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Academic and research periodical “MIA Medical Bulletin” N 3 – 2019 (С) was published

CONTENTS

Public health

FORMATION OF THE INNOVATIVE SUBSYSTEM OF DEPARTMENTAL HEALTH SERVICE MANAGEMENT AS ILLUSTRATED BY THE REGIONAL PILOT PROJECT

Sidorenko V., Sukhorukov A., Zubritskiy V.

Based on the study, systematization and critical appraisal of scientific views and approaches to the development of innovative management systems and using the principles of innovative management the authors suggest their own variant of practical implementation of the temporary management subsystem and way of its practical application in the framework of the innovative pilot project.

Key words: medical organization management, departmental medicine, management techniques, management approach, innovative management.

MEDICAL AND SOCIAL AID FOR VICTIMS OF WORK-RELATED ACCIDENTS AND PERSONS WITH OCCUPATIONAL DISEASES

Mayev E.

Health care and social protection of the population are the most urgent problems, especially in the context of the recently changed social, economic and political situation in the country. Return to work, socially useful activity of persons with temporary or permanent disability, disability prevention, improving the quality of life of work-related accidents victims and persons with occupational diseases is an important state task.

Key words: rehabilitation of victims, social policy, social insurance.

LEGAL FACTORS OF SLEEPING DRIVING IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME

Yashchenko A., Kon’kova L.

Patients with obstructive sleep apnea syndrome have evident daytime sleepiness, which significantly reduces efficiency, limits attention and memory, disrupts the coordination of movements and slows the reaction rate. The emergence of these disorders greatly increases the risk of road accidents. A sleeping driver cannot take any action to reduce the speed or avoid obstacles; this is often associated with deaths and serious injuries.

Key words: traffic injuries, traffic accidents, falling asleep while driving, daytime sleepiness, obstructive sleep apnea syndrome, sleeping driving.

Forensic medicine

PROBLEMS OF AEGEROGENIC TREATMENT COMPLICATIONS: CLASSIFICATION AND LEGAL EVALUATION

Kadоchnikov D.

The article draws attention to the fact that not all complications of treatment are iatrogenic. Some of treatment complications may come from the patient’s failure of compliance with the treatment and rehabilitation regime. The author suggests the classification of such complications and its substantiation.

Key words: iatrogenic, patients’ rights, treatment complications, aegerogenic.

Traumatology and orthopedics

DUAL MOBILITY AS THE METHOD OF CHOICE IN COMPLICATED CASES OF HIP ENDOPROSTHESIS REPLACEMENT

Zagorodniy N., Ivashkin A.

The achievements of modern medicine in the treatment of major diseases and injuries of the musculoskeletal system and their consequences caused the change of approaches to hip replacement. Progress in drug therapy, anesthesia provision, increase in the number of medical specialists in hip arthroplasty, significant implant price reduction, various state programs for the material and technical support of medical institutions led to a projected increase in the number of these operations.

Key words: musculoskeletal system, endoprosthesis replacement, hip joint.

Surgery

CLINICAL AND DIAGNOSTIC PARALLELS OF ENTERAL INSUFFICIENCY AND ENDOGENOUS INTOXICATION IN CASE OF PERITONITIS

Mikhaylichenko V., Samarin S., Trofimov P.

The research objective is detecting clinical and diagnostic parallels between the degree of depression of bowel motor-evacuation function and the degree of endogenous intoxication in case of peritonitis.

Key words: enteral insufficiency, widespread peritonitis, endogenous intoxication, bowel motor function.

Cardiology

CORRELATION ANALYSIS OF BODY STATE INDICATORS IN THE SPECIAL CONTINGENT IN CASE OF ISCHEMIC HEART DISEASE

Zolotukhin N., Kon’kov A.

The research objective is the comprehensive assessment of humoral factors affecting the state of carbohydrate metabolism using correlation analysis of anthropometric and general clinical indicators in patients with ischemic heart disease from among the special contingent (persons with unrecoverable professional risks) verified by coronary angiography.

Key word: correlation analysis, ischemic heart disease, blood hormones.

INTERRELATION BETWEEN GAMMA-RAY BACKGROUND OF THE ENVIRONMENT IN THE PERIOD OF MAGNETIC STORMS AND THE CONTENT OF POTASSIUM AND SODIUM IN BLOOD SERUM IN PATIENTS WITH HYPERTENSION DEPENDING ON THE PATIENT’S PSYCHOSOMATIC STATUS AND TREATMENT OPTIONS

Vasendin D., Usenko G., Makarova L., Machmudyan D.

The authors detected and analyzed the interrelation between the dynamics of the γ-background of the external environment in the days of magnetic storms and the content of potassium and sodium in

blood serum in patients with hypertension and with different temperament and trait anxiety taking an empirical variant of antihypertensive therapy, which targets at a blockade of the temperamental characteristics of an organism. The most effective treatment option was detected too.

Key words: hypertension, temperament, anxiety, magnetic storms, γ-background, antihypertensive therapy.

SUBACUTE MYOCARDITIS AS A COMPLICATION OF VARICELLA IN A YOUNG MAN

Fedorchenko Yu., Rogate T., Aksenova N., Koreneva T., Kozlova M.

The article presents the case of subacute myocarditis in a police officer (a young man) associated with moderate varicella. Myocarditis was not severe but with progressing supraventricular arrhythmia. The case ended with a clinical recovery of the patient with residual cardiac arrhythmias.

Key words: acute myocarditis, varicella, herpesvirus, supraventricular arrhythmia.

Gastroenterology

THE APPROACHES TO DIFFERENTIAL DIAGNOSTICS OF LIVER DISEASES AT EARLY STAGE

Samsonov A., Penkina T., Shikina Ye., Berezutskaya O., Bektemirova L., Dicheva D., Pozharova G., Golovkina N., Lebedeva Ye., Turayeva P.

Screening detecting the changes in biochemical indicators of liver functional activity in requires additional examination of a patient to detect the origin of a disease. Recently isolated transaminase level detection is used in routine practice most often; that makes it impossible to detect latent cholestasis syndrome timely. This is crucial for the diagnosis of many diseases: drug-related hepatitis, nonalcoholic fatty liver disease, primary sclerosing cholangitis, primary biliary cholangitis. The screening stage enables to form a further direction of timely diagnostics. In case of level increasing of alkaline phosphatase and/or gamma-glutamyl transpeptidase (especially in women) it is necessary to analyze the level of antimitochondrial antibodies for early diagnosis of primary biliary cholangitis.

Key words: antimitochondrial antibodies, cholestasis syndrome, primary biliary cholangitis, liver function indicators.

Radiation diagnosis, radiation therapy

DIGITAL TOMOSYNTHESIS IN A MULTI-SPECIALTY HOSPITAL

Kushnyr K., Yudina A., Frolov A.

The article deals with the analysis of the results of many studies using digital tomosynthesis and feasibility of this radiologic technique for detecting lesion focuses of lung tissue, intrathoracic lymph nodes and gas in pleural cavities. In addition, tomosynthesis is effective for the diagnosis of undisplaced fractures, destructive degenerative changes of bones. This technique is highly informative for verification of paranasal sinuses and urinary system state. Having regard to the low cost of the examination and low radiation exposure, digital tomosynthesis can be recommended for use as a technique that extends the capabilities of standard radiography.

Key words: digital tomosynthesis, lung tumors, bone destruction, urolithiasis.

Dermatovenerology

COMPLIANCE AS ONE OF THE PROBLEMS OF RATIONAL PHARMACOTHERAPY

OF DERMATOPHYTOSIS OF THE FEET

Gladko V., Saverskaya Ye., Montes Rosel K., Sokolova T., Malyarchuk A., Golovinov A., Panchenko L.

The problem of compliance was studied in 242 patients with dermatophytosis of the feet (DF) – 212 (87.6%) men and 30 (12.4%) women. An extremely low level of compliance was detected – 1.7 points on the Moriska – Green scale. The maximum level of commitment to therapy was detected in persons of elderly (2.4 points) and senile (2.0 points) age; working-age persons had the minimum level (1.4 points). The compliance level was significantly higher in the presence of onychomycosis (2.2 points), light variants of the course of DF (intertriginous / squamous / squamous + intertriginous – 1.8–2.1), in the absence of complications – secondary pyoderma and microbial eczema (1.8 points). The compliance value according to anamnesis significantly increased with an increase in the number of applied topical antimycotics (TA) – from 1.8 points (one TA) to 2.5 points (three or more TA) (p <0.05). Patients’ understanding the doctor’s recommendations and characteristics of the drugs (efficacy / safety / quality) strongly influence the commitment to therapy.

Key words: commitment to therapy, compliance, rational pharmacotherapy, dermatophytosis of the feet, onychomycosis, topical antimycotics.

06.08.2019More

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