Vol 20, No 3 (2017)

Articles
THE QUESTIONS OF DISABILITY AND FORMING LABOUR RECOMMENDATIONS FOR CASES SUFFERED DUE TO OCCUPATIONAL DISEASES IN THE RUSSIAN FEDERATION
Dymochka M.A., Andreeva O.C., Omarov M.A., Shakhsuvaryan S.B., Tarasova L.A., Rychkova V.A., Makkaeva S.M., Puzin M.N., Afanas’ev B.G., Lepaev Y.V., Denishchuk I.S.
Abstract
There has been presented an analysis of the contingent of persons suffered due to occupational diseases in the Russian Federation during 2015 year: results of the primary and repeated examination in the bureaus for the medical and social expertise, the structure of the primary and repeated disability in consideration of the age and groups of the disability. There have been formulated in detail the recommendations with respect to indicated and contraindicated conditions of labor in the main kinds of occupational diseases and poisonings.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3):116-121
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EFFICIENCY OF THE USE OF TAPE KINESIOLOGY AND HAND TRAINERS IN COMPLEX REHABILITATION OF PATIENTS WITH FOREARM FRACTURES
Yulov V.V., Kerimov U.S., Goncharov N.G., Shishkin V.B.
Abstract
Fractures of bones of the forearm are the most frequent damage of the bones of the upper limb. A high percentage of unsatisfactory results of the treatment necessitates research on the development of effective methods of medical rehabilitation. Purpose. To evaluate the effectiveness of tape kinesiology and hand trainers in the medical rehabilitation of patients with fractures of the forearm bones. Material and methods. 68 patients (22 men and 46 women) aged of 19-85 years with isolated fractures of the forearm bones were examined. In 65 patients, bone osteosynthesis was performed, external fixation devices were used in 3 patients. All patients were divided into three groups. All patients were divided into three groups. The 21 cases from the control group received standard medical rehabilitation. In 23 patients from the comparison group the standard medical rehabilitation was supplemented by standard kinesiology with standard medical rehabilitation. In 24 patients from the main group hand trainers were used against the background of standard medical rehabilitation and kinesiology. The effectiveness of the treatment was assessed on the basis of the VAS scale, the DASH and SF-36 questionnaires, the Green and O’Brien scoring scheme. Results. The complex application of tape kinesiology and hand trainers in comparison with standard medical rehabilitation and the use of tape kinesiology allows increase the amplitude of movements by 29,1% and 11,0%, rotational movements by 24,11% and 9,12%, to improve the DASH 46,8% and 19,6%; reduce the severity of the pain syndrome by 45,5% and 22,7%, diminish the number of patients with edema by 1,8 and 1,5 times, respectively. In the long-term period surpasses the effectiveness of using kinesiotherapy by the amplitude of movement by 7,9%, rotational movements by 13,4%, DASH by 8,9%, and quality of life by 11,7%. Conclusion. The comprehensive application of tape kinesiology and hand trainers allows significantly reduce the severity of the pain syndrome, contributes both to the cupping of the edema and the most complete restoration of the functions of the wrist joint, as well to the improvement of the quality of life of patients.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3):122-127
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CLINICAL AND EXPERT EVALUATION OF PERSISTENT DISTURBANCES OF FUNCTIONS IN BREAST CANCER
Sklyarenko R.T., Dovgalyuk A.Z., Spiridonova V.S.
Abstract
There is proposed clinical expert and quantitative evaluation of persistent disorders of body functions with taking into account the TNM classification and prognostic factors in breast cancer patients.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3):128-130
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EFFICIENCY OF THE TREATMENT OF DISABLED PERSONS WITH OBLITERATING ATHEROSCLEROSIS OF ARTERIES OF LOWER EXTREMITIES ACCORDING TO DATA OF THE PROSPECTIVE MEDICAL-SOCIAL RESEARCH
Kalichava A.S., Karasaeva L.A., Avdeeva M.V., Luchkevich V.C.
Abstract
By the end of the 5-year follow-up period, the limb was succeeded to be preserved in most patients with obliterating atherosclerosis of the vessels of the lower limbs who underwent surgery, both in the aorto-iliac and the femoral-popliteal segment (82,4 and 69,7%). Only in half of patients with obliterating atherosclerosis who underwent surgery on the aorto-iliac or femoral-popliteal segment, the limb was preserved (52,3 and 52,8%). The frequency of amputation after revascularization operations was 2,5 times lower than in cases received the conservative treatment (17,7 and 44,3%; p < 0,05). In the group of conservatively treated patients, a significant and mostly significant restriction of movement was found in 41,6% of patients with obliterating atherosclerosis of the vessels of the lower limbs, while after reconstructive operations, such restrictions were 2,8 times less frequent (41,6 and 14,8%; p < 0,05). After revascularization, the number of people with disabilities in group III was 2,5 times higher than among patients treated conservatively (27,9 and 11,0%; p < 0,05). The main advantage of this type of treatment was a significant reduction in the proportion of patients requiring constant external care than with conservative treatment (11,4 and 33,8%; p < 0,05). Lumbar sympathectomy demonstrated the highest efficacy, because in 43,6% (n = 55) of cases it was performed in the combination with an operation for to revascularization of arteries of lower extremities. Thus, in the study there was demonstrated the higher medical and social effectiveness of the use of surgical methods of treatment compared with conservative ones in the treatment of patients with obliterating atherosclerosis of the vessels of the lower extremities.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3):131-135
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NOSOLOGICAL SPECTRUM OF THE DISABILITY IN THE ELDERLY POPULATION OF THE ELDERLY CATEGORY IN THE RUSSIAN FEDERATION AND PECULIARITIES OF REHABILITATION-EXPERT DIAGNOSTICS, REHABILITATION AND ABILITATION
Shurgaya M.A.
Abstract
Disability of the elderly age group of the population is the most important problem of public health and social services of all developed countries over the world without exception. In the Russian Federation, this age segment is characterized by the gain, reflecting the global process of population aging. The aim of the study was to analyze the nosological structure of the primary and secondary disability in elderly people in comparison with the main age categories of the adult population in the Russian Federation and the evaluation of rehabilitation / rehabilitation activities for disabled people. The volume of the study was 34,840,933 people aged of from 18 years and over, recognized as disabled, including the disabled elderly - 12,971,062. The subject of a special study was the nature of functional disorders, the degree of the disability, the nosological spectrum of causes of the disability of elderly people and the effectiveness of implemented measures of medical and social rehabilitation (rehabilitation and expert characterization). The study was selective, the sample size account of 370 people. The results of the research demonstrate the nosological structure of the pathology, the associated types of impairments and the nature of the disability to determine the severity of the disability in elderly people, the complexity of the formation and implementation of individual programs for the rehabilitation and rehabilitation of disabled people (IPRA). The improvement of the quality of life and integrating disabled people into the society has been and remains a difficult task for rehabilitation and habilitation activities. Rehabilitation and provision of technical means of rehabilitation, to a lesser extent - social and professional rehabilitation are the most feasible for the implementation.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3):136-143
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ANALYSIS OF THE STRUCTURE OF THE PRIMARY DISABILITY DUE TO MULTIPLE SCLEROSIS IN THE CITY OF UFA OVER 2010-2016
Ivanova E.V., Bakhtiyarova K.Z., Safronova E.V.
Abstract
There was performed the analysis of the primary disability of multiple sclerosis in a large industrial city of Ufa during the period of 2010-2016. There was noted the decline in levels of the disability from 0.23 in 2010 to 0,14 per 10,000 in 2016, the prevalence in the structure of disability in young and middle-aged, persons with the third disability group. During the first 5 years from the onset of the disease 36,8% of patients have signs of the permanent disability, after 10 years 62% of cases show signs of the permanent disability. The majority of the disability have secondary progressive and remission-progressive type of the disease.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3):144-147
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THE STUDY OF ADAPTATIONAL CHANGES AGAINST THE BACKGROUND OF THE INTOXICATION INDUCED BY LOW DOSES OF ORGANIC SOLVENTS
Orujov R.A., Jafarova R.E.
Abstract
Objectives of the study are the experimental study of the adaptational changes occurring in the animal organism against the background of intoxication induced by low doses of benzene and acetone. Material and methods. There were studied 45 white mice divided into three groups: 1st group was consisted of intact animals; 2nd group included animals exposed to benzene through inhalation at a concentration of 32,6 mg/l; 3rd group included animals exposed to acetone at a concentration of 99,0 mg/l. Animals were poisoned five times in special chambers. Eosinophil, neutrophil and lymphocyte blood count (absolute) was determined according to common procedures. Results and discussion. After general anesthesia the benzene poisoning for the first time resulted in statistically significant reduction of the body temperature by 7,7oC, while after the 5th poisoning procedure this index was reduced slightly. Upon the first poisoning procedure in the animals after their emergence from anesthesia the leukocyte count was reduced by 26,3%, while eosinophil, neutrophil and lymphocyte counts were reduced by 41,3, 87,6 and 62,8% accordingly. The neutrophil to lymphocyte ratio (neutrophil/lymphocyte) was reduced by 39,49%. Before the fifth poisoning procedure, relative to baseline values, the reduction in lymphocyte count amounted to 13,3%; in eosinophil, neutrophil and lymphocyte counts - to 40,0, 1,7 and 13,7% accordingly, while the neutrophil/lymphocyte radio was reduced by 18,9%. After the emergence of the animals from anesthesia of the fifth poisoning procedure, the changes observed in the above-mentioned indices were much less than the changes caused by the first poisoning. Thus, reduction in lymphocyte count amounted to 13,8%; in eosinophil, neutrophil and lymphocyte counts - to 18,3, 4,8 and 17,7% accordingly, while the neutrophil/lymphocyte radio was increased by 16,9%. The results of chronical acetone poisoning of the animals show that after one month from the beginning of the study, the number of neutrophils and monocytes was reduced due to the slight reduction in the quantity of eosinophils, neutrophils and lymphocytes. Conclusion. The shifts in the leukocytic response due to еру repeated exposure to petroleum products through inhalation may be considered as the intensification of protective reaction.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3):148-151
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INTESTINAL MICROBIOCENOSIS AND CYTOKINE STATUS IN LUNG CANCER PATIENTS RECEIVING CHEMOTHERAPY
Serkova M.Y., Avalueva E.B., Bakulin I.G., Sitkin S.I.
Abstract
In patients with oncological diseases chemotherapy leads to the damage of a mucous membrane of gastrointestinal tract, as well as to a deterioration of the intestinal microbiocenosis. The article presents the changes in intestinal microbiocenosis in lung cancer patients, chemotherapy, the nature of the influence appointed in the schemes of the treatment of lung cancer, impact of anticancer drugs on the state of the intestinal microflora, and the improvement of technologies of treatment of lung cancer patients receiving chemotherapy on the basis of supplementation of the complex therapy by the probiotics Material and methods. 41 lung cancer patient receiving the first line of the first cycle of chemotherapy was included. The age of patients varied from 49 to 73 years, the average duration of the disease was 1 year. Patients from the main group (n = 21) received probiotics treatment together with the chemotherapy course. Patients from the control group (n = 20) received only chemotherapeutic preparations. All patients were observed before and after treatment, the study of metabolites of intestinal microorganisms in blood was performed by the method of the gas-liquid chromatography - mass-spectrometry by G.A. Osipov’s method, determination of cytokine status multiplex method. The efficiency of probiotic therapy was evaluated by results of the dynamics of studied indices. Results. The deterioration in intestinal microflora was manifested as the decreased quantity of Lactobacillus, Bifidobacterium, and increased quantity of different pathogenic microorganisms. It was noted decreased rate in the improvement of composition intestinal microflora after the treatment course with the metabiotic. Conclusion. Using of metabiotic medicines with the chemotherapy in lung cancer patients is promising to prevent deterioration of the gut microflora.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3):152-157
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THE PECULIARITIES OF DIAGNOSTICS AND THERAPY OF THE POSTTRAUMATIC STRESS DISORDER IN THE PRACTICE OF A NEUROLOGIST
Khozhenko E.V., Kiparisova E.S., Ekusheva E.V., Puzin M.N., Denishchuk I.S., Pryanikov I.V., Makkaeva S.M., Lepaev Y.V., Afanas’ev B.G., Dymochka M.A., Tarasova L.A.
Abstract
The posttraumatic stress disorder (PTSD) is no longer the pathology proper only to military men both over the world and in our country. At the present time there is observed a gain in PTSD patients. The disease has the negative impact both on the psychical and on somatic state of patients. The untimely and unqualified treatment of PTSD patients contributes to the chronicity of a pathologic process, results in social dysadaptation, prevents the return to the working activity. Doctors of very different specialities, most often neurologists, come into collision with PTSD. The article touches up the most urgent questions concerning PTSD, with the great attention paid to the differentiated diagnostics of the disease and methods of the treatment according to the achievements of the clinical practice. The methods of pharmacotherapy and psychotherapy of PTSD patients have been described on a contemporary level.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3):158-161
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BIOCONTROL AND PAIN DISORDERS
Puzin M.N., Kiparisova E.S., Khozhenko E.V., Lepaev Y.V., Denishchuk I.S., Afanas’ev B.G., Dymochka M.A., Shtelle A.A., Prokof’ev A.S., Tarasova L.A.
Abstract
A man is a complex biological and psychological phenomenon comprised of different behavioral patterns. Just these behavioral patterns cause the development of many diseases. In the article different types of pain disorders are reported, especially in the field of neurostomatology. One of the most interesting trends of behavioral medicine is a method of computer selfregulation based on a universal principle of a biological feedback (BOS is a Russian abbreviation). A method of biological feedback (BOS) and its variations have been proposed for the treatment of pain disorders such as headaches, especially tension-type headache, migraine, associated with depressive states, temporomandibular disorder, burning syndrome etc. There have been described different types of BOS - trainings - relied upon the temperature, EMG, EEG, the influence on frontal muscle groups and other effective trainings - influence on the pain for its healing with the direct participation of the patient. BOS-trainings have been presented in the article as one from dominated methods in contemporary neurostomatology based on universal means of fight against pain - biological self-regulation.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(3):162-168
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