Подписан в печать 21.03.2019
THE ROLE OF PILOT PROJECTS IN IMPROVING THE ORGANIZATION OF INTERNAL CONTROL OF MEDICAL CARE QUALITY AND SAFETY IN DEPARTMENTAL MEDICO-PROPHYLACTIC INSTITUTIONS
Sidorenko V., Zubritskiy V.
The article deals with the problems of the organization of internal control of medical care quality and safety in a departmental medico-prophylactic institution in process of reorganization of its work in the framework of special pilot projects from the standpoint of modern ideas about the management of medical institutions. The authors note the relevance and appropriateness of the approach and suggest some possible options for improving assessment of medical organization management in connection with the introduction of new management decisions.
Key words: internal control of medical care quality and safety, medical organization management, departmental medicine.
PROBLEMS OF THE STATUTORY REGULATION OF FIRST AID TREATMENT IN THE RUSSIAN FEDERATION
Dezhurniy L., Kudrina V., Zakurdayeva A.
First aid organization in the Russian Federation requires development. The main directions of development are the improvement of the legal and regulatory framework and making the effective learning system of first aid regulations based on the framework. The authors consider the legal and regulatory environment of first aid treatment and make suggestions for its improvement. They also analyse the main problems of formation of the effecttive training system for various categories of first aid participants and offer suggestions for its unification. Training programs and teaching materials are offered for this purpose, they are designed in accordance with current Russian legislation and modern Russian and international regulations of first aid treatment.
Key words: first aid organization, first aid training, health protection.
ORGANIZATION OF CONTROLLED PROPHYLACTIC MEDICAL EXAMINATION IN THE POLYCLINIC OF THE MEDICAL CARE UNIT OF THE MIA OF RUSSIA IN THE AMUR REGION
Smolin D., Vakhnenko A., Malchits M., Dorovskikh V.
The article deals with the issues of organization of controlled prophylactic medical examination of the police staff, introduction of modern technologies of “economical polyclinic” into the MIA Medical Service activities.
Key words: prophylactic medical examination, police staff, “economical polyclinic”.
THE SIMULATION CENTER OF THE MUNICIPAL POLYCLINIC: THE INNOVATIVE TECHNOLOGY IN PRIMARY MEDICAL CARE SETTING
The reformation of the educational system of medical personnel involves not only large-scale and very costly changes, but also local resources of professional development for medical personnel at the level of health care organizations. The article deals with the formation of the educational process in the municipal polyclinic. The author recommends introducing the educational simulation center as an innovative technology at the level of health care organizations.
Key words: simulation center of the municipal polyclinic, educational content and test system, e-learning technologies, standard operating procedures.
MODERN METHODS OF SMALL INTESTINE TUMOR DIAGNOSIS
Levchuk A., Zubritskiy V., Kovtun A.
Small intestine tumors are quite rare pathology (5% of all gastrointestinal neoplasms). They have the second place (10%) among all causes of hidden gastrointestinal bleeding. The article presents the modern possibilities of clinical, laboratory, radiologic, endoscopic and morphological diagnosis.
Key words: small intestine tumor, clinical picture, diagnosis, laparoscopy.
Traumatology and orthopedics
TRANSOSSEOUS OSTEOSYNTHESIS WITH EXTERNAL FIXATORS FOR TREATMENT OF INTRAARTICULAR CALCANEUS FRACTURES
The article deals with the specifics of intra-articular calcaneus fractures subject to biomechanics of foot segments. Transosseous osteosynthesis with Ilizarov and other external fixators for bloodless sparing reposition is optimal treatment of these fractures. The author presents own construction arrangement of external fixators and results of the analysis of the treatment of 120 patients with intra-articular calcaneus fractures.
Key words: calcaneus fractures, foot biomechanics, Ilizarov fixator, external fixator.
NEW APPROACHES TO DETECTING INDICATIONS FOR THROMBOLYTIC AND ANTICOAGULANT THERAPY IN PATIENTS WITH PULMONARY EMBOLISM
Tyurin V., Pronin A.
The article deals with the research aimed at improving indications for thrombolytic or anticoagulant therapy in patients with pulmonary embolism based on clinical, laboratory and instrumental indicators.
Key words: pulmonary embolism, thrombolytic therapy, anticoagulant therapy, scale of treatment tactics selection, volume of pulmonary arteries damage.
BUTYRIC ACID AND INULIN AS AGENTS OF CHOICE FOR PHARMACOTHERAPEUTIC CORRECTION OF ANTIBIOTICASSOCIATED DIARRHEA
Smolyaninov S., Sharikov R., Maltsev T.
The article deals with the clinical efficacy and safety of Zacofalk NMX in patients with antibiotic-associated diarrhea. The authors point out the positive effect of this method on diarrhea relief without side effects and stronger clinical effect in this group of patients than in the group of patients who received only standard therapy with pre- and probiotics.
Key words: antibiotic-associated diarrhea, Zacofalk NMX, butyric acid, inulin, effectiveness.
MECHANISM OF SYSTEMIC PREVENTION AND METAPHYLACTIC OF UROLITHIASIS
Ivashchenko V., Chernishov I., Melnik K., Kasaikin A.
The article deals with the consideration of urolithiasis with relation to the disorder of systemic body regulation as regulatory homeostasis disease. The experimental rat study was conducted as part of the development of measures for systemic prevention and metaphylactic of urolithiasis; it showed a significant efficiency of 0.06% sodium hypochlorite solution in indirect electrochemical blood oxidation for the reduction of urine lithogenic properties. Dosage form of 0.06% sodium hypochlorite solution is a multi-factorial medicine, which stabilizes cell membranes, improves the function of transmembrane electrolyte pumps, and eliminates tubulopathy of various origins. The mechanism of adaptogenic effect of sodium hypochlorite can be used as a possible way of systemic prevention and metaphylactic of urolithiasis.
Key words: urolithiasis, sodium hypochlorite, prevention, metaphylactic, indirect electrochemical blood oxidation.
Medical rehabilitation, physiotherapy and balneology
LOW-FREQUENCY ELECTROSTATIC FIELD IN COMBINATION THERAPY OF SCOLIOSIS IN PAEDIATRIC PATIENTS
Kulikov A., Zaytseva T.
Idiopathic scoliosis is a common disorder of a musculoskeletal system with body organs and systems dysfunction, which causes severe physical and psychological suffering in children. The purpose of the study is to increase the effectiveness of conservative treatment in children with idiopathic scoliosis of I and II stages with inclusion low-frequency electrostatic therapy in the treatment regimen. It was detected that the use of low-frequency electrostatic therapy significantly increases the effectiveness of treatment, thereby contributing reduction of the scoliosis symptoms.
Key words: idiopathic scoliosis, low-frequency electrostatic therapy, combined treatment, rehabilitation, physical therapy.
THERAPEUTIC EXERCISES IN THE EARLY POSTOPERATIVE PERIOD IN MAXILLOFACIAL SURGERY
Lukyanenko A., Mikhalyeva A.
Medical rehabilitation of patients in maxillofacial hospitals is a serious problem because it is necessary not only to regain person’s health and achieve complete cure, but also to restore the former appearance.
Key words: facial trauma, maxillofacial surgery, medical rehabilitation, therapeutic exercises.
Anesthesiology and reanimatology
IMPORTANCE OF MONITORING INDICATORS OF RESPIRATORY BIOMECHANICS
FOR ECONOMIC EFFICIENCY IN THE TREATMENT OF PATIENTS WITH SEVERE CHEST TRAUMA
Smelaya Т., Skorokhodova L., Boltaev P.
The article deals with the analysis of the impact of active surgical tactics results on outcomes of the treatment of patients with severe chest trauma based on monitoring indicators of respiratory biomechanics. The authors estimate the impact of the complex treatment of these patients on the length of stay in an intensive care unit, duration of artificial pulmonary ventilation, number of infectious complications, need for antimicrobial drugs, and economic efficiency of the used method.
Key words: severe chest trauma, surgical fixation, artificial pulmonary ventilation, intraesophageal pressure.
The article deals with the organizational and legal aspect of the problem of first aid by medical professionals out of duty. The authors make proposals for changes in regulatory acts and advise medical professionals.
The analysis of the differential diagnostic capabilities of the most used in clinical practice clinical and laboratory tests was made for study of the clinical course of various forms of acute pancreatitis. The authors compared the clinical and laboratory data of pathomorphological changes of the pancreas and retroperitoneal tissue in different periods of necrobiotic process.
The military medical examination in the internal affairs agencies of the Russian Federation is an important management tool of quality staffing with healthy and practically healthy personnel reinforcements including the contingent studying in the educational organizations of the MIA of Russia as the basic personnel reserve of the internal affairs agencies of the Russian Federation.
Despite the great achievements of modern medicine in the field of wound infection, anesthesiology and resuscitation science, a high percentage (more than 30%) of pyoinflammatory complications persists in treatment of facial gunshot wounds. Experience in the treatment of the wounded in a face during local armed conflicts confirms this.