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Academic and research periodical “MIA Medical Bulletin” N 4 – 2017 (LXXXIХ) was published

Academic and research periodical “MIA Medical Bulletin” N 4 – 2017 (LXXXIХ) was published

Подписан в печать 24.07.2017

CONTENTS

Health care management

MODERN ASPECTS OF MEDICAL CARE MANAGEMENT IN THE RUSSIAN FEDERATION

Kudrina V.

The article deals with the current aspects of the development of the health system for improving the management of medical care for population. The author determined development priorities, legal framework, directions of improvement, and possible risks to implementation. The main emphasis is on the creation of the quality management system of medical care and professional activities of medical staff.

Key words: medical care, quality management system of medical care, requirements for professional activities of medical staff.

Health care management in the Ministry

OPPORTUNITIES FOR MANAGING THE PSYCHOSOMATIC STATUS OF POLICE OFFICERS

Shogenov A., Elgarov A.

Psychosomatic status of police officers largely determines their state of health, quality performance of special, including dangerous professional duties usually accompanied with significant systemic psycho-emotional and workload stress. A reliable prevalence of chronic noninfectious diseases in the structure of morbidity of hospitalized patients – police officers was detected. At the same time the social and hygienic portraits of colleagues and some modified risk factors that form different features of the course of chronic non-infectious diseases have a significant impact on the health status and disability of police staff. Using the correctional program for patients’ motivation has a positive effect on their predictors; that makes it possible to reduce the frequency of rehospitalizations and number of persons with permanent occupational disability (invalidization).

Key words: police officers, screening, psychosomatic status, psychophysiological testing, individual medical and psychological support.

Surgery

COMPLEX ANTICOAGULANT THERAPY OF THROMBOEMBOLIC AND INFECTIOUS COMPLICATIONS OF HIP ENDOPROSTHESIS REPLACEMENT

Zubritskiy V., Ivashkin A., Martirosyan K., Kozlov Yu.

Infectious complications after primary hip endoprosthesis replacement are often combined with thromboembolic episodes and pose a significant threat to the outcome of surgical treatment in this category of patients. Simultaneous correction of infectious and thromboembolic disorders is very important for the overall outcome of the disease and helps to avoid fatal outcomes. The measures for reducing surgical trauma and timing of surgery are of great importance for the prevention of tandem complications of hip endoprosthesis replacement.

Key words: hip joint, endoprosthesis replacement, anticoagulant therapy.

NEW METHOD OF SURGICAL TREATMENT OF COMPLICATED FORMS OF CHRONIC PANCREATITIS

Zubritskiy V., Zvolskaya N.

Surgical treatment of chronic pancreatitis is a complex and urgent problem of abdominal surgery. This problem is one of the most urgent because of rising incidence of chronic pancreatitis in recent years, frequent periods of disability, invalidization, high fatalities, and dissatisfaction with the results of surgical treatment of the disease.

Key words: chronic pancreatitis, complicated form, surgical treatment.

COMPLEX METHOD OF TREATMENT OF PATIENTS WITH DEEP BURNS

Kovalev A., Menzul V., Guban, V., Tsvigun O., Pilnikov S., Barkalev M., Selivanova Ye.

The authors studied results of treatment of 123 patients with deep burns from 3% to 62% of the body surface area who had performed 167 operations including subtotal dermatomal necretomy, pretransplantation resection of granulations, and single-stage autodermoplasty. Local treatment of wounds was carried out in intrinsic liquid medium with the use of film dressings. Using method of burns complex treatment makes it possible to shorten the preoperative period for 6 days and the period of inpatient treatment for 10 days, reduce the incidence of postoperative complications from 25.1 to 3.8%, improve the functional and cosmetic results of treatment.

Key words: treating burns, film dressings, pretransplantation resection of granulations, intrinsic liquid medium.

NEW SKIN PLASTIC METHOD OF SURGICAL TREATMENT OF PILONIDAL CYST

Khodakov V., Zabrodin V., Zabrodin Ye., Chernikova L.

The urgency of the problem of surgical treatment of sacrococcygeal pyoinflammatory diseases is primarily due to a high incidence of postoperative complications, frequent recurrences of the disease, long-term temporary disability of patients, and anatomical features of the structure of sacrococcygeal soft tissues. The authors developed and clinically applied a new skin plastic surgical method for the treatment of pilonidal cysts, which made it possible to reduce the incidence of postoperative wound complications and the risk of recurrence of the disease. The method can be used both for pilonidal cyst suppuration and in the “cold period”of the disease without obvious signs of inflammation.

Key words: pilonidal cyst, skin plastic surgery, radical operation.

ANAEROBIC NONCLOSTRIDIAL INFECTION OF LIMB SOFT TISSUES COMPLICATED BY PEPTOSTREPTOCOCCIC SEPSIS (Case study)

Kovalev A., Guban, V., Tsvigun O., Pilnikov S., Barkalev M., Selivanova Ye.

The article describes the case study of anaerobic nonclostridial cellulitis of the upper limb caused by gram-positive cocci of Peptostreptococcus spp. and complicated by sepsis, secondary purulent meningitis, and palmar arterial arch thrombosis.

Key words: anaerobic nonclostridial infection, Peptostreptococcus.

Maxillofacial surgery

FACIAL GUNSHOT WOUNDS AS A PROBLEM OF MODERN TRAUMA SURGERY

Lukyanenko A., Sadovskiy I., Ob’edkov R., Kupriyanov M.

The article explains some important points of the teaching of a gunshot wound which are not covered enough in schematized and tailormade materials of course books on military surgery. Some basic tenets of the teaching of a gunshot wound were dogmatically taught in medical higher education institutions, it was further developed in the treatment of the wounded during the war in Afghanistan, the Chechen Republic and other local wars. The article explains the appropriateness of discussion with the authors of recent publications about surgical debridement of gunshot wounds which give very controversial instructions.

Key words: facial gunshot wound, trauma surgery, battle injuries, peacetime injuries, initial surgical debridement, secondary surgical debridement.

Therapy

DIACEREIN IN TREATMENT OF KNEE JOINT OSTEOARTHROSIS FOR OUTPATIENTS: EFFECTIVENESS AND SAFETY

Smolyaninov S., Piskov V., Sklyarov R., Maltsev T.

The article deals with the clinical effectiveness and safety of Diaflex in patients with knee joint osteoarthrosis. The authors note the positive effect of this drug on joint parameters and draw attention to the more pronounced clinical effect in this group of patients than in the group of patients, which received only peroral monotherapy with non-steroidal anti-inflammatory drugs.

Key words: knee joint osteoarthrosis, Diaflex, non-steroidal anti-inflammatory drugs, effectiveness.

Oncology

THE RARE CASE OF UNDIFFERENTIATED LUNG CARCINOMA

Platonova G., Shepelenko A., Yashchenko A., Khimochko T., Bezkopylnaya I., Gurevich L., Korsakova N.

Undifferentiated lung carcinoma is a rare oncological disease with the rapidly progressive clinical presentation, massive mixed infiltrating tumor growth enveloping the entire lung, and diffuses growth of undifferentiated large tumor cells with the expression of vimentin and wide spectrum cytokeratins.

Key words: malignant neoplasms, undifferentiated lung carcinoma, vimentin, cytokeratin.

ANALYSIS OF ONCOLOGICAL SITUATION IN THE POLICE STAFF OF THE REPUBLIC OF SAKHA (YAKUTIA) IN 2014–2016

Dolinskaya E., Zakharova V., Solovyeva S., Gubko R.

Malignant diseases are the third most common among all diseases. These diseases are one of the causes of mortality, disability and early incapacitation of the police staff. Recently malignant neoplasms have a significant tendency to rapid uncontrolled growth, which leads to early incapacitation among the police staff.

Key words: malignant diseases, oncological situation, incapacitation, police staff.

Infectious diseases

INFLUENCE OF ASSOCIATED DISEASES ON HCV INFECTION COURSE

Patlusov Ye., Kuznetsov P., Chernov V., Patlusova V.

The article deals with the analysis of the complete and complex examination of 168 patients with chronic viral hepatitis type C; this diagnosis was confirmed by the serological method and the presence of antibodies to HCV infection. All patients underwent the medical examination and treatment in the Infectious Department of the 5th Military Clinical Hospital of the National Guard Forces Command of the Russian Federation from 2014 to 2016.

Key words: chronic viral hepatitis type C, hepatic steatosis, antiviral treatment, hepatic fibrosis.

Functional diagnostics

ST-SEGMENT ELEVATION DURING EXERCISE ECG TESTING (Case study)

Kaverin N., Basova A., Kaverin D., Chistyakov A.

ST-segment elevation during exercise ECG testing is rare and indicates the severe transmural ischemic myocardial lesion.

Key words: ischemic heart disease, exercise ECG testing.

Psychiatry

THE CASE OF TREATMENT OF THE PATIENT WITH CATATONIC SYNDROME. DIFFERENTIAL DIAGNOSTICS OF CATATONIA AND NEUROLEPTIC MALIGNANT SYNDROME

Korenyak R., Yavorskiy R.

The urgency of studying this case is due to the severity of catatonic syndrome and neuroleptic malignant syndrome, the high probability of complications with the threat of an unfavorable outcome, and the extreme rarity of supervision of patients with these disorders, especially in departmental psychiatric clinics and hospitals, which makes it difficult to diagnose and treating such patients.

Key words: catatonic syndrome, neuroleptic malignant syndrome.

SPECIFICS OF FAMILY-MATRIMONIAL RELATIONS IN POLICE OFFICERS WITH SOMATOFORM DISORDERS

Medina O., Stepanenko N., Sagatelova E., Bezchasniy K., Marilov V.

The article shows the influence of various factors on the formation of family-matrimonial relations of police officers. The authors detected some risk factors that caused somatoform disorders and ways to resolve the situations that affected the formation of somatoform pathology in police officers.

Key words: family relations, somatoform disorders, police officers.

03.10.2017More

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