Cardiovascular Therapy and Prevention最新文献

{"title":"Low-intensity inflammation as a manifestation of comorbidity and a factor in the unfavorable clinical course of heart failure with preserved ejection fraction","authors":"K. N. Vitt, E. A. Kuzheleva, O. V. Tukish, M. Soldatenko, M. Kondratiev, O. Ogurkova, T. Suslova, A. A. Garganeeva","doi":"10.15829/1728-8800-2024-3847","DOIUrl":"https://doi.org/10.15829/1728-8800-2024-3847","url":null,"abstract":"Aim. To analyze the prognostic significance of clinical, anamnestic and paraclinical parameters in patients with heart failure with preserved ejection fraction (HFpEF) and non-obstructive coronary artery disease.Material and methods. The study included 54 patients. Cardiac and lung ultrasound was performed. In addition, the level of N-terminal pro-brain natriuretic peptide (NT-proBNP), interleukin-1β, interleukin-18, growth differentiation factor 15 (GDF-15), and cryopyrin was determined. The level of quality of life, anxiety and depression, and adherence to treatment were analyzed.Results. The patients were divided into 2 following groups: group 1 (n=22) with an unfavorable course and group 2 (n=32) with a favorable disease course. Basic echocardiographic parameters, as well as the number of B-lines in lungs, were comparable in both groups. An unfavorable HFpEF course was associated with a longer history of hypertension — 17,5 [10;20] and 7 [5;15] years (p=0,03), smoking — 36,4 and 9,4% (p=0,035), impaired carbohydrate metabolism — 54,5 and 15,6% (p=0,003) and lower adherence to treatment (p=0,02). In group 1, GDF-15 levels were higher than in group 2 — 1841 [1237;3552] vs 1709,5 [1158;2492] pg/ml (p=0,026).Conclusion. Low-intensity subclinical inflammation, the predisposing factors of which are smoking, impaired carbohydrate metabolism, and a long history of hypertension, is associated with higher GDF-15 values in patients with HFpEF and, along with low patient adherence to treatment, has an adverse effect on the clinical course of heart failure.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"85 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486049","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}

{"title":"The concept of teaching internal medicine subjects","authors":"E. Onuchina, M. G. Golubchikova","doi":"10.15829/1728-88002023-3912","DOIUrl":"https://doi.org/10.15829/1728-88002023-3912","url":null,"abstract":"Бурное развитие медицинской науки, из года в год возрастающий объем научно-технической информации, значительные успехи практического здравоохранения, все более широкое оснащение лечебно- профилактических учреждений сложной современной аппаратурой и оборудованием требуют дальнейшего совершенствования системы подготовки врачебных кадров.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"71 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486172","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}

{"title":"Pulmonary arterial hypertension associated with type II Abernethy malformation in an adolescent: a case report","authors":"I. Miklashevich, E. A. Potrokhova, D. A. Morozov, Yu. S. Isaeva","doi":"10.15829/1728-8800-2024-3754","DOIUrl":"https://doi.org/10.15829/1728-8800-2024-3754","url":null,"abstract":"The article provides a case of pulmonary arterial hypertension (PAH) associated with congenital extrahepatic portocaval shunt (CEPS), or Abernethy malformation, in a 17-year-old female patient. CEPS, which remained undiagnosed for a long time, manifested with severe encephalopathy at an early age. By the age of 6 years, it was complicated by PAH, and by the age of 9 years — by hepatic focal nodular hyperplasia. In the absence of timely surgical treatment and adequate therapy of CEPS, PAH progressed. Combined dual therapy for PAH, prescribed only at age 14, was ineffective. Despite the potential for clinical and functional improvement documented with combination triple therapy at 17 years of age, the patient continued to meet criteria for a high risk of adverse events, including mortality. Two months after the initiation of triple therapy for PAH, not achieving the target hemodynamic characteristics that would reduce operative and perioperative risks lead to an attempt of surgical treatment of CEPS, which led to the patient death in the early postoperative period. The description of this case report shows the difficulties of diagnosing a rare form of portopulmonary hypertension, the modern possibilities of drug therapy for a severe, potentially curable PAH in the early stages.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"26 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140488503","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}

{"title":"Hyperuricemia and hypertension in working-age people: results of a population study","authors":"S. Shalnova, A. Imaeva, V. Kutsenko, Y. Balanova, A. Kapustina, R. Shepel, O. Drapkina","doi":"10.15829/1728-8800-2023-3783","DOIUrl":"https://doi.org/10.15829/1728-8800-2023-3783","url":null,"abstract":"Aim. To study the prevalence of hyperuricemia (HU) and gout depending on hypertension (HTN), as well as to evaluate their associations with mortality in the Russian population.Material and methods. The analysis included data obtained in two cross-sectional studies — ESSE-RF and ESSE-RF2. All study participants were surveyed using a modular designed questionnaire. Serum uric acid (UA) was determined using the uricase method. HU corresponded to a UA >420 µmol/l in men and >360 µmol/l in women. HU without gout was considered asymptomatic HU in the present study. Associations with endpoints were assessed using Cox proportional hazards models with associated hazard ratios.Results. The average prevalence of HU was 18,2%. HU, as expected, predominates among the male cohort — 22,6% vs 15,7%, respectively. The prevalence of asymptomatic HU was 4,4% higher among men compared to women. The prevalence of gout increased with age and averaged 2,6% in the entire population. A high content of UA was revealed in men in the absence of hypertension. The prevalence of HU in women with HTN was 3 times higher than in participants without hypertension. In the male cohort, in the group of hypertension without HU, all-cause and cardiovascular mortality significantly increases, and in the group with hypertension and HU, only all-cause mortality increases. In women, the cardiovascular death risk increased in HTN — hazard ratio 3,98 (95% confidence interval 1,86-8,52). At the same time, in women with HTN and HU, all-cause and cardiovascular death risk increased by 66% and 6,7 times, respectively.Conclusion. Every fifth study participant was diagnosed with HU. The prevalence of HU in hypertensive men was approximately 1,5 times higher than without hypertension. In women with HTN, HU was detected three times more often than without HTN, which may indicate a more pronounced relationship between HTN and HU in women. HU can worsen the HTN prognosis. Thus, monitoring and timely correction of UA levels in hypertensive patients become necessary to improve the prognosis.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"258 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491286","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}

{"title":"Assessment of criteria influencing the location of healthcare facilities in small and hard-to-reach areas","authors":"I. Deev, A. Polikarpov, N. A. Golubev, S. V. Moravskaya, O. Kobyakova","doi":"10.15829/1728-8800-2023-3832","DOIUrl":"https://doi.org/10.15829/1728-8800-2023-3832","url":null,"abstract":"Aim. To identify and systematize the criteria influencing the location of healthcare facilities in small and hard-to-reach areas.Material and methods. Within the study, regulatory legal acts of the Russian Federation and methodological guidelines on territorial planning were analyzed. Content analysis and statistical methods were used.Results. The following criteria for a comprehensive assessment of the location of healthcare facilities should be used: 1. Age structure of the population. 2. Distance to a similar medical organization. 3. Population size within the working radius of the organization. 4. Availability of public roads (criteria and categories of roads). 5. Availability of public transport. 6. Climatic. 7. Availability of medical workers residing in the locality. 8. Availability of mobile medical teams. 9. Dilapidation and breakdown of buildings. Taking into account various criteria affecting the accessibility of primary health care to a patient, it is possible to develop and implement management decisions on the rational placement of healthcare facilities at the regional level with detail for each locality.Conclusion. The use of criteria in territorial planning for a comprehensive assessment of the location of healthcare facilities makes it possible to take into account regional climatic, geographic, infrastructural, social and other features of the Russian constituent entities. This contributes to the implementation of development targets for primary health care in small and hard-to-reach areas.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"412 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490476","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}

{"title":"Quality balanced scorecard for the outpatient clinic","authors":"O. A. Latukha, I. M. Son, Y. Bravve, A. Kalinichenko, E. Pushkareva, K. Tolstova","doi":"10.15829/1728-8800-2023-3809","DOIUrl":"https://doi.org/10.15829/1728-8800-2023-3809","url":null,"abstract":"The quality audit system for healthcare in various countries is based on the quality of medical services, the satisfaction of the patient and his relatives, as well as the quality of medical documentation. At the same time, quality indicators of healthcare facilities include criteria of the social and economic efficiency. Often these groups of indicators are considered by researchers separately from each other, and the literature available does not show balanced approaches to combining indicators from different groups within one process, which served as the basis for this work.Aim. The article is devoted to identifying the specifics of quality balanced scorecard for outpatient clinic using the example of the results of preventive examination for children in the first year of life.Material and methods. The study of quality indicators of the outpatient clinic was carried out from 2019 to 2023. The base of the study was the Clinical Consultative and Diagnostic Clinic № 27 in Novosibirsk. The study of the Clinic development was carried out from 2012 to 2023. The work used data from a social and expert survey of managers (20122018), as well as comparative modeling, general logical methods and techniques.Results. The longest multi-level and complex medical service is the process of preventive examination of children in the first year of life. Therefore, using his example, a quality balanced scorecard for the outpatient clinic was developed. At the first stage, medical quality criteria were determined. Patients were interviewed and quality criteria important for the patients' parents were determined. The complexity, multi-stage nature and short time frame for providing medical services determined the criteria for the economic efficiency. At the second stage, criteria for the management effectiveness and criteria for quality monitoring were developed, which allow department heads to track key performance indicators, as well as build coordinated work between various departments. At the third stage, the quality criteria were developed, which, on the one hand, reflect the clinic work, and, on the other hand, are not redundant and can be used to assess the effectiveness of the organization as a whole.Conclusion. The study showed that to increase the sustainability of the clinic development, effective monitoring based on key performance indicators is necessary. The classical approach to determining the effectiveness of medical facilities is based on general performance indicators to the quality criteria of individual processes, which does not allow identifying violations in individual medical and auxiliary processes, and, accordingly, does not allow identifying ways to solve them. It also does not indicate the level of violation. The use of a process and system approach in developing quality criteria allows developing a quality balanced scorecard with respect to the criteria of various groups, which ultimately reflects the effectiveness of processes as a whol","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"276 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491199","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}

{"title":"Satisfaction of housing and utility service employees with the quality and conditions of health care","authors":"G. Y. Bendyuk, V. V. Lyutsko, M. A. Dokhov, A. A. Sidorov","doi":"10.15829/1728-8800-2023-3816","DOIUrl":"https://doi.org/10.15829/1728-8800-2023-3816","url":null,"abstract":"Providing primary health care is one of the priority areas of healthcare due to importance of early detection, treatment and prevention of diseases. The development of management decisions aimed at improving the healthcare management is impossible without taking into account patient satisfaction with the availability and quality of medical services.Aim. To assess the satisfaction of housing and utility service employees with the quality and conditions of health care in the context of the implementation of follow-up monitoring program.Material and methods. The study was carried out before and after the implementation of the Regulations for treatment and prevention of hypertensive employees of the Water Utility of St. Petersburg. A total of 292 people were surveyed by the questionnaire recommended by the territorial compulsory medical insurance fund of St. Petersburg. There were following evaluation criteria: for the availability of healthcare — how easy it is to make an appointment with a specialist on the day of treatment; for the quality of healthcare — satisfaction with the conditions of waiting for an appointment and medical support.Results. The majority of respondents were satisfied with both the conditions of waiting and provision of care, the respectful and professional attitude of medical staff (satisfaction rate, 83,2%). After the implementation of the Regulations, the number of people who were completely satisfied with the waiting conditions in a medical institution increased from 80,2% to 90%. Satisfaction with the medical support increased from 83,2% to 95,7%. The share of those who were completely satisfied with the clinical setting also increased — from 75,7% to 82,3%. The number of \"excellent\" ratings given for the physician’s explanation of the prescribed treatment and procedures has increased (from 76,8% to 85,6%). The greatest satisfaction with the quality of care was among those aged 45-49 years.Conclusion. The results obtained indicate that there is a connection between satisfaction and both the quality of care provided and the involvement of patients in the treatment and preventive process.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"158 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491504","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}

{"title":"Providing primary care to military personnel: legal regulation and areas of concern","authors":"P. Y. Naumov, R. Shepel, I. Kholikov","doi":"10.15829/1728-8800-2023-3885","DOIUrl":"https://doi.org/10.15829/1728-8800-2023-3885","url":null,"abstract":"Aim. In the Russian Federation, various types of care (primary care; specialized, including high-tech, care; ambulance, including specialized emergency care; palliative care) in different conditions (outpatient, day hospital and inpatient) and forms (elective, emergency and immediate) are provided. The basis is primary health care (PHC). This also applies to military personnel, since the level of their health maintenance, recovery, and the workload of military health facilities with sick military personnel depend on the effective PHC. Thus, consideration of legal regulation and areas of concern of providing primary health care to military personnel is an urgent task and aim of the work, which requires appropriate conceptualization.Material and methods. Characteristics of legal regulation and areas of concern of providing PHC to military personnel was studied using comparative legal, formal legal and comprehensive methodological approaches. The practical implementation of these approaches and obtaining meaningful scientific data is carried out using analytical-synthetic, deductive-inductive, system-essential and abstract-concrete methods of cognition.Results. The main results include a generalization of regulatory legal requirements in providing PHC to military personnel.Conclusion. The specifics of providing PHC were studied. A comparative legal study of PHC provision within compulsory health insurance and military personnel without insurance policy has been carried out. The problems associated with the legal aspects of organizing and implementing the PHC provision to military personnel are summarized and specific ways to solve them are proposed.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"90 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491876","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}

{"title":"Motivation and responsibility of employees of primary health care facilities: results of a social survey on current motivation measures","authors":"O. Drapkina, A. Senenko, R. Shepel","doi":"10.15829/1728-8800-2023-3825","DOIUrl":"https://doi.org/10.15829/1728-8800-2023-3825","url":null,"abstract":"Aim. To study the relevance of motivation measures based on the survey of medical staff.Material and methods. Medical staff of adult primary health care facilities was surveyed using an original questionnaire regarding the organization of work, the importance of financial and non-financial incentives. The survey was strictly voluntary and anonymous, and conducted electronically and on paper. In total, 35191 questionnaires were accepted for processing. Processing was carried out using the method of descriptive statistics.Results. The organization of work environment is of the greatest importance to respondents (>80%), while in second place is the presence of clear criteria for work efficiency assessment, and in third place — a clear incentive and penal scheme. Respondents rated the opportunity for contact with the administration more highly than \"communicating work assessment criteria to employees\". The undisputed top in financial incentives is payments for high performance criteria in all categories of personnel. Of the non-financial measures, the most popular were a letter of gratitude from the manager and permission to independently plan working hours (maximum among medical specialists (51%)).Conclusion. The results obtained make it possible to highlight the main directions for motivation system of medical staff as follows: clear evaluation criteria for all personnel categories, provision of conditions for fulfilling the developed criteria, active outreach on evaluation criteria, incentive payments and other measures of material incentives, development of targeted incentive technologies, feedback with employees on issues related to their performance, working conditions, etc., developing a system of non-financial incentives and corporate culture.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490905","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}

{"title":"Comparative analysis of the availability and satisfaction of patients with acne with medical assistance in various healthcare facilities","authors":"L. O. Golikova, Yu. E. Antonenkov","doi":"10.15829/1728-8800-2023-3828","DOIUrl":"https://doi.org/10.15829/1728-8800-2023-3828","url":null,"abstract":"Accessibility and satisfaction with the quality of care for patients with acne are relevant, including in Russia. Therefore, Voronezh Oblast, being one of the largest in the Central Federal District, is able to present these indicators for the whole of Russia. The aim was to compare the accessibility and satisfaction of patients with acne with medical assistance in various healthcare facilities through a survey. The results obtained during the work revealed significant problems in this area and created opportunities for overcoming them.","PeriodicalId":9545,"journal":{"name":"Cardiovascular Therapy and Prevention","volume":"400 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490681","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}