Vol 20, No 2 (2017)

The article discusses the issues of providing rehabilitation care in sanatorium-and-spa facilities to patients with benign neoplasms of the gynecological sphere. The importance of this issue is caused by the high percentage of physiological and psychological disorders occurring in patients of this group in the period of postoperative recovery. In the course of the study, there was executed the assessment of the effectiveness of the organization of sanatorium-and-spa care for patients with benign neoplasms of the gynecological sphere on the example of the experience of a foreign sanatorium-and-spa institution. The study was carried out from the position of the study of the medical documentation of this center, as well as the opinion of patients regarding the provision of assistance in these institutions. It was important that every fourth patient who underwent treatment in a sanatorium-resort environment was a woman of a rather young age, of from 31 to 45 years. Climatic therapy and physiotherapy exercises were carried out in all cases of sanatorium treatment of patients with diseases of this group. Such methods of the treatment as psychotherapy, manual therapy and physiotherapy were popular. Based on the results of rehabilitation in a sanatorium and SPA establishment, in almost all cases, a number of important issues is being resolved, such as maintaining working capacity, social integration into society, preventing of possible violations of functions and preventing and reducing the degree of possible disability, maintaining functions in the process of the current pathological condition. It is important that all the interviewed patients are generally satisfied with the treatment provided to them, while 93.7% of them are completely satisfied and 6.3% indicated that «yes, they are more satisfied».

In the article there are substantiated organizational approaches to the employment of persons with disabilities in the independent movement with the use of information and communication technologies. There were evaluated activities of the employment service on the employment of people with disabilities in St. Petersburg for five years (2011-2015). There are presented data of clinical experts, social, psychological, socio-environmental characteristics of the 1120 invalids suffering from obliterating atherosclerosis of vessels of lower extremities, with disabilities in the independent movement. There was scientifically substantiated the possibility of the employment in special working conditions at home in the form of distance mode. There was recommended the algorithm for the mutual employment of specialists of the Bureau of the ITU and the employment service

In an article there are presented results of a sociological survey of elderly people who underwent inpatient treatment at the State Budget Institution «Hospital for Veterans of Wars» in the Rostov Region in 2016. The survey was implemented according to a specially developed questionnaire. The respondents included 220 cases of elderly and senile age. The results of the survey showed the majority of elderly respondents, including disabled people, as to mention the main problems of elderly people as health problems and access to medical care as note a high level of anxiety.

Purpose of the study. To evaluate the efficiency of the prevention programs aimed at the prevention of the spread of HIV infection, represent the it in disabled adjusted life years (DALY) and compare the efficiency with the prevention and treatment costs. Material and methods. Results of the panel study executed in 2006-2013 in 10 regions of Russian Federation in HIV infection risk groups (4 waves). The total number of include participants accounted of 9891. The study protocol included the detailed survey for the risk behavior and HIV testing. The obtained results of the study were used to calibrate the dynamic (Markov) model of the effect of the prevention on the length of the quality-adjusted life and treatment cost. The cost of the prevention was estimated on the base of reporting documents of prevention programs. Results. Programs of the comprehensive prevention of HIV-infection, among injecting drug users give rise in the significant decrease in the HIV incidence. The evaluation of the effect of prevention in frameworks of a multidimensional model shows odds ratio to be of 0.56 (95% CI = 0.40-0.78). This relative reduction of the incidence corresponds to the absolute incidence decrease from 3.98 per 100 person-years, among those not participating in prevention programs (95% CI: 3.37-4.69) to 2.22 per 100 person-years (95% CI: 1.89-2.62) among participants. This effect of the prevention leads to averting losses of 0.75-1.1 DALY per person, with most savings from the diminishing of the disability. In most plausible scenario this results in cost saving with return on the investment of 40 kopeks per rouble invested in prevention. Conclusion. Comprehensive programs of HIV prevention in Russian Federation possess of the significant effectiveness and under plausible assumptions are cost-saving. When discussing financing preventive measures they should be evaluated on real effectiveness and cost.

The article presents an analysis of a clinical case of a female patient D., aged of 93 years, hospitalized in the cardiology department of the hospital with multimorbidity and polypragmasy, who had the fall episode due to the prescription of midazolam administered parenterally. The fall was accompanied by the development of trauma - bruising her forehead, followed by suppuration, which demanded surgery in a surgical department. In this clinical case, the fall was a predictor of adverse drug reactions associated with the prescription of the drug preparation.