Vol 21, No 2 (2015)

Articles
The development of oncological care in the Russian Federation in view of implementation of public programs
Kaprin A.D., Starinskii V.V., Aleksandrova L.M., Chissov V.I., Balashov P.Y., Lutkovskii A.S., Savinov V.V.
Abstract
The data of electronic questionnaire “The passport of oncological dispensary” was used for monitoring of effectiveness of oncological care support of population in 20 regions of the Russian Federation implementing public programs of health care development in 2009 and 2010. The evaluation was given concerning development of material technical base and manpower of oncological service, effectiveness of preventive activities in the regions with total population more than 31 millions individuals. The development and implementation of preventive programs of federal and regional level, activation of activity and numbers of examination and primary oncological rooms based in curative preventive institutions permits to increase identification of patients with early stages of disease that significantly impacts effectiveness of specific treatment and benevolent outcome.
Medical Journal of the Russian Federation. 2015;21(2):4-9
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The analysis of the Federal normative legal base in sphere of paid medical services in public and municipal health institutions of the Russian Federation
Skvirskaia G.P., Pushkova S.I.
Abstract
The article deals with review and concise analysis of the Federal normative legal base regulating procedure of rendering of paid medical services in public and municipal health institutions of the Russian Federation. The changes in legislation came into force in 2013 are described. The rules of formation of tariffs, characteristics of taxation of medical institutions, requirements to form and content of agreement about paid medical services and requirements to making up internal information about paid services provided by medical institution are presented.
Medical Journal of the Russian Federation. 2015;21(2):9-12
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The comparative analysis of average duration of treatment of victims with different forms of acute intoxications of chemical etiology in 2006 and 2013
Sabaev A.V., Goleva O.P., Zubenko L.A.
Abstract
The article deals with comparative analysis of average duration of treatment victims with different forms of acute intoxications of chemical etiology in 2006 and 2013 in Omsk. It is established that in 2013 duration of hospitalization increased under light forms of acute drug intoxications, average severity forms of alcoholic intoxications. The duration of hospitalization of patients with acute intoxications with cauterizing poisons of different degrees of severity is significantly decreased. The implementation of new diagnostic and curative technologies, standards and algorithms of medical care and extension of bed stock of department of acute intoxications permitted in general to decrease average period of hospitalization of patients in 2013 as compared with 2006.
Medical Journal of the Russian Federation. 2015;21(2):13-15
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The algorithm of verification of risk of reactions of hypersensitivity to medicinal remedies in peri-operational period
Jukova D.G., Fedenko E.S., Yudin A.A., Lebedeva N.V., Nikitin A.E., Loshkareva E.O.
Abstract
The article presents the algorithm of identification of risk of reactions of hypersensitivity to medicinal remedies in perioperational period. The method includes clinical laboratory techniques and such allergenic tests as test of inhibition of natural emigration of leukocytes, sub lingual and dosage provocative test with evaluation of eosinophilia in peripheral blood and nasal secretion, increasing of basic level of tryptase (to detect hypersensitivity to anesthetics, antibiotics, nonsteroid anti-inflammatory remedies), application, prick- and intra-cutaneous tests (to detect hypersensitivity to anesthesia remedies, muscle relaxants, opioid analgesics, rentgenocontrast substances, vancomycin), prick-test with latex allergen. In 2010-2012, according to developed algorithm, in the central clinical hospital of the Russian academy of sciences 20 healthy volunteers were examined. The maximal concentrations of working solutions for cutaneous testing without irritation effect were selected. The absence of false positive results of tests and non-specific histamine liberation is demonstrated.
Medical Journal of the Russian Federation. 2015;21(2):16-22
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The actual possibilities of radiological diagnostics under endoprosthesis replacement of knee joints in patients with hemophiliac arthropathies
Abdrakhmanova Z.S., Rakhimjanova R.I., Junusov E.T., Sultangereev A.B.
Abstract
The article deals with the results of examination and treatment of 37 patients with hemophiliac arthropathies of knee joints being observed in department of restorative ortho-surgery and poly-trauma of the Republican research center of emergency medical care (Astana, Kazakhstan) during 2010-2013. The organization of highly specialized medical care to patients with hemophilia with active implementation of early surgical rehabilitation of affected joint in complex treatment facilitated increasing of number of positive results at the expense of recovering of quality of life of patients. The excellent anatomical functional results are obtained in 26.7%, good results in 51.1% and satisfactory results in 22.2% of patients. There were no unsatisfactory outcomes of treatment.
Medical Journal of the Russian Federation. 2015;21(2):23-27
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The thickness of skin of mammary gland as factor of diagnostics of edematous cancer
Saribekian E.K., Stepanov S.O., Rubtsova N.A., Ermakov A.V., Maiorova M.V.
Abstract
The condition of skin of 100 patients with edematous form of cancer of mammary gland was examined. The thickening of skin larger than 2.5-3 mm as compared with symmetric area of healthy mammary gland. The average thickness of skin of edematous gland is 5.6 cm, maximal thickness is 14 mm. The sensitivity of techniques of digital radiologic mammography and echography with sensor rate of 7.5 mHz and higher amounted to 97% and plicometry to 96%. The quantitative detection of thickness of skin with radiological techniques of examination and plicometry technique is a precise and objective mode of diagnostic of edematous cancer of mammary gland.
Medical Journal of the Russian Federation. 2015;21(2):27-29
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The diagnostic value of determination of haptoglobin level and ceruloplasmin activity in patients with ovary cancer
Surikova E.I., Goroshinskaia I.A., Maksimova N.A., Kachesova P.S., Sergeeva M.M.
Abstract
The monitoring of patients with ovary cancer was implemented to evaluate effect of combined treatment the content of haptoglobin (the immunoturbidimetric technique applied) and oxydase activity of ceruloplasmin (the colorimetric technique applied). The comparison of obtained data with results of ultrasound monitoring and parameters of intratumoral hemodynamics of local recurrence was implemented. The reliable alterations of examined indicators were established under appearance of recurrence of ovary cancer and intensification of vascularization of recurrent tumor. The study established increased content of haptoglobin in patients with remission (as compared with its level in group of healthy women) and its significant increasing under expressed vascularization of recurrent tumor. The dynamics of level of haptoglobin corresponded to dynamics of ultrasound parameters of evaluation of effectiveness of treatment of recurrence. The alteration of ceruloplasmin activity was less expressed though it was detected at the earlier stage of recurrence in patients with avascular recurrence.
Medical Journal of the Russian Federation. 2015;21(2):29-33
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The inertness of lymphocitic Fc-receptors under effect of prostaglandins and isoproterenol and alteration of lipid metabolism in children with insulin-dependent diabetes mellitus
Turkina T.I., Scherbo S.N., Vaganov P.D., Talitskii V.V., Mandjiev E.T.
Abstract
The study was organized to examine lipid spectrum of blood lymphocytes in children with insulin-dependent diabetes mellitus. The capacity of Fc-receptors of lymphocytes to respond to effect of prostaglandins and isoproterenol having modulating characteristics was also examined. The sampling included 18 children with insulin-dependent diabetes mellitus in decompensation phase aged from 7 to 15 years. The control group consisted of 12 healthy children of the same age. The examination of surface receptors to Fc-fragments IgG was implemented using reaction of EA-rosetting. The lipid and phospholipid spectrum of lymphocytes were analyzed using technique of thin-layer chromatography of lipids. The established “areactivity” of surface Fc-receptors of lymphocytes is related to alteration of lipid composition of membranes of lymphocytes. In this connection, it is possible to expect that other receptors fixed on the membrane will faintly react to effect of modulators similar to prostaglandins and isoproterenol.
Medical Journal of the Russian Federation. 2015;21(2):33-35
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The results of epidemiological surveillance of enterovirus gastroenteritis on social ecosystem, cellular and sub-cellular levels in Azerbaijan
Rustamova L.I., Alieva N.N., Kulieva Z.M., Azizova N.A., Mamedova M.N.
Abstract
The epidemiological surveillance of enterovirus infections is an actual issue of health care in many countries and provides organization of control at different levels. The study was organized to examine particular characteristics of enterovirus infection at social ecosystem, cellular and sub-cellular levels. During 2010-2012 the fecal suspensions from 121 children and 127 adults were analyzed. The serological, virological and molecular genetic methods were applied. The following marker characteristics of enterovirus were examined: characteristics of miotropism, cytopathic effect, s, d and rct 40. The rate of occurrence of enterovirus infection in different age groups was established: 0-6 months - 22%, 7-11 mouths - 41.1%, 1-2 years - 39%, 2-14 years - 19%. The serotype-specific landscape of isolated enteroviruses was as follows: Coxsackie A types 17, 18, 20 and 21. It is demonstrated that express diagnostic of enterovirus infection requires applying indication of RNA enterovirus in different bio-samples simultaneously. It is established that cultural and serological methods are rather important for retrospective epidemiological analysis of enterovirus infection.
Medical Journal of the Russian Federation. 2015;21(2):36-39
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The international recommendations and national perspectives of rational application of pharmaceuticals for resolving issues of medicinal support of population
Rostova N.B.
Abstract
The article presents the review of comparative analysis of regulation of arrangements of support of rational application of pharmaceuticals recommended by WHO. The implementation of mentioned arrangements in Russia and also activities regulated by legal and other normative legal acts in field of circulation of medicinal agents. The applied analysis established weak aspects of public policy concerning implementation of arrangements directed to rational application of pharmaceuticals. The results of analysis demonstrate that clear-cut regulation of arrangements mentioned above is needed on all levels (Federal, regional, medical organization) to successfully implement complex of measures and to exclude weak aspects of public policy concerning medicinal support and rational application of medicinal agents. The scientifically substantiated approaches and recommendations are needed to satisfy therapeutic demands of population using best selected pharmaceuticals in compliance with evidences of effectiveness and safety. The application of these medicines will be determined by professionals educated and aware in the field of rational implementation of pharmaceuticals.
Medical Journal of the Russian Federation. 2015;21(2):40-45
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The approaches to diagnostic and treatment of anxiety and depressive disorders in oncological patients
Scherbakova I.V., Bardenshtein L.M., Averianova S.V.
Abstract
The malignant neoplasms are quite often combined with psychic disorders of depressive and anxiety spectrum which aggravate course and prognosis of main disease. The article considers issues related to detection of comorbide emotional disorders in patients with cancer. The diagnostic value of psychometric techniques of evaluation of symptoms of anxiety and depression and data concerning of effectiveness and safety of pharmaceutical agents applied in oncological practice are analyzed. The results of implementation of techniques of psychotherapeutic intervention in complex treatment of patients with oncological pathology are presented. The conclusion is made that further development of actual issues of diagnostic, therapy and prevention of anxiety and depressive conditions in patients with cancer require integration of scientific and practical activities of oncologists, psychiatrists and psychotherapists.
Medical Journal of the Russian Federation. 2015;21(2):46-50
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The immune aspects of collagen metabolism under tuberculosis
Tarasova L.G., Streltsova E.N.
Abstract
The caseous necrosis and pneumosclerosis as the onset and the outcome of tuberculosis are extreme conditions reflecting collagen metabolism in organism of patient. The review presents main scientific data characterizing modern ideas about immune pathogenic interrelationship of synthesis and disassimilation of collagen, cytokines, collagenases (matrix metalloproteinases), their inhibitors and autoantibodies to them under the given disease. The characteristics of collagen homeostasis under pharmacologically resistant tuberculosis are presented.
Medical Journal of the Russian Federation. 2015;21(2):51-55
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The book review of the handbook for physicians “Endocrinology” edited by V.V. Potemkin
Solun M.N.
Medical Journal of the Russian Federation. 2015;21(2):55-56
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