Turaev R.G., Khamidullina E.R. Monitoring of blood and its components donation in Tatarstan Republic: status, demographic and social aspects ......................4
Chechulina O.V., Kadyrova G.M. When the pleasure of motherhood is under the threat.............7
Gerasimova L.I., Shuvalova N.V., Tyurnikova S.R., Denisova T.G., Barsukova E.V. Circulatory diseases morbidity rate and structural peculiarities of primary disablement indicators, connected with circulatory diseases of adult population in Chuvash Republic............13
113814.0
PROTECTION OF
MATERNITY AND CHILDHOOD
Zhukov I.V., Kazakova E.A., Mikhailov M.K. Organization of prenatal diagnostics of congenital malformations and hereditary pathology in the Republic of Mari El.................17
Perepelkina N.Ju., Vyaltsin S.V., Kalinina E.A., Mylnikov I.G. Children’s AIDS morbidity in Orenburg region.......................20
HEALTH CARE SPECIALIZED SERVICES
Dobrokvashin S.V., Volkov D.E., Izmailov A.G., Pyrkov V.A., Rakhimov R.R. The strategy of replacement therapy for acute ulcerative gastroduodenal bleeding..........23
Terekhova S.N., Kosterina A.V., Chuvikov V.E., Fakhrutdinov I.A. Evaluation of the need to determine the protein C using the therapy of indirect anticoagulants...................25
Belopukhov V.M., Gorshenin P.V., Fakhrutdinov I.A., Khusnutdinova I.V., Shigapov B.G. Effectiveness and justification program for correcting severe anemia.....................27
Koreyba K.A., Klyushkin I.V., Fatykhov R.I., Zagidullina A.I. Application of ozonized physiological solution for patients with diabetic foot..........30
Terekhova S.N., Safiullina S.I., Kosterina A.V., Sagitova O.V., Chuvikov V.E., Fakhrutdinov I.A. The effec-tiveness of the program plasmapheresis for the treatment of platelet bleeding disorders in antiphospholipid syndrome on the background of systemic inflammatory response in gravids.........................................................................32
Turaev R.G., Gadylshina R.S., Belskaya E.E. Evaluation of effectiveness of problem's solution of immune-conflict pregnancy during the prophylactic of hemolytic disease of the newborn from Rh0(D) women...............................................36
Fatykhov R.I., Klyushkin I.V., Koreyba K.A. Formation of infusional therapy at the syndrome of «diabetic foot»....................38
Turaev R.G., Gadylshina R.S., Belskaya E.E. The organization of observation of pregnancy women with rare antigens of MNS system........................................41
Belopukhov V.M., Yakupov I.F., Khusnutdinova I.V. Statistics of dynamics of external breaks infarction in emergency cardiology ...........................................................42
113714.0
ETHIC-LEGAL ASPECTS OF PUBLIC HEALTH
Egiazaryan K.A., Attayeva L.Zh. Legal aspects of rendering of paid medical care in the public and municipal authorities of health care in Russia.....................................49
Zhiburt E.B., Madzaev S.R., Vergopulo A.A. Should transfusionists be fined?.............52
117814.0
ORGANIZATION AND IMPROVEMENT OF PROTECTION SYSTEM MANAGEMENT
OF PUBLIC HEALTH
Beylina N.I., Gazizov R.M. New approaches to preventive maintenance of diseases of bodies of digestion at rendering initial medical aid to students of high schools......55
Korop O.A. Integral estimation of efficiency of development of system of the specialized medicare in the conditions of introduction and functioning of general practice — domestic medicine..............................................................................58
Monitoring of blood and its components donation in TatarStan REPUBLIC: status, demographic and social aspects
R.G. Turaev, E.R. Khamidullina
Abstract. The information about the status of blood and its components donation, influencing the quality of rending of medical help in Tatarstan, is represented. The middle volume of one blood donation in the institutions of blood services of Health Ministry of Tatarstan Republic increased in 6,0 ml in comparison with 2010 and formed 428,0 ml that becomes equal with Russia. In 2011, the part of active donors (people, delivered their blood 3 times and more during the year) was 34,6%. Reserve’s donors (less than 3 donations during the year) were 65,4%. In Russian Federation, in 2010, the active donors have constituted 8,6%. The authors think that the perspective tendency of donation’s development is the increasing number of active blood and its components donation, reduction of number of initial donors and efficient use of donors’ potential. In modern conditions, the donation’s planning on the base of institutional need in donors’ components of blood, takes on a special significance.
Key words: donor, blood components, index of donation.
When the pleasure of motherhood is under the threat
O.V. Chechulina, G.M. Kadyrova
Abstract. The number of primiparas of older age groups grows from year to year not only in Russia, but also in all economically developed countries that is connected with increase in the professional role of the woman in society and increase of level of the obstetric and pediatric care, development of reproductive technologies. The basis for definition of age of the pregnant woman as risk factor is frequency of extragenital diseases increasing in proportion to age of pregnant women.
Key words: somatic, reproductive health of primiparas of older age.
Circulatory diseases morbidity rate and structural peculiarities of primary disablementindicators, connected with circulatory diseases of adultpopulation in Chuvash Republic
Abstract. Medical statistical analysis of circulatory diseases morbidity rate of adult population and research of structural peculiarities of primary disablement indicators connected with circulatory diseases of adult population in Chuvash Republic have been made. Administrative regions with high and ultrahigh indicators of circulatory diseases morbidity rate and primary disablement and disablement reasons’ structure have been determined. Indicators of primary disablement connected with circulatory diseases of adult population are higher in the rural regions of the Republic. The result of the research is the reason to optimize preventive measurements of morbidity and disablement in the regions and to increase the efficiency of the social policy and also to develop the rural healthcare programmes.
Organization of prenatal diagnostics of congenital malformations and hereditary pathology in the Republic of Mari El
I.V. Zhukov, E.A. Kazakova, M.K. Mikhailov
Abstract. In this article the topicality of detection of congenital malformations and hereditary diseases in pregnancy has been considered. The order and organization of prenatal diagnostics of congenital malformations have been shown in Mari El Republic during 2009—2011. Changes in the organization of prenatal diagnosis of Mari El Republic in 2012 have been presented.
Key words: prenatal diagnosis, congenital malformations, health care organization, Mari El Republic.
Abstract. The article gives results of analysis of children’s AIDS morbidity and evaluation of prenatal chemoprophylaxis efficiency. The research took place in Orenburg region, from 2000 till 2001. The link between the rise of the children’s AIDS morbidity and the growth of the cumulative number of women of reproductive age with AIDS has been shown. In industrial centers we detected the higher index of birth-rate children with prenatal contact with AIDS infection. As the result of chemoprophylaxis of vertical way of AIDS transmission from mother to a child we can observe the reduction of the number of children infected with AIDS during the birth up to 8,3% (RF — 8,5%).
Abstract. The article highlights the modern aspects of infusion — transfusion drug therapy in patients with acute gastroduodenal ulcer bleeding. Replacement therapy for blood loss is divided into immediate, urgent and delayed. The therapeutic tactics of DIC — syndrome and hemorrhagic shock were represented.
Abstract. Further investigation of protein C concentration after administration of vitamin K dependent indirect anticoagulants is discussed. Some questions should be noted in indirect anticoagulants treatment. Possible inherited and acquired causes of protein C and S decrease after administration of indirect anticoagulants are discussed. Protein C resistance is analyzed. Repeated testing of protein C after cessation of therapy with oral coagulants is recommended in suspected deficiency of protein C and S. Protein C testing can be used for prognosis in septic conditions. Some laboratory tests indicating reduced protein C and S values are recommended to the wider use before initiating of anticoagulation therapy.
Key words: protein C, protein S, indirect anticoagulants, normalized ratio (NO).
Effectiveness and justification programfor correcting severe anemia
Abstract. The effectiveness and validity of the correction program of acute blood loss is shown. The parameters of the adaptation of hemorheological reserve to hypoxia and blood loss are estimated correction algorithm of severe anemia and its use in medical practice is worked out. The modern methods of examination of patients from the newborn period to 70 years old are the basis of the research. The algorithm of correction of acute blood loss in children is worked out. Stepping use of the presented algorithm, based on the clinical picture, allows to determine the true volume of blood loss.
Key words: blood loss, anemia, and hemostasis system, blood volume.
Application of ozonized physiological solution for patients with diabetic foot
Abstract. Оzone therapy is a highly effective drug-free method of therapy. The paper presents the main methods of ozone therapy, experience and method of application of ozonated saline infusion with positive results in patients with diabetic foot in the Centre «Diabetic foot» Kazan.
The effectiveness of the programplasmapheresis for the treatmentof plateletbleeding disorders in antiphospholipid syndrome on the background of systemic inflammatory response in gravids
Abstract. The significance of antiphospholipid syndrome (APS) on the background of a systemic inflammatory response, which is a common cause of thrombo-hemorrhagic complications, is discussed. The clinical and laboratory criteria for APS are considered. Standard medical APS therapy is analyzed. The analysis of plasma exchange in 22 patients with recurrent miscar-riages, which have been diagnosed by antiphospholipid syndrome, is given. The positive effect of treatment (childbearing at least up to 34 weeks from delivery viable child without significant pathology) was reported in 90.5% of cases.
Evaluation of effectiveness of problem's solution of immune-conflictpregnancy during the prophylactic of hemolytic disease of the newborn fromRh0(D) women
R.G. Turaev, R.S. Gadylshina, E.E. Belskaya
Abstract. Hemolytic disease of the newborn occurs because of the immune conflict in connection with the incompatibility of the blood of the mother and fetus to the antigens of groups of human blood. From the known systems of the groups of the blood, the antigens systems: AWO, MNS, P, Rhesus (RH), Lutheran (LU), Kell, Lewis (LE), Duffy (FY), Kidd (JK), Diego (DI) have the greatest immunogenicity. At hit in an organism of the individual missing antigens, they may begin to produce antibodies. Diagnosis of hemolytic disease should be integrated, with the use of a number of diagnostic techniques, and it is based on identifying signs indicating the immunization of mother, the determination of antibodies and their title, assessment of the condition of the fetus and indicators in the amniotic fluid. Another important factor is the choice of research methods which depend on the tactics of the pregnancy. In addition, a pregnant woman may be in the status of the recipient. If the blood of a pregnant has antibodies against the red blood cells, the transfusion of erythrocyte mass, conducted without taking into account individual characteristics (phenotype of the blood of the pregnant woman and the presence in the blood of antibodies) may lead the development of post-transfusion complications hemolytic type. A study of the blood of pregnant women is regulated by a number of normative documents and must be conducted twice a year.
Key words: group and Rh affiliation, hemolytic disease of the newborn, hemolytic disease of the fetus, immunological conflict, antibodies immune-conflict pregnancy, erythrocyte antigens.
Formation of infusional therapy atthe syndrome of diabetic foot
R.I. Fatykhov, I.V. Klyushkin, K.A. Koreyba
Abstract. Case rate indicators of diabetes mellitus of the 2nd type testify a pandemic of this disease. In complex the disturbance of a microvascular link and nervous regulation, form a wide variation of pathology. The work purpose the description of the key moments of algorithm of conservative treatment, with possibility of their assessment by the method of ultrasonic control. The research was based on registration of indicators of a blood flow, as bases of formation of a course of infusion therapy. Microcirculation restoration, objectively prove the efficiency of a carried-out course of treatment. Therefore, formation of the scheme of the therapy based on indicators of ultrasonic dynamic control, allows to resolve an issue of positive or negative dynamics in perfusion of tissues of the bottom extremity.
Key words: syndrome of diabetic foot, diagnostics, conservative therapy.
The organization of observation of pregnancy women with rare antigens of MNSsystem
R.G. Turaev, R.S. Gadylshina, E.E. Belskaya
Abstract. The cause of hemolytic disease of the newborn (HDN) is the presence in maternal blood red antibody cells which can pass through the placenta into the bloodstream of the fetus and interact with its red blood cells, causing extra- or intravascular hemolysis. Hemolysis of erythrocytes and anemia stimulate increased production of erythroblasts which fall in peripheral blood flow that leads to erythroblastosis in severe cases. Hemolysis contributes to increase level of bilirubin. The fetus unconjugated bilirubin passes through the placenta and is neutralized by the mother’s liver enzymes, that leading to a decrease in bilirubinemia of fetus. After birth, the insufficiency of the liver enzyme leves of bilirubin in the newborn child increases. Clinically it is manifested by jaundice and the accumulation of bilirubin in the subcortical and brainstem nuclei of the brain, resulting kernicterus in developing. The results, received in the research and described by the authors, tell about the necessity of determination of groups and Rh-characteristics. Testing of serum in presence of anty erythrocytic antibodies must be lead in accordance to working normative acts among all pregnancy women independently of Rh-characteristic.
Key words: MNS system, red cell antibody, hemolytic disease of the newborn.
Statistics of dynamics of external breaks infarction in emergency cardiology
V.M. Belopukhov, I.F. Yakupov, I.V. Khusnutdinova
Abstract. A retrospective study of patients with myocardial infarction treated in coronary care unit (CCU) was performed. Analysis of myocardial ruptures by year, type of heart attack, according to the operational activity, the ratio of deaths from myocardial ruptures and the proportion of ruptures in the different age groups, time of admission to the development rupture eve studied.
The study found that number of myocardial ruptures in 2008—2009 was reduced, both in absolute terms (total) and relative terms (percentage of all patients with myocardial infarction), which is probably due to the increase share revascularization. Often myocardial ruptures occur up to one day of hospitalization («early breaks») and in 3—7 days («late breaks»). Often myocardial ruptures occur in the age of over 70, in the group of myocardial infarction with ST-segment elevation, and happen in the anterior myocardial infarction. Female is an additional risk factor for rupture. Myocardial ruptures tend to occur on the background of moderately reduced / preserved left ventricular function.
Key words: myocardial infarction, external cardiac rupture, free wall ruptures of the left ventricle in myocardial infarction, the mortality in myocardial infarction.
Legal aspects of rendering of paid medical care in the public and municipal authorities of health care in Russia
K.A. Egiazaryan, L.Zh. Attayeva
Abstract. The purpose of article is consideration of features of standard and legal regulation of rendering of paid medical care in the public and municipal authorities of health care in Russia. Now the financial means allocated from budgets of various levels for needs of health care aren’t capable to cover fully the expenses connected with real volume of rendered medical care. The organization and providing paid medical services help with the solution of this problem and allow citizens of the country to receive the constitutional laws in the field of health protection and receiving medical care. Federal Law of 21.11.2011 № 323-FL «About the basis of health protection in the Russian Federation» (here and after — the Law on Health Law № 323-FL) links health care with the need to pay for medical services.
Key words: medical service, legal regulation, paid medical services.
Should transfusionists be fined?
E.B. Zhiburt, S.R. Madzaev, A.A. Vergopulo
Abstract. The draft of federal law d/d February 11, 2013 “About Amendments to the Code of Administrative Offences” is discussed. The draft proposes to introduce penalties for physicians and health care organizations for violating of the law in the field of blood and its components. Compliance of the proposed administrative penalty practices has been assessed with modern legal documents for the activity of the blood service. It was found that the bill is the transformation of unrealized ideas of administrative pressure on business leaders that prevent blood donations. There are no indicators of proposed penalties for doctors. Mistakes and misunderstandings of the regulations will hamper the objectivity of regulatory authorities to impose a penalty. The proposed law should be deviated and the regulatory framework of the blood service should be modernized.
Key words: blood donor, blood service, penalty.
Newapproaches to preventive maintenance of diseases of bodies of digestion atrendering initial medical aid to students of high schools
N.I. Beylina, R.M. Gazizov
Abstract. The purpose of research is development of new approaches to preventive maintenance of diseases of bodies of digestion at rendering initial medical aid to students of high schools (use of questioning on medical surveys, conducting patients in an ambulance station, a day time hospital). The database of questioning of 1 148 students Kazan State Veterinary Academy of Medicine (KSVAM) under the questionnaire of the student during medical surveys in the Kazan municipal polyclinic № 4 «Student’s», including repeated questioning of 284 students in the year after recommendations on medical survey is given. Beside the database of dynamic supervision over 104 students of several High schools of Kazan with erosion-ulcer defects gastric-duodenal zones was used. The efficiency of application of the method of questioning on mass surveys of students for selection of the patients requiring for inspection gastroenteric path is proved. Students with revealed erosion-ulcer defects defeats gastric-duodenal zones in most cases can be supervised in out-patient and in a day time hospital of polyclinics.
Key words: preventive maintenance, the questionnaire, erosion-ulcer defects defeats gastric-duodenal zones, an ambulance station, a day time hospital.
Integral estimation of efficiency of developmentof systemof the specialized medicare in the conditions of introduction and functioning of general practice — domestic medicine
О.А. Korop
Abstract. Database of the study of integral efficiency of ambulatory-policlinic surgical help the population of some regions of Ukraine is presented in the modern terms of reformation of health protection on principles of general practice — domestic medicine by the method of estimation of its medical, social and economic efficiency.
Key words: mеdical, social and economic efficiency, ambulatory-policlinic surgical help, reformation of health protection on principles of general practice — domestic medicine.
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