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2016г. №4 Print E-mail

CONTENTS

HEALTH AND SOCIETY

Egiazaryan K.A., Cherkasov S.N., Attaeva L.Zh. The analysis of primary disease incidence on the class «Injury, poisoning and certain other consequences of external causes» (ICD-10) of adult population of the Russian Federation............5

Kazimova M.M. Regional features of the prevalence of haemophilia and its age dynamics in Azerbaijan...................................8

PROTECTION OF MATERNITY AND CHILDHOOD

Samoylova A.V., Gerasimova L.I., Bogdanova T.G. Maternal & child health in Chuvash Republic in 2015............................11

Mamedova S.N., Alieva L.M., Agaeva K.F. Comparative evaluation of the level of perinatal mortality and frequency of caesarean sections.............................................................................16

Gerasimova L.I., Denisov M.S., Denisova T.G. Medical social and institutional risk factors of menstrual disorders................20

Samoylova A.V., Bogdanova T.G., Gerasimova L.I. The children’s health in Chuvash Republic in 2015................................23

HEALTH CARE SPECIALIZED SERVICES

Gilmanov A.A., Sherputovsky V.G., Khisamutdinov A.N., Shamatova A.F., Klykova E.S. Status and problems of staff assistance of infectious service in Tatarstan Republic............................................................................................................30

Nikolaeva A.V., Borisova L.V., Nikolaev N.S., Osipova E.V. Management of periprosthetic infection prevention after replacement arthroplasty.........................................................................................................................................................35

ORGANIZATION AND IMPROVEMENT OF PROTECTION SYSTEM MANAGEMENT OF PUBLIC HEALTH

Ziatdinov V.B., Badamshina G.G. Infections associated with health care as the modern problem of health management......42

Kuzmin S.A., Solodovnikov V.V., Vakhitov E.M., Boev V.A. The results of health care at run-up to military service (after the example of Orenburg region)...................................................................................................................................46

Badaev F.I., Klimusheva N.F., Chernova T.V., Karakina M.L. SWOT-analysis of allergologic and immunologic department of regional multidisciplinary hospital....................................................50

 

THE ANALYSIS OF PRIMARY DISEASE INCIDENCE ON THE CLASS «INJURY, POISONING AND CERTAIN OTHER CONSEQUENCES OF EXTERNAL CAUSES» (ICD-10) OF ADULT POPULATION OF THE RUSSIAN FEDERATION

Karen A. Egiazaryan, Candidate of Medical Sciences, Associate Professor of traumatology, orthopedics and military field surgery sub-faculty of Pirogov Russian National Research Medical University [117997 Moscow, Ostrovityanova str., 1; ]

Sergey N. Cherkasov, Doctor of Medical Sciences, head of department of studying of public health, chief research scientist of N.A. Semashko National Research Institute of Public Health [105064 Moscow, Vorontsovo Pole str., 12, bld. 1; ]

Leyla Zh. Attaeva, Candidate of Medical Sciences, the applicant for degree of Doctor of Medical Sciences, N.A. Semashko National Research Institute of Public Health [105064 Moscow, Vorontsovo Pole str., 12, bld. 1; ]

Abstract. Dynamics of prevalence of the conditions entering the class «Injuries, poisoning and certain other consequences of external causes» (ICD-10) observed in the Russian Federation don’t always correspond to the tendencies observed in regions and in Federal districts. The separate analysis of prevalence showed the availability of various dynamic processes not corresponding to data of studying of dynamics at the Federal level. The received results confirm the assumption of need to take into account not only the risk of change of tendency, but also to consider influence of regional features and factors of the estimated indicators and influence of result of the events on injury rate prevention. Especially it is important in case of implementation of planning for the medium-term and long-term outlook.

Key words: prevalence of injury rate, planning, regional features, injury rate prevention.

 

REGIONAL FEATURES OF THE PREVALENCE OF HAEMOPHILIA AND ITS AGE DYNAMICS IN AZERBAIJAN

Mekhpara M. Kazimova, Author of dissertation of hematology sub-faculty of Azerbaijan A. Aliyev Physicians’ Continuing Education Institute, head physician of Central Hospital of Kelbedzharsky district, Ganja, Gyulyustan settlement [AZ1022 Baku, Tbilissky Av., 3165 quar.; а ]

Abstract. Purpose of the study was the assessment of the significance of regional differences of prevalence rate of haemophilia taking into account the age of patients, clinical forms and severity of pathology. We used the content of united state register of haemophilia, created in haemophilia sub-faculty of Aziz Aliyev Azerbaijan State Physicians’ Continuing Education Institute on basis of haemophilia department of Republic Hospital. The data of all patients (1517) with approved diagnosis of haemophilia were summarized. Patients were divided by gender (1323 male, 194 female), by age (0—4, 5—13, 13—18, 19—44, 45 years and older), by clinical forms (haemophilia А, В and other forms, von Willebrand’s disease). The prevalence rate of haemophilia in Azerbaijan is high (17,2±0,44 per 100 thousand people) and clearly differs by 0—4 (8,7±1,05)0/0000, 5—13 (14,7±1,08)0/0000, 14—18 (17,0±1,63)0/0000, 19—44 (21,3±0,77)0/0000, 45 years and older (15,2±0,80)0/0000. 87,2% of all patients are men, 70,3% have haemophilia А, 9,7% — haemophilia В and 5,5% von Willebrand’s disease. Respectively 21,3; 28,8 and 49,9 % of patients have severe, moderate and mild hemophilia. So, Azerbaijan is a country with high rate of prevalence of haemophilia (17,2±0,44 per 100 thousand people), with clearly expressed regional differences of frequency of this pathology (the lowest frequency 1,40/0000, highest — 47,730/0000). Clearly expressed differences between cities and regions according to prevalence rate of haemophilia are basis for differentiated distribution of haemophilia service resources.

Key words: prevalence, haemophilia, age dynamics, regional features.

 

MATERNAL & CHILD HEALTH IN CHUVASH REPUBLIC IN 2015

Alla V. Samoylova, Doctor of Medical Sciences, Professor, Health Minister of Chuvash Republic

Ludmila I. Gerasimova, Doctor of Medical Sciences, Professor, rector of SAI «Physicians’ Continuing Education Institute» of Health Ministry of Chuvash Republic [428032 Chuvash Republic, Cheboksary, Krasnaya sq., 3; ]

Tatyana G. Bogdanova, Candidate of Medical Sciences, head of public health and healthcare sub-faculty of SAI «Physicians’ Continuing Education Institute» of Health Ministry of Chuvash Republic [428032 Chuvash Republic, Cheboksary, Krasnaya sq., 3; ]

Abstract. Women and children’s health status is one of the main indicators of socio-economic development of society. System of maternal and child health is focused on the implementation of socio-economic and preventive measures of optimization of the family life style, the strengthening of women’s and children’s health, providing appropriate living. Implementation of measures providing the quality health care, improvement of infant, child and maternal mortality and morbidity at women and children population was continued on the territory of Chuvash Republic in 2015.

Key words: women’s health, pediatric services, reproductive health, Chuvash Republic.

 

COMPARATIVE EVALUATION OF THE LEVEL OF PERINATAL MORTALITY AND FREQUENCY OF CAESAREAN SECTIONS

Sevindge N. Mamedova, Candidate of Medical Sciences, director of Azerbaijan Republican Perinatal Center [AZ 1025 Baku, Ju. Safarov str., 12; a ]

Lyaman M. Alieva, gynecologist of policlinic of Writers’ Union [Baku, Azerbaijan Av., 41]

Kamalа F. Agaeva, Candidate of Medical Science, assistant of social hygiene and healthcare management sub-faculty of Azerbaijan A. Aliyev Physicians’ Continuing Education Institute [AZ1022 Baku, Tbilissky Av., 3165 quar.; а ]

Abstract. Purpose of the study was comparative evaluation of the level of perinatal mortality in maternity homes, depending on the frequency of caesarean section. Monitoring was carried out in the state maternity homes in cities (Sumgayit, Ganja, Shirvan and Mingechaur) and in regions (Lenkoran, Masally, Udzhar, Beylagan, Tovuz, Sheki, Guba and Shemakha) of Azerbaijan during 2012—2014. We have determined the proportion of abdominal deliveries (PAD) (in percentage) and level of perinatal mortalities (Still births after 22 completed weeks of gestation and neonatal mortality in the early neonatal period) per 1000 live births and the dead for maternity homes of each city and region during a calendar year. The proportion of abdominal delivery in 2012 was the lowest in Shemakhinsky region (5,1%) and highest in Mingechaur city (27,5%). The lowest level of perinatal mortality during the recent year have been determined in Tovuzsky region (1,7±0,76)‰ (proportion of abdominal deliveries was 23,4%), and the highest in Ganja city [(58,0±3,41)‰] where the proportion of abdominal deliveries was 19,5%. Proportion of abdominal deliveries (x) and level of perinatal mortality (y) in regional maternity homes are not correlated (r=0,09) during 2012. So, the proportion of abdominal deliveries and level of perinatal mortalities change are between 5,1—57,2% and (0,6±0,42) — (64,2±3,85)‰ in regions of Azerbaijan. The level of perinatal mortality and proportion of abdominal deliveries have no bi-directional communication and haven’t been clearly defined.

Key words: frequency, perinatal mortality, caesarean section, comparative evaluation.

 

MEDICAL SOCIAL AND INSTITUTIONAL RISK FACTORS OF MENSTRUAL DISORDERS

Ludmila I. Gerasimova, Doctor of Medical Sciences, Professor, rector of SAI «Physicians’ Continuing Education Institute» of Chuvash Republic Health Ministry [428032 Chuvash Republic, Cheboksary, Krasnaya sq., 3; ]

Mels S. Denisov, Resident Medical Practitioner of propaedeutics of internal diseases sub-faculty of FSEI HPE «I.N. Ulyanov Chuvash State University»

Tamara G. Denisova, Doctor of Medical Sciences, Vice-Rector for scientific research of SAI APE «Physicians’ Continuing Education Institute» of Health and Social Development Ministry of Chuvashia, Professor of gynecology and obstetrics sub-faculty of FSEI HPE «I.N. Ulyanov Chuvash State University» [428032 Cheboksary, Krasnaya sq., 3; ]

Abstract. Importance of reproductive health protection has become significant because of the worsening demographic indicators in the Russian Federation. Students’ reproductive health is exposed to negative influence of the environment and society and presents a complex multidimensional problem. Questionnaire survey of female students, focused on features of the reproductive system functioning, living conditions, psycho-emotional state, life style has been made.

Key words: adolescent reproductive health, menstrual dysfunction, algomenorrhea.

 

THE CHILDREN’S HEALTH IN CHUVASH REPUBLIC IN 2015

Alla V. Samoylova, Doctor of Medical Sciences, Professor, Health Minister of Chuvash Republic

Tatyana G. Bogdanova, Candidate of Medical Sciences, head of public health and healthcare sub-faculty of SAI APE «Physicians’ Continuing Education Institute» of Health Ministry of Chuvash Republic [428032 Chuvash Republic, Cheboksary, Krasnaya sq., 3; ]

Ludmila I. Gerasimova, Doctor of Medical Sciences, Professor, rector of SAI APE «Physicians’ Continuing Education Institute» of Health Ministry of Chuvash Republic [428032 Chuvash Republic, Cheboksary, Krasnaya sq., 3; ]

Abstract. Children’s health is the most important indicator of the efficiency of public policy and the well-being of the nation as a whole. The article presents statistic analysis of the children’s and adolescents’ health in Chuvash Republic. The increase in респираторthe child population in comparison with 2014 and reduction of morbidity in children are noted. The level of secondary and tertiary care, prenatal and neonatal early diagnostics of hereditary and congenital diseases are raising in the republic.

Key words: children’s health, morbidity in children, Chuvash Republic.

 

STATUS AND PROBLEMS OF STAFF ASSISTANCE OF INFECTIOUS SERVICE IN TATARSTAN REPUBLIC

Anas A. Gilmanov, Doctor of Medical Sciences, Professor, head of public health and healthcare management sub-faculty with course of medical informatics of FSBEI HPE «Kazan State Medical University», deputy Health Minister of Tatarstan Republic [4200012 Kazan, Butlerov str.,49; ]

Vladimir G. Sherputovsky, PhD in Medical Science, Senior Lecturer in public health, economics and healthcare management of SBEI HPE «Kazan State Medical Academy» [4200012 Kazan, Butlerov str.,36; ]

Alfir N. Khisamutdinov, PhD in Medical Science, deputy director in information technologies of SAHI «Republican Medical Informational Analytical Center», Senior Lecturer of public health and healthcare management sub-faculty with course of medical informatics of FSBEI HPE «Kazan State Medical University» [4200012 Kazan, Butlerov str.,49; ]

Albina F. Shamatova, Chief of organizational and methodical department of SAHI «Republican Medical Information and Analytical Center» of Tatarstan Republic; [420073, Kazan, A. Kutuy str., 88; ]

Elena S. Klykova, the infectious disease physician of SAHI «Prof. Agafonov Republican Clinical Infectious Diseases Hospital» [420140, Kazan, Pobeda av., 83]

Abstract. The analysis of staff assistance of infectious service of the Tatarstan Republic is carried out. Decrease in number of infection disease physicians is noted: the highest reduction of the number is among the physicians working in hospital [loss rate — (-) 36,1%]; the loss rate of the number of infection disease physicians working in out-patient departments has constituted (-) 9,6%. There are no established posts of the hospital’s physicians in the 6 municipalities, the indicator of completeness of established posts of infection disease physicians constitutes 96,0%. The percent of infection disease physicians having qualification categories is at approximately identical level — 57,3—58,0% in 2005—2015. It should be noted that the skill level of infection disease physicians is significantly higher, than in general in the healthcare system.

Key words: infectious disease service, infectious disease physicians, staff assistance.

 

MANAGEMENT OF PERIPROSTHETIC INFECTION PREVENTION AFTER REPLACEMENT ARTHROPLASTY

Alena V. Nikolaeva, PhD of Medicine, physician-trainer of FSBI «Federal Traumatology, Orthopedics and Arthroplasty Center» of Health Ministry of Russia (Cheboksary) [428020 Cheboksary, F. Gladkov str., 33; ]

Ludmila V. Borisova, clinical pharmacologist of FSBI «Federal Traumatology, Orthopedics and Arthroplasty Center» of Health Ministry of Russia (Cheboksary), [428020 Cheboksary, F. Gladkov str., 33; ]

Nikolay S. Nikolaev, Doctor of Medical Sciences, head physician of FSBI «Federal Traumatology, Orthopedics and Arthroplasty Center» of Health Ministry of Russia (Cheboksary); chief of traumatology, orthopedics and extreme medicine of FSEI HPE «I.N. Ulianov Chuvash State University» [428020 Cheboksary, F. Gladkov str., 33; ]

Elena V. Osipova, epidemiologist assistant of FSBI «Federal Traumatology, Orthopedics and Arthroplasty Center» of Health Ministr of Russia (Cheboksary) [428020 Cheboksary, F. Gladkov str., 33; ]

Abstract. Organizational model of healthcare delivery on «Traumatology and Orthopedics» was created and implemented taking into account the follow-up of patient at all stages of preparation and treatment. The purpose of model’s implementation was the efficient management of healthcare delivery and minimization of infectious postoperative complications. Corrections of co-morbidity on the outpatient stage and the hospitalization regimen on days of the week allow reducing as the preoperative period to 1,3 bed-days, so the total period of stay of patients in the hospital, increasing the surgical activity to 98%, and minimizing the risk of healthcare-associated infection (HAI). Pathogenic and opportunistic pathogenic flora is identified in (3,1±0,7)% of patients in the primary arthroplasty, and during the revision arthroplasty — in (31,4±2,7)%, p<0,001. Monitoring and analysis of infectious complications emergence and management decisions in the area of sanitary-epidemiological security are carried out at the meeting of the Medical Board of the Center and the Committee for HAI Prevention. Implementation of the organizational model allows keeping infection complications rate on the low level (0,4—0,6%).

Key words: periprosthetic infection, arthroplasty, prevention management.

 

INFECTIONS ASSOCIATED WITH HEALTH CARE AS THE MODERN PROBLEM OF HEALTH MANAGEMENT

Vasil B. Ziatdinov, Doctor of Medical Sciences, Professor, head physician of FBHI «Hygienic and Epidemiological Center in Tatarstan Republic» (Tatarstan) [420061 Kazan, Sechenov str., 13a; ]

Gulnara G. Badamshina, Candidate of Medical Sciences, chief of bacteriology laboratory of FBHI «Hygienic and Epidemiological Center in Tatarstan Republic» (Tatarstan) [420061 Kazan, Sechenov str., 13a; ]

Abstract. Retrospective epidemiological study of nosocomial urinary tract infections on the territory of Tatarstan Republic was performed with the aim of studying the characteristics of the epidemiological characteristics due to the high economic losses of infections associated with health care and low registrations of urinary tract infections associated with health care. The epidemiological characteristics of negative dynamics of the incidence of urinary tract infections associated with health care during 2002—2015. These studies indicate the need to develop measures for early detection of urinary tract infections associated with health care in healthcare institutions.

Key words: economic damage, health organization, nosocomial infection, epidemiological characteristics, infections associated with health care.


THE RESULTS OF HEALTH CARE AT RUN-UP TO MILITARY SERVICE (after the example of Orenburg region)

Sergey A. Kuzmin, Doctor of Medical Sciences, Associate Professor , Chairman of military physician board of FSI «Military Commissariat of Orenburg region», Professor of disaster medicine sub-faculty of FSBHI HPE “Orenburg State Medical Academy» of Health Ministry of Russia [460000 Orenburg, Kirov str., 28; kuzmin.sergey.58 @ yandex.ru]

Vitaly V. Solodovnikov, Candidate of Medical Sciences, Associate Professor of disaster medicine sub-faculty of FSBHI HPE «Orenburg State Medical Academy» of Health Ministry of Russia [460000 Orenburg, Sovetskaya str., 6]

Eduard M. Vakhitov, Candidate of Medical Sciences, Associate Professor of disaster medicine sub-faculty of FSBHI HPE «Orenburg State Medical Academy» of Health Ministry of Russia [460000 Orenburg, Sovetskaya str., 6]

Vitaly A. Boev, Candidate of Medical Sciences, Associate Professor of disaster medicine sub-faculty of FSBHI HPE «Orenburg State Medical Academy» of Health Ministry of Russia [460000 Orenburg, Sovetskaya str., 6]

Abstract. The aim of the research was the study of the results of health care at run-up to military service during five-year period from 2012 till 2016 after the example of Orenburg region. It was established that the number of youths of 15—16 years old was declined by 10,8% during five years in Orenburg region. Coverage of preventive medical examinations ranged annually from 91,3 percent to 94,6%, where more than 50% of boys were registered in dispensary for diseases. From 21,2% to 29,8% of boys needed in oral cavity sanation. Not all young men were treated .The result of therapeutic interventions during the study time period was the transfer of boys (12,8% to 16,3%) from the third to the second group of health. The result of continuity between Health Ministry, health institutions and Military Commissariat became the physical fitness index to military service which was increased by 7,6% during the initial military registration. Consistently high mental disorder is noted at the studying of structure of disease. The number of diseases of the musculoskeletal system was reduced more than 2 times, but at the same time, there was an increase in diseases of the nervous system, circulatory system, respiration and digestive organs.

Key words: military service, conscript, diseases, suitability for military service.

 

SWOT-ANALYSIS OF ALLERGOLOGIC AND IMMUNOLOGIC DEPARTMENT OF REGIONAL MULTIDISCIPLINARY HOSPITAL

Felix I. Badaev, Doctor of Medical Sciences, Professor, head physician of SBHI «Sverdlovsk Regional Clinical Hospital № 1» of the Sverdlovsk region [620102 Ekaterinburg, Volgogradskaya str., 185]

Natalia F. Klimusheva, Candidate of Medical Sciences, chief medical officer of SBHI «Sverdlovsk Regional Clinical Hospital № 1» of the Sverdlovsk region [620102 Ekaterinburg, Volgogradskaya str., 185]

Tatyana V. Chernova, Doctor of Medical Sciences, Professor, deputy director for studies SBEI APE «Ural Scientific-Practical Center of medical-social, health and economic problems» [620075 Ekaterinburg, Karl Liebknecht str., 8b]

Marina L. Karakina, Candidate of Medical Sciences, allergologist- immunologist of SBHI «Sverdlovsk Regional Clinical Hospital № 1» of the Sverdlovsk region [620102 Ekaterinburg, Volgogradskaya str., 185; ]

Abstract. The importance of SWOT-analysis of allergy and immunology department of regional multidisciplinary hospital is driven by the need of strategic planning what would improve the treatment of the immuno-compromised patients of different profiles. This analysis is made at the example of SAHI «Sverdlovsk Regional Clinical Hospital № 1» (Ekaterinburg). The result of SWOT-analysis became the identification of factors influencing the development of allergy and immunology service. Besides, strategic steps affecting the achievement of the objectives and mission of the institution have been represented.

Key words: SWOT-analysis, Allergic and Immunological department, regional multidisciplinary hospital.