Vol 19, No 2 (2016)

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.

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.

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.

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.

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.