abstract. Blood plasma donorship goes over from extensive intensive way of development; this is required by modern technologies and production realites. Transition to automated plasmapheresis and maximum use of the capabilities of blood service institutions will allow to meet the need of the Republic in blood components and preparations, and also to get the additional products (above RT needs) for other regions. With it the need in plasma donors doesn’t exceed donors potential of the Republic. Provision of blood preparations requires the introduction of new organizational approaches.
characteristics of chronic diseases morBidity among the medical workers (according to data on medical examination in the frame work of additional prophylactic medical examination in nizhni novgorod region)
m.S. GouRyanov
abstract. The article includes the analysis of prophylactic medical examination of medical staff of one of the largest agro-industrial districts of Nizhni Novgorod region. Levels and structure of chronic diseases differ from the analogous characteristics among workers. The author connects the determined differences not only with specifcity of medical work, but also with negative tendencies in their life-style and with a neglect to their own health.
Key words: medical staff, medical examination, health groups, chronic diseases, life-style, attitude to one’s health.
analysis of the state of health of the population followed up By general practitioners
S.R. miRaliyEv
abstract. As a result of study of the health state of the population followed up by the general practitioner the annual increase in number of patients’ and their families’ appeals to general practitioners (family doctors), a stable tendency of their frequency increase with growing age, particularly among women, have been assessed. Progressive dynamics of morbidity in years of follow up proved to be characteristic not only for the older age group, but also for the patients and members of followed up families up to 50 years of age.
Key words: health state, general practitioner, morbidity dynamics.
Реферат. Наоснованиианализаболее 60 тыс. амбулаторныхкарти 555 историйболезнипредставленысведения обобращаемостиигоспитализированнойзаболеваемостиприболезняхитравмахязыка. Причастотеобращаемости (1,89±0,18) случаяна 10 тыс. взрослогогородскогонаселениячастотаихгоспитализациисоставляет (0,05±0,008) случая. Пораженияязыканаиболеехарактерныдляженщинилиц 60—69 лет. Надолюзаболеванийприходится 83%, травм— 17%. Болееполовинывсехболезнейязыказанимаютневрогенныезаболевания. Ростчастотыболезнейязыкасвязанв основномсегоновообразованиямиивоспалительнымипроцессами. Средигоспитализированных 56,76% —городские жители, 43,24% —сельские. Операциямподверглось 73,69% больных. Результатыисследованиясвидетельствуюто необходимостиболееуглубленногоисследованияэтойпроблемыкакновогонаправлениявмедицине—клинической лингвалогии.
Ключевыеслова: язык, частотаболезнейитравмязыкаприобращаемостиигоспитализации.
lingual diseases prevalence
i.G. nizamov, i.G. yamaShEv, R.S. matvEyEv
abstract. Based on the analysis of more than 60 thousand outpatients’ cards and 555 case reports data are presented on appealability and hospitalized morbidity in diseases and traumas of a tongue. In appealability of 1,89±0,18 cases per 10 thousand of adult urban population their hospitalization rate is 0,05±0,008 cases. Tongue injuries are mostly characteristic of women and persons of 60—69 years of age. 83% fall to the share of diseases, 17% to that of traumas. More than a half of all lingual injuries are neurogenic diseases. Increase in lingual diseases prevalence is mostly connected to neoplasms and infammatory processes. Among the hospitalized 56,76% — are urban citizens, 43,24% — rural inhabitants. 73,69% patients underwent operations. The obtained results of investigation indicate the necessity of more through study of this problem as a new line in medicine — clinical lingualogy.
Key words: tongue, prevalence of diseases and traumas of a tongue in appealing and hospitalization.
reproductive portrait of women of a highly-urBanized region: the century left, the coming century
G.a. uShaKova, l.B. niKolayEva
abstract. Study results of long-term dynamics of the core indices of health and behaviour of women living in one of the highly-urbanized regions of the country are presented. According to the investigation fndings, demographic situation in Kemerovo region is characterized by the narrowed character of reproduction. Comparative analysis of reproductive function of several cohorts of women of one and the same region indicates that some characteristics are of stable character, the others — undergo changes. Reproductive «portrait» of modern women of reproductive age is characterized by high prevalence of somatic pathology and genital organs pathology. Among all the factors infuencing the reproductive intentions and behaviour of women the most signifcant are material security and social stability, and the leading factors limiting childbirth are lack of confdence in stability of family relations, fear of loosing work and poverty. A conclusion is made that in new century not numerous population of women having serious problems with reproductive health entered the active phase of reproduction, and attempts to change demographic situation with the help of arbitrarily chosen measures could be condemned to failure.
Key words: cohort, reproductive health, reproductive behaviour of women of a highly-urbanized region.
the research results of teenagers reproductive Behaviour peculiarities
n.i. maKEyEv, t.i. SadiKova, v.a. Rodionov, E.v. antonova, a.i. yaRoullina
abstract. In the article there are presented the results of questionning of 310 teenagers of 15—17 years old (170 girls and 140 boys) — pupils of schools of general education in Zhoukovskiy town. It was found out correlation connection between attitude to pre-marital sexual relations and frequency of alcohol use (r=0,88 for boys and r=0,97 for girls), and also with the level of inclination to realization of addictive behaviour (r=0,94 for boys; r=0,83 for girls). The main resources of obtaining information by teenagers on intimate relatuonships, reproductive aims are studied. It is shown the need for interdepartmental measures on forming of reproductive health of teenagers.
complex assessment of risk factors of forming of chronic inflammatory genital diseases
i.G. zhouKovSKaya, l.f. molchanova
abstract. Clinical and morphological, psychological, social-hygienic risk factors of forming of chronic infammatory genital diseases are discussed. It is conducted mathematics modeling of this pathology frequency in reduction of smoking prevalence, alcohol use, and increasing of patient medical activity, that allow to select women with this pathology development risk and to carry out differentiated medical-and-prophylactic measures among them.
Key words: chronic infammatory genital diseases, risk factors, medical activity.
study of risk factors of eczema as optimization means for rendering medical aid to patients of this category
a.v. dEdKova, l.a. yuSoupova
abstract. Immunological monitoring has been carried out in 90 patients out of 1 157 patients suffering from eczema in the age of 18—80 years. As it was revealed, risk factors of eczema were: a male, age of 51—60 years, prevalence of eczematous processes, the microbic variant of eczema, non-observance of personal hygiene, nutrition defciency, residence in a city. Parameters of immunity links were reliably changed and coincided with characteristics of eczematous process activity. The results of examination might be used for optimization of medical aid to patients of the named category.
medical and socio-economic efficacy of gastric and duodenal ulcer patients' post-surgical recovery
G.i. tiKhomiRova, l.f. molchanova
abstract. Advice elaboration aimed at the development of gastric and duodenal ulcer patients’ post-surgical recovery was implemented. For the frst time comprehensive comparative analysis of effcacy of activities conducted under the different forms of medical care was carried out on the basis of retrospective and prospective supervision of patients operated on for the complicated gastric and duodenal ulcers. Criteria of the optimal organizational rehabilitation forms and indications for their option were defned on the ground of study of clinical, medico-biological and social factors, affecting the course and clinical outcome of gastric and duodenal ulcers.
Key words: peptic ulcer, optimal rehabilitation technology, medical, social and economical effcacy.
comparative estimation of efficiency of prophylactic medical examination of patients with peptic ulcer living in rural and urBan settings
l.i. EfREmova, E.v. BElova, m.v. moSEyEva
abstract. Three-year observation of 161 patients with gastric and duodenal ulcers is exposed in this article. It was determined that the organization of regular medical check-up with account of medico-social characteristics of patients’ age group and conditions of their residing allows to improve the quality of prophylactic medical examination, choose correctly the focus and volume of adequate preventive measures.
Key words: gastric and duodenal ulcers, prophylactic medical examination.
prognosing Border-line mental disorders in women with arterial hypertension
R.R. naBioullina
abstract. Results of study of structures of border-line mental disorders (BLMD) and genetic markers are presented in patients with arterial hypertension (AH) depending on severity of clinical manifestations for further differentiated psychotherapy. The investigation was carried out in the organized population of women (570 patients) of 40—55 years at the large industrial enterprise of Kazan, and in 260 women I–II stage AH was revealed and verifed. While research process the clinico-psychologic, clinico-anamnestic and experimental-psychopathologic methods were used and velocity of Na+-L+-antitransport in the red blood cell membrane according to M. Canessa as an index of functional state cell membranes was defned and HLA-phenotyping of two-stage microlymphocytic cytotoxity was fulflled. Difference in structure and frequency of BLMD depending on AH severity, differences in HLA distribution and a shift toward higher velocity of Na+-L+-antitransport in the red blood cell membrane were revealed.
Key words: arterial hypertension, border-line mental disorders, Na+-L+-antitransport in the red blood cell membrane, HLA system.
estimation of effectiveness of diagnostic protocols clinical application and treatment of chronic generalized periodontitis
i.i. Giniyatoullin, S.l. BlaShKova, n.a. maKaRova
abstract. For further improvement of organization of dental service of population in periodontium diseases interviewing was carried out in the frame-works of general aggregate of dentists working in Kazan. Problems of organization of periodontal service activity, revealed in interviewing, were systematized, scientifcally justifed and presented as protocols of diagnostics and treatment. It is found that working out and use of algorythms of periodontium diseases treatment infuenced the effectiveness of periodontal treatment and lowered the risk of complications development manifested in plausible quality increase of treatment-and-diagnostic measures.
Key words: chronic generalized periodontitis, protocols of diagnostics and treatment, organization of qualifed periodontal service.
abstract. While treating epilepsy different anti-epileptic drugs (AED) are used. Recently new AED appeared with wide spectrum effect, but much move expensive. At the same time traditional AED are of considerably high effciency in treatment of epilepsy. Therapy success depends on the right choice of the medication.
Key words: epilepsy, treatment, choice of the drug.
abstract. Prognosing data on appearance of dental-maxillary disorders (DMD) in pre-school children according to unfavourable medico-social antenatal risk factors are presented. Calculations and tables of DMD prognosing in children, fnal prognostic coeffcients are given. Dentists, working in antenatal clinics and stomatological institutions are recommended to use the DMD prognosing method in children.
abstract. The purpose of the study was to estimate the level of nosocomial infection diseases in treatment-and-prophylactic institutions of the Republic of Tartarstan and reveal the typical epidemiological particularities. Retrospective and operative epide-miological analysis of nosocomial infection diseases in the Republic of Tartarstan for 1997—2007 was used in the article. It was revealed that nosocomial infection diseases during this period tended to reduction, especially in surgical hospitals. The leading place occupied newborn infections with increase of nosocomial infections. Organizing epydemiological control in medical institutions special attention is drawn to disinfectant — sterilizational mode. At the same time the problem of etiological interpretation of nosocomial infection diseases is not fnally solved.
Key words: nosocomial infection diseases, fetal infections, the Republic of Tatarstan, treatment-and-prophylactic institutions, sterilization.
approaches to estimation of educational services on the Basis of indicators of nursing aid quality
G.m. zloBina
abstract. Medical care quality improvement directly depends on the level of professional training of nursing managers, who understand that to operate processes in public health is possible only on the basis of innovative practice using means of quality control. On the basis of therapeutic branches of Izhevsk municipal hospital research was conducted for estimating patients’ satisfaction with nursing care quality and need for educational service in patients with chronic non-infectious diseases. With the aim of qualimetric estimations of nursing activity such indicators were used, as professionalism, culture of service, infuence on emotional state of patients and their satisfaction. The conducted research confrms presence of patients’ need in getting knowledge concerning their disease, and results of experiment make it possible to judge that the indicators developed by us may be one of tools of nursing aid quality management while rendering educational services.
Key words: nursing care managers, educational services, indicators of quality of nursing care.
prognostic modelling of medico-social examination and rehaBilitation as a developing social-economic system
S.n. pouzin, Kh.v. iKSanov, E.i. aouchadEyEv
abstract. Prognostic modelling of medico-social examination and rehabilitation solves 2 tasks: frstly, preservation of positive characteristics, that is realization of cybernetic mechanisms of system development, secondly – acquisition of new characteristics on synergy mechanisms. Relying on these theoretical views, we can speak about «genetic model» of medico-social examination and rehabilitation as of social-economic system endowed with characteristics of self-organization and self-development in modern conditions of economic and social life in Russian and world space. In this article 5 models are represented which in the aggregate present «holographic» evolutionally genetic model of regional system of medico-social examination and rehabilitation, as an object of scientifc analysis, defnition of perspectives – strategy and tactics, monitoring its development.
Key words: prognostic modelling, medico-social examination and rehabilitation, perspectives of development.
Ключевыеслова: специалистысосредниммедицинскимобразованием, хронометражныеисследования, структура рабочеговремени, качествомедицинскойпомощи.
time studies as a condition for improvement of nursing care
G.m. zloBina, E.v. SychEva, n.p. pEnKin
аbstract. The effciency of carried out reforms in health care directly depends on rational use of personnel resources and their conformity to the needs of public health care system. With the aim to fx the structure of working time of district specialists with secondary medical education there has been conducted photo-and-time study on the basis of three polyclinics of municipal institutions of health care of Udmourt Republic. The research results allowed to fnd out the elements and types of professional activity of district nurse, to reveal time resources which allow to shorten the volume of irrational working time, and at the same time to determine factors which infuence on quality of medical nursing care.
Key words: specialists with secondary medical education, time study, structure of working time, quality of medical care.
* * *
Раздел Качество медико-социального обеспечения населения
НадеждаФеофановнаКнязюк, канд. мед. наук, доценткафедрыменеджментаИркутскогогосударственногоуниверситета, зам. гл. врачаИркутскогодиагностическогоцентра ()
ИгорьСергеевичКицул, докт. мед. наук, профессоркафедрыобщественногоздоровьяиздравоохраненияГОУДПО «ИркутскийгосударственныйинститутусовершенствованияврачейРосздрава» ()
integration of international standards iso 9000 - 2000 in the system of medical services quality management
n.f. KnyazyuK, i.S. KitSoul
abstract. Research was conducted as an organizational experiment on the basis of Irkoutsk Regional Consultative-Diagnostic Centre, aimed to assess the opportunities of use of International Standards ISO 9000–2000 (ISO, International Organization for Standardization) within the frameworks of medical services quality management. The aim of the research was scientifc ground, development and introduction of the system of medical care quality management using the innovative technologies for increasing the effciency of medical services activity. The research results are used in the systems of medical institutions activity management irrespective of their ownership forms. The analysis results of introduction of quality management system (QMS) allows to allows to make conclusion that at different stages of development it is revealed the positive dynamics of indices. Suggested model truly allows to achieve the increase of medical care quality, satisfaction level of consumers, the enlargement of budgetary funds use success.
Key words: quality management system, international standard, effciency of medical institution activity, consumer.
life quality of children of the udmourt repuBlic in conducting tuBerculosis chemoprophylaxis
o.v. moiSEyEva
abstract. Results of studying life quality of children in conducting chemoprophylaxis in Udmourt Republic are presented. For assessment of life quality a blanket questionnaire of estimation of health state of children PedsQL (4.0 version — Russian) which proved to be good was used. 150 persons were interrogated. Depending on age, children taking preparations for chemoprophylaxis of tuberculosis we divided into three groups: 2—4 years (50 persons), 5—7 years of age (50 persons), 8—12 years of age (50 persons). The control group comprised 150 conditionally healthy children of the same age (having I or II group of health), not taking drugs for chemoprophylaxis of tuberculosis. 150 parents took part in the examination. It was found that chemoprophylaxis is carried out in children and adolescents from asocial families, having background diseases. They have statistically signifcant lower indexes of life quality in comparison with conditionally healthy children.
Key words: quality of life, children, Udmourt Republic.
monitoring of iodine deficiency and nutritional state in saratov region inhaBitants
S.v. SERGEyEva, yu.yu. yEliSEyEv, m.yu. SvinaRyov
abstract. Saratov region belongs to the endemic regions by the prevalence of iodine-defcient states among population due to natural low iodine content in biosphere. This explains wide prevalence of endocrine pathology among the population, particularly in children — 97,4%. The data on the analysis of answers of 5 171 respondents to the questionnaire «Healthy diet» are presented in this work. The authors of the study have come to the conclusion that the leading part in elimination of iodine defciency is played by the iodine prophylaxis based on large-scale provision of the population of the region with iodinated salt and other products, creation of social marketing and advertising.
ЗДОРОВЬЕ И ОБЩЕСТВО Хамидуллина Э.Р., Сидорук Е.А., Глушаков А.И. Донорство плазмы крови: состояние, потребность, технологическая и экономическая целесообразность ее заготовки (на примере Республики Татарстан) .............................................................4 Гурьянов М.С. Характеристика заболеваемости медицинских работников хроническими болезнями (по материалам медицинских осмотров в рамках дополнительной диспансеризации в Нижегородской области) ...........................................................8 Миралиев С.Р. Анализ состояния здоровья населения, находящегося под наблюдением врача общей практики .....................................................................12 Низамов И.Г., Ямашев И.Г., Матвеев Р.С. Распространенность лингвальных заболеваний ....14
ОХРАНА МАТЕРИНСТВА И ДЕТСТВА Ушакова Г.А., Николаева Л.Б. Репродуктивный портрет женщины высокоурбанизированного региона: век ушедший, век грядущий ....................................................................... 16 Макеев Н.И., Садыкова Т.И., Родионов В.А., Антонова Е.В., Яруллина А.И. Результаты исследования особенностей репродуктивного поведения подростков ........................... 21 Жуковская И.Г., Молчанова Л.Ф. Комплексная оценка факторов риска формирования хронических воспалительных заболеваний гениталий ................................................. 24
СПЕЦИАЛИЗИРОВАННЫЕ СЛУЖБЫ ЗДРАВООХРАНЕНИЯ Дедкова А.В., Юсупова Л.А. Изучение факторов риска заболевания экземой как средство оптимизации оказания медицинской помощи больным данной категории ...................... 27 Тихомирова Г.И., Молчанова Л.Ф. Медицинская, социальная и экономическая эффективность реабилитации больных язвенной болезнью желудка и двенадцатиперстной кишки после оперативного лечения ............................................................................................ 29 Ефремова Л.И., Белова Е.В., Мосеева М.В. Сравнительная оценка эффективности диспансеризации больных язвенной болезнью, проживающих в условиях села и города ................................................................................................................... 33 Набиуллина Р.Р. О прогнозировании пограничных психических расстройств у женщин, больных артериальной гипертензией .................................................................................... 36 Гиниятуллин И.И., Блашкова С.Л., Макарова Н.А. Оценка результативности клинического применения протоколов диагностики и лечения хронического генерализованного пародонтита ........................................................................................................... 41 Прусаков В.Ф. Медицинская результативность различных противоэпилептических препаратов..............................................................................................................44 Гиниятуллин И.И., Набиуллин Р.Р., Галиуллин А.Н. Моделиро¬вание зубочелюстных аномалий у детей дошкольного возраста по медико-социальным антенатальным факторам риска ........46
ОРГАНИЗАЦИОННО-УПРАВЛЕНЧЕСКИЕ ВОПРОСЫ САНИТАРНО-ЭПИДЕМИОЛОГИЧЕСКОЙ СЛУЖБЫ Трифонов В.А., Локоткова А.И., Макарова Т.В., Нуруллова Н.С., Хакимуллина А.Х. О заболеваемости внутрибольничными инфекциями в медицинских учреждениях Республики Татарстан .....................................................................................................50
ОБРАЗОВАНИЕ И КАДРЫ Злобина Г.М. Подходы к оценке образовательной услуги на основании индикаторов качества сестринской помощи .....................................................................................53
НОВОСТИ ЗДРАВООХРАНЕНИЯ Яркаева Ф.Ф. Всероссийское совещание «Регулирование цен на лекарственные средства в РФ» завершило свою работу .................................................................................. 57
ИСТОРИЯ ЗДРАВООХРАНЕНИЯ Тураев Р.Г., Войт Л.Н. К истории становления и развития здравоохранения Амурской области .........................................................................................................59 Фатыхов А.М., Воронцова М.М. История службы скорой медицинской помощи г. Казани в деталях ....................................................................................................64
ОРГАНИЗАЦИЯ И СОВЕРШЕНСТВОВАНИЕ УПРАВЛЕНИЯ СИСТЕМОЙ ОХРАНЫ ЗДОРОВЬЯ НАСЕЛЕНИЯ Пузин С.Н., Иксанов Х.В., Аухадеев Э.И. Прогностическое моделирование медико-социальной экспертизы и реабилитации как развивающейся социально-экономической системы .........69 Злобина Г.М., Сычева Е.В., Пенкин Н.П. Хронометражные исследования как условие совершенствования сестринской помощи .............................................................. 73
КАЧЕСТВО МЕДИКО-СОЦИАЛЬНОГО ОБЕСПЕЧЕНИЯ НАСЕЛЕНИЯ Князюк Н.Ф., Кицул И.С. Интеграция международных стандартов серии ИСО 9000-2000 в систему управления качеством медицинской организации ................................... 80 Моисеева О.В. Качество жизни детей Удмуртской Республики при проведении химиопрофилактики туберкулеза .. ..................................................................86
ЭКОЛОГИЯ И ЗДОРОВЬЕ Сергеева С.В., Елисеев Ю.Ю., Свинарев М.Ю. Мониторинг йодного дефицита и пищевого статуса жителей Саратовской области .........................................................................91