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2017г. №2 Print E-mail

CONTENTS

HEALTH AND SOCIETY

Klimova T.M., Kuzmina A.A., Malogulova I.Sh. Prevalence of antibiotics’ self-treatment practices in Sakha Republic (Yakutia)........................................................................................................................... 5

Gilmutdinov R.G., Perepelkina N.Yu., Zakharova I.V., Kalinina E.A. Medical-social portrait of donors and motivation for blood donation (after the example of Orenburg region)....................................................................................................... 9

Timerzyanov M.I., Maleev M.V., Valiev F.V. Influence of medical-social factors of nutrition on morbidity of convicted persons...................................................................................................12

HEALTH OF ECONOMICALLY-ACTIVE POPULATION

Osipov S.A., Trofimova M.V., Malysheva I.Yu., Berkheeva Z.M., Giniyatova A.M. Common patterns of development of occupational diseases in Tatarstan Republic...................................................................................................................... 17

Karimova L.K., Mingazova S.R., Gimranova G.G., Beygul N.A., Mavrina L.N., Larionova T.K. Occupational risk factors of occupational chronic bronchitis among workers of diverse economic sectors of Bashkortostan Republic and its clinical course’s characteristics...........................................................21

HEALTH CARE OF SPECIALIZED SERVICES

Zalesskaya Ju.V., Dzhumagulova A.S., Kydyralieva R.B. Medical prophylactic model at patients with coronary heart disease: focus on nonconventional risk factors....................................................................................................................... 26

Guevorkyan A.R. Future development of municipal out-patient urological services (a case study of expert interview of urologists) ............................................................................ 32

Laryukov A.V., Khasanov R.Sh., Kurtasanov R.S., Shulaev A.V., Laryukova E.K. Clinical-economic efficiency of preventive use of FDG-PET/CT in potentially operative patients with peripheral non-small cell lung cancer.............................. 38

Timasheva G.V., Masyagutova L.M., Shaikhlislamova E.R., Akhmetshina V.T., Galimova R.R., Nafikov R.G. The role of laboratory studies in the diagnostics of metabolic disorders in health personnel of the infection hospital..........................42

EDUCATION AND PERSONNEL

Perepelkina N.Yu., Redyukov A.V., Kalinina E.A. Medical service density in the Orenburg region (after the results of the 10-year monitoring)................................................................................................. 46

ORGANIZATION AND IMPOVEMENT OF PROTECTION SYSTEM MANAGEMENT OF PUBLIC HEALTH

Kostikova A.Yu., Cherkasov S.N. Motivation set of the heads of state healthcare institutions................................................. 54

Smirnov A.O. Some results of the expert assessment of the medical provision implementation during international sports competitions (after the example of Kazan Universiade 2013)................................................................................................. 57

 

PREVALENCE OF ANTIBIOTICS’ SELF-TREATMENT PRACTICES IN SAKHA REPUBLIC (YAKUTIA)

Tatyana M. Klimova, Candidate of Medical Sciences, Associate Professor of pharmacology and pharmacy sub-faculty of Medical Institute of M.K. Ammosov North-Eastern Federal University [677016 Yakutsk, Oyunsky street 27; ]

Ariana A. Kuzmina, Candidate of Pharmaceutical Sciences, Head of pharmacology and pharmacy sub-faculty of Medical Institute of M.K. Ammosov North-Eastern Federal University [677016 Yakutsk, Oyunsky street 27; ]

Irina Sh. Malogulova, Candidate of Biological Sciences, Associate Professor of pharmacology and pharmacy sub-faculty of Medical Institute of M.K. Ammosov North-Eastern Federal University [677016 Yakutsk, Oyunsky street 27; ]

Abstract. Antimicrobial resistance is growing global threat for human health. Irrational use of antibiotics aids development of resistance to infectious agents. The aim of this study was to determine the prevalence of antibiotics’ self-treatment in Sakha Republic (Yakutia). Questionnaire was completed by pharmacy visitors in March 2017 (358 respondents in 17 pharmacies). 73% of respondents reported about antibiotics’ self-treatment. People believe that antibiotics treat acute respiratory viral diseases (33%; n = 118) and influenza (41%; n = 147). The high level of antibiotics’ self-treatment requires the public health education on the appropriate use of antibiotics.

Key words: self- treatment, antibiotics, antibiotic resistance.

 

MEDICAL-SOCIAL PORTRAIT OF DONORS AND MOTIVATIO FOR BLOOD DONATION (after the example of Orenburg region)

Rinat G. Gilmutdinov, Candidate of Medical Sciences, head physician of MBHI «Orenburg Regional Clinical Blood Transfusion Station» [460018 Orenburg, Aksakov str., 32; ]

Natalia Yu. Perepelkina, Doctor of Medical Sciences, Professor, head of public health and healthcare sub-faculty № 2 of Orenburg State Medical Academy Ministry of Health Ministry of Russia [460000 Orenburg, Sovetskaya str., 6; ]

Irina V. Zakharova, deputy head physician of MBHI «Orenburg Regional Clinical Blood Transfusion Station» [460018 Orenburg, Aksakov str, 32; ]

Ekaterina A. Kalinina, Candidate of Medical Sciences, Ass. Professor of public health and healthcare sub-faculty № 2 of Orenburg State Medical Academy Ministry of Health Ministry of Russia [460000 Orenburg, Sovetskaya str., 6; ]

Abstract. The article presents the results of sociological research carried out among blood donors. Medical-social portrait of the blood donor in Orenburg region: predominantly male, average age — 24,5 years, higher or incomplete higher education, working. It was established that the main motive for giving blood and its components was the desire to save the lives and health of strangers or relatives.

Key words: donor, medical and social portrait, the motivation to blood donation, Orenburg region.

 

INFLUENCE OF MEDICAL-SOCIAL FACTORS OF NUTRITION ON MORBIDITY OF CONVICTED PERSONS

Marat I. Timerzyanov, Candidate of Medical Sciences, Expert in Forensic Medicine, Chief of SAHI «Republican Bureau of Forensic Medicine of Health Ministry of Tatarstan Republic», [420029 Kazan, Sibirsky tract str., 31 а; ]

Mikhail V. Maleev, Candidate of Physical and Mathematical Sciences, Head of Patent and Inventive Work Department of SAHI «Republican Clinical Hospital of Health Ministry of Tatarstan Republic» [420064 Kazan, Orenburgsky tract str., 138]

Fasil V. Valiev, Physician of FSHI «Medical Department №16» of Federal Penitentiary Service of Russia [420029 Kazan, Kremlevskaya str., 12/20]

Abstract. Problem of nutrition of convicted persons is studied not well as it needs. Effective actions in life and health quality improvement at convicted persons are impossible without study of nutrition. The group of factors which can impact on incidenc of convicts has been selected for our analysis, and these factors were ranged. The method ‘relation of chances’ was used for calculation of medical-social factors of nutrition of convicted persons. The technique of complex assessment of convict’s morbidity has been developed by authors. The probabilistic approach has been chosen as basic one (E.V. Gubler, 1978). Application of this technique has given the chance to receive a reliable impact assessment of medical-social factors of nutrition on morbidity of convicts. The technique has been spread around and implemented in institutions of Federal Penitentiary Service of Russia in the territory of Tatarstan Republic.

Key words: health of convicted persons, incidence of convicted persons, convict’s nutrition, nutrition factors.

 

COMMON PATTERNS OF DEVELOPMENT OF OCCUPATIONAL DISEASES IN TATARSTAN REPUBLIC

Sergey A. Osipov, Candidate of Medical Sciences, First Deputy Health Minister of Tatarstan Republic [Kazan, Ostrovsky str., 11/6; ]

Marina V. Trofimova, Deputy Head of Federal Service for Supervision of Consumer Rights Protection and Human Welfare in Tatarstan Republic [Kazan, B. Krasnaya str., 30; ]

Irina Yu. Malysheva, Head of Department of Curative and Preventive Care of Health Ministry of Tatarstan Republic [Kazan, Ostrovsky str., 11/6; ]

Zukhra M. Berkheeva, Candidate of Medical Sciences, Associate Professor of hygiene and labor medicine sub-faculty of FSBEI HPE «Kazan State Medical University» of Health Ministry of Russia [Kazan, Butlerov str., 49; ]

Alsu M. Giniyatova, Head of Occupational Health Surveillance, Radiation hygiene and transport of Administration of Federal Service for Supervision of Consumer Rights Protection and Human Welfare in Tatarstan Republic [Kazan, B. Krasnaya, 30; ]

Аbstract. Work in dangerous and unfavourable conditions has a negative impact on the health of workers and is the reason for the development of professional pathology. Leading harmful and hazardous production factors are physical (noise, vibration, non-ionizing radiation), chemical factors and fibrogenic aerosols. The reasons of non-identification of these diseases completely and often in the later stages of their development were detected. These are: imperfection of the legislation on protection of labour, the lack of legal and economic sanctions for their concealment, the shortcomings of the organization and quality of preventive medical examinations of workers, later medical resource utilization because of fear of loss of work.

Key words: occupational diseases, prevalence, prophylaxis.

 

OCCUPATIONAL RISK FACTORS OF OCCUPATIONAL CHRONIC BRONCHITIS AMONG WORKERS OF DIVERSE ECONOMIC SECTORS OF BASHKORTOSTAN REPUBLIC AND ITS CLINICAL COURSE’S CHARACTERISTICS

Lilia K. Karimova, Doctor of Medical Sciences, Professor, Chief Researcher of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94; ]

Svetlana R. Mingazova, Candidate of Medical Sciences, physician of professional allergology and immune rehabilitation department of clinic of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94]

Galina G. Gimranova, Doctor of Medical Sciences, Deputy Director for scientific and organizational-methodical work of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94]

Natalia A. Beygul, Candidate of Chemical Sciences, Associate Professor; senior researcher of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94]

Liana N. Mavrina, Candidate of Biological Sciences, senior researcher of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94]

Tatyana K. Larionova, Candidate of Biological Sciences, head of research quality assurance service of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94]

Abstract. It has been found that 140 from 234 patients with occupational bronchitis had the disease’s development due to long exposures to industrial aerosols containing dust of toxic or/and irritating, allergenic compounds in concentrations exceeding the permissible exposure limit (PEL) in 6—11 times (Classes 3.3—3.4). Dust bronchitis has developed in 94 individuals due to weakly fibrogenic dust containing 6-8% of silicon dioxide in concentrations exceeding the current PEL in 7—12 times (Classes 3.3—3.4). The disease had a progressive course leading to early disability. Preventive programs aimed to reducing development risks of dust pathology in certain industries have been developed on the base of the studies.

Key words: industrial aerosol, hazardous substances, chronic occupational bronchitis, workers of diverse economic sectors.

 

MEDICAL PROPHYLACTIC MODEL AT PATIENTS WITH CORONARY HEART DISEASE: FOCUS ON NONCONVENTIONAL RISK FACTORS

Juliana V. Zalesskaya, Candidate of Medical Sciences, chief of coronary heart disease and atherosclerosis department, senior researcher of General Medicine Department of Academician M.Mirrakhimov National Centre of Cardiology and Internal Diseases [720040 Kyrgyz Republic, Bishkek, Togolok Moldo str., 3; ]

Aynagul S. Dzhumagulova, Doctor of Medical Sciences, Professor, director of Academician M.Mirrakhimov National Centre of Cardiology and Internal Diseases [720040 Kyrgyz Republic, Bishkek, Togolok Moldo str., 3]

Ryskul B. Kydyralieva, Doctor of Medical Sciences, managing director of Academician M.Mirrakhimov National Centre of Cardiology and Internal Diseases [720040 Kyrgyz Republic, Bishkek, Togolok Moldo str., 3]

Abstract. The modern data about negative influence of the nonconventional (psycho-social) risk factors on development and progression of coronary heart disease are presented in the article. The necessity of their timely definition and correction is proved. Practical recommendations on case management are presented. The efficiency of the correction of psychological factors at patients with coronary heart disease is demonstrated.

Key words: coronary heart disease, psycho-social risk factors, poor prognosis, intervention, practical recommendations.

 

FUTURE DEVELOPMENT OF MUNICIPAL OUT-PATIENT UROLOGICAL SERVICES (a case study of expert interview of urologists)

Ashot R. Guevorkyan, Candidate of Medical Sciences, chief of urological department of SBHI «Municipal Polyclinic № 195» of WAD of Moscow, branch № 2 [123467 Moscow, 31/1 Molodogvardeyskaya str., ]

Abstract. Sociological survey was conducted in Moscow in 2016 according to special program. It was a tool for collecting information from experts-physicians and urologists about the organization of urological outpatient care, its accessibility and satisfaction of physicians with the results of medical work of out-patients polyclinic institutions (OPI). The results of the study allowed to attend additional characteristics not reflected in official statistics by the following parameters: age and gender, length of service, qualifications and specialization of the respondents, by the organization of outpatient urological care, about economic efficiency, about the implementation of modern diagnostic and treatment techniques and equipment by the modern diagnostic facilities, by the quality of postgraduate training of urologists and the economic motivation to work. Problems of out-patient urological service were marked, in particular, the imperfection of the concept of urological care in the healthcare system, lack of economic independence of OPI, the lack of legal and regulatory framework for the development of OPI, the low level of payment for health personnel. It was find out which changes were necessary to optimize the organization of the municipal urological service of OPI, how to put them in place within the limits of municipal-private partnership (MPP) project in healthcare, what was the purpose of MPP project. Thus, our method expert assessment study of the problems of organization of outpatient urological service allowed us to obtain the objective, multilateral, comprehensive, competent information, which was a priority indicator of social efficiency of outpatient urology and the important factor in management decisions aimed at improving of urological services.

Key words: organization of municipal outpatient urological service, expert opinion of urologists in Moscow and Russian regions, municipal-private partnership.

 

CLINICAL-ECONOMIC EFFICIENCY OF PREVENTIVE USE OF FDG-PET/CT IN POTENTIALLY OPERATIVE PATIENTS WITH PERIPHERAL NON-SMALL CELL LUNG CANCER

Andrey V. Laryukov, Candidate of Medical Sciences, Associate Professor, chief of X-ray diagnostics unit of SAHI «Republican Clinical Oncology Dispensary of TR HM» [420019 Kazan, Sibirsky tract, 29]

Rustem Sh. Khasanov, Corresponding Member of RAS, Doctor of Medical Sciences, Professor, director of KSMA — affiliated branch of FSBEI HPE «RMASPE of Health Ministry of Russia» [420012 Kazan, Mushtari str., 11]

Refat S. Kurtasanov, Candidate of Medical Sciences, Associate Professor, deputy head physician of SAHI «Republican Clinical Oncologic Dispensary of Health Ministry of Tatarstan Republic» [420019 Kazan, Sibirsky tract, 29]

Aleksey V. Shulaev, Doctor of Medical Sciences, Professor, vice-rector of FSBEI HPE «Kazan State Medical University of Health Ministry of Russia» [420012 Kazan, Butlerov str., 49]

Elena K. Laryukova, Candidate of Medical Sciences, Associate Professor of KSMA — branch of FSBEI APE «RMASPE of Health Ministry of Russia» [420012 Kazan, Mushtari str., 11; ]

Abstract. Comparison of the economic costs of surgical treatment of peripheral lung cancer and the costs for the preventive use of fluorodeoxyglucose position emission tomography (FDG-PET/CT) for early detection of metastatic involvement of the skeleton in patients with potentially resectable peripheral NSCLC (non-small cell lung cancer) is presented. Methods of economic analysis, such as method of minimizing of the costs and method of clinical and economic modeling were used. Preventive use of FDG-PET/CT in patients with potentially resectable peripheral NSCLC allows the rational use of specialists-surgeons and bed capacity, to improve the economic, social and medical effectiveness by changing the phase of the disease and the rejection of unjustified surgical interventions.

Key words: peripheral non-small cell lung cancer, bone metastases, FDG-PET/CT, economic efficiency.

 

THE ROLE OF LABORATORY STUDIES IN THE DIAGNOSTICS OF METABOLIC DISORDERS IN HEALTH PERSONNEL OF THE INFECTION HOSPITAL

Gulnara V. Timasheva, Candidate of Biological Sciences, Associate Professor, leading researcher of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94]

Lyailya M. Masyagutova, Candidate of Medical Sciences, Senior Researcher, chief of laboratory studies department of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94]

Elmira R. Shaikhlislamova, Candidate of Medical Sciences, Senior Researcher of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94; ]

Venera T. Akhmetshina, Head physician of clinic of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94]

Rasima R. Galimova, Candidate of Medical Sciences, Senior Researcher of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94]

Rim G. Nafikov, Candidate of Medical Sciences, neurologist of clinic of FBSI «Ufa Occupational Health and Human Ecology Research Institute» [450106 Ufa, Kuvykin str., 94]

Abstract. We have conducted a complex laboratory study of health personnel of infection profile. Hematologic and biochemical indices including «the oxidant-antioxidant» system of the body have been analyzed. Changes of lipid metabolism in the form of increased atherogenic fractions of cholesterol and reduced cholesterol of high density lipoproteins have been detected. At the same time, an increase in activity of hepatobiliar system enzymes as well as moderate hyperbilirubinemia has been detected. The study of «the oxidant-antioxidant» system indices has revealed initial signs of oxidative stress in the body that can be characterized as a starting point in the development of various diseases. The studies have shown the importance of complex laboratory study of health personnel, and its results have informative and prognostic value for identifying the early metabolic disorders in the body.

Key words: health personnel, hematologic and biochemical indices, «the oxidant-antioxidant» system, metabolic disorders.

 

MEDICAL SERVICE DENSITY IN THE ORENBURG REGION (after the results of the 10-year monitoring)

Natalia Yu. Perepelkina, Doctor of Medical Sciences, Professor, head of public health and healthcare department № 2 of SBEI HPE «Orenburg State Medical Academy» of Health Ministry of Russia [460000 Orenburg, Sovetskaya str., 6; ]

Alexander V. Redyukov, Candidate of Medical Sciences, Senior lecturer of public health and healthcare department № 2 of SBEI HPE «Orenburg State Medical Academy» of Health Ministry of Russia [460000 Orenburg, Sovetskaya str., 6]

Ekaterina A. Kalinina, Candidate of Medical Sciences, Ass. Professor of public health and healthcare department №2 of SBEI HPE «Orenburg State Medical Academy» of Health Ministry of Russia [460000 Orenburg, Sovetskaya str., 6; ]

Abstract. The article presents the results of 10-year monitoring of medical service density of the Orenburg region. The decrease of this index on 11,0% was observed from 2006 to 2015. The index has constituted 40,3 physicians per 10 000 population in 2015. The structure of health personnel had: physicians (22,9%), surgeons (14,9%), pediatricians (9,6%), neonatologists (9,6%) and obstetricians (6,3%). Level of medical service density has decreased in certain specialties: general practitioners on 29,2%, pediatricians and neonatologists on 19,6%, therapists on 6,1%, but the most significant reduction (in 1,9 times) was observed among emergency physicians. Low rate of medical service density was discovered in several districts of the Orenburg region against the general reduction in the number of physicians on 8,5%.

Key words: health personnel, medical service density, staffing level of healthcare institutions.

 

MOTIVATION SET OF THE HEADS OF STATE HEALTHCARE INSTITUTIONS

Anna Yu. Kostikova, Doctoral candidate of FSBSI «Semashko National Public Health Research Institute» [105064 Moscow, Vorontsovo pole str., 12, bld. 1; ]

Sergey N. Cherkasov, Doctor of Medical Sciences, chief researcher of FSBSI «Semashko National Research Public Health Institute» [105064 Moscow, Vorontsovo pole str., 12, bld. 1; ]

Abstract. The increase of labor motivation of health personnel, in particular, heads of healthcare institutions, is the most important health management function. The work quality of healthcare institution depends on the degree of motivation of its head. So, the term of labor effectiveness of the institution directly related to labor effectiveness of the leader. Manager activity in commercial or public medicine is a set of tasks aimed at the organization of the treatment process in the institution. However, the priorities of these two directions are different, which is reflected in the ways of the leaders’ motivation of these institutions. Fundamental differences in motivation set and satisfaction level of the heads of state and private healthcare institutions were revealed in the course of the study. The most important criterion of personnel is the salary level. Leaders in public health centers are interested in the possibility of career promotion and psychological climate.

Key words: motivation, health personnel, managers, healthcare, efficiency, satisfaction.

 

SOME RESULTS OF THE EXPERT ASSESSMENT OF THE MEDICAL PROVISION IMPLEMENTATION DURING INTERNATIONAL SPORTS COMPETITIONS (after the example of Kazan Universiade 2013)

Aleksey O. Smirnov, Candidate of Medical Sciences, Assistant Professor of public health, economics and public health management sub-faculty of Kazan State Medical Academy – affiliated branch of FSBEI APE «Russian Medical Academy of Continuing Professional Education» of Health Ministry of Russia [420012 Kazan, Mushtari str., 11; ]

Abstract. The results of the expert assessment of the effectiveness of the medical and organizational measures of Medical, Sanitary and Anti-Doping Framework during Universiade 2013 in Kazan are presented. The assessment was carried out by experts who had experience in provision of medical care during competitions. They determined the main directions for the implementation of the Concept on a 10-point scale. The weight of the sections of the effectiveness of the implementation of medical provision measures during Universiade was determined by the method of preference. The events within the limits of the Concept were grouped into the following sections: purpose and structure; regulatory and legal support; construction, hospitals and Universiade facilities; staffing; organization of medical care and health interventions in case of emergency. Integral assessment of the effectiveness of the activities was carried out taking into account the evaluation of the criteria according to six sections. The final assessment of the effectiveness of the activities of the Concept was 9,52 points or 95,2%.

Key words: the concept of medical, sanitary and anti-doping support during Universiade 2013 in Kazan, an expert assessment.