Vol 20, No 2 (2017)

Articles
SOME RISK FACTORS FOR THE FORMATION OF CHILDREN’S DISABILITY
Baranov A.A., Namazova-Baranova L.S., Terletskaya R.N., Antonova E.V.
Abstract
The creation of the system of early prophylaxis of children disability and support of families bringing up disabled children and children with limited opportunities of health are among the main priorities of the state social policy of the Russian Federation. The search for literature sources was performed in the Scientific Online Library (eLIBRARY.RU) and PubMed. The dynamics of children’s disability in our country is characterized by the process of stagnation. Among risk factors for the formations of the disability the most discussed are achievements of perinatology leading to the improvement of nursing of prematurely born and small for date newborns, and wide uses of auxiliary reproductive technologies. An important part of all preventive measures aimed at the decline of the genetic load of population is the prenatal and preimplantation diagnosis. It seems appropriate to extend the screening for congenital and hereditary metabolic diseases in neonatal period, including the most common nosological forms of rare illnesses. In the solution of problems of the prevention of the childhood disability a priority should be given to the development of services of family planning, improvement of the antenatal and perinatal care, the preventive work with healthy children with deviations in the development, the development of medical genetic services, implementation of programs of different types of pathology screening.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):60-64
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ORGANIZATIONAL APPROACHES TO REHABILITATION OF PATIENTS WITH BENIGN NEOPLASMAS OF THE GYNECOLOGICAL SPHERE IN SANATORIC CONDITIONS
Tsivyan B.L.
Abstract
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».
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):65-68
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DISABILITY DUE TO THE CLASS OF RESPIRATORY DISEASES IN ELDERLY PEOPLE
Shurgaya M.A.
Abstract
The main strategic task of the provision for health and social care and alimentation of the quality of life in the elderly patient is the implementation of clinical, diagnostic and preventive measures, taking into account characteristics of the course of different diseases in geriatric population. In an article there are highlighted modern approaches to the diagnosis and treatment of bronchial asthma, which is the leading pathology that determines the morbidity and disability due to diseases of the respiratory system in elderly citizens. Accounting for the morphological and functional features of the elderly age allows provide the medical and social care and achieve quality standards in the treatment of asthma in the geriatric population.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):69-74
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INNOVATIVE APPROACHES TO THE EMPLOYMENT OF DISABLED PERSONS WITH SEVERE DISABILITIES IN INDEPENDENT MOVEMENT
Karasayeva L.A., Luchkevich V.S., Kalichava A.S., Vladimirova O.N.
Abstract
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
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):75-79
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THE IMPACT OF CONDITIONS AND LIFE STILE OF DISABLED PEOPLE ON THE ASSESSMENT OF THE MEDICAL-SOCIAL ASSISTANCE AND QUALITY OF THE ACCESSIBILITY OF THE ENVIRONMENT
Alekseev M.A., Moiseeva K.E., Kharbedia S.D.
Abstract
Disability is the one of the topical medico-social problems in the Russian Federation and all over the world. In recent years, our country has developed and implemented a large number of state programs aimed at the adaptation of persons with disabilities for the life in society, one of which is the program «Accessible environment». In the framework of the implementation of the Federal law, persons with disabilities are provided with social housing. In this article on the example of wheelchair users who received social housing and living on the territories of intercity municipality of the village of Pargolovo, Vyborgsky district of the city of Saint Petersburg, in the current socio-economic conditions there is presented the scientific analysis of the impact of the environment and lifestyle on the assessment of health and social care and quality of the accessible environment. This study was executed by the method of the main body by means of the survey of 110 by wheelchair users who received social housing. A study identified main shortcomings of the medico-social assistance to wheelchair users living in the municipality. In the course of the study there were evaluated the quality of environment accessibility for the following indices: openness, adaptability, comfort and security of the social infrastructure, culture, leisure and recreation, as well as skills and the cooperation of the staff of the social infrastructure, culture, leisure, and individuals with disabilities. The analysis of the quality of accessibility of the environment established its compliance with the expected results of the program «Accessible environment».
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):80-85
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OLDER GENERATION: MEDICAL AND SOCIAL PROBLEMS
Shurgaya M.A., Memetov S.S., Silenko L.V.
Abstract
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.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):86-88
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LEGISLATIVE AND STANDARD AND METHODICAL BASE OF THE STANDARDIZATION, ASSESSMENT OF THE COMPLIANCE AND ACCREDITATION IN AREAS OF MEDICAL PRODUCTS
Ivanova V.A., Chesnokova A.A., Shamina E.O.
Abstract
The standard and methodical documents regulating activity in the field of standardization, estimates of compliance, accreditation of bodies for a compliance assessment in the field of medical products are submitted. The list of participants of works and documents in the field of standardization of medical products is provided, forms of an assessment of compliance of medical products - certification, compliance declaring, the state registration, technical tests are characterized. Requirements to contents of necessary documentation and an order of accreditation of testing laboratories in the field of medical products are established.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):89-94
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ASSESSMENT OF EFFICIENCY OF PROGRAMS OF COMPREHENSIVE PREVENTION OF HIV-INFECTION FROM THE POINT OF VIEW OF THE PREVENTION OF LOSS OF YEARS, CUSTOMIZED FOR DISABILITY
Barinova A.N.
Abstract
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.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):95-99
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FINANCIAL PROVISION OF RUSSIAN HEALTH CARE FROM THE FEDERAL FUND OF MANDATORY MEDICAL INSURANCE AND THE BUDGETS OF THE SUBJECTS OF THE RUSSIAN FEDERATION
Goncharov N.G., Boychenko Y.Y., Klochkov V.P., Lukyantseva D.V., Moiseenko S.M., Pidde A.L., Pishchita A.N., Prosyanik L.D., Preobrazhenskaya M.I., Rakhimova O.Y.
Abstract
The ongoing reform of the national health care impacted significantly on the health care financing system to the population. Especially these changes were reflected in the financing of public health organizations of the Federal Fund of CHI and from budgets of different levels. The article analyzed the financial aspects of providing public health care system in recent years and estimates prospects for the further reform of the Russian health care.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):100-103
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FALL IN ELDERLY PATIENTS, ASSOCIATED WITH THE USE OF MEDICINES: CLINICAL OBSERVATION
Ilina E.S., Sychev D.A., Bogova O.T.
Abstract
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.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):104-106
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NONINVASIVE METHODS IN THE DIAGNOSIS OF NON-ALCOHOLIC FATTY LIVER DISEASE
Bakulin I.G., Abatsieva M.P.
Abstract
Non-alcoholic fatty liver disease (NAFLD) being increasingly diagnosed worldwide is considered as the most common liver disease in Western countries. The incidence is growing rapidly due to the continuing epidemic of the obesity and diabetes mellitus type 2. There is the extremely topical question of the affordable, effective and early diagnosis of NAFLD. Over the past few years, significant progress has been made in the understanding of its risk factors, pathogenesis, clinical course, methods of diagnosis and treatment of NAFLD. The article gives an overview of modern and promising methods for diagnosing NAFLD, useful for physicians of various specialties who have to deal with NAFLD patients. Key problems of diagnostics are formulated and directions for further research are determined. There is discussed the role of biomarkers as promising noninvasive diagnostic methods, that provides to assess the severity of necrotic inflammatory processes and liver fibrosis in NAFLD patients.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(2):107-112
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