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Academic and research periodical “MIA Medical Bulletin” N 1 – 2019 (ХСVIII) was published

Подписан в печать 23.01.2019

CONTENTS

Public health

FIRST AID BY MEDICAL PROFESSIONALS: PROBLEMS OF THEORY AND PRACTICE

Dezhurniy L., Zakurdayeva A.

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.

Key words: first aid organization, medical aid, health protection, medical professionals.

CONSEQUENCES OF CRIMINALIZATION OF THE “MEDICAL ERROR” CONCEPT IN THE SYSTEM OF HEALTH CARE ORGANIZATION

Boyko Yu., Vinogradova S.

The article deals with the problems of the contradiction between patients’ expectations as medical service acquirers and medical professions’ necessity to meet the expectations of society in the provision of quality medical services, as well as exclusion of facts of bringing medical workers to criminal responsibility for inadvertent medical errors.

Key words: medical error, criminalization of medical activities.

Surgery

SPECIFICS OF SURGICAL TACTICS IN TREATMENT OF BLUNT FACIAL GUNSHOT WOUNDS

Lukyanenko A., Koltovich A.

Shrapnel, bullet and mine explosive wounds only with entry are classified as blunt facial gunshot wounds. Based on experience (Afghanistan war, North Caucasian armed conflict and other local armed conflict) the author draws conclusions after the analysis of more than 1100 such wounds.

Key words: blunt facial gunshot wounds, surgical tactics, foreign body.

PUNCTURE TREATMENT OF PANCREATONECROSIS WITH WIDESPREAD PARAPANCREATITIS. PRO ET CONTRA

Zubritskiy V., Kovalyev A., Zemlyanoi A.

According to many modern surgeons, minimally invasive surgery of pancreatonecrosis using ultrasonic scanning and roentgenoscopy can replace the open surgery even in the case of infected pancreatonecrosis with purulo-necrotic parapancreatitis. The authors don’t recommend such tactics at this stage of the disease because adequate drainage is impossible in most cases of severe forms of pancreatonecrosis. Using drains will be blocked and only complicate the pathological process. At this stage of pancreatonecrosis priority should be given to the considered use of minimally invasive surgical puncture and drainage techniques, but the primacy of open surgical methods for sanation of the infectious focus persists, and minimally invasive operative interventions should be adjunctive.

Key words: minimally invasive surgery, pancreatonecrosis, parapancreatitis, puncture drainage, sepsis.

RESOURCES OF ULTRASOUND DIAGNOSTICS IN CASE OF PERITONITIS

Zubritskiy V., Mikhailichenko V., Maslov Ya., Samarin S., Churilov A., Mikhailichenko K.

Early diagnostics of intraabdominal complications in emergency surgery is very important because unjustified or late relaparotomy not only significantly worsens the general condition of a patient, but can also be fatal.

Key words: ultrasonic diagnostics, peritonitis, intraabdominal infection, failure of sutures of enteroanastomosis.

Internal diseases

COMMUNITY-ACQUIRED PNEUMONIA: THE NEW IN THE NATIONAL GUIDELINES

Zaitsev А., Yashchenko A., Sinopal’nikov A.

The article deals with the topical issues

of epidemiology, diagnosis and treatment of community-acquired pneumonia. The data on the etiology of the disease and important problems of pneumonia diagnosis and start antibacterial therapy are presented. The authors analyze the new items of the national guidelines for managements of patients with pneumonia.

Key words: community-acquired pneumonia, antibacterial therapy.

COMPREHENSIVE HEALTH ASSESSMENT OF PERSONS WITH HAZARDOUS OCCUPATIONS WITH ISCHEMIC HEART DISEASE AND CONFIRMED CORONARY ATHEROSCLEROSIS

Zolotukhin N., Kon’kov A., Anychkin A.

One of the most important problems of military and police departmental cardiology is timely diagnosis, treatment and rehabilitation in case of various forms of ischemic heart disease in persons with hazardous occupations.

Key words: ischemic heart disease, coronary atherosclerosis, persons with hazardous occupations, pancreatic hyperreactivity, lipid profile.

GASTROESOPHAGEAL REFLUX DISEASE AND DIABETES: MECHANISMS OF COMORBIDITY

Samsonov A., Andreyev D., Rimareva Ye., Dicheva D., Lebedeva Ye., Berezutskaya O., Kuznetsova Ye., Golovkina N., Larina V., Sirazitdinova N.

The article presents the structured material about etiology and pathogenesis of gastroesophageal reflux disease in patients with type 2 diabetes mellitus. Its interrelated pathogenetic mechanisms are hyperglycemia, neuropathy and esophagus dysmotility, which causes progressing gastroesophageal reflux. Moreover, many patients with diabetes have increased body mass index and obesity. The main mechanisms caused pathologic reflux in persons with overweight and obesity are high intra-abdominal pressure, low pressure in the lower esophageal sphincter area, increased frequency of lower esophageal sphincter spontaneous relaxations. Besides, taking some hypoglycemic drugs provokes the progression of gastroesophageal reflux disease.

Key words: gastroesophageal reflux disease, diabetes mellitus, pathogenesis.

Medical rehabilitation, physiotherapy and balneology

DIABETIC RETINOPATHY: PHYSIOTHERAPY RESOURCES

Kulikov A., Kiselyeva O.

Diabetic retinopathy is one of the complications of diabetes. Increased incidence of this disease as the cause of poor eyesight and blindness makes it necessary to search for the new way of treatments with sanogenetic orientation and high efficiency.

Key words: diabetic retinopathy, diabetes mellitus, magnetotherapy, ozone therapy.

RESULTS OF STANDARDIZATION OF QUALITY CONTROL SYSTEM OF MEDICAL REHABILITATION OF PATIENTS AFTER CARDIAC SURGERY

Yudin V., Shkarupa O., Shchegol,kov А., Yaroshenko V.

The system of quality control of medical rehabilitation of patients after cardiac surgery was developed and implemented in the practical activity of the branch. The system includes the comprehensive monitoring of the patients’ condition in transitional points of treatment conducted by a multidisciplinary team and internal quality and medical safety control. The long-term experience of the rehabilitation center was the basis for the development. Standardization of quality control system of medical rehabilitation furthered the reduction of in-patient rehabilitation duration and increasing its efficiency.

Key words: stage medical rehabilitation, multidisciplinary team, internal quality and medical safety control.

Urology

RECONSTRUCTION OF STENOSING PERINEAL URETHROSTOMY USING VARIOUS KINDS OF REPLACEMENT PLASTIC SURGERY: OUR RESULTS AND LITERATURE REVIEW

Zhivov A., Pushkar, D., Vedernikov K., Melnik K., Koshmelev A., Tedeyev R.

The mention of perineal urethrostomy appeared at the beginning of the second millennium, and multistage urethra reconstruction was described in at the beginning of the 20th century. Since then such outstanding figures of reconstructive urology as S. Duplay, G. Marion, D. Brown, B. Johanson, R. Turner-Warwick, W. Leadbetter, J. Gil-Vernet, C. Wells, J. Williams, B. Crawford, J. Blandy, F. Schreiter, S. Venn, A. Mundy and others made many attempts to optimize the technique of perineal urethrostomy as the obligatory stage of surgical treatment.

Key words: perineal urethrostomy, urethra, urethral stricture disease.

Forensic medicine

PROBLEMS OF DETECTING THE SEVERITY OF HARM TO HUMAN HEALTH IN ORDER TO FOOD SAFETY

Glad,ko V., Kadochnikov D.

The article deals with the theoretical underpinning for the possibility of developing the scientific research “Assessment of the severity of harm to health in order to food safety” (original for the Russian Federation) on the base of the Moscow State University of Food Production. Forensic medical examiners are authorized to detect harm actually caused to human health (it is not the probabilistic assessment but actually caused harm or the absence of harm). This research does for the profile of the Moscow State University of Food Production, has broad scientific and practical perspectives.

Key words: food safety, harm to health, biological factor.

Psychiatry

SPECIFICS OF NEUROTIZATION IN POLICE OFFICERS WITH SOMATOFORM DISORDERS: COMPENSATORY AND ADAPTIVE MECHANISMS

Bezchasniy K., Belokrilov I.

The article presents the results of the examination of police officers reflecting the most important connections between the compensatory mechanisms of neurotization and detecting the specifics of adaptive processes in terms of social functioning. The authors detect the grounds for the formation of a “risk” group for the progress of somatoform disorders.

Key words: neurotization, internal affairs agencies, adjustment and compensation.

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