Pub Date : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-183-190
Andreeva S.N., Furchakova A.V.
Today, ensuring the safety of patients and medical personnel is an integral part of medical practice. In dentistry, this problem is especially relevant, given the fact that dentists occupy one of the leading places in terms of the frequency of professional errors among doctors who have been sued, as well as the frequency of complaints from patients about the quality of medical care. This article discusses the safety of medical activities and the safety of medical care in medical organizations, in general, and in dentistry in particular, an analysis of the regulatory documentation in relation to these concepts is carried out, and issues of terminology are considered. Analysis of literary sources shows that today there is uncertainty in the interpretation of the concept of "safety of medical activity" due to the lack of a legislatively enshrined definition of this concept. With regard to dental practice, the safety of medical activities includes the safety of the patient, the safety of medical personnel, the safety of the environment in which dental care is provided, as well as the safety of pharmaceuticals and medical dental equipment. Organizational, legal, personnel and economic security can also be considered as constituent parts of the safety of medical activities. At the same time, there is no unambiguous understanding of the relationships between the concepts of safety of medical activity, safety of medical care, safety of medical services, safety of the medical environment. An important unresolved to date task is to determine the criteria for assessing the safety of medical activities. Taking into account the versatility of the concept of the safety of medical activities and the specifics of medical activities, it is necessary to develop criteria for assessing the safety of medical activities for each specialty, including dentistry. It seems that the assessment structure should be uniform for all medical activities, but include specific elements with criteria for the safety of medical activities in individual specialties.
{"title":"SAFETY OF MEDICAL ACTIVITY IN DENTISTRY","authors":"Andreeva S.N., Furchakova A.V.","doi":"10.26787/nydha-2686-6838-2021-23-9-183-190","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-183-190","url":null,"abstract":"Today, ensuring the safety of patients and medical personnel is an integral part of medical practice. In dentistry, this problem is especially relevant, given the fact that dentists occupy one of the leading places in terms of the frequency of professional errors among doctors who have been sued, as well as the frequency of complaints from patients about the quality of medical care. This article discusses the safety of medical activities and the safety of medical care in medical organizations, in general, and in dentistry in particular, an analysis of the regulatory documentation in relation to these concepts is carried out, and issues of terminology are considered. Analysis of literary sources shows that today there is uncertainty in the interpretation of the concept of \"safety of medical activity\" due to the lack of a legislatively enshrined definition of this concept. With regard to dental practice, the safety of medical activities includes the safety of the patient, the safety of medical personnel, the safety of the environment in which dental care is provided, as well as the safety of pharmaceuticals and medical dental equipment. Organizational, legal, personnel and economic security can also be considered as constituent parts of the safety of medical activities. At the same time, there is no unambiguous understanding of the relationships between the concepts of safety of medical activity, safety of medical care, safety of medical services, safety of the medical environment. An important unresolved to date task is to determine the criteria for assessing the safety of medical activities. Taking into account the versatility of the concept of the safety of medical activities and the specifics of medical activities, it is necessary to develop criteria for assessing the safety of medical activities for each specialty, including dentistry. It seems that the assessment structure should be uniform for all medical activities, but include specific elements with criteria for the safety of medical activities in individual specialties.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125385856","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-67-75
Kubasova E.D., Korelskaya G.V., Kubasov R.V.
The Medicinal Lovage (Levisticum Officinale) grows almost everywhere. In order to use Levisticum Officinale in economic needs, including in medicine, a number of countries are specially engaged in its cultivation. The analysis of the scientific literature revealed a large number of publications confirming the diverse chemical spectrum of rhizomes, roots and herbs of the medicinal lovage. In this regard, it is used as a medicinal raw material and is included in a number of European Pharmacopoeias. For medical purposes, all parts of this plant that contain biologically active substances can be used. Levisticum officinale contains various phytochemical compounds and secondary metabolites – terpenoids, flavonoids, essential oils, phthalides, polyacetylenes, coumarins, phenylpropanoids, alkaloids, tannins, phenolic acids, polyacetylenes. All of them have properties that can have a therapeutic effect on the organism. The composition of essential oils of Levisticum Officinale is the most studied. It is mainly represented by monoterpene hydrocarbons, sexwiterpenes and phthalides. There are some differences in the chemical composition of Levisticum Officinale. Most scientists agree that such a discrepancy may be related to the period and process of harvesting plant raw materials, age, genotype of the plant, climatic conditions and place of growth, as well as the method of extraction and the method of identification and quantitative determination of biologically active substances. Therefore, there is a problem of a single universal system of preparation and further use of raw materials. The development of modern methods for analyzing the raw materials of lovage and the study of its chemical composition creates prerequisites for expanding its use as a medicinal plant.
{"title":"LEVISTICUM OFFICINALE (F. APIACEAE): HABITAT, BOTANICAL DESCRIPTION AND CHEMICAL COMPOSITION (REVIEW)","authors":"Kubasova E.D., Korelskaya G.V., Kubasov R.V.","doi":"10.26787/nydha-2686-6838-2021-23-9-67-75","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-67-75","url":null,"abstract":"The Medicinal Lovage (Levisticum Officinale) grows almost everywhere. In order to use Levisticum Officinale in economic needs, including in medicine, a number of countries are specially engaged in its cultivation. The analysis of the scientific literature revealed a large number of publications confirming the diverse chemical spectrum of rhizomes, roots and herbs of the medicinal lovage. In this regard, it is used as a medicinal raw material and is included in a number of European Pharmacopoeias. For medical purposes, all parts of this plant that contain biologically active substances can be used. Levisticum officinale contains various phytochemical compounds and secondary metabolites – terpenoids, flavonoids, essential oils, phthalides, polyacetylenes, coumarins, phenylpropanoids, alkaloids, tannins, phenolic acids, polyacetylenes. All of them have properties that can have a therapeutic effect on the organism. The composition of essential oils of Levisticum Officinale is the most studied. It is mainly represented by monoterpene hydrocarbons, sexwiterpenes and phthalides. There are some differences in the chemical composition of Levisticum Officinale. Most scientists agree that such a discrepancy may be related to the period and process of harvesting plant raw materials, age, genotype of the plant, climatic conditions and place of growth, as well as the method of extraction and the method of identification and quantitative determination of biologically active substances. Therefore, there is a problem of a single universal system of preparation and further use of raw materials. The development of modern methods for analyzing the raw materials of lovage and the study of its chemical composition creates prerequisites for expanding its use as a medicinal plant.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124162295","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-128-135
Rybakova T.A., Stolyarov V.V., Gizova M.V.
This work is devoted to the dynamic study of heart rate variability indicators for one year in patients with paroxysmal atrial fibrillation treated with antiarrhythmic drugs metoprolol and cordarone. The study found that patients treated with metoprolol monotherapy had a weakening of parasympathetic effects on the heart, due to a decrease in Mean by 12.9%, Mo by 13%, Amo by 29.4%, SDNN by 28.3% compared to the group of healthy individuals, but they differed in stable indicators of heart rate variability and 33% retained sinus rhythm during the year. With cordarone monotherapy, there was a curative effect of sympathetic and parasympathetic effects on the heart, as indicated by an increase in: Mean by 15.9%, Mo by 15.9%, IVR by 95.5%, Amo by 41.1% and a decrease in SDNN by 37.5%, compared with the group of healthy individuals at the initial stage. A year later, a negative dynamics was revealed - the predominance of sympathetic influences on the heart compared to the groups of healthy individuals and the control due to an increase in: IVR by 363.3% and 238.5%; VPR by 116.7% and 106%; Amo by 111.2% and 72.9; IN by 304% and 246.8%; PAPR by 92% and 79.1%, respectively. During the year, 39% of patients left the study due to the replacement of antiarrhythmic therapy and 16.5% due to the development of a permanent form of atrial fibrillation. In the remaining patients in the study, in comparison with their initial data, there was a predominance of sympathetic effects on the heart due to an increase in IVR by 137%. In combination therapy with metoprolol and cordarone, there were no significant changes in heart rate variability compared to the initial ones. Initially, there was a decrease in overall heart rate variability due to a decrease in SDNN by 28.4% and a decrease in parasympathetic effects on the heart due to an increase in Amo by 45.2% and a decrease in Delta X by 32.9% compared to the group of healthy individuals. After a year, 40% left the study due to the replacement of antiarrhythmic therapy and 30% due to the development of a permanent form of atrial fibrillation. During dynamic observation of patients, it was found that the following indicators have the most important prognostic value in the development of atrial fibrillation: SDNN, Delta X and RMSSD. Therefore, it is very important to register an ECG with the measurement of these indicators at least once every 3 months for timely correction of treatment.
{"title":"STUDY OF HEART RATE VARIABILITY IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION DURING PROPHYLACTIC TREATMENT OF METOPROLOL AND CORDARONE FOR ONE YEAR","authors":"Rybakova T.A., Stolyarov V.V., Gizova M.V.","doi":"10.26787/nydha-2686-6838-2021-23-9-128-135","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-128-135","url":null,"abstract":"This work is devoted to the dynamic study of heart rate variability indicators for one year in patients with paroxysmal atrial fibrillation treated with antiarrhythmic drugs metoprolol and cordarone. The study found that patients treated with metoprolol monotherapy had a weakening of parasympathetic effects on the heart, due to a decrease in Mean by 12.9%, Mo by 13%, Amo by 29.4%, SDNN by 28.3% compared to the group of healthy individuals, but they differed in stable indicators of heart rate variability and 33% retained sinus rhythm during the year. With cordarone monotherapy, there was a curative effect of sympathetic and parasympathetic effects on the heart, as indicated by an increase in: Mean by 15.9%, Mo by 15.9%, IVR by 95.5%, Amo by 41.1% and a decrease in SDNN by 37.5%, compared with the group of healthy individuals at the initial stage. A year later, a negative dynamics was revealed - the predominance of sympathetic influences on the heart compared to the groups of healthy individuals and the control due to an increase in: IVR by 363.3% and 238.5%; VPR by 116.7% and 106%; Amo by 111.2% and 72.9; IN by 304% and 246.8%; PAPR by 92% and 79.1%, respectively. During the year, 39% of patients left the study due to the replacement of antiarrhythmic therapy and 16.5% due to the development of a permanent form of atrial fibrillation. In the remaining patients in the study, in comparison with their initial data, there was a predominance of sympathetic effects on the heart due to an increase in IVR by 137%. In combination therapy with metoprolol and cordarone, there were no significant changes in heart rate variability compared to the initial ones. Initially, there was a decrease in overall heart rate variability due to a decrease in SDNN by 28.4% and a decrease in parasympathetic effects on the heart due to an increase in Amo by 45.2% and a decrease in Delta X by 32.9% compared to the group of healthy individuals. After a year, 40% left the study due to the replacement of antiarrhythmic therapy and 30% due to the development of a permanent form of atrial fibrillation. During dynamic observation of patients, it was found that the following indicators have the most important prognostic value in the development of atrial fibrillation: SDNN, Delta X and RMSSD. Therefore, it is very important to register an ECG with the measurement of these indicators at least once every 3 months for timely correction of treatment.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132019122","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-45-51
Jalilov A.K., I. R.G.
Antiplatelet therapy with aspirin and clopidogrel has clear advantages in reducing serious adverse cardiovascular events and mortality following acute coronary syndrome. Although these drugs may pose an additional risk of bleeding in the small percentage of acute coronary syndrome patients who will undergo coronary artery bypass grafting, the benefits are vastly superior, and most bleeding can be reduced, if possible, by delaying coronary artery bypass grafting. Short-acting anticoagulants can be administered flexibly, allowing platelet function to be restored after clopidogrel is discontinued. The postoperative bleeding time may clarify the need for platelet transfusion in case of bleeding. Coronary artery bypass grafting without the use of a heart-lung machine may offer some benefits by avoiding heparinization and the inflammatory response associated with bypass surgery. Secondary prophylaxis with antiplatelet therapy, beta-blockers, lipid-lowering therapy, and ACE inhibitors or angiotensin-converting enzyme inhibitors is critical to the long-term success of revascularization. In this regard, it should be borne in mind that regardless of the method of revascularization, patients with acute coronary syndrome are characterized by the clinical benefit of taking antiplatelet agents such as aspirin and clopidogrel, since these drugs reduce the risk of serious adverse events. On the other hand, antiplatelet agents also increase the risk of bleeding in patients who will eventually undergo coronary artery bypass grafting. However, scientists indicate that in most cases, the benefits of early initiation of antiplatelet therapy outweigh the potential risks [1]. In addition, the beneficial effects of aspirin and clopidogrel in acute coronary syndrome are additive. In the study of clopidogrel, indicated for the prevention of recurrence of unstable angina and non-ST-segment elevation myocardial infarction, patients taking both clopidogrel and aspirin were less likely to die of cardiac death, non-fatal myocardial infarction, or stroke at 30 days and 1 year compared with patients who took only aspirin [22]. All these studies confirm that antiplatelet therapy with aspirin and clopidogrel should be carried out in the early stages of acute coronary syndrome. In patients with ST-segment elevation myocardial infarction, clopidogrel improves outcomes in addition to aspirin. In a trial of clopidogrel and metoprolol for myocardial infarction, clopidogrel, in addition to aspirin, was associated with a significant reduction in death, re-heart attack, or stroke compared with aspirin alone [14].
{"title":"ANTIPLATELET THERAPY AND SECONDARY PROPHYLAXIS AFTER CORONARY BYPASS SURGERY IN ACUTE CORONARY SYNDROME","authors":"Jalilov A.K., I. R.G.","doi":"10.26787/nydha-2686-6838-2021-23-9-45-51","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-45-51","url":null,"abstract":"Antiplatelet therapy with aspirin and clopidogrel has clear advantages in reducing serious adverse cardiovascular events and mortality following acute coronary syndrome. Although these drugs may pose an additional risk of bleeding in the small percentage of acute coronary syndrome patients who will undergo coronary artery bypass grafting, the benefits are vastly superior, and most bleeding can be reduced, if possible, by delaying coronary artery bypass grafting. Short-acting anticoagulants can be administered flexibly, allowing platelet function to be restored after clopidogrel is discontinued. The postoperative bleeding time may clarify the need for platelet transfusion in case of bleeding. Coronary artery bypass grafting without the use of a heart-lung machine may offer some benefits by avoiding heparinization and the inflammatory response associated with bypass surgery. Secondary prophylaxis with antiplatelet therapy, beta-blockers, lipid-lowering therapy, and ACE inhibitors or angiotensin-converting enzyme inhibitors is critical to the long-term success of revascularization. In this regard, it should be borne in mind that regardless of the method of revascularization, patients with acute coronary syndrome are characterized by the clinical benefit of taking antiplatelet agents such as aspirin and clopidogrel, since these drugs reduce the risk of serious adverse events. On the other hand, antiplatelet agents also increase the risk of bleeding in patients who will eventually undergo coronary artery bypass grafting. However, scientists indicate that in most cases, the benefits of early initiation of antiplatelet therapy outweigh the potential risks [1]. In addition, the beneficial effects of aspirin and clopidogrel in acute coronary syndrome are additive. In the study of clopidogrel, indicated for the prevention of recurrence of unstable angina and non-ST-segment elevation myocardial infarction, patients taking both clopidogrel and aspirin were less likely to die of cardiac death, non-fatal myocardial infarction, or stroke at 30 days and 1 year compared with patients who took only aspirin [22]. All these studies confirm that antiplatelet therapy with aspirin and clopidogrel should be carried out in the early stages of acute coronary syndrome. In patients with ST-segment elevation myocardial infarction, clopidogrel improves outcomes in addition to aspirin. In a trial of clopidogrel and metoprolol for myocardial infarction, clopidogrel, in addition to aspirin, was associated with a significant reduction in death, re-heart attack, or stroke compared with aspirin alone [14].","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123241352","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-23-29
Ermolaev D.O., Ermolaeva Yu.N., Mordovсev N.A.
The relevance of the study due to the need to pay more attention to the effective planning of health care volumes under the compulsory health insurance and the creation of an accessible system of medical rehabilitation for adults in the region. The purpose of the study is to analyze the availability and effectiveness of medical care provided to adults in the "medical rehabilitation" profile within the framework of compulsory medical insurance in the Astrakhan region. Materials and methods - on the basis of data from the Federal State Statistics Service, the territorial fund of compulsory medical insurance in the Astrakhan region, annual reporting statistical forms No. 30, 14, 14-DS, the calculation and analysis of indicators of the optimal volume of medical care for the profile of medical rehabilitation was carried out, taking into account the profile of the disease (the number of hospitalizations per one inhabitant per year, funding per unit of the volume of medical care) of adult patients aged 18 years and older. Results and discussion - the article presents the results of assessing the planned and actual indicators of the volume of medical care for medical rehabilitation for adults, taking into account the profile of diseases in the conditions of round-the-clock and day hospitals of medical organizations participating in the territorial program of state guarantees of free provision of medical care to citizens in the region in 2019. It was revealed that at the expense of the compulsory medical insurance fund, the largest proportion of treated patients in rehabilitation beds is noted among those who receive medical services for neuro- and cardiac rehabilitation. However, rehabilitation care for critically ill patients with scores on the rehabilitation routing scale of 5 and 6 points, with a high rehabilitation potential, as well as for other categories of patients with somatic diseases, remains inaccessible. Conclusion. The obtained research data can be used for further organizational and methodological work to increase the availability and efficiency of medical rehabilitation care for adults, the development of available routing schemes, selection procedures, digitalization of the management of patient flows sent to medical rehabilitation within the framework of compulsory medical insurance at the regional level.
{"title":"ANALYSIS OF THE AVAILABILITY AND EFFICIENCY OF MEDICAL CARE PROVIDED TO PATIENTS IN THE PROFILE \"MEDICAL REHABILITATION\" IN ASTRAKHAN REGION","authors":"Ermolaev D.O., Ermolaeva Yu.N., Mordovсev N.A.","doi":"10.26787/nydha-2686-6838-2021-23-9-23-29","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-23-29","url":null,"abstract":"The relevance of the study due to the need to pay more attention to the effective planning of health care volumes under the compulsory health insurance and the creation of an accessible system of medical rehabilitation for adults in the region. The purpose of the study is to analyze the availability and effectiveness of medical care provided to adults in the \"medical rehabilitation\" profile within the framework of compulsory medical insurance in the Astrakhan region. Materials and methods - on the basis of data from the Federal State Statistics Service, the territorial fund of compulsory medical insurance in the Astrakhan region, annual reporting statistical forms No. 30, 14, 14-DS, the calculation and analysis of indicators of the optimal volume of medical care for the profile of medical rehabilitation was carried out, taking into account the profile of the disease (the number of hospitalizations per one inhabitant per year, funding per unit of the volume of medical care) of adult patients aged 18 years and older. Results and discussion - the article presents the results of assessing the planned and actual indicators of the volume of medical care for medical rehabilitation for adults, taking into account the profile of diseases in the conditions of round-the-clock and day hospitals of medical organizations participating in the territorial program of state guarantees of free provision of medical care to citizens in the region in 2019. It was revealed that at the expense of the compulsory medical insurance fund, the largest proportion of treated patients in rehabilitation beds is noted among those who receive medical services for neuro- and cardiac rehabilitation. However, rehabilitation care for critically ill patients with scores on the rehabilitation routing scale of 5 and 6 points, with a high rehabilitation potential, as well as for other categories of patients with somatic diseases, remains inaccessible. Conclusion. The obtained research data can be used for further organizational and methodological work to increase the availability and efficiency of medical rehabilitation care for adults, the development of available routing schemes, selection procedures, digitalization of the management of patient flows sent to medical rehabilitation within the framework of compulsory medical insurance at the regional level.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115541143","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 : 2021-09-11DOI: 10.26787/nydha-2686-6838-2021-23-9-136-141
Shurygin A.A., M. E.A.
The effectiveness of a course of chemotherapy largely depends on the continuity and duration. An ineffective outcome of a course of chemotherapy, in addition to objective reasons, also has an additional factor that strengthens it – a break in treatment or its early termination. The aim of the work is to study the effectiveness of treatment of patients with pulmonary tuberculosis with preserved drug sensitivity of the pathogen with early termination of the course of chemotherapy. Materials and methods: A retrospective analysis of the outcomes of a course of chemotherapy of tuberculosis patients who prematurely interrupted treatment, registered for 1-2-3 chemotherapy regimens in the Perm Region, was carried out. Results: Interruptions in treatment or its early termination were present in 7.8% of patients registered for treatment with 1-2-3 chemotherapy regimens. At the stage of inpatient treatment, there is a separation from treatment in 3.5% of patients receiving treatment in the intensive phase of 1-2-3 chemotherapy regimens. Separation from treatment at the outpatient stage is noted in 7.9% of patients receiving treatment in the continuation phase of 1-2-3 chemotherapy regimens, these terms are insufficient for a full course of chemotherapy.. An additional unfavorable factor of intermittent treatment is the formation of secondary drug resistance of Mycobacterium tuberculosis. The ineffectiveness of the course of chemotherapy leads to an increase in the number of patients with tuberculosis and the tension of the epidemic situation. Conclusions: In the treatment of patients with drug-sensitive tuberculosis in the Perm Region, treatment is interrupted more often at the outpatient stage than at the inpatient stage (p=0.03), which requires further study of the reasons for preventing early termination of treatment. It was found that the termination of treatment prematurely in all patients led to the ineffectiveness of CT. Social factors (lack of income, unfavorable living conditions and distance from drug dispensaries, staffing of qualified medical personnel) can affect the adherence and effectiveness of treatment.
{"title":"INFLUENCE OF EARLY TERMINATION OF TREATMENT OF PATIENTS WITH TUBERCULOSIS ON ITS EFFECTIVENESS","authors":"Shurygin A.A., M. E.A.","doi":"10.26787/nydha-2686-6838-2021-23-9-136-141","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-136-141","url":null,"abstract":"The effectiveness of a course of chemotherapy largely depends on the continuity and duration. An ineffective outcome of a course of chemotherapy, in addition to objective reasons, also has an additional factor that strengthens it – a break in treatment or its early termination. The aim of the work is to study the effectiveness of treatment of patients with pulmonary tuberculosis with preserved drug sensitivity of the pathogen with early termination of the course of chemotherapy. Materials and methods: A retrospective analysis of the outcomes of a course of chemotherapy of tuberculosis patients who prematurely interrupted treatment, registered for 1-2-3 chemotherapy regimens in the Perm Region, was carried out. Results: Interruptions in treatment or its early termination were present in 7.8% of patients registered for treatment with 1-2-3 chemotherapy regimens. At the stage of inpatient treatment, there is a separation from treatment in 3.5% of patients receiving treatment in the intensive phase of 1-2-3 chemotherapy regimens. Separation from treatment at the outpatient stage is noted in 7.9% of patients receiving treatment in the continuation phase of 1-2-3 chemotherapy regimens, these terms are insufficient for a full course of chemotherapy.. An additional unfavorable factor of intermittent treatment is the formation of secondary drug resistance of Mycobacterium tuberculosis. The ineffectiveness of the course of chemotherapy leads to an increase in the number of patients with tuberculosis and the tension of the epidemic situation. Conclusions: In the treatment of patients with drug-sensitive tuberculosis in the Perm Region, treatment is interrupted more often at the outpatient stage than at the inpatient stage (p=0.03), which requires further study of the reasons for preventing early termination of treatment. It was found that the termination of treatment prematurely in all patients led to the ineffectiveness of CT. Social factors (lack of income, unfavorable living conditions and distance from drug dispensaries, staffing of qualified medical personnel) can affect the adherence and effectiveness of treatment.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125995783","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}
The relevance of the study is due to the insufficient development of improving the structural component of the quality of medical care in terms of the cultural characteristics of the participants in their provision. The purpose of the study: to determine the contribution of the patient's culture factor to ensuring the quality of medical care of different profiles. The collection of material was carried out by the method of sociological survey of patients on the original questionnaires and the method of expert assessment of cases of medical care. The volume of the sample population formed by random selection amounted to 256 patients of dental profile, 320 therapeutic, 196 surgical (urological), 210 pediatric profile, respectively. An expert assessment of the quality of medical care was carried out according to the methodology that takes into account the implementation of its individual properties, for 984 cases of assistance. It is established that the quality of medical care is reliably influenced by the state of the cultural profile of patients. It was found that the assessment of the patient structural component of the quality of medical services without taking into account their profile was reduced to 40.6% relative to the maximum assessment, especially the characteristics of the sanological and information culture of the patient. The analysis of the role of patient cultural characteristics in the formation of the structural component of the quality of medical services showed the presence among them of characteristics that have a significant impact on the decline in the quality of services. The revealed differences in the value of the relative risk of the same patient cultural risk factor for reducing the quality of medical services in their different profiles substantiated the need to differentiate factors into high-risk and low-risk. The basis for managing the culture of patients should be measures to transform low gradations of cultural characteristics of patients into high ones, through medical information and education, socio-psychological counseling, patient education and the formation of behaviors focused on the preservation and promotion of health.
{"title":"PATIENT CULTURE AS A FACTOR IN ENSURING THE QUALITY OF MEDICAL CARE","authors":"Oleynik A.V., Mushnikov D.L., Germakhanov Z.Z., Drobysheva E.V.","doi":"10.26787/nydha-2686-6838-2021-23-9-106-112","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-9-106-112","url":null,"abstract":"The relevance of the study is due to the insufficient development of improving the structural component of the quality of medical care in terms of the cultural characteristics of the participants in their provision. The purpose of the study: to determine the contribution of the patient's culture factor to ensuring the quality of medical care of different profiles. The collection of material was carried out by the method of sociological survey of patients on the original questionnaires and the method of expert assessment of cases of medical care. The volume of the sample population formed by random selection amounted to 256 patients of dental profile, 320 therapeutic, 196 surgical (urological), 210 pediatric profile, respectively. An expert assessment of the quality of medical care was carried out according to the methodology that takes into account the implementation of its individual properties, for 984 cases of assistance. It is established that the quality of medical care is reliably influenced by the state of the cultural profile of patients. It was found that the assessment of the patient structural component of the quality of medical services without taking into account their profile was reduced to 40.6% relative to the maximum assessment, especially the characteristics of the sanological and information culture of the patient. The analysis of the role of patient cultural characteristics in the formation of the structural component of the quality of medical services showed the presence among them of characteristics that have a significant impact on the decline in the quality of services. The revealed differences in the value of the relative risk of the same patient cultural risk factor for reducing the quality of medical services in their different profiles substantiated the need to differentiate factors into high-risk and low-risk. The basis for managing the culture of patients should be measures to transform low gradations of cultural characteristics of patients into high ones, through medical information and education, socio-psychological counseling, patient education and the formation of behaviors focused on the preservation and promotion of health.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121654444","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 : 2021-08-30DOI: 10.26787/nydha-2686-6838-2021-23-8-41-48
Spiridenko G.Yu., Petrov Yu.A., Palieva N.V.
Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.
{"title":"REPRODUCTIVE POTENTIAL OF WOMEN WITH PREMATURE OVARIAN INSUFFICIENCY","authors":"Spiridenko G.Yu., Petrov Yu.A., Palieva N.V.","doi":"10.26787/nydha-2686-6838-2021-23-8-41-48","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-8-41-48","url":null,"abstract":"Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125104283","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 : 2021-08-30DOI: 10.26787/nydha-2686-6838-2021-23-8-34-40
Petrov Yu.A., Spiridenko G.Yu., Bragina T.V.
The topic of intrauterine contraception remains relevant for a very long time. The active search for optimal and safe means of intrauterine contraception began in the last century and is gaining more and more momentum in the modern world. The importance of this issue is due to the continuing need of the population of reproductive age to control childbearing, the popularization of data on various methods of birth control and the desire to use safe, effective, environmentally friendly methods of contraception. The presented topic touches on the aspects of family planning and pre-gravidar training, so it is not only a significant medical, but also a social problem. This leads to the constant need to study new mechanisms of systemic and local effects of intrauterine contraceptives on the female body. This article discusses the use of intrauterine contraceptives, the features of their impact on the endometrium, the reproductive potential of women, as well as the positive and negative aspects of their use. There are also groups of women for whom intrauterine contraception is the method of choice for birth control. The indications for the extraction of an intrauterine contraceptive are described. Among them, there are menstrual disorders of the type of hypermenorrhea lasting more than 6 months in the absence of the effect of the use of non-steroidal anti-inflammatory drugs, the end of the period of use of an intrauterine contraceptive, the desire and need of a woman, the desired pregnancy, expulsions, the postmenopausal period. Knowledge of all aspects of intrauterine contraception allows the obstetrician-gynecologist to correctly select a certain type of IUD, to explain to the woman all the risks of its use, to diagnose and correct complications in a timely manner.
{"title":"THE RESURGENCE OF INTRAUTERINE CONTRACEPTION","authors":"Petrov Yu.A., Spiridenko G.Yu., Bragina T.V.","doi":"10.26787/nydha-2686-6838-2021-23-8-34-40","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-8-34-40","url":null,"abstract":"The topic of intrauterine contraception remains relevant for a very long time. The active search for optimal and safe means of intrauterine contraception began in the last century and is gaining more and more momentum in the modern world. The importance of this issue is due to the continuing need of the population of reproductive age to control childbearing, the popularization of data on various methods of birth control and the desire to use safe, effective, environmentally friendly methods of contraception. The presented topic touches on the aspects of family planning and pre-gravidar training, so it is not only a significant medical, but also a social problem. This leads to the constant need to study new mechanisms of systemic and local effects of intrauterine contraceptives on the female body. This article discusses the use of intrauterine contraceptives, the features of their impact on the endometrium, the reproductive potential of women, as well as the positive and negative aspects of their use. There are also groups of women for whom intrauterine contraception is the method of choice for birth control. The indications for the extraction of an intrauterine contraceptive are described. Among them, there are menstrual disorders of the type of hypermenorrhea lasting more than 6 months in the absence of the effect of the use of non-steroidal anti-inflammatory drugs, the end of the period of use of an intrauterine contraceptive, the desire and need of a woman, the desired pregnancy, expulsions, the postmenopausal period. Knowledge of all aspects of intrauterine contraception allows the obstetrician-gynecologist to correctly select a certain type of IUD, to explain to the woman all the risks of its use, to diagnose and correct complications in a timely manner.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115050913","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 : 2021-08-30DOI: 10.26787/nydha-2686-6838-2021-23-8-28-33
Kolyagina N.M., Berezhnova T.A., Kulintsova Ya.V., Elistratova O.S., Drapalyuk M.A.
Relevance. Exacerbation of the disease, as a rule, leads to the patient seeking medical help. In this regard, data on the population's access to medical care can serve as an indicator of the exacerbation of the disease. Aim: to analyze meteorological risk factors that contribute to the development of cardiovascular diseases. Material and methods. The ratio of the average number of cases of requests for medical care on unfavorable days for meteorological factors to the average number of cases of requests per day for medical care during the year was calculated. Using software tools (STATISTICA Base V6. 1), the type of data distribution was estimated, and a correlation analysis of the likely relationship between the number of medical care requests and the indicators of meteorological factors was carried out. Results. As a result of the study, it was found that the average number of cases of medical care requests on hot days (air temperature over + 300C) is 1.1-1.4 times higher than the average number of cases of requests per day for the same reasons (diagnoses) during the year and is abnormal for the territory of the city of Voronezh, due to such diagnoses as hypertension without heart failure, brain vascular lesions (specified), cerebrovascular disease, hypertension with heart failure. Conclusions. Thus, it was found that one of the meteorological risk factors for the formation of cardiovascular pathology is high air temperature (above + 300C), which is the goal for the implementation of the main directions of prevention of increased weather sensitivity and treatment of weather-dependent patients.
的相关性。通常情况下，病情加重会导致患者寻求医疗帮助。在这方面，关于人口获得医疗保健的数据可以作为疾病恶化的一个指标。目的:分析心血管疾病发生的气象危险因素。材料和方法。计算了在气象因素不利的日子请求医疗护理的平均病例数与一年中每天请求医疗护理的平均病例数的比率。使用软件工具(STATISTICA Base V6)。1)估计了数据分布类型，并对医疗请求次数与气象因素指标之间的可能关系进行了相关分析。作为这项研究的结果,发现医疗服务请求的平均病例数天热时(空气温度超过+ 300 c)是1.1 - -1.4倍的平均数量情况下每天的请求同样的理由(诊断),是不正常的沃罗涅日市境内,由于没有心力衰竭等诊断高血压,大脑血管病变(指定)、脑血管疾病、高血压和心脏failure.Conclusions。由此发现，高气温(+ 300C以上)是心血管病理形成的气象危险因素之一，是防治天气敏感性增高和治疗天气依赖患者的主要方向。
{"title":"ADVERSE METEOROLOGICAL SITUATION AS A RISK FACTOR FOR CARDIOVASCULAR DISEASES","authors":"Kolyagina N.M., Berezhnova T.A., Kulintsova Ya.V., Elistratova O.S., Drapalyuk M.A.","doi":"10.26787/nydha-2686-6838-2021-23-8-28-33","DOIUrl":"https://doi.org/10.26787/nydha-2686-6838-2021-23-8-28-33","url":null,"abstract":"Relevance. Exacerbation of the disease, as a rule, leads to the patient seeking medical help. In this regard, data on the population's access to medical care can serve as an indicator of the exacerbation of the disease.\u0000Aim: to analyze meteorological risk factors that contribute to the development of cardiovascular diseases.\u0000Material and methods. The ratio of the average number of cases of requests for medical care on unfavorable days for meteorological factors to the average number of cases of requests per day for medical care during the year was calculated. Using software tools (STATISTICA Base V6. 1), the type of data distribution was estimated, and a correlation analysis of the likely relationship between the number of medical care requests and the indicators of meteorological factors was carried out.\u0000Results. As a result of the study, it was found that the average number of cases of medical care requests on hot days (air temperature over + 300C) is 1.1-1.4 times higher than the average number of cases of requests per day for the same reasons (diagnoses) during the year and is abnormal for the territory of the city of Voronezh, due to such diagnoses as hypertension without heart failure, brain vascular lesions (specified), cerebrovascular disease, hypertension with heart failure.\u0000Conclusions. Thus, it was found that one of the meteorological risk factors for the formation of cardiovascular pathology is high air temperature (above + 300C), which is the goal for the implementation of the main directions of prevention of increased weather sensitivity and treatment of weather-dependent patients.","PeriodicalId":445713,"journal":{"name":"\"Medical & pharmaceutical journal \"Pulse\"","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129937023","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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