeb informaciis gaziarebisTvis;დ)yoveldRiuri kursusebis, klinikuri aRniSvnebis da gaweris epikrizis warmoeba.

46

4. praqtikaze dafuZnebuli swavleba da misi gaumjobesebaა) SemTxvevaTa ganxilvis konferenciebSi monawileoba;

ბ)Cvenebis mixedviT klinikuri meTodis gamoyeneba;გ)gamoqveynebuli praqtikuli parametrebis mimoxilva.

5. profesionalizmi:ა)klinikis interdisciplinuri gundis muSaobaSi monawileoba;ბ)eTikuri normebi (maT Soris, pospitalis Sinaganawesis, paliatiuri movlis, Tavis tvinis sikvdilis, reanimaciul RonisZiebebis ardaqvemdebarebuli SemTxvevebis Sesaxeb).

6. sistemaze dafuZnebuli praqtika:ა)klinikaSi muSaoba bavSvisa da misi ojaxisaTvis da lideris rolis TandaTanobiT mateba; ბ)internet-gverdebis perioduli mimoxilva axali praqtikuli parametrebis da gaidlainebis gasacnobad;გ)daavadebaTa an mSobelTa organizaciebis, maTi samarTlebrivi dacvis meqanizmebis codna;დ)ambulatoriuli pacientis xangrZlivi marTva.

მუხლი 34. swavlebis meTodebi1. didaqtikuri meTodi - orsaaTiani swavleba kviraSi 3 jer, nevrologiis ZiriTad sakiTxebze, maT Soris 4 kvira gadaudebeli nevrologiis sakiTxebis ganxilviT;2. rezidentis mier pacientis gasinjva/ganxilva kviraSi orjer, maT Soris, 4

kvira gadaudebeli nevrologiuri mdgomareobebis mqone pacientTa;3. rezidenturis xelmZRvanelis mier kviraSi 2 pacientis saCvenebeli

gasinjva/ganxilva sruli anamneziT, istoriiT da diskusiiT;4. yovelwliurad 5 pacientis SemTxvevis momzadeba prezentaciisaTvis;5. kursis xelmZRvanelTan erTad TveSi½1 Ramis morigeobis Sesruleba.

muxli 35. Sefaseba/gamocda

1. saboloo Sefasebis mizani ar unda iyos ubralod ,,yvela grafis Sevseba”, aramed mTeli saswavlo kursis Sedegebis analizi da imis gansazRvra ramdenad Seesabameba rezidentis codna arsebul standartebs;2. rezidenturis swavlebis kursis ganmavlobaSi rezidentis Sefaseba unda moxdes kompetenciebis specifikis gaTvaliswinebiT:

a) I. pacientze zrunva/movla:a.a) saerTo da kompetencia-specifikuri Sefaseba damswre eqimis mier

palatasa da klinikur sesiebze. a.b) saerTo da kompetencia-specifikuri Sefaseba zeda kursis rezidentis da

mozrdilTa nevrologiis rotaciaze myofi rezidentis mier;a.g) monawileoba bavSvTa nevrologis stacionarul gundSi, ambulatoriul

klinikaSi, gadaudebel ganyofilebaSi, intensiuri Terapiis ganyofilebaSi, reabilitaciur ganyofilebaSi;

a.d) monawileoba bavSvTa nevrologisTvis Sesabamis klinikur konferenciebSi;

a.e) anamnezis Segrovebis, nevrologiuri gasinjvis, diagnostikis da marTvis codnis gamomJRavneba konsiliumebsa da saintereso SemTxvevebis ganxilvebze;

47

a.v) procedurebis Sesrulebis Sefaseba;a.z) kt, mrt, eeg, emg, neirosonografiuli kvlevebis, specifikuri

bioqimiuri/genetikuri testirebis, neirofsiqiatriuli testirebis, antikonvulsantebis da fsiqofarmakologiuri medikamentebis Rirebulebis codnis gamomJRavneba.

b) samedicino codna:b.a) saerTo da kompetencia-specifikuri Sefaseba damswre eqimis mier

palatasa da klinikur sesiebze;b.b) saerTo da kompetencia-specifikuri Sefaseba zeda kursis rezidentis da

mozrdilTa nevrologiis rotaciaze myofi rezidentis mier;b.g) Sefaseba rezidentis yovelwliur gamocdaze;b.d) monawileoba stacionarul nevrologiur gundSi, konsultaciebSi

gadaudebeli daxmarebis departamentSi, intensiuri Terapiis ganyofilebaSi, reabilitaciis ganyofilebaSi;

b.e) monawileoba bavSvTa nevrologiis ambulatoriul klinikaSi;b.v) monawileoba klinikur konferenciebSi (dilis konferencia, bavSvTa

nevrologiuri SemTxvevebis ganxilva, Semovla, bavSvTa nevrologiis qvespecialobebis da Sesabamis neiromecnierebebis konferenciebi);

b.z) yovelkvireul nevrologiur da pediatrul Semovlebze daswreba;b.T) rezidenturis finalur gamocdaze Sefaseba;b.i) samedicino da mecnieruli, maT Soris biblioTekis da eleqtronuli,

pacientis/ojaxis an daavadebis mixedviT Seqmnili jgufebisa da organizaciebis resursebis codnis demonstrireba diagnostikis, marTvisa da mkurnalobisTvis;

g) interpersonuli da komunikaciuri unar-Cvevebi:g.a) saerTo da kompetencia-specifikuri Sefaseba damswre eqimis mier

palatasa da klinikur sesiebze;g.b) saerTo da kompetencia-specifikuri Sefaseba zeda kursis rezidentis da

mozrdilTa nevrologiis rotaciaze myofi rezidentis mier;g.g) istoriebis sistematuri mimoxilva;g.d) pacientTan/ojaxTan interviuebsa da urTierTobebze dakvirveba; g.e) monawileoba stacionarul nevrologiur gundSi, gadaudebel, intensiur

Terapiis da reabilitaciis ganyofilebaSi konsultaciebSi;g,v) monawileoba bavSvTa nevrologiis ambulatoriul klinikaSi, maT Soris

eqimTan pacientis prezentacia, referirebul eqimTan, janმრთელობის dacvis sxva personalTan, konsultantebTan, skolis pedagogTan, mSoblebTan/ojaxis wevrebTan komunikacia;

g.z) klinikur konferenciebze pacientis prezentacia da ganxilva;g.T) avadoba-letalobis konferenciebis momzadeba da prezentacia;g.i) bavSvTa nevrologiis SemTxvevebis pediatriul dilis konferenciebze

moxseneba; d) praqtikaze dafuZnebuli swavleba da misi gaumjobeseba:

d.ა)saerTo da kompetencia-specifikuri Sefaseba damswre eqimis mier palatasa da klinikur sesiebze;d.ბ)saerTo da kompetencia-specifikuri Sefaseba zeda kursis rezidentis da mozrdilTa nevrologiis rotaciaze myofi rezidentis mier;

d.გ)departamentis da ganyofilebis SemTxvevaTa ganxilvis konferenciebSi monawileoba;

d.დ)avadoba-letalobis konferenciebSi monawileoba;d.ე)monawileoba stacionarul nevrologiur gundSi, gadaudebel, intensiuri Terapiis da reabilitaciis ganyofilebaSi konsultaciebSi, maT Soris mSoblebTan/ojaxis wevrebTan SexvedrebSi, komunikacia pediatriul

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rezidentebTan, janმრთელობის dacvis sxva personalTan, socialur muSakebTan da sxva konsultantebTan;

d.ვ)monawileoba bavSvTa nevrologiis ambulatoriul klinikaSi, maT Soris, eqimTan pacientis prezentacia, komunikacia referirebul eqimTan, janმრთელობის dacvis sxva personalTan, mSoblebTan/ojaxis wevrebTan;

d.ზ)pacientis movla/zrunvisas protokolis gamoyeneba;d.თ)gamoqveynebuli praqtikuli parametrebis codnis demonstrireba;d.ი)klinikur konferenciebze SemTxvevaTa prezentacia da ganxilva;d.კ)avadoba-letalobis konferenciis momzadeba, prezentacia da daswreba;d.ლ)samedicino da mecnieruli resursebis, maTYSoris biblioTekis, eleqtronuli biblioTekis da monacemTa bazebis, farmakologiur monacemTa bazis codnis demonstrireba.e) profesionalizmi;e.a) saerTo da kompetencia - specifikuri Sefaseba damswre eqimis mier

palatasa da klinikur sesiebze;e.b) saerTo da kompetencia-specifikuri Sefaseba zeda kursis rezidentis da

mozrdilTa nevrologiis rotaciaze myofi rezidentis mier;e.g) monawileoba stacionarul nevrologiur gundSi, gadaudebel, intensiur

Terapiis da reabilitaciis ganyofilebaSi konsultaciebSi, maT Soris mSoblebTan/ojaxis wevrebTan SexvedrebSi, janმრთელობის dacvissxva personalTanda sxva konsultantebTan ;

e.d) monawileoba bavSvTa nevrologiis ambulatoriul klinikaSi, maT Soris eqimTan pacientis prezentacia, komunikacia referirebul eqimTan, janმრთელობის dacvis sxva personalTan, konsultantebTan;

e.e) avadoba-letalobis konferenciis momzadeba, prezentacia da daswreba;e.v) eqvsTviani sruli mimoxilva;e.z) samedicino da mecnieruli resursebis, maTYSoris saerTaSoriso

konferenciebis da kongresebis, biblioTekebis (eleqtronuli da beWdviTi), farmakologiuri da samedicino monacemTa eleqtronuli bazebis codnis demonstrireba;

e.T) nevrologiis da pediatriis kurikulumSi Semavali eTikuri modulis gavla. v) sistemaze dafuZnebuli praqtika:

v.a) saerTo da kompetencia-specifikuri Sefaseba damswre eqimis mier palatasa da klinikur sesiebze;

v.b) saerTo da kompetencia-specifikuri Sefaseba zeda kursis rezidentis da mozrdilTa nevrologiis rotaciaze myofi rezidentis mier;

v.g) kompetenciebis Sesabamisi samedicino Canawerebis mimoxilva;v.d) nevrologiur jandacvis gundSi monawileoba;v.e) monawileoba bavSvTa nevrologiis ambulatoriul klinikaSi pacientis

marTvis procesSi, komunikacia damswre da referirebul eqimTan, janმრთელობის dacvis sxva personalTan;

v.v) jandacvis gundis komponentebis, maT Soris, movlis, fizikuri Terapiis, okupaciuri Terapiis, metyvelebis Terapiis, socialuri servisis, ganaTlebis da SemTxvevis marTvis;

v.z) socialuri servisis da pacientis dacvis hospitalSiga resursebis codnis demonstrireba;

v.T) Sesabamisi samedicino Canawerebis warmoebis demonstrireba. klinikur konferenciebSi monawileoba;

v.i) konsensusze damyarebuli praqtikuli gaidlainebis da resursebis codnis demonstrireba;

49

v.k) pacientTa dacvis lokaluri da saxelmwifo organizaciebis codna da am organizaciebTan dakavSirebis unari.

3. rezidentis pirveli Sefasebaa) unda moxdes rezidenturis dawyebidan pirvel 6 TveSi. formebi rezidentis

kursis ganmavlobaSi SefasebisTvis mocemulia qvemoT; b) uSualo dakvirvebis forma:forma ivseba rezidentze dakvirvebisas misi klinikuri diagnostikis procesSi

kom

pete

ntur

i

iviT

are

bs

kom

peSe

usab

amo

an

ar

pacientis movla/zrunvayuradRebas amaxvilebs ojaxis momarTvis mizezze agrovebs dawvrilebiT monacemebs ganviTarebis Sesaxeb, maT Soris:

iyenebs ganmartebul Sesabamis SekiTxvebs “ganviTarebis” mTavari Civilis asaxsnelad

mimoixilavs sistemebs ise, rom SekiTxvebi moicavdes ganviTarebis Sesaxeb monacemebs

krebs informacias ojaxis Sesaxeb ganviTarebasTan kavSirSi

asrulebs srul pediatriul-nevrologiur Sefasebasadekvaturad ganumartavs ojaxs daxmarebebs rTavs ojaxs mkurnalobis/moqmedebebis gegmis gansazRvraSiinterpersonuli da komunikaciuri unar-Cvevebidiagnozis da marTvis Sesaxeb informacias awvdis gulisxmierad, damajereblad da ara-ganaCenis saxiTganumartavs ojaxs ganviTarebiTi unarSezRudulobis Sedegebsaxorcielebs aqtiur mosmenasCans manugeSebeli da auCqarebeli Sesabamisad afasebs mSoblebis wuxilis xarisxs; vizitis dros da moculobas marTvas adekvaturadbavSvs ganviTarebis etapis Sesabamisad rTavs vizitisas gansaxilvel sakiTxebSi acnobierebs Tarjimnis saWiroebas; iyenebs Tarjimans efeqturad

------------------------------------------------------------------------ -------------------------------------------------------------------- --------------rezidentis saxeli da gvari xelmoweriT damswres saxeli da gvari xelmoweriT TariRikomentarebi---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

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--------------------------------------------------------------------------------------------------------------------------------------g) pediatriuli rezidentis Sefaseba:

nevrologiuri gasinjvis Sefasebis forma ki arapre- da postrotaciuli SefasebaCanawerizogadigasinjvismonacemebisSesaxeb (mag.: dismorfuliniSnebi, yiflibandi, kefisgabrtyeleba, kardialurianomaliebi, hepatosplenomegalia, kanismieridazianebebi)Canaweri mentaluri statusis Sesaxeb (mag.: orinetacia, sifxizle, metyveleba da saWiroebis SemTxvevaSi inteleqtis Sefasebis Sedegi) kraniuli nervebi

II – fundoskopia, mxevelobis veli, mxedvelobis simaxvile, quTuTos daxuWvis refleqsi

III, IV, VI – SeuRlebuli moZraobebi, strabizmi, eqstraokuluri moZraobebi, ftozi

V – mgrZnobeloba, kornealuri refleqsi VII – saxis kunTebis Zala VIII – smena, nistagmi IX/XII – mkerd-laviw-dvrilisebri kunTis Zala, ena

motoruli masa tonusi (mag.: traqciaze pasuxi, horizontaluri/vertikaluri

dakideba, kidurebis tonusi) Zala motoruli ganviTareba

siaruli (mag.: sxeulis wonis tareba, TiTebi, quslebi, tandemuri siaruli, rombergis niSani)koordinacia (mag.: dismetria an saTamaSomde miwvdena, swrafi alternatiuli moZraobebi, muxl-quslis cda, cxvir-TiTis cda)refleqsebi (mag.: Rrma refleqsebi, martivi refleqsebi, maT Soris moros, kisris tonuri, yrdnobis, paraSutis)mgrZnobeloba (mag.: tirili, lokalizeba, mizanmimarTuli moSoreba, spinaluri done, dorzaluri svetis – vibraciuli, propriocepcia, temperatura, Sexeba)

1. gasinjvas eswreboda -----------------------------------------------/xelmowera/2. rCevebi/fokusirebis sfero ----------------------------------------------------------

4. Sefaseba unda moxdes pacientis sawolTan, xelmZRvanelis mier rezidentis muSaobaze dakvirvebiT. is unda grZeldebodes 1 saaTi da Sedgebodes Semdegi nawilebisagan:

ა)anamnezis Sekreba - 30 wuTi;ბ)nevrologiuri gasinjva, Sefaseba 15 wuTi;გ)Sedegebis interpretacia - 15 wuTi.

5. qulebis 50% mogrovebis SemTxvevaSi, barieri daZleulad iTvleba.amave periodSi xdeba dakvirveba unar-Cvevebze da maTi Sesrulebis xarisxze. dgeba CamonaTvali in unarebis, romelTa gaumjobesebaze saWiroa muSaoba.

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6. meore Sefaseba igive programiT xdeba rezidenturis pirveli wlis bolos. am SemTxvevaSi, barieri daZleulia, Tu rezidentma moagrova qulaTa 80%.

7. rezidentis saboloo Sefaseba xdeba finalur gamocdaze, romelic Sedgeba zepiri da weriTi nawilisgan. rezidenturis zepiri gamocda unda Catardes kursis dasrulebamde ramodenime TviT adre, raTa SesaZlebeli iyos arsebuli xarvezebis gamosworeba.

8. zepiri gamocda unda iTvaliswinebdes Sefasebas 4 sferoSi: ა)anamnezis Sekreba;ბ)nevrologiuri gasinjva;გ)profesionalizmi da konsultirebis unari;დ)prezentacia/formulirebis unari;

ე)rezidentis mier gasinjuli unda iyos misTvis (da sasurvelia, danarCeni rezidentebisTvisac) ucnobi 3 bavSvi an mozardi, romelTagan erTi aucileblad iqneba 2 wlamde asakis da erTi – kritikul mdgomareobaSi myofi; ვ)pacientebis SerCevas awarmoebs rezidenturis programis xelmZRvaneli (an komitetis Tavmjdomare);

ზ)TiToeul rezidents damoukideblad afasebs minimum 3 sertificirebuli (da komitetis wevri) bavSvTa nevrologi Sesabamisi qulebiT (gamocdebis dros gamosayenebeli specialuri Sefasebis formebi warmodgenilia damatebis saxiT); თ)Sefasebis erTi dRe unda gagrZeldes daaxloebiT 1 saaTi. rezidents unda mieces maqsimum 45 wuTi anamnezis Sesagroveblad da nevrologiuri gasinjvisaTvis. damatebiT eZleva 15 wuTi Sedegebis Sesajameblad da prezentaciisTvis.

9. Sefasebis komponentebi da kriteriumebi:ა) anamnezis Sekrebis unari;

ბ) kompetenciebis RerZs warmoadgens rezidentis mier pacientis daavadebis naTeli, zusti istoriis Sekrebis unari. bavSvTa nevrologi unda flobdes unars istoriis mixedviT moaxdinos daavadebis diagnostika da dazianebis lokalizacia. Semfasebeli akvirdeba am unars da misi gamxorcielebis Tanmimdevrobas; გ)rezidentma SeiZleba sxvadasxva strategia gamoiyenos anamnezis Sesagroveblad, magram Sedegad unda moagrovos srulyofili informacia qvemoT CamoTvlil sakiTxebze:

გ.ა)daavadebis amJamindeli istoria;გ.ბ)daavadebis adreuli istoria;გ.გ)ojaxuri anamnezi;გ.დ)socialuri anamnezi;გ.ე)sxva sistemebis Sesaxeb monacemebi.

დ)Sefasebul unda iyos monacemTa xarisxi da maTi amomwuravoba.garda nevrologiuri anamnezisa rezidentma yuradReba unda gaamaxvilos im sistemebze da faqtorebze, romlebis maprovocirebel an etiologiur faqtorebs SeiZleba warmoadgendnen. mag.: pediatriuli insultis dros unda dazustebul iyos gulis paTologiis arseboba/ ararseboba. Tavis tkivilis dros maprovocirebeli faqtorebi - gadaRla, stresi da a.S.pacientis asakis da inteleqtis mixedviT rezidents unda SeeZlos strategiis Secvla. Semfasebeli akvirdeba rezidentis moqnilobasa da komunikaciis unars;ე)rezidenti ar unda ecnobodes pacientis adreul istorias (Tu arsebobs) Canawerebis mixedviT, aramed TviTon unda SeZlos amomwuravi informaciis Segroveba pacientisa Tu misi ojaxis wevrebisagan;ვ)rezidentma unda moipovos informacia daavadebis xangrZlivobisa da mimdinareobis Sesaxeb. Umjobesia, rom es procesi qronologiis mixedviT iyos,

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Tumca sxva strategiac misaRebia Tu saboloo amocana kargad iqneba Sesrulebuli;ზ)daavadebis xangrZlivi mimdinareobis SemTxvevaSi, rezidentma unda daafiqsiros axali niSnebi an cvlilebebi niSnebSi, Tu paroqsizmuli daavadebaa zustad unda aRnusxos SetevaTa xasiaTi da raodenoba, aseve, xangrZlivoba, maprovocirebeli da Semamsubuqebeli faqtorebi. rezidentma unda SearCios SekiTxvebi da aRmoaCinos rogorc mniSvnelovani “plus” (igulisxmeba axlad ganviTarebuli simptomebi), aseve “minus” (romlebic an ar arian, an aRar arian) simptomebi. es gulisxmobs tkivilis arsebobas, cnobierebis Secvlas, sisustis ganviTarebas da sxva;თ)rezidentis mier Segrovili samedicino informaciiT Semfaseblisa da rezidentis mier SesaZlebeli unda iyos nevrologiuri daavadebis bunebis dadgena;

10. nevrologiuri gasinjvis unar-Cveva:ა) bavSvTa nevrologisTvis mTavar klinikur unar-Cvevas swored srulyofili nevrologiuri gasinjva warmoadgens;ბ) gasinjva aucileblad unda Seicavdes mentaluri statusis, dgoma-siarulis, motoruli, sensoruli sferos, koordinaciis, kraniuli nervebis da refleqsebis kvleva-Sefasebas. garda zogadi gasinjvisa, TiToeuli sferos gamokvlevisas rezidenti unda iTvaliswinebdes pacientis problemebs da Sesabamis sferos ufro detalur Sefasebas awarmoebdes. mag: mexsierebis problemebis dros mentaluri statusi ufro detalurad unda Seiswavlos, vidre periferiuli nervis parezis SemTxvevaSi;გ) zogadi gasinjva rezidentis kompetenciaSi ar Sedis, Tumca Tu saWiroa unda SesZlos misi elementebis gamoyeneba; დ) unda Sefasdes rezidentis urTierToba pacientTan: xom ar iyo uxeSi? tkivilis arsebobisas gaiTvaliswina gasinjvisas es Tu ara? sworad Caatara gasinjva? ama Tu im refleqsis gamowveva sworad iyo Catarebuli Tu ara? xom ar gamotova gasinjvis mniSvnelovani detalebi? amoicno Tu ara mniSvnelovani niSnebi? sworad Seafasa maTi klinikuri Rirebuleba Tu ara? gasinjvisas gaiTvaliswina anamnezi da Civilebi, Tu trafaretulad Caatara gasinjva? gasinjviT miRebuli Sedegebis analizis Semdeg dasva Tu ara damatebiTi kiTxvebi? SeZlo Tu ara gasinjvis Sedegebis mixedviT dazianebis lokalizaciis dadgena;ე) gasinjvis damTavrebis Semdeg, rezidents da Semfasebels unda hqondes naTeli warmodgena nevrologiuri daavadebis bunebis da paTologiuri procesis lokalizaciis Sesaxeb. miRebuli Sedegebi unda eTanxmebodes pacientis anamnezur monacemebs. 11. profesionalizmi da konsultirebis unari:ა) pacientTan da mis ojaxTan efeqturi komunikaciis unari erT-erT mTavar kompetencias warmoadgens. efeqturi komunikacia aris mkurnalobis procesSi Zalian saWiro pacient-eqimis kavSiris Camoyalibebis safuZveli. Sefasebisas unda dadgindes ramdenad Seiswavla rezidentma es kompetencia; ბ) Sefaseba iwyeba rezidentis pacientTan SexvedriT. komunikacia gulisxmobs rogorc verbalur, aseve araverbalur urTierTobas. unda dadgindes ramdenad moaxerxa rezidentma gasinjvis dros urTierToba pacientTan, gansakuTrebiT sxvadasxva asakis bavSvebTan.;გ) rezidenti sensitiuri unda iyos eTikuri, kulturuli da religiuri sakiTxebis mimarT; დ) unda Sefasdes rezidentis dialogi pacientsa da mis ojaxTan. ramdenad komfortuli iyo es dialogi ojaxisaTvis? Camoyalibda Tu ara pozitiuri ganwyoba? moeqca Tu ara pativiscemiT pacientsa da mis ojaxs? xom ar iyo uxeSi, imperatiuli? ahyva Tu ara pacientis an ojaxis komentarebs? bolomde moTminebiT moismina kiTxvebze pasuxebi Tu ara? Tu kiTxva gaugebari iyo ojaxisa da pacientisaTvis, gaimeora an Secvala kiTxvis forma ufro gasagebi

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rom gamxdariyo Tu ara? auxsna gasagebad gasinjvis Sedegebi da SesaZlo daavadeba Tu ara.

12. prezentacia-unda Sefasdes rezidentis mierpacientis SemTxvevis moxsenebis da ganxilvis unary.13. saboloo Sefaseba-saboloo Sefaseba emyareba zemoT aRwerili oTxi komponentis Sedegebs.

14. klinikuri unar-Cvevis dadebiTi SefasebisaTvis rezidentma unda daimsaxuros minimum 5 qula TiToeul kompetenciaSi. qvemoT mocemulia Sesafasebeli formebi oTxive sferosTvis. 15. anamnezis Segrovebis Sesafasebeli forma:qula anamnezis Segrovebis unaris Sefasebis kriteriumebi8 gansakuTrebuli anamnezi Segrovda unaklod. anamnezi zustad xsnis

nevrologiur daavadebas 7 saukeTeso anamnezSi aris Zalian umniSvnelo defeqtebi an

uzustoba6 Zalian kargi anamnezSi aris mcire defeqtebi an uzustoba5 kargi anamnezSi aris defeqtebi an uzustoba, magram

monacemebi sakmarisia SemTxvevis formulirebisTvis4 mosazRvre,

magram miuRebeli

anamnezSi aris iseTi defeqtebi an uzustoba, ris gamoc daikarga informacia

3 aradamakmayofilebeli

anamnezSi aris iseTi didi defeqtebi an uzustoba, ris gamoc daikarga mniSvnelovani informacia

2 cudi gamotovebulia anamnezis ZiriTadi nawili, ris gamoc SemTxveva Sefasda araadekvaturad

1 Zalian cudi anamnezis Sekreba imdenad cudad moxda, rom rezidentma ver gaacnobiera SemTxveva

16.nevrologiuri gasinjvis Sesafasebeli formaqula nevrologiuri gasinjvis Sefasebis kriteriumebi8 gansakuTrebuli nevrologiuri gasinjva Sesrulda unaklod7 saukeTeso nevrologiuri gasinjva Sesrulda Zalian umniSvnelo

defeqtebiT an uzustobiT6 Zalian kargi mcire defeqtebi an uzustoba nevrologiuri gasinjvisas5 kargi defeqtebi an uzustoba nevrologiuri gasinjvisas, magram

inaxa sakmarisi monacemebi SemTxvevis formulirebisTvis

4 mosazRvre, magram miuRebeli

nevrologiuri gasinjvis iseTi defeqtebi an uzustoba, ris gamoc daikarga informacia


nevrologiuri gasinjvis iseTi didi defeqtebi an uzustoba, ris gamoc daikarga mniSvnelovani informacia

2 cudi gamorCa nevrologiuri gasinjvis ZiriTadi nawili, ris gamoc SemTxveva Sefasda araadekvaturad

1 Zalian cudi nevrologiuri gasinjva imdenad cudad moxda, rom rezidentma ver gaacnobiera SemTxveva

17.profesionalizmisa da konsultirebis unaris Sesafasebeli formaqula profesionalizmisa da konsultirebis unaris Sefasebis

kriteriumebi8 gansakuTrebu

liefeqturi komunikaciis unar-Cvevebi da pacient-eqimis urTierToba

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7 saukeTeso umniSvnelo problemebi komunikaciasa da pacient-eqimis urTierTobaSi

6 Zalian kargi mcire problemebi komunikaciasa da pacient-eqimis urTierTobaSi

5 kargi problemebi komunikaciasa da pacient-eqimis urTierTobaSi, magram urTierTgagebis SenarCuneba


problemebi komunikaciasa da pacient-eqimis urTierTobaSi, ris gamoc urTierTgageba mosazRvrea an ar aris kargi


didi problemebi komunikaciasa da pacient-eqimis urTierTobaSi, urTierTgagebis SeuZlebloba

2 cudi didi problemebi komunikaciasa da pacient-eqimis urTierTobaSi, uxeSoba an usiamovneba

1 Zalian cudi komunikacia da pacient-eqimis urTierToba imdenad cudi iyo, rom saWiro gaxda gamomcdelis Careva

18. prezentacia/formulirebis Sesafasebeli formaqula prezentacia/formulirebis unaris Sefasebis kriteriumebi8 gansakuTrebu

liar aris deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi

7 saukeTeso erTi mcire (meorexarisxovani) deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi

6 Zalian kargi ori mcire (meorexarisxovani) deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi

5 kargi ramdenime (cota) mcire an erTi didi deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi


ramdenime (bevri) mcire da ori didi deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi, gamorCenilia calkeuli sakiTxi


ramdenime didi deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi, gamorCenilia ramdenime sakiTxi

2 cudi ramdenime didi deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi, monacemTa Sejameba gaugebaria

1 Zalian cudi mravali didi deficiti anamnezis da nevrologiuri gasinjvis sakvanZo monacemebis aRweraSi, monacemTa Sejameba gaugebaria

19. rezidenturis jamuri Sefasebis forma rezidenti (saxeli, gvari) -------------------------------------------------------------------------------gamomcdeli (saxeli, gvari) ----------------------------------------------------------------------------pacientis asaki -------qula/kompetencia

aradamakmayofilebeli damakmayofilebeli1 2 3 4 5 6 7 8

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anamanezis Segrovebis unarinevrologiuri gasinjvaprofesionalizmisa da konsultirebis unariprezentacia/formulirebis unarisaerTo Sefaseba: aradamakmayofilebeli/damakmayofilebeli (markeriT aRiniSneba Sesabamisi)gamomcdelis komentari:--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------gamomcdelis xelmowera -------------------------------------------------rezidentis xelmowera --------------------------------------------------TariRi -------------------------------------მუხლი 36. aucilebeli saxelmZRvaneloebis CamonaTvali

1. m. janeliZe - klinikuri nevrologia, 2009, 724gv.;2. n. tatiSvili, m. gabunia, i. bokeria - bavSvTa nevrologiur daavadebaTa

mkurnaloba, qarTuli biografiuli centri, 2011, 584gv.;3. J. Aicardi – Deseases of the Nervous system in childhood, 3rd edition, Mac keith

Press, 2009, 965 p.;4. K. Swaiman, S. Ashwal - Pediatric Neurology, Principle and Practice, 4 th edition,

Mosby, 2006, 2672 p.;5. G. Fenichel - Clinical Pediatric neurology, Signs and Symptom Approach, 6 th

edition, Saunders, 2009, 432 p.;6. J. Volpe - Neurology of Newborn, 5th edition, Saunders, 2008, 1120 p.;7. Д. Гринберг, М. Аминоф - Клиническая Неврология. Медпресс. 2004. 512стр.;8. Д. Феничел - Педиатрическая Неврология. Медина. 2004. 635 стр..

მუხლი 37. kurikulumis marTva1. kurikulumis Sinaarsi, misi dizaini efuZneba im kompetenciebs da samuSao normativebs, romelic miRebuli da aRiarebulia aSS-sa da evropis ganviTarebuli qveynebis warmatebuli nevrologiuri skolebis mier da romelTa danergvac unda moxdes Cvens qveyanaSi. kurikulumis Seqmnis procesSi Sefasda is aucilebeli admianuri da instituciuri resursebi (literatura, samedicino bazebi da sadignostiko-samkurnalo teqnologiebi), romelic SesaZlebels gaxdida programis ganxorcielebas, procesis efeqtur marTvas da sabolo miznebis miRwevas.2. bavSTa nevrologiis sarezidento programa Sedgeba ori savaldebulo kursisgan - pediatriis kursi da pediatriuli nevrologiis kursi. programa iwyeba pediatriis kursiT, romelic grZeldeba 1 wels, sadac 3 Tve daTmobili aqvs neonatologiis Seswavlas, aseve gadaudebeli da intensiuri Terapiis modulebis savaldebulo gavlas. 3. saswavlo kursi pediatriul nevrologiaSi Sedgeba Semdegi nawilebisgan:

ა) mwvave pediatriuli nevrologia - minimaluri xangrZlivoba 15 Tve;ბ) reabilitacia - minimaluri 5 Tve;გ) mozrdilTa nevrologia - 2 Tve;დ)bavSvTa fsiqiatria - minimaluri periodi 1 arasruli dRe/kviraSi 6 Tvis manZilze an Sesabamisi eqvivalenti.

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