CONTENTS

HEALTH AND SOCIETY

Ermakova M.K., Ermakov G.I., Kapoustina N.R., Matveyeva L.P., Botnikova E.A., Naidenkina S.N., Yasaviyeva R.I. Smoking frequency among different age groups of population in Izhevsk...............................................................................5

Lazareva S.V. Health and way of life of students of primary and secondary professional educational institutions......................7

PROTECTION OF MATERNITY AND CHILDHOOD

Albitskiy V.Yu., Vinyarskaya I.V., Shouvalova M.P. Present-day approaches to the children’s health assessment using QALY integral indices..................................................................................................17

Ivanova I.E., Rodionov V.A. Morbidity of children and adolescents in different ecologic biogeochemical regions of Chouvashiya............................................20

Boboshko I.E., Zhdanova L.A., Salova M.N. Realization of primary prophylaxis tasks in children’s polyclinic........................24

HEALTH OF ECONOMICALLY ACTIVE POPULATION

Timasheva G.V., Basharova G.R. Clinical functional signs of developing diseases in workers of chlororganic production spheres in chemical industry ...29

Koudrina E.A., Artemyeva N.N. Socio-hygienic characteristics of working conditions, health and quality of life of specialists

with secondary medical education, working in the emergency system...................................................................................32

ECONOMICS OF PUBLIC HEALTH

Moroshek A.A., Bourmistrov M.V., Galkin S.V., Sigal E.I., Broder I.A., Ivanov A.I., Zhavoronkov V.V. Pharmacoeconomic analysis of application of comprehensive algorithm for diagnostics and treatment of complicated gastroesophageal reflux disease in patients with esophageal niatus hernia.......................................36

Petrounko I.L., Menshikov L.V. On the expenses for patients with rheumatoid arthritis...........................................................44

HEALTH CARE SPECIALIZED SERVICES

Kamayev I.A., Khlapov A.L., Korsakova L.A. Combination of diabetes and concomitant pathology: medical organizational and economical aspects..................................................................................................................................48

Khakimova R.F., Kamasheva G.R. Risk factors for the formation of atopic dermatitis in infants .............................................. 52

Podgayeva V.A., Goloubev D.N., Chernyayev I.A., Shoulev P.L. Character of influence of organization

and efficiency of TB case detection in the Urals region on the epidemiological indices related to TB.................................... 56

DRUG PROVISION

Shakirova D.Kh., Yarkayeva F.F., Safioullin R.S., Zhavoronkov D.E. Development to simulation model

to automation of medicinal care management system within the framework of programs PNM and free medicinal provision in Tatarstan Republic....... 62

ETHIC-LEGAL ASPECTS OF PUBLIC HEALTHINFORMATION SUPPORT OF HEALTH CARE

Housnoutdinova G.R., Garipova R.V., Berkheyev I.M. Medico-social and legal aspects of health protection of medical workers..................................................................... 66

Kamayev I.A., Khlapov A.L. Health protection of citizens as the object of administrative-legal regulation................................ 69

ORGANIZATION AND IMPROVEMENT OF PROTECTION SYSTEM MANAGEMENT OF PUBLIC HEALTH

Nizamov I.G., Nouriyev I.R. «Normal» value of prostatic specific antigen (PSA) in blood serum as a criterion for improvement of management of prostate diseases early diagnostics.......................................................................................................... 73

Molсhanova L.F., Zhoukova I.V. The estimation of social-economic effectiveness of treatment of patients with a bronhial

asthma in the outpatient-polyclinic setting................................................ 76

QUALITY OF MEDICO-SOCIAL SECURITY OF THE POPULATION

 Mavlikayeva Yu.A., Podlouzhnaya M.Ya. Evaluation of quality of life of the employable aged disabled people......................80

ECOLOGY AND HEALTH        

Daoutov F.F., Khakimova R.F., Yusoupova N.Z., Taeepova G.F. Results of studying risk factors of allergic diseases development in children of agricultural female workers..........................................................................................................85

Smoking frequency among different age groups of population in Izhevsk

M.K. Ermakova, G.I. Ermakov, N.R.Kapoustin a, L.P. MatveYeva, E.A. Botnik ova, S.N. Naidenkin a, R.I. YasaviYeva

Abstract. Smoking frequency among schoolchildren, students, adults was studied in Izhevsk. 29,0% of 100 questioned young

men smoke in the 9th grade at school, and 50,9% of young men smoke in the 11th grade at school. Smoking schoolgirls are

3 times less. 36,3% of 100 students smoke, students of medical academy smoke more rarely than other students. Among adults

of 100 questioned 73,4% of men and 20,6% of questioned women smoke.

Key words: smoking, of population groups.

Health and way of life of students of primary and secondary profess ional educational institutions

S.V. Lazareva

Abstract. Results of examination of health and way of life of students of primary and secondary professional educational

institutions are presented according to the data of anonymous questioning and copying out information of reports records

documentation. It is found that the prevalence of chronic diseases increases with each subsequent year of studies. In the structure

of morbidity from the first till the last course the diseases of the eye and its appendages take the leading position, their proportion

is steadily growing with each subsequent course of studies. Digestive apparatus diseases at the I and II courses are on the 2nd

place, and at the III and IV courses they are drawn back to the IV place owing to the increase of the proportion of such classes of

diseases as diseases of respiratory and musculoskeletal system. Diseases of musculoskeletal system at the III and IV courses

are to be on the 2nd place. A proportion of nervous system diseases has increased. The level of morbidity according to records

on appealability also has the tendency for an increase in the each subsequent year of studies. In the structure of morbidity

according to the data on appealability on the first year of studies respiratory system diseases, some infections and parasitic

diseases, digestive system diseases are at the leading positions, and on the II, III and IV years — diseases of respiratory system,

digestive system and traumas. The comparison of indices of total morbidity according to appealability and morbidity according

to the data on prophylactic medical examinations reveals their significant difference owing to the significant proportion of such

classes of diseases as diseases of an eye and its appendages and musculoskeletal system diseases in the structure of morbidity

according to the data on prophylactic examinations. Way of life of students causes trouble such bad habits as smoking, taking

alcoholic drinks, drugs.

Key words: students, studying youth, adolescents, way of life, morbidity according to appealability, morbidity according to

the data on prophylactic medical examinations, bad habits.

Present-day approaches to the children’s health ass ess ment using QALY integral indices

V.Yu. Albitskiy , I.V. Viny arskaya, M.P.Shouvalova

Abstract. For the assessment of efficiency of medical interventions in the public health the dynamic studies of health

evaluation, including «models of indices of health state», are conducted. A quality assessment life year (QALY) is a universal

index of health-related results. Nowadays such indices are not used in the Russian pediatrics. Development of methodology for

QALY index in pediatrics will give the opportunity to improve the assessment quality of efficiency of therapeutic and preventive

interventions and impact on treatment priority medical technologies.

Key words: quality-adjusted life year, children, efficiency, health-related life quality.

Morbidity of children and adolescents in different ecologic biogeochemical regions of Chouvashiya

I.E. Ivanova, V.A. Rodionov

Abstract. Morbidity according to appealability and its structure in children of 0—17 years living in different ecological

biogeochemical territories of Chouvashiya was studied. It was stated that for 3 years the most intensive growth of morbidity was

marked in children of Prisoursk region — the territory with the most unfavorable natural ecological biogeochemical situation.

Different structure of morbidity and pathology rate depending on the place of residence were revealed and that factor should be

taken into account while medical supervision.

Key words: morbidity, children, adolescents, ecological biogeochemical regions.

Realization of primary prophylaxis tasks in children’s polyclinic

I.E. Boboshko, L.A. Zhdanova, M.N. Salova

Abstract. For the first time in the history a differentiated program of forming the healthy life style for children with account

of their individual properties, based on their psychosomatic constitution type was developed and introduced into the practice of

pediatricians of the primary health care. Recommendations were formed regarding individual peculiarities of extravert-, introvertand

centrovert-children and were aimed at prophylaxis and correction of constitutionally-caused health disorders, organism

resistance increasing and better social adaptation. The program proposes non-medicine methods, the high efficiency of which

are confirmed by clinic and functional examinations: by reduction of acute diseases incidence, by increase of mental health

indices. The sphere of application of the outcomes is pediatrics and health care organization. Implementation of differentiated

health-improving measures with account of individual constitutional properties allows to prevent the realization of medical-social

risk factors and essentially improve the state of children’s somatic and mental health.

Key words: primary prophylaxis, psychosomatic constitution.

Clinical functional signs of developing diseases in workers of chlororganic production spheres in chemical industry

G.V. Timasheva, G.R. Basharova

Abstract. We present results of long-term studies on health state of petrochemical workers engaged in chlororganic production

spheres in chemical industry of 2,4 dichlorphenoxiacetic acid, monochloracetic acid, chlorbenzene. The most common diseases

are the diseases of the skin, blood circulation and digestive systems. Complex functional and laboratory examinations of workers

have revealed disorders of lipid metabolism, an increase in an activation of enzymes, hypercoagulation, significant changes of

cellular and humoral immunity, signs of autoimmunization, changes in peripheral blood indices (reticulocytosis, monocytosis).

Most of them are due to occupational factors and this is expressed by high coefficients of relative risk.

Key words: chemical industry, chlororganic production, workers’ health state, clinical functional studies.

Socio-hygienic characteristics of working conditions, health and quality of life of specialists with secondary medical education, working in the emergency system

E.A. Koudrina, N.N. Artemyeva

Abstract. The complex socio-hygienic assessment of health, working conditions, way and quality of life of 218 specialists with

secondary medical education, working at the emergency station in Izhevsk. To study the quality of life, the Russian-variant of the

universal questionnaire «SF-36 Health status survey» was used. It was found that medical nurses have low health resources and

low quality of life (especially on the scales of mental and social functioning), which is associated with not only a socio-hygienic

conditions, but also with the characteristics of their professional activities.

Key words: specialists with secondary medical education, emergency care, health, working conditions, medical activity, way

and quality of life.

Pharmacoeconomic analysis of application of comprehensive algorithm

for diagnostics and treatment of complicated gastroesophageal reflux disease

in patients with esophageal hiatus hernia

A.A. Moroshek , M.V. BOurmi strov, S.V. Galkin , E.I. Sig al, I.A. Broder, A.I. Ivanov, V.V. Zhavoronk ov

Abstract. Gastroesophageal reflux disease (GERD) bears important social implication due to high prevalence in population

and high development rate of severe complications such us esophageal bleeding, peptic stricture and Barrett esophagus. But

no valuable studies devoted to pharmacoeconomical investigation of diagnostic and treatment of GERD were held up to now

in Russia. We have worked out the method of calculation and calculated socio-economic (1 billion 600 million rubles annually)

harm associated with natural history of GERD by the example of the Republic of Tatarstan. Cost-profit analysis of low-invasive

treatment of GERD was carried out for assessment of total socio-economical effect of diagnostics and treatment of 388 patients

with GERD in Esophagus Surgery Department of Tatarstan Regional Clinical Oncology Center (RCOC MH RT). According to

the findings of the study diagnostics and treatment of GERD and its complications with the use of mogern low-invasive methods

is cost-effective. Over a period of using endosurgery for treatment of GERD in RCOC MH RT the total socio-economic effect

amounted to 33 million roubles, one fatal outcome, 2 cases of disability and 8 cases of malignization were prevented, 99 manyears

and 60 man-years in the working age were saved.

Key words: gastroesophageal reflux disease, esophageal hiatus hernia, Barrett esophagus, pharmacoeconomic analysis,

low-invasive treatment mode.

On the expenses for patients with rheumatoid arthritis

I.L. Pe trounko, L.V. Menshikov

Abstract. The purpose of work was the calculation of economic expenses for the patient with rheumatoid arthritis (RA) on the

model of Irkutsk city. 195 patients with RA, living in Irkutsk and being observed in city polyclinics, were questioned with specially

developed questionnaire. Besides, the data on the statistical report under forms № 12 and № 16 of temporary disablement on

Irkutsk, the database on the examined adult citizens of Irkutsk in the bureau of medical-social examination for 2008 were used.

Direct and indirect expenses for 1 patient were calculated. Charges for one working non-invalid patient with RA per a year made

117 841,7 roubles, for non-working invalid these charges in view of indirect expenses are much higher — 1 198 800,6 roubles.

Indirect expenses in the form of non-made products were the highest: for working non-invalids owing to temporary invalidity —

69,8%, for non-working invalids owing to physical disability — 92,4%. The proportion of the disability pension and monthly

monetary payment made 7,8%, payments of temporary disablement allowances made 5,4%. Thus, RA causes the big economic

damage, especially due to disability of patients, and it is profitable to prevent it with early application of the newest expensive

technologies of treatment.

Key words: rheumatoid arthritis, economic damage.

Combination of diabetes and concomitant pathology: medical organizational

and economical aspects

I.A. Kamayev, A.L. Khlapov, L.A. Korsakova

Abstract. This article represents the results of analysis of necessity of changes in the system of medical care of diabetic

patients having concomitant pathology. Some factors defining the diagnostic process in type 1 and 2 diabetic patients in combination

with concomitant pathology at the stage of the primary aid medical care were found and their interdependence was studied. A

complex of medical organizational measures optimizing aid to diabetic patients with concomitant pathology was worked out. The

results of the investigation may serveas a basement for adopting administrative decisions by medical-prophylactic institutions

and health care departments of concrete territories.

Key words: type 1 and type 2 diabetes, medical organizational measures, treatment of diabetes, pharmacoeconomic

effect.

Risk factors for the formation of atopic dermatitis in infants

R.F. Khakimova, G.R. Kamasheva

Abstract. The aim of the study was to identify risk factors for the formation of atopic dermatitis (AD) in infants. The risk factors

of AD progression and allergologic status have been investigated in 205 children aged from 3 months to 3 years. In children

with AD high frequency of hereditary predisposition to atopy, pathology of pregnancy, of delivery in their mothers; in infants of

the mentioned category also the pathology of the neonatal period the violation of a dietary regime were revealed. Environmental

factors in case of hereditary predisposition to atopy influence on the formation of AD in children, which requires realization of

early prevention of the disease.

Key words: atopic dermatitis, infants, risk factors.

Character of influence of organization and efficiency of TB case detection

in the Urals region on the epidemiological indices related to TB

V.A. Podgayeva, D.N. Goloube v, I.A. Cherny aye v, P.L. Shoule v

Abstract. Activity results of institutions involved into detection of tuberculous patients on the territory of 11 areas supervised by

the Urals scientific-research institute of phthisiopulmonology for the time period 2003—2009 were analysed. Impact of organization

and efficiency of TB case detection on the epidemiological indices related to TB were studied. Differentiation between Urals region

subjects according to coefficients characterizing the organization and efficiency of TB case detection was determined. The role

of above-stated indices in formation of those defining the epidemiological situation related to TB in regions was proved. Obtained

examination results are necessary for optimization of TB case detection in regions.

Key words: tuberculosis, organization, efficiency of detection, epidemiological situation.

Development to simulation model to automation of medicinal care management system

within the framework of programs PNM and free medicinal provision in Tatarstan Republic

D.Kh. Shakirova, F.F. Yarkaye va, R.S. S afi oullin , D.E. Zhavoronk ov

Abstract. One of the most actual problems of the modern public health is a rendering medicinal care within the framework of

programs PNM and free medicinal provision. Raising efficiency of medicinal care control in TR is possible by means of optimization

of the search processes, collation and exchange of pharmaceutical information. We have designed technical-economic task for

automated system of medicinal care management. The basis for supposed information-computer technology should be a unloading

which will allow to get data in the form of spreadsheet, containing information on non-liquid remainder in pharmacies of SUE

«Tattechmedpharm». Supposed computer technology will allow to carry on monitoring of medications remainder, to check the

application time of appointed and redistributed medications to rationalize control of goods stocks until providing final user that

will raise accessibility of medications for rendering medicinal care at the expense of the budgetary funds.

Key words: computer technologies, medicinal care.

Medico-social and legal aspects of health protection of medical workers

G.R. Housnoutdinova, R.V. Garipova, I.M. Berkheye v

Abstract. The problem of health protection of medical workers consists of the fact, that work conditions shouldn’t disturb

balanced state of organism. Unfortunately existing system of safety and health protection of medical workers under the conditions

of market relations doesn’t guarantee the function of protection of their health. Despite an increase of material investments,

directed toward an improvement in the working conditions of the medical workers of Tatarstan Republic, the state of their health

is worsened. It is recommend to evaluate work in the protection of health of medical workers, using the indicative indices: the

state of occupational morbidity, industrial injuries in the dynamics, disability caused by occupational diseases and morbidity with

temporary disability.

Key words: health protection, medical workers, indicative indices

Health protection of citizens as the object of administrative-legal regulation

I.A. Kamayev, A.L. Khlapov

Abstract. The main directions of administrative-legal regulation of relations in the sphere of health care are reflected in the

article. The great attention is paid to administrative regulations of assignment of state services and execution of state functions

as new possibilities in cooperation between society and state. The importance of state management in medical aid for the citizens

is shown.

Key words: administrative regulation, health care, purpose programs, state management

«Normal» value of prostatic specific antigen (PSA) in blood serum as a criterion

for improvement of management of prostate diseases early diagnostics

I.G. Nizamov, I.R. Nouriye v

Abstract. According to data on deep medical preventive examination of 4 395 healthy workers of industrial works in Kazan

the age levels of prostatic specific antigen (PSA) in their blood are determined. Average values of this index (X) with its mean

quadratic deflection (δ) and average error (m) are calculated. It is revealed that «normal» values of PSA (X+ δ) level of PSA also

raise with the age, that indicates on higher variability of PSA dispersion in elder age groups of population.

Key words: prostatic specific antigen (PSA), age dependence, monitoring.

The estimation of social-economic effectiveness of treatment of patients

with a bronhial asthma in the outpatient-polyclinic setting

L.F. Molсhanova, I.V. Zhoukova

Abstract. Under supervision in conditions of a polyclinic there have been 109 patients with a bronchial asthma (BА). All patients

received inhalation glucocorticosteroids basic therapy. Research of social efficiency of treatment, studying of medical activity and

hygienic literacy of patients has been carried out. It is proved, that a close attitude of the medical personnel to patients, qualitative

service, an opportunity to keep a habitual rhythm of a life promote that patients prefer treatment in the outpatient-polyclinic setting.

Purposeful activity of the medical personnel on increase of medical activity and hygienic literacy of patients would allow to lower

frequency of exacerbation BА in 2,3 times.

Key words: a bronchial asthma, treatment in a polyclinic, social-economic effect.

Evaluation of quality of life of the employable aged disabled people

Yu.A. Mavlikayeva, M.Ya. Podlouzhnaya

Abstract. There was carried out the evaluation of the quality of life of disabled people of employable age and comparison of

the resulting parameters with the figures of the quality of life of the practically healthy persons of employable age in the region,

which were taken as the normative figures. As the instrument of research we used the International Standardized Common

Questionnaire SF-36. It was found that the quality of life of disabled people in the region was noticeably lower than the value of

the normative figures mainly because of the parameters of physical, role physical and role emotional functioning. Such factors as

age, place of residence, type of disease and disability group have a significant influence on the indicators of the quality of life.

Key words: quality of life, disabled people, employable age.

Results of studying risk factors of allergic diseases development

in children of agricultural female workers

F.F. Daoutov, R.F. Khakim ova, N.Z. Yusoupova, G.F. Taee pova

Abstract. The results of studying risk factors of allergic diseases forming in children of pre-school age are presented. 856

children at the age of 4—6 years attending organized collectives and living in rural regions of the Republic of Tatarstan were

the object of investigation. We carried out a sociological questioning of the parents of the investigated children using a special

questionnaire including more than 30 questions. Studying the factors influencing the forming of allergic diseases in children of

pre-school age allowed to pick out 28,7% of agricultural female workers’ children into the high-risk group of allergic pathology

development.

Key words: allergic diseases, questioning, children, agriculture.