Pub Date : 2019-04-08DOI: 10.17709/2409-2231-2019-6-1-11
V. V. Maslyakov, V. Barsukov, A. V. Uskov
Objectives. To make analysis of main types of surgeries performed at various neck wounds in civil medical institution in the conditions of the local military conflict.Patients and methods. The work is based on a retrospective analysis of the treatment of 241 patients with various neck wounds who were admitted in an urgent order to the surgical department of a city hospital in Chechen Republic from 1991 to 2000. All the wounded were divided into two groups: 129 with gunshot wounds (main group) and 112 with stab wounds of the neck (comparison group). The average age was 35 ± 5 years, dominated by males — 78%.Results. It was established that in 25 (19.3%) cases the operation was started under local anesthesia, in 45% of cases anesthesia was given to continue the surgery, in 84% intubation was made, in 16% — intravenous operations. As a result of the analysis, it was revealed that for neck gunshot wounds the following operations were most often performed: a typical tracheostomy without a laryngeal and tracheal suture in 26.3% cases; atypical tracheostomy without suture of larynx and trachea — 16.2% cases; the laryngeal or tracheal suture with tracheostomy was performed in 13.1% cases, in 12.4% of cases was performed operative exploration of neck organs.In cases of concomitant chest wounds, in 10.8% of cases, in addition to operative exploration of neck organs, thoracotomy was performed, in most cases for suturing wounds of the esophagus.Conclusion. The study confirmed that in the wounded with neck gunshot wounds, the amount of aid consisted primarily in restoring airway patency, stopping bleeding and anti-shock actions.
{"title":"TYPES OF SURGERIES PERFORMED AT NECK WOUNDS IN CIVIL MEDICAL INSTITUTION IN THE CONDITIONS OF THE LOCAL MILITARY CONFLICT","authors":"V. V. Maslyakov, V. Barsukov, A. V. Uskov","doi":"10.17709/2409-2231-2019-6-1-11","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-11","url":null,"abstract":"Objectives. To make analysis of main types of surgeries performed at various neck wounds in civil medical institution in the conditions of the local military conflict.Patients and methods. The work is based on a retrospective analysis of the treatment of 241 patients with various neck wounds who were admitted in an urgent order to the surgical department of a city hospital in Chechen Republic from 1991 to 2000. All the wounded were divided into two groups: 129 with gunshot wounds (main group) and 112 with stab wounds of the neck (comparison group). The average age was 35 ± 5 years, dominated by males — 78%.Results. It was established that in 25 (19.3%) cases the operation was started under local anesthesia, in 45% of cases anesthesia was given to continue the surgery, in 84% intubation was made, in 16% — intravenous operations. As a result of the analysis, it was revealed that for neck gunshot wounds the following operations were most often performed: a typical tracheostomy without a laryngeal and tracheal suture in 26.3% cases; atypical tracheostomy without suture of larynx and trachea — 16.2% cases; the laryngeal or tracheal suture with tracheostomy was performed in 13.1% cases, in 12.4% of cases was performed operative exploration of neck organs.In cases of concomitant chest wounds, in 10.8% of cases, in addition to operative exploration of neck organs, thoracotomy was performed, in most cases for suturing wounds of the esophagus.Conclusion. The study confirmed that in the wounded with neck gunshot wounds, the amount of aid consisted primarily in restoring airway patency, stopping bleeding and anti-shock actions.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"111 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120987688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-08DOI: 10.17709/2409-2231-2019-6-1-5
A. D. Karnin, A. Kostin, S. Stepanov, N. Vorobyev, P. Bespalov, V. Dimitrov
Purpose. To evaluate the eff ec veness of intraopera ve ultrasonography (IOUS) in the surgical treatment of kidney tumors. Pa7 ents and methods. Possibili es of IOUS applica on in the surgical treatment of kidney tumor according to the results of examina on and surgical treatment of 145 pa ents (95 men and 50 women) diagnosed with kidney cancer were evaluated. The pa ents were divided into 2 groups: group 1 (comparisons) — 76 pa ents; during the examina on and treatment, the IOUS method was not used, group 2 (basic) — 69 pa ents, who during the surgical treatment used the IOUS method to further clarify the localiza on, the size and boundaries of the tumor forma on. Results. The use of IOUS helped to reduce the frequency of nephrectomy (11.9% in the comparison group and 8.7% in the main group), and reduce the frequency of intraopera ve complica ons, which amounted to (8.7% against 13.2%). The frequency of damage to the spleen and the transi on to open surgery did not diff er. The use of IOUS allowed to characterize in detail the anatomical features of the tumor, its vasculariza on and to implement the RENAL prognosis: favorable — in 50.7% of pa ents, unfavorable — in 15.9%. Conclusion.When performing kidney tumor surgery, it is recommended to perform IOUS of the aff ected kidney in order to further clarify the boundaries of the tumor lesion to improve the eff ec veness of the opera on.
{"title":"ANALYSIS OF THE INTRAOPERATIVE ULTRASOUND RESULTS IN THE SURGICAL TREATMENT OF RENAL TUMORS","authors":"A. D. Karnin, A. Kostin, S. Stepanov, N. Vorobyev, P. Bespalov, V. Dimitrov","doi":"10.17709/2409-2231-2019-6-1-5","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-5","url":null,"abstract":"Purpose. To evaluate the eff ec veness of intraopera ve ultrasonography (IOUS) in the surgical treatment of kidney tumors. Pa7 ents and methods. Possibili es of IOUS applica on in the surgical treatment of kidney tumor according to the results of examina on and surgical treatment of 145 pa ents (95 men and 50 women) diagnosed with kidney cancer were evaluated. The pa ents were divided into 2 groups: group 1 (comparisons) — 76 pa ents; during the examina on and treatment, the IOUS method was not used, group 2 (basic) — 69 pa ents, who during the surgical treatment used the IOUS method to further clarify the localiza on, the size and boundaries of the tumor forma on. Results. The use of IOUS helped to reduce the frequency of nephrectomy (11.9% in the comparison group and 8.7% in the main group), and reduce the frequency of intraopera ve complica ons, which amounted to (8.7% against 13.2%). The frequency of damage to the spleen and the transi on to open surgery did not diff er. The use of IOUS allowed to characterize in detail the anatomical features of the tumor, its vasculariza on and to implement the RENAL prognosis: favorable — in 50.7% of pa ents, unfavorable — in 15.9%. Conclusion.When performing kidney tumor surgery, it is recommended to perform IOUS of the aff ected kidney in order to further clarify the boundaries of the tumor lesion to improve the eff ec veness of the opera on.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"200 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132437842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-08DOI: 10.17709/2409-2231-2019-6-1-3
A. Zikiryakhodzhayev, E. Rasskazova, A. Tukmakov, I. Shirokikh
Objective . To evaluate 3‑year disease-free survival in patients with breast cancer who underwent radical subcutaneous/skin-sparing mastectomy with simultaneous reconstruction. Patients and methods . The article analyzes 472 patients diagnosed with breast cancer who underwent radical subcutaneous/skin-sparing mastectomy in combined or complex treatment. In the Department of Oncology and reconstructive plastic surgery of the breast and skin radical skin mastectomy was performed in 255 (54.1%) and 217 (45.9%) patients with radical subcutaneous mastectomy. Reconstruction was carried out by autotissues, expanders, followed by replacement with endoprostheses, as well as a combination of flaps and endoprostheses. The mean age of patients was 43.8 ± 2.2 (18–73) years. In 32.3% of cases patients were in the age group up to 40 years. Results . In 9 (1,7 ± 0,6%) of patients diagnosed with a recurrence of breast cancer, herewith in 5 cases of local and in 4 cases of regional recurrence (metastases in the infraclavicular lymph nodes). Treatment of recurrences of breast cancer was as follows: in two cases polychemotherapy courses were conducted, in 6 cases operations were performed — excision of relapse in the breast (3) and subclavian lymphadenectomy (1), removal of the reconstructed gland (2), in 1 case — radiation therapy. In 13% relapses of breast cancer were diagnosed at stage III of breast cancer, the lowest percentage of relapse 0.7% at stage III. In luminal type A recurrence of breast cancer was diagnosed in 1.8%, in luminal B in 2.4%, in triple negative type — 2.5%, in luminal B Her2 positive — 2.7%. Metastases of breast cancer in our group of patients were diagnosed in 22 (4.7 ± 0.9%) patients. The highest percentage of long-term metastasis in our study revealed — 12.5% at stage III, the lowest percentage of 2.8 at stage I breast cancer. 3‑year overall survival of breast cancer patients in our group was 97.8% (n = 269). Conclusion . Radical subcutaneous/skin-sparing mastectomies with simultaneous reconstruction are radical in the oncological plan of treatment and improve the quality of life in patients with breast cancer.
{"title":"RELAPSES AFTER RADICAL SUBCUTANEOUS/SKIN-SPARING MASTECTOMY WITH SIMULTANEOUS RECONSTRUCTION IN BREAST CANCER","authors":"A. Zikiryakhodzhayev, E. Rasskazova, A. Tukmakov, I. Shirokikh","doi":"10.17709/2409-2231-2019-6-1-3","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-3","url":null,"abstract":"Objective . To evaluate 3‑year disease-free survival in patients with breast cancer who underwent radical subcutaneous/skin-sparing mastectomy with simultaneous reconstruction. Patients and methods . The article analyzes 472 patients diagnosed with breast cancer who underwent radical subcutaneous/skin-sparing mastectomy in combined or complex treatment. In the Department of Oncology and reconstructive plastic surgery of the breast and skin radical skin mastectomy was performed in 255 (54.1%) and 217 (45.9%) patients with radical subcutaneous mastectomy. Reconstruction was carried out by autotissues, expanders, followed by replacement with endoprostheses, as well as a combination of flaps and endoprostheses. The mean age of patients was 43.8 ± 2.2 (18–73) years. In 32.3% of cases patients were in the age group up to 40 years. Results . In 9 (1,7 ± 0,6%) of patients diagnosed with a recurrence of breast cancer, herewith in 5 cases of local and in 4 cases of regional recurrence (metastases in the infraclavicular lymph nodes). Treatment of recurrences of breast cancer was as follows: in two cases polychemotherapy courses were conducted, in 6 cases operations were performed — excision of relapse in the breast (3) and subclavian lymphadenectomy (1), removal of the reconstructed gland (2), in 1 case — radiation therapy. In 13% relapses of breast cancer were diagnosed at stage III of breast cancer, the lowest percentage of relapse 0.7% at stage III. In luminal type A recurrence of breast cancer was diagnosed in 1.8%, in luminal B in 2.4%, in triple negative type — 2.5%, in luminal B Her2 positive — 2.7%. Metastases of breast cancer in our group of patients were diagnosed in 22 (4.7 ± 0.9%) patients. The highest percentage of long-term metastasis in our study revealed — 12.5% at stage III, the lowest percentage of 2.8 at stage I breast cancer. 3‑year overall survival of breast cancer patients in our group was 97.8% (n = 269). Conclusion . Radical subcutaneous/skin-sparing mastectomies with simultaneous reconstruction are radical in the oncological plan of treatment and improve the quality of life in patients with breast cancer.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"335 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115879857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-08DOI: 10.17709/2409-2231-2019-6-1-7
L. Moskvicheva
Extrahepatic bile duct cancer is one of those pathologies in which about 70% of patients due to the prevalence of the tumor process can not receive radical treatment, which determines the need for active implementation of methods that allow, while maintaining a satisfactory quality of life of patients, to increase survival rates. Due to the peculiarities of localization and development of malignant tumors of the extrahepatic bile ducts, as well as the nature of the disease, special importance in the treatment of these patients is given to various methods of external or internal bile removal and on the second stage of treatment can be considered local or systemic methods of exposure. Currently, as a method of local therapy in patients with unresectable extrahepatic bile duct cancer, various options of radiation therapy, radiofrequency and microwave ablation, photodynamic therapy are used. This article presents a literature review covering the feasibility, safety and efficacy of photodynamic therapy in patients with Klatskin tumor.
{"title":"PHOTODYNAMIC THERAPY IN PATIENTS WITH HILAR CHOLANGIOCARCINOMA","authors":"L. Moskvicheva","doi":"10.17709/2409-2231-2019-6-1-7","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-7","url":null,"abstract":"Extrahepatic bile duct cancer is one of those pathologies in which about 70% of patients due to the prevalence of the tumor process can not receive radical treatment, which determines the need for active implementation of methods that allow, while maintaining a satisfactory quality of life of patients, to increase survival rates. Due to the peculiarities of localization and development of malignant tumors of the extrahepatic bile ducts, as well as the nature of the disease, special importance in the treatment of these patients is given to various methods of external or internal bile removal and on the second stage of treatment can be considered local or systemic methods of exposure. Currently, as a method of local therapy in patients with unresectable extrahepatic bile duct cancer, various options of radiation therapy, radiofrequency and microwave ablation, photodynamic therapy are used. This article presents a literature review covering the feasibility, safety and efficacy of photodynamic therapy in patients with Klatskin tumor.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"226 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117354586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-08DOI: 10.17709/2409-2231-2019-6-1-10
M. Chernyavskiy, B. S. Artyushin, A. Chernov, D. Chernova, N. Zherdev, Y. Kudaev
Purpose. The purpose of the article is to access possibilities of blood flow mathematical analysis in aortic aneurysm before and after bare metal stent implantation.Materials and methods. Mathematical models of aortic blood flow were based on data received at studying 15 CT-scans of patients with abdominal aorta aneurysms (12) and dissections (3) and their duplex ultra-sound hemodynamic data. At constructing mathematical model the program SolidWorks was used. Working with the program consisted of two stages: establishment of conditions for geometric objects; forming of abdominal aorta model from these objects. In the study hemodinamic aneurysm indexes was evaluated on rectilinear and curvilinear segments. Some of characteristics were variable: diameter, aneurysm wall thickness, its length, elasticity.Results. Correlation of extreme tension into aneurysm wall on rectilinear and curvilinear segments according to aneurysm wall thickness was assessed. Possibilities of pathological blood flow changes correction at bare metal stent implantation into aortic aneurysm were estimated: if presence of bare metal stent were introduced into mathematical parameters blood flow characteristics became almost as standard characteristics. Received data can enhance successful endovascular treatment of aortic diseases with using of bare metal stents.Conclusion. Mathematical models of aortic and vascular aneurysms before and after surgery can be an effective tool in bettering quality of medical help for vascular patients.
{"title":"POSSIBILITIES OF APPLYING MATHEMATICAL ANALYSIS OF BLOOD FLOW CHARACTERISTICS IN ENDOVASCULAR TREATMENT OF AORTIC DISEASES USING HOLOMETALLIC STENTS","authors":"M. Chernyavskiy, B. S. Artyushin, A. Chernov, D. Chernova, N. Zherdev, Y. Kudaev","doi":"10.17709/2409-2231-2019-6-1-10","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-10","url":null,"abstract":"Purpose. The purpose of the article is to access possibilities of blood flow mathematical analysis in aortic aneurysm before and after bare metal stent implantation.Materials and methods. Mathematical models of aortic blood flow were based on data received at studying 15 CT-scans of patients with abdominal aorta aneurysms (12) and dissections (3) and their duplex ultra-sound hemodynamic data. At constructing mathematical model the program SolidWorks was used. Working with the program consisted of two stages: establishment of conditions for geometric objects; forming of abdominal aorta model from these objects. In the study hemodinamic aneurysm indexes was evaluated on rectilinear and curvilinear segments. Some of characteristics were variable: diameter, aneurysm wall thickness, its length, elasticity.Results. Correlation of extreme tension into aneurysm wall on rectilinear and curvilinear segments according to aneurysm wall thickness was assessed. Possibilities of pathological blood flow changes correction at bare metal stent implantation into aortic aneurysm were estimated: if presence of bare metal stent were introduced into mathematical parameters blood flow characteristics became almost as standard characteristics. Received data can enhance successful endovascular treatment of aortic diseases with using of bare metal stents.Conclusion. Mathematical models of aortic and vascular aneurysms before and after surgery can be an effective tool in bettering quality of medical help for vascular patients.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116196345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-08DOI: 10.17709/2409-2231-2019-6-1-4
S. Popov, R. Guseynov, O. Skryabin, I. Orlov, A. Vorobyov, A. Martov, V. L. Shchukin
{"title":"IMMUNOHISTOCHEMICAL ANALYSIS AS A METHOD FOR INCREASING THE DETECTION OF PROSTATE CANCER IN PRIMARY BIOPSY","authors":"S. Popov, R. Guseynov, O. Skryabin, I. Orlov, A. Vorobyov, A. Martov, V. L. Shchukin","doi":"10.17709/2409-2231-2019-6-1-4","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-4","url":null,"abstract":"","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"601 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132828643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-08DOI: 10.17709/2409-2231-2019-6-1-9
I. P. Dudanov, N. Vasilchenko, M. A. Askerov, O. Rubleva, D. V. Merkulov, V. V. Akhmetov, O. Shulga, M. O. Telukhina
{"title":"RARE CAUSES OF ISCHEMIC STROKE. FEATURES OF ACUTE STROKE IN PATIENTS WITH DISSECTION OF THE GREAT VESSELS","authors":"I. P. Dudanov, N. Vasilchenko, M. A. Askerov, O. Rubleva, D. V. Merkulov, V. V. Akhmetov, O. Shulga, M. O. Telukhina","doi":"10.17709/2409-2231-2019-6-1-9","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-9","url":null,"abstract":"","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"260 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132749523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-08DOI: 10.17709/2409-2231-2019-6-1-14
I. Lutskan, E. Borisova, N. Savvina, A. Bravin, L. Timofeev, O. Konovalov
Purpose. Population assessment of the quality and effectiveness of medical services, as well as the activities of medical organizations working with the child population in comparison with 2016–2017.Materials and methods. Sociological research in polyclinics of four large health care institutions of Yakutsk of the compared groups is carried out: Polyclinic No. 1–100 respondents, City hospital No. 2–60 respondents, City hospital No. 3–80 respondents, medical center of Yakutsk — 100 respondents. The study was conducted in 2016–2017. during the study, 340 respondents were interviewed, including 87% of women and 13% of men (the survey was conducted among parents and other legal representatives of minor patients).Results. The article deals with the issues related to the implementation in the activities of public health institutions of the Republic of Sakha (Yakutia) quality standards and evaluation of the results of their implementation in terms of patient awareness of the service (availability, openness of information), comfort conditions of service, waiting time for the service, the attitude of staff to patients (courtesy, goodwill), competence of staff and the overall level of satisfaction with the service provided. Despite the fact that more than 60% of respondents are aware of the functioning of the official websites of medical institutions, only 15.8% of respondents used information about the services and how to get them posted on them. At the same time, three-quarters of respondents are aware of the possibility of remote appointment by phone or Internet. However, only 18.6% of them took advantage of these opportunities, and 56% did not resort to them. The greatest criticism is caused by the lack of medical report on the patients’ state of health –60.8% of dissatisfied surveyed parents chose this criterion. More than 40% of complaints are due to the fact that pediatricians have not given recommendations for diagnosis and treatment. More than half of the survived participants (54.5%) at the recent visit to a medical institution, received a medical service on the day of making an appointment. The average waiting time to visit a paediatrician is 76 minutes. Two-thirds of respondents complain about the lack of available sitting chairs. Almost half of the respondents indicate the lack of drinking water in medical institutions, Almost 80% of respondents are generally satisfied with the medical services received in the clinics of Yakutsk. More than 70% of respondents are ready to recommend their clinic to friends, acquaintances and colleagues.Conclusion. According to the results of the study, it was concluded that the organizers of health care need to readjust appropriately some management procedures of the organizations, in particular: patients’ attendance by specialists, public relations, personnel management, facilities and resources, in connection with the visitor’s basic rebukes.
{"title":"THE BASIC CRITERIA FOR SATISFACTION WITH THE QUALITY OF MEDICAL SERVICES PROVIDED TO CHILDREN IN YAKUTSK","authors":"I. Lutskan, E. Borisova, N. Savvina, A. Bravin, L. Timofeev, O. Konovalov","doi":"10.17709/2409-2231-2019-6-1-14","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-14","url":null,"abstract":"Purpose. Population assessment of the quality and effectiveness of medical services, as well as the activities of medical organizations working with the child population in comparison with 2016–2017.Materials and methods. Sociological research in polyclinics of four large health care institutions of Yakutsk of the compared groups is carried out: Polyclinic No. 1–100 respondents, City hospital No. 2–60 respondents, City hospital No. 3–80 respondents, medical center of Yakutsk — 100 respondents. The study was conducted in 2016–2017. during the study, 340 respondents were interviewed, including 87% of women and 13% of men (the survey was conducted among parents and other legal representatives of minor patients).Results. The article deals with the issues related to the implementation in the activities of public health institutions of the Republic of Sakha (Yakutia) quality standards and evaluation of the results of their implementation in terms of patient awareness of the service (availability, openness of information), comfort conditions of service, waiting time for the service, the attitude of staff to patients (courtesy, goodwill), competence of staff and the overall level of satisfaction with the service provided. Despite the fact that more than 60% of respondents are aware of the functioning of the official websites of medical institutions, only 15.8% of respondents used information about the services and how to get them posted on them. At the same time, three-quarters of respondents are aware of the possibility of remote appointment by phone or Internet. However, only 18.6% of them took advantage of these opportunities, and 56% did not resort to them. The greatest criticism is caused by the lack of medical report on the patients’ state of health –60.8% of dissatisfied surveyed parents chose this criterion. More than 40% of complaints are due to the fact that pediatricians have not given recommendations for diagnosis and treatment. More than half of the survived participants (54.5%) at the recent visit to a medical institution, received a medical service on the day of making an appointment. The average waiting time to visit a paediatrician is 76 minutes. Two-thirds of respondents complain about the lack of available sitting chairs. Almost half of the respondents indicate the lack of drinking water in medical institutions, Almost 80% of respondents are generally satisfied with the medical services received in the clinics of Yakutsk. More than 70% of respondents are ready to recommend their clinic to friends, acquaintances and colleagues.Conclusion. According to the results of the study, it was concluded that the organizers of health care need to readjust appropriately some management procedures of the organizations, in particular: patients’ attendance by specialists, public relations, personnel management, facilities and resources, in connection with the visitor’s basic rebukes.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129219067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-08DOI: 10.17709/2409-2231-2019-6-1-13
A. Panov, T. Bykovskaya
The article pertains the main problems faced by manufacturers and consumers of paid medical services. The increase in the volume of paid medical care prevails in the fields of dentistry, diagnostics and cosmetology. Of course, the expansion of voluntary medical insurance in almost all areas of medicine, further digitalization and gradual development of commercial outpatient care will be promising areas in the domestic health care. After all, currently every fourth outpatient medical organization is private owned. In this regard, taking into account the foreign and domestic experience of modernization of the medical services market, the paper comprehensively analyzes the trends in the development of commercial medicine within the legal, organizational and socio-economic regulation of the health care industry. Marketing tools to optimize the system of paid services are presented. The key role of mechanisms of public-private interaction in health care management is proved. Integrative approaches to the problems of introduction and development of paid medical services, considered in this study, will allow to systematize and to adjust the extra-budgetary activities of medical organizations while simultaneously increasing the availability and quality of medical care in Russia.
{"title":"MODERN APPROACHES TO THE IMPROVEMENT OF THE INSTITUTE OF PAID MEDICAL SERVICES IN RUSSIA","authors":"A. Panov, T. Bykovskaya","doi":"10.17709/2409-2231-2019-6-1-13","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-13","url":null,"abstract":"The article pertains the main problems faced by manufacturers and consumers of paid medical services. The increase in the volume of paid medical care prevails in the fields of dentistry, diagnostics and cosmetology. Of course, the expansion of voluntary medical insurance in almost all areas of medicine, further digitalization and gradual development of commercial outpatient care will be promising areas in the domestic health care. After all, currently every fourth outpatient medical organization is private owned. In this regard, taking into account the foreign and domestic experience of modernization of the medical services market, the paper comprehensively analyzes the trends in the development of commercial medicine within the legal, organizational and socio-economic regulation of the health care industry. Marketing tools to optimize the system of paid services are presented. The key role of mechanisms of public-private interaction in health care management is proved. Integrative approaches to the problems of introduction and development of paid medical services, considered in this study, will allow to systematize and to adjust the extra-budgetary activities of medical organizations while simultaneously increasing the availability and quality of medical care in Russia.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125200089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-08DOI: 10.17709/2409-2231-2019-6-1-6
O. Fatuev, N. S. Kozlov, G. M. Korolyuk, I. Ratke, A. V. Ronzin, N. Stepanyants, E. N. Belov, V. V. Safronova, I. M. Vagabova
{"title":"NEW APPROACHES TO PREVENTION AND TREATMENT OF EARLY AND LATE POSTOPERATIVE LIMPHORRHEA","authors":"O. Fatuev, N. S. Kozlov, G. M. Korolyuk, I. Ratke, A. V. Ronzin, N. Stepanyants, E. N. Belov, V. V. Safronova, I. M. Vagabova","doi":"10.17709/2409-2231-2019-6-1-6","DOIUrl":"https://doi.org/10.17709/2409-2231-2019-6-1-6","url":null,"abstract":"","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127232661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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