Medical and Social Expert Evaluation and Rehabilitation

Diagnosis of chronic heart failure (CHF) causes certain difficulties. This is caused by the fact that patients in seeking medical care, especially in the early stages of heart failure (HF), present complaints, many of which have low specificity. Echocardiography and ECG in most of the patients help to expose CHF preliminary diagnosis and treatment plan. These studies in any particular clinical situation can be supplemented by other methods. Central role in the diagnosis of heartfailure belongs to an imaging method, which allows also to monitor the effectiveness of treatment.

Psychological diagnostics is an important component of the state service on the inspection of preschool children in the medico-social examination bureau of mixed and specialized profile. Symptoms of mental dysfunctions are verified and objectivised in the process of expert psychological diagnosis of preschoolers, which are then combined in pathopsychological symptom, resistance and severity of violations are specified. Obligatory components of the psycho-diagnostics expert assessment are damaged and intact sides of child mental activity, the state of his behavioral and emotional-volitional, cognitive-gaming activities, the determination of proximal development zone. The symptoms of abnormalities in the development of speech, pathophysiological mechanisms, its causes are identified and assessed in the process of psycho-diagnostics. These data are necessary for the formation of clinical and functional diagnosis, assessment of rehabilitation potential of the child, formation of rehabilitation measures complex. The article suggests that we use in the expert work of the criteria and methods of evaluation of disorders of language and speech functions in this category being examined. Techniques are intended to diagnose disorders of speech in children. An algorithm is proposed, which facilitates identification and objectification of the severity and persistence of speech disorders by experimental psychological examination.

The number of the citizens in city settlements ofthe Orenburg region for the first, who were recognized as disabled people owing to cardiovascular pathology for the first time in the period of 2003-2012 has been analysed. The comparative characteristic with similar regional and average Russian indicators is given. As a result of the analysis it is revealed that average city level practically in all analyzed years is stable below regional average level and above the average Russian level. As a whole in the dynamics of 2003-2013 the positive tendency ofprimary disability level of able-bodied population of city settlements, but with smaller rate of a decrease (24,1%), than in the Russian Federation (26%) and in the Orenburg region (25,9%) is noted. In two cities one of which has a low ecological component (Mednogorsk), another the unstable production sphere (Kuvandyk) the highest level ofprimary disability of able-bodied population is noted. Changes in the legislation with introduction of social benefits monetization reflected lesser in level of able-bodied population disability (growth rate of regional average indicator is 14,2%, average town - 10,8%). On introduction of social benefits monetization the highest growth rate level was noted in the cities with trouble in an ecological situation (Novotroitsk of +38,6%, Mednogorsk of +38%). The city more reacted to decrease in economic and social situation was Yasnyy in which in 2009 the city-forming enterprise underwent reconstruction (+42,6%).

The article analyzes the indicators of the primary disability due to disease of the musculoskeletal system and connective tissue in the central federal district of the Russian Federation. Tendencies of disability have been revealed. The Central Federal District level of primary disability in all years of observation is higher than in the Russian Federation, the highest level of primary disability due to diseases of the musculoskeletal system and connective tissue observed in the Kursk region, the lowest - in the Moscow region.

The paper analyses the level of primary disability in different disease classes and nosologic units in the pediatric population in the Chechen Republic in the dynamics of 2006-2012 years.

Purpose: to explore the relationships between pain, emotional state and blockes of segmental intraosseous receptors in patients with chronic neck pain. Methods: Study involved 50 patients with chronic neck pain. For treatment of pain syndrome all patients received course of intraosseous blockades. Neck pain syndrome was investigated with visual-analog scale, MacGill pain questionnaire. Psychological state was investigated with Standardized Multifactorial method of Studying Personality - short version of MMPI questionnaire, State-Triat Anxiety Inventory, Becks Depression Inventory. Results: Intraosseous blockade led to a simultaneous and significant reduction of pain and affective disorders in patients with chronic neck pain. Peripheral osteoreceptor mechanism is very important in the pathogenesis of affective disorders in patients with chronic neck pain. Intraosseous blockades are an effective technique of management for pain and emotional disorders in patients with chronic neck pain. The study was supported by the Russian Foundation for Basic Research, project 12-06-00146-a.

In recent years there has been a sharp increase in the prevalence of obesity in the world that stimulate interest in the effects on health and quality of life of the phenomenon. In developed countries, obesity is considered the fifth most significant riskfactorfor disability. Quality of life of obese patients is an important issue that must be considered more carefully. Unfortunately, not enough studied the effect weight loss on sexual function and quality of life. Consequently, the aim of our study was to - to study the effect of weight loss on erectile function and quality of life in men with obesity. The study involved 40 men aged 30 to 50 years, mean age 43,4 ± 7,5, BMI 40,4 ± 7. At the initial ethane we measured anthropometric indicators, questionnaires using the International Index of Erectile Function-5, Hospital Anxiety and Depression Scale, the Russian version of the general questionnaire MOS-SF-36 (MOSSF-Item Short Form Health Survey). Further, all patients received sibutramine 10-15 mg (Reduxine, Promo-Med) on a par with changing lifestyles within 6 months. We have found that with the increase in severity of erectile function were growing anxiety symptoms (r = 0,521; p < 0,05) and depression (r = 0,593; p < 0,01). After weight loss the patients’ quality of life significantly improved in terms ofpsychological health, as well as indicators ofviability and role emotional functioning. Conclusions: Obesity reduces the quality of life ofpatients, leading to the development of erectile dysfunction, depression and anxiety, moderate weight loss is largely due to the improved quality of life, erectile function, decrease symptoms of anxiety/depression.