Vol 19, No 2 (2016)

Articles
Rehabilitation of participants of battle actions: posttraumatic stress syndrome
Puzin S.N., Memetov S.S., Shurgaya M.A., Baleka L.Y., Sumedi I.R., Muteva T.A.
Abstract
A negative psychical background is the imprint of smell ofpowder, hampering social and professional adaptation, and also interpersonal relations ofparticipants of battle actions. The study of level of socially-psychological adaptation of invalids and participants of battle actions showed that their considerable part (about 58%) has signs of zero adaptability, and in 12% of cases from this category the signs of complete social disadaptation are pronounced with the expressed negative reaction on situations, by irreconcilable attitude toward all surrounding, by the expressed protest reactions. The low level of adaptation of this category of persons is caused by the array of factors of both objective and subjective character. To the objective factors it is possible to refer socio-economic indexes, characterizing quality of the life of this contingent, state of health, weight of disability. However it is not always succeeded to observe the direct dependence between these indices and state of adaptation. It is explained by subjective psychological descriptions. The psychological consequences of traumatic stress determine the special requirement of contingent of private traders of battle actions in a socially-psychological rehabilitation. In cases of expressed posttraumatic stress disorders, socio-psychological disadaptation of persons from a number the veterans of battle actions, individual work is required after a vocational orientation and further employment taking into account compensatory-adaptive possibilities of organism and features ofpsychical reactions for the servicemen injured as a result of armed conflict.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(2):60-63
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Experience of optimization of adaptive activity of mentally ill patients in conditions of medical rehabilitation department of the district psychoneurologic dispensary
Milyutin S.M., Karasayeva L.A., Spikina A.A., Valiakhmetova D.T.
Abstract
The article analyzes the progress and results of activity of medical-rehabilitation Department, created by reorganization of Department of medical-labor rehabilitation, in the situation of upgrading of the system of rehabilitation strategies. On the basis of categories of the International classification of functioning (ICF) updated the factors of the increase and established an analysis of the dynamics of adaptive activity of the mentally ill patients in the process of implementation of rehabilitation measures, with an emphasis on modified forms of interpersonal interaction. There were illustrated: a method of rehabilitative community led by the Council ofpatients, and involvement in the rehabilitation system of interpersonal interaction not only ofpsychiatrists, psychotherapists, psychologists, but nurses and other medical staff. Results of medical rehabilitation are shown to be optimized due to the emergence of new conditions and prerequisites for the increase in adaptive activity of patients in the rehabilitation center as part of their adaptation to everyday available, «micro-social» environment.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(2):64-67
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Aspects of modern medical-social expertise and rehabilitation of disabled persons in Republic of Tajikistan
Gaibov A.G., Lukyanov N.B., Chudinov A.V.
Abstract
The prevalence of adult and children disability in Tajikistan is relatively low and accounts for 2% of the total population. In 70% of the cases it is caused by chronic diseases of various etiology, including congenital pathology. At that, everyfifth disabled person considers his health condition to be satisfactory. The medical service and social expertise as well as the criteria used for determination of the status of the disability are considered to fail to correspond to the current models and classifications, approved by the legislation in 2010. The solution of the multifactorial problem of disability in the country (gross per capita income less than $ 1200) with 32% poverty rate, and pensions three times lower than the cost of the consumer basket, demand the targeted optimization of the system ofmedical and social expertise and rehabilitation both in the urban and, particularly, in the rural areas.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(2):68-70
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Efficacy of the comprehensive antiresorptive therapy at different stages of surgical rehabilitation in dentition defects in female patients with postmenopausal osteoporosis
Mashchenko E.A., Khesin R.A., Malichenko S.B., Kozlova M.V.
Abstract
Question of the interrelationship of systemic disorders of bone remodeling and the condition of the bone tissue of the alveolar bone, as well as the efficiency of comprehensive antiresorptive therapy at different stages of surgical rehabilitation in dentition defects in female patients with postmenopausal osteoporosis (PMOP) requires further clarification and remains a subject of active discussion of scientists and clinicians. In the study there was demonstrated that in PMOP female patients with atrophy of the alveolar process of the maxilla in edentulous area there is noted was a significant excess in indices of bone turnover (TNF-alpha level - by 184%, IL-1 - 224%, IL-6- 85%, CTx -156% osteocalcin - 32.9%, PTH- 55%) against the background of the reduced level of a D(OH)25 (by 25.8%) in comparison with patients of reproductive age without osteoporosis. These data correlate with a significant increase in indices of osteosynthesis (index level of the osteoid volume - by 17.6%, index of total resorptive surface by - 51.5%) and a decrease in bone quality indices (index level of the total volume of trabecules - by 60%, index of average width of trabeculae - by 40 %) according to results of the histological examination of bioptate of the process from the edentulous area. At that in PMOP patients with concomitant accompanying somatic pathology the level of TNF-a, IL-1, IL-6 and CTx was significantly higher than in patients of this the group without comorbidity. Appointment of the comprehensive antiresorptive therapy at all stages of surgical rehabilitation (open sinus lifting, dental implantation) in PMOP patients with atrophy of the maxilla in edentulous area during the year before and after sinus lifting significantly increasedthe efficiency of the dental implant. Supplementation of NSAIDs (Arcoxia 60 mg per day) for 2 months prior to dental implantation and within 1 month after a comprehensive antiresorptive therapy in PMOP patients with concomitant estrogen-induced pathology also significantly increases the efficiency of the dental implant in comparison with given indices in patients which received no combined therapy.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(2):71-79
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The morphofunctional status of the young students at the intersection of the XX and XXI centuries for compliance with the tests of the All-Russian physical-sport complex «Ready for Labor and Defense» («Gotov k Trudu i Oborone» - GTO, in Russian)»
Shteynerdt S.V., Achkasov E.E., Mashkovskiy E.V., Narkevich A.N.
Abstract
According to data of researchers throughout the duration of 2002-2012 the morbidity rate in students increased by 35%. One of the measures aimed at correction of the level of population health is to revive in Russia the all-Russian sports complex «Ready for Labor and Defense» (aRSC RLD). Objectives of the aRSC RLD are the elevation of the efficiency of opportunities of physical culture and sports in promoting health, harmonious and comprehensive development of personality, upbringing of patriotism and the provision of succession in the implementation ofphysical education of the population. In this regard, the study of the current morpho-functional state ofpersons occupying in the ontogeny of human development the special position - adolescence, is a topical and timely study in the accomplishment of the analysis of conformity of kinds of testing aRSC RLD and their regulations with the current physical condition of modern young male students.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(2):80-85
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Analysis of disability due to tuberculosis in the Novgorod region in the dynamics throughout 2010-2014
Orlova V.M.
Abstract
The article presents analysis of primary and second disability due to tuberculosis in the Novgorod region in dynamics throughout 5 years period based on age, disability groups, compared with the same official data of the Russian Federation, Northwestern Federal District. The level of disability rate caused by tuberculosis tends to decrease. In the structure of disability in 2010-2014 the prevalence of the second group of disability is dominated.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(2):86-88
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Modern trends in repeated disability due to diseases of the musculoskeletal system and connective tissue in retirement age citizens of the Russian Federation
Shurgaya M.A.
Abstract
The article presents results of the study ofproblems of the repeated disability due to diseases of the musculoskeletal system and connective tissue in retirement age citizens of the Russian Federation in the period of from 2005 to 2014. There were analyzed the number of this category of invalids, their specific weight among re-recognized as disabled cases with account of classes of diseases and the age, structure of the repeated disability in groups, the level of repeated disability and ranking places of subjects of the Russian Federation on this index in 2014. The results of the executed analysis indicate that only in the Russian Federation for 10 years (2005-2014) there were re-recognized as disabled due to diseases of the musculoskeletal system and connective tissue 487.1 thousand people from citizens of retirement age with distinct dynamics of the increase as their absolute number (from 22.1 thousand persons in 2005 to 69.3 thousand people in 2014) and the index of disability level (respectively from 7.6 to 20.5 per 10 thousand of the corresponding adult population). This pathology was established to determine a high level of repeated disability in this age group (20.5 per 10 thousand population). Comparative analysis by age revealed that in the Russian Federation in the structure of the repeated disability due to diseases of the musculoskeletal system and connective tissue in the adult population invalids of the retirement age prevail (42.8% in 2014). Along with diseases of the circulatory system (of rank 1) and malignant neoplasms (rank 2), diseases of the musculoskeletal system and connective tissue form the contingent of cases repeatedly recognized as disabled of retirement age (3th rank place). A ranking ofall subjects of the Russian Federation by the level of repeated disability of citizens of retirement age due to diseases of the musculoskeletal system and connective tissue allowed to select 70 ranking places, that with bearing in mind the present demographic situation, has a practical orientation for planning the organization of medical and social care for the given large category of the population.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(2):89-95
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Spinal Cord Independence Measure (SCIM-III). Preparation of the Russian-language version
Vasilchenko E.M., Zoloev G.K., Kislova A.S., Kostrov V.V., Lyakhovetskaya V.V., Karapetyan K.K., Zhatko O.V., Palatkin P.P., Makarov D.N., Filatov E.V., Yurkovetskaya N.D.
Abstract
There was accomplished the procedure of linguistic and cultural adaptation of a questionnaire Spinal Cord Independence Measure (SCIM-III) specifically designed for the assessment of disorders of life activity in patients with traumatic disease of the spinal cord. In the work there are presented: the Russian-language version of the questionnaire, instructions on features of the filling and evaluation of results.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(2):96-102
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Features of the organization of outpatient drug supply for certain population groups in the Russian Federation
Malichenko V.S., Malichenko S.B., Yavisya A.M.
Abstract
Changes in the scope and structure of morbidity increase the cost of health care, medical and social services, especially in terms of drug supply. The cost of medicines amounts to the third largest component of costs in the health sector. The Russian Federation possesses the one out provisuinfastest growing pharmaceutical market. However, for the time being the current system of drug supply in the Russian Federation was faced with a number of systemic issues that have a direct effect on the availability of medicines, the quality and timeliness of care. Within frameworks of the executed analysis there was demonstrated the ineffectiveness of the existing drug supply system in an outpatient setting, as well as there was supposed a number of measures to optimize government programs of drug provision in the current economic situation.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(2):103-108
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On the problem of nursing care organisation as a factor of successful rehabilitation of stroke patients
Petrova N.G., Minnullin T.I.
Abstract
The stroke is characterized by multivarious symptoms, causing a number of patients 'problems which require nursing interventions as dependent (i.e. carried out according to a doctor order and independent (carried out independently). Their complete qualitative performance is one of the conditions for the subsequent successful rehabilitation. The aim of the study was the determination of the amount of nursing interventions in stroke patients on the base of established nursing diagnoses (patient problems). This study was carried out on the basis of a specially developed Card of the study. There was performed an investigation of the character ofproblems and the rate of various nursing interventions in patients treated in a specialized department for stroke patients (the sample size - 50 persons.). The study showed that the main types of independent nursing interventions were: interviews with patients and their relatives about the disease, its course and outcome (frequency of the performance - 97.5% in the first day of hospitalization); assisting in the implementation ofpersonal hygiene (90.0%); training of relatives and patients in care and self-care techniques, elements of massage and self-massage, training in the use of bandages and compression hosiery (87.5% and 85.0%); early verticalization (60.0%), changing diapers (52.5%), frequent changes in body position ofpatients (47.5%), respiratory gymnastics classes (45.0%); the using of anti-decubitus mattresses (35.0%); help with feeding (42.5%). In this, the regulation of nursing auxiliary employment (including a clear classifier of services, their documentation, the existence of standards, the ability to assess the quality and so on) is practically absent. The establishment of appropriate regulations will contribute to the objectification of the activities of specialists in nursing care, to the assurance of the consistency in their work at all stages of the rehabilitation of patients.
Medical and Social Expert Evaluation and Rehabilitation. 2016;19(2):109-112
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