Vol 17, No 3 (2014)

Currently, chronic heart failure (CHF) is one of the most relevant health and social problems. This is stipulated by its high prevalence, morbidity growth (annually develops about 0.5 million new cases) and poor prognosis. CHF is the final stage of cardiovascular continuum, which causes most of the mortality and high rates of disability in the population. Treatment of CHF requires considerable spending in many countries around the world - up to 1 to 2 % ofall health care facilities and 10.8% of the total budget allotted to the treatment of cardiovascular diseases. Approximately 70 % of this amount is spent on the treatment ofpatients hospitalized in the hospital with worsening heart failure. Low survival at this stage, on the one hand, and the high costs of hospital care, on the other - the need to define the optimization approaches to medical and social rehabilitation of patients with chronic heart failure. This article, the first of a planned series of articles that will highlight current issues of epidemiology, etiopathogenetic formation, clinical expert diagnosis, therapy and prevention of heart failure.

We analyzed the functional status of patients with spinal cord injury (late period) using the profile with the International classification of functioning, disability and health (ICF) categories. We identified the changes in bodyfunctions, body structures, activity and participation that can be corrected in the rehabilitation hospital.

This article seeks to improve approaches to expert examination of sick children in the mixed profile bureau of medico - social examination to the identification and assessment of mental dysfunctions in patients with lesions of the brain. The difficulties encountered in the process of medical and social assessment of people with this disorder were analyzed. The use of the experimental psychological examination for the detection of cognitive and regulatory violations, the objectification of the severity and persistence of mental disorders was justified. A case of expert practice, which caused significant difficulties in determining the disorders of the body (type, severity, and persistence ), certain restrictions on the major categories of life, the formulation of clinical andfunctional diagnosis and expert determination was presented. The need to develop common criteria and approaches to assessment of mental dysfunctions is shown.

The paper analyses general disability in children in all regions of the North Caucasus Federal District, taking into account the different age groups in the dynamics over 5 years - 2008-2012.

Prior disability caused by digestive diseases has been studied with consideration of age, disability grade and occurrence among adult population of the Belgorod region from 2000 to 2012. In general, despite the growth of the population, and its ageing the level of prior disability caused by digestive diseases decreased. Such cohort mostly includes employable population with disability of 2nd and 3rd grades. A negative trend related to prior disability manifests as increasing ratio ofpersons with disability of the 1st grade. Prior disability becomes more severe with age.

The article analyzes the primary disability due to tuberculosis in the Rostov region. The level and structure of disability in different age groups and different disability categories was calculated. 5years observation period (2009-2013).

The present article is devoted to questions of carrying out medico-social and military-medical expertise. In the presented material the modern concept and methodology of medico-social expertise is considered, the factors being the basis for recognition of the person by the disabled person and proving the expert decision are allocated, the principles of creation of the clinical-functional diagnosis are defined, regulations, classifications and the criteria used at implementation of medico-social examination are specified. The main categories of activity of the person and degree of expressiveness of restrictions of these categories are presented; the assessment of restriction of ability to work, actual for persons of able-bodied age is given. The regulations defining the purposes and an order of carrying out military-medical expertise and establishing uniform categories of the validity to military service by results ofphysical examination are considered, the subject of military-medical examination is defined, its basic laws and the criteria proving the expert decision are considered. Classification of degree of expressiveness of functional violations by which the military-medical commissions, in comparison to the conclusion about corresponding to this type of violations of category of the validity are guided in the activity is presented. The order of carrying out medico-social and military-medical expertise, and also the criteria used at establishment of disability groups and category definition of the validity to military service are analysed. The general expert approaches at implementation of expert actions concerning civilians and the military personnel, distinctly expressed legal character of expert opinions with certain social consequences of the examined persons are revealed.