卷 4, 编号 2 (2024)
Articles
Questionnaires of the comprehensive assessment questionnaire for CAA-25 treatment adherence for pregnant women and legal representatives of patients: internal stability and reliability assessment
摘要
According to the criteria of internal stability and the measure of consent, questionnaires for a comprehensive assessment of treatment adherence to CAA-25 for pregnant women and legal representatives of patients were evaluated. In a descriptive one-stage study involving 96 pregnant women in Omsk with at least one previously born child, the level of treatment adherence was determined using the CAA-25 questionnaire, using the CAA-25 MB and CAA-25 MH questionnaires, with an assessment of internal stability and consent measures. The CAA-25 MB questionnaire demonstrated good internal stability (α 0.900, ast 0.912) with high reliability (consistent exclusion of scale points preserves the validity of the questionnaire in the range 0.889-0.910), with almost perfect agreement (κ 0.913). The CAA-25 MH questionnaire demonstrated good internal stability (α 0.902, ast 0.922) with high reliability (consistent exclusion of scale points preserves the validity of the questionnaire in the range of 0.884-0.902), with almost perfect agreement (κ 0.909), it is advisable to use the tested questionnaires to assess comprehensive adherence to treatment of pregnant women and legal representatives of patients.
5-11
Indoor plants as an additional preventive means of improving the air environment in closed rooms of preschool educational organizations
摘要
Annotation. The purpose of the study is to assess the role of the preventive (biological) effects of phytoncidal properties of indoor plants on the health of children who are in closed rooms of preschool educational institutions for a long time, in order to reduce the incidence rate in winter by taking a set of preventive measures.
Material and methods: In the analysis of the assessment of increasing attendance and reducing morbidity in children in preschool in winter under the influence of phytoncidal properties of indoor plants, hygienic (sanitary-descriptive, monitoring, method of comparing actual indicators with hygienic standards, assessment of chances), biological (measurement of the area of the leaf apparatus, width and height of plants, assessment of chemical leaf composition) and statistical (methods of parametric and nonparametric statistics). The object of the study was the effect of indoor plants (safe for children's health, unpretentious in care and possessing phytoncidal properties according to literary sources) on the health of children 5-6 years old (in terms of attendance and morbidity in winter) attending preschool.
The results and their discussion. The study determined a direct dependence on the placement of indoor plants and the omissions of children in the incidence of acute respiratory diseases in the study groups ("observation" and "control"). The experimental data obtained on the use of phytoncidal properties of indoor plants as an additional method of improving the air environment in the premises of preschool educational organizations suggest that indoor plants not only purify the air and contribute to a favorable preventive effect on children's health, but also prevent the development of acute respiratory viral infections (ARVI).
Conclusion. The role of houseplants as an additional preventive means of improving the air environment of closed premises is determined. It has been experimentally established that indoor plants have a beneficial effect on air purification and a decrease in the development of microorganisms in children, which helps to increase immunity to colds, including acute respiratory diseases (ARI). The results obtained and the conclusions drawn at the same time indicate the need to use indoor indoor plants in order to prevent the beneficial effects of the released phytoncides on the health of children.
12-19
Vaccination and immunity: the role of the pediatrician in shaping parents' commitment to preventive measures
摘要
Mass immunization of the population is the most effective measure to combat infectious diseases. Despite the fact that the introduction of the vaccine does not guarantee that the child will not get sick, vaccination can reduce the risk of complications and death. In recent years, there has been a negative trend towards a decrease in the number of children who have been vaccinated according to the National Calendar of Preventive Vaccinations. The situation is complicated by unreliable information about the dangers of vaccines, mainly in groups of anti-vaxcers, on social networks, which negatively affects the attitude of parents to vaccination. The review provides an analysis of the causes and conditions affecting the decision of parents to refuse vaccination of children. The main reason for refusal is related to the fear of harm to the child after vaccination. Despite this, most parents express the opinion that the main source of authoritative information on immunization issues is the district pediatrician. The medical staff of the polyclinic have a direct influence on the formation of parents' opinions. The high professional competence of the doctor, the ability to inform parents in an accessible way about the risk of complications in the event of severe forms of infectious diseases, careful medical selection of children before vaccination, contributes to parents making the right decision. On the other hand, the word of a pediatrician or a specialist doctor does not always have an effect on parents. Many of them prefer to trust people who do not have medical education, the media, the incompetent opinion of bloggers, etc. In order to achieve the positive effect of mass immunization, it is necessary to popularize specific prevention of infectious pathology, extensive explanatory work by leading specialists in the media, and increase the professional authority of a doctor, primarily primary care.
20-27
Alternative forms of testing the antioxidant blood status of cows at different stages of the reproductive cycle
摘要
The purpose of the study was to study the indicators of the pro- and antioxidant blood systems of cows at different stages of the reproductive cycle (30th day after calving (control), 3rd, 5th, 7th, 8th months of pregnancy, 7–10- 1 day before calving, 10–15 days after calving) using an enzymatic colorimetric test to correct housing and operating conditions. Scientific research was carried out on the basis of JSC "Rassvet" in the Lyubinsky district of the Omsk region. The total pro- and antioxidant capacity of blood serum was determined using an enzymatic colorimetric test on the Multiscan device. The study revealed a significant decrease in blood pro-oxidative capacity starting from the 3rd month of pregnancy with a tendency towards an intensive increase in the pre- and post-calving periods. The antioxidant capacity of blood serum reaches critically low values by the 5th month of pregnancy, begins to increase in deeply pregnant cows, decreases towards calving, and in the post-calving period tends to control values. The data obtained indicate that the maximum intensity of free radical processes is observed in cows 7–10 days before calving and on the 15th day after calving. Antioxidant protection of the body decreases as the pregnancy period increases; in the last months and before calving, there is a tendency to increase it.
28-33
Calculation of the dosimetric characteristics of the radiopharmaceutical “188re-albumin microspheres” in the body of mice based on pharmacokinetic modeling
摘要
Purpose. Development of a compartment mathematical model of the kinetics of the radiopharmaceutical “188Re-albumin microspheres” in the body of intact mice and calculation on its basis of the dosimetric characteristics of this drug – accumulated and total absorbed doses.
Material and methods. The objects of the study were serum albumin microspheres labeled with rhenium-188 with a diameter of 10−20 microns and the comparison drug Na188ReO4. Experimental pharmacokinetic data were obtained on mongrel white mice. The compartment model includes a central blood compartment and peripheral compartments of the lungs, thyroid gland, stomach, spleen, liver and kidneys. Identification of the kinetic parameters of the model (transport constants) was performed using experimental data. The pharmacokinetic and dosimetric characteristics of radiopharmaceuticals in mice were calculated based on the identified values of the transport constants of the model.
Results. The compartment mathematical model of the kinetics of 188Re-albumin microspheres in the body of intact mice has been developed in accordance with experimental conditions. The radiopharmaceutical “188Re-albumin microspheres” has high stability in vivo, selectively accumulates in the lungs. Its increased accumulation in the compartments of the liver and spleen was also revealed, which may be due to the partial disintegration of the deposited 188Re-albumin microspheres in the lung tissue as the protein microspheres resorbed. This drug is excreted from the blood mainly by the kidneys. The blood clearance value for it is about 8 times higher, and the radiation load on the blood is less, compared with Na188ReO4. The values of accumulated absorbed doses in organs and tissues increase monotonously from the moment the drug is injected into the blood, reaching their maximum values equal to the total absorbed doses by about 80 hours. The maximum values of absorbed doses were obtained in the lung compartment, which reflects the tropicity of 188Re-albumin microspheres to this organ.
Conclusion. The obtained simulation results allow us to consider the radiopharmaceutical “188Re-albumin microspheres” as promising for radionuclide therapy of tumors of different localization with intravascular administration.
34-45
Experience of organizing specific medical classes at Omsk state medical university in general educational organizations
摘要
In this article, the authors presented certain results of activities on current aspects of training future medical university applicants in general education organizations in Omsk (using the example of the Omsk Gymnasium No. 139). A definition is given to the concept of specialized education (Article 2, Clause 25 of the Federal Law “On Education in the Russian Federation” dated December 29, 2012 No. 273), “...the focus (profile) of education is the orientation of the educational program towards specific areas of knowledge and (or) types of activities, determining its subject-thematic content, the predominant types of educational activity of the student and the requirements for the results of mastering the educational program”[1].
The purpose of this work was to describe the results and prospects of organizing specialized medical classes in an educational organization, which provide the prospect of increasing applicants to a medical university. In the article, the authors tried to answer the questions: How ready is the department of normal physiology of a medical university to implement specialized training in an educational organization in Omsk? What work training programs most effectively implement the professional orientation of students in educational organizations? A number of studies conducted at the Department of Pedagogy and Psychology of Advanced Vocational Education together with the Department of Normal Physiology indicate that university applicants have a number of knowledge deficits that make it difficult to successfully pass the Unified State Exam in biology. The reasons for these deficits are varied, since the training of students in schools, lyceums, gymnasiums, etc. is different.
The work was based on regulatory documents, such as Federal Law dated December 29, 2012 №273-FZ (as amended on December 25, 2023) “On Education in the Russian Federation” (as amended and supplemented, entered into force on May 1, 2024) [1]; Order of the Ministry of Education of the Russian Federation of July 18, 2002 № 2783 “On approval of the Concept of specialized training at the senior level of general education”; “Strategic priorities in the implementation of the state program of the Russian Federation “Development of Education” until 2030” [2]; Regulation P-243-2023 “On specialized medical classes (OmSMU)”, which normatively describes the process of organizing “… specialized (medical) classes, which are formed at the level of secondary general education in agreement with the founder of a general educational institution (hereinafter - OOU). The purpose of training in a specialized (medical) class is indicated – indepth training in natural science subjects with pre-professional training in medical specialties, professional guidance for students for admission to Omsk State Medical University”[3].
46-54
The evolution of scientific knowledge about irritable bowel syndrome
摘要
The study of the causes and mechanisms of symptoms of functional bowel diseases, the study of diagnostic methods and the search for the most effective algorithms for managing patients with irritable bowel syndrome have remained highly relevant since the formation of medical science. Previous studies of the structure of the intestine at the macro- and microstructural level, physiological and pathophysiological processes, the introduction and modification of new diagnostic methods for functional diseases of the colon have become the basis for modern algorithms for the management of patients with irritable bowel syndrome.
55-70
The impact of smoking e-cigarettes on human health
摘要
This literature review presents data on the effects of electronic cigarettes on the human body. The composition of vape liquid and the harm caused by each component separately, including glycerin, propylene glycol, is described. Vegetable glycerin is used for refueling electronic cigarettes, which determines the flavor. Propylene glycol is used to dissolve flavorings. The role of nicotine is more detailed than the other components, because among other things it is a neurotoxin and addictive. Literature sources have been analyzed to study the formation of pathological changes in tissues and organs during the use of electronic cigarettes. One of the first systems to be negatively affected by smoking is the respiratory system. Nicotine causes prolonged constriction of capillaries and arterioles, due to which normal gas exchange in the lungs is disturbed. Under the influence of nicotine is depressed activity of the nervous system. But the insidiousness of nicotine is not only that. Particularly dangerous to health long-term smoking. The brain gets used to the constant supply of nicotine. On the blood vessels nicotine has a spasmodic effect, promotes thrombosis. Diseases associated with the use of electronic delivery of nicotine, called EVALI, are presented, the latter meaning “lung injury associated with the use of electronic cigarettes”. The review emphasizes the negative effects of nicotine on the digestive system. Smoking contributes to narrowing of stomach vessels, gastric juice secretion is disturbed, and its composition changes, appetite decreases, peristalsis changes, and digestive diseases occur. To date, there is a growing trend in the number of people smoking electronic cigarettes, which is actively promoted by marketers [8]. They position smoking e-cigarettes as a fashion that does not cause harm to health. But this is a big misconception. E-smoking is virtually the same as regular smoking, except that e-cigarettes do not contain tar. The availability of vapes increases the trend of increasing use of these products by schoolchildren, which is a serious social problem.
71-76
Catheter-associated bloodstream infections: essence, methods of prevention and factors influencing them
摘要
In modern medical practice, the issue of catheter-associated bloodstream infections is becoming more and more relevant, as these infections now account for a significant proportion of all cases of bacteremia among hospitalized patients. This review offers a detailed investigation of various strategies aimed at reducing the incidence of catheter-associated infections, with particular emphasis on methods for which there is robust evidence of efficacy.
The impact of changes in problem definition and health care regulation on the dynamics of incidence reduction is analyzed. Particular emphasis is placed on the period covered by the COVID-19 pandemic, discussing the vulnerabilities of some infection prevention strategies identified in the face of health system variability.
The focus is on the increased prevalence of catheter-associated infections during the pandemic period. This reveals weaknesses in some existing strategies and highlights the urgent need to develop more flexible and adaptive infection prevention methods, especially in a rapidly changing health care environment.
This review provides a comprehensive analysis of the effectiveness of strategies to prevent catheter-associated infections, with attention to their applicability in the variable environment of modern healthcare. The pandemic period emphasizes the need to update the prevention system, with a focus on strategies free from human error and able to adapt to rapidly changing healthcare environments.
An important recommendation is the active use of advanced technologies such as antiseptic-impregnated catheters and dressings. This not only ensures system resilience in the face of rapidly changing demands and uncertainty, but can also reduce the risk of infections.
The implementation of simplified definitions and electronic automation are put forward as key measures to improve system robustness and effective control of catheter-associated infections in today's dynamic healthcare environment.
Thus, this review not only provides an extensive analysis of strategies to prevent catheter-associated infections, but also emphasizes their applicability in today's variable healthcare environment, especially in a pandemic, suggesting specific measures to strengthen the prevention system and ensure stability in a rapidly changing healthcare environment.
77-89
Infographics as a tool for improving the medical literacy of the population in relation to critical health conditions
摘要
The number and severity of complications in acute appendicitis correlate with late access to medical care, which, in turn, directly depends on the level of medical literacy of the population.
Goal. A comparative analysis of the results of the impact of the developed infographic technology on improving the level of medical literacy of the population in relation to critical conditions that threaten life and health using the example of acute appendicitis.
Material and methods. An open single-center prospective controlled sociological survey in the form of a questionnaire included 350 respondents divided into two groups identical in age and gender. The main group included 177 respondents who were exposed to the developed infographic tools. The comparison group consisted of 173 respondents who were not exposed to infographics. The effectiveness of the impact was assessed using a fragment of the adapted HLS19-Q22-RU questionnaire.
Results. The results of the comparative analysis revealed a statistically significant increase in correct answers in the group exposed to infographics (the main group), about lack of appetite (question No.4) by 20.3% (χ2=17,83; р<0,05) and the presence of intestinal disorders in acute appendicitis (question No.5) by 14.9% (χ2=9,62; р<0,05).This fact significantly influenced an increase in the proportion of respondents in the main group (question No.8) who will seek medical help on the first day of the disease by 12.7% (χ2=6,45; р<0,05), and a decrease in the proportion of those who find it difficult to answer by 7.8% (χ2=4,77; р<0,05).
Conclusion. The problem of late hospitalization for acute appendicitis cannot be solved within the surgical community and requires an integrated approach at the state administrative level. The technology developed and put into practice to improve the medical literacy of the population using infographic materials is effective and easily reproducible. A comparative analysis of the results of the study demonstrated the effectiveness of the influence of the developed infographic technology on the growth of medical literacy of the population in relation to critical conditions that threaten life and health, using the example of acute appendicitis.
90-98
Improving the prevention of circulatory system diseases at the regional level
摘要
The article presents an assessment of morbidity, mortality and secondary prevention of the population by diseases of the circulatory system on the territory of the North-Kazakhstan region of the Republic of Kazakhstan. The characterization of levels and structure of morbidity by diseases of the circulatory system is given. The leading nosological forms were arterial hypertension, ischemic heart disease and cerebrovascular diseases.
99-102
Improving the organization of medical care for patients with chronic non-infectious diseases
摘要
The article presents the estimation of the level of morbidity and mortality from circulatory system diseases among the adult population of the North-Kazakhstan region of the Republic of Kazakhstan for 2010-2022, characterizes the organization of medical care for patients with circulatory diseases by analyzing the performance indicators of medical organizations of primary health care and hospitals of the region, providing medical care for patients with circulatory diseases. Priority directions of measures to improve the organization of medical care for patients with circulatory diseases have been identified.
103-105
Organization of internal control of quality and safety of medical activity in a polyclinic
摘要
The article presents an assessment of the effectiveness of measures to improve the system of internal control over the quality and safety of medical activity on the basis of the Proposals (practical recommendations) on the organization of internal control over the quality and safety of medical activity in a medical organization (polyclinic).
106-108
Communication channels for obtaining information on healthy lifestyle issues
摘要
The article raises the issue of the importance of informing the population on the issues of healthy lifestyle, including information about the main risk factors for the development of chronic non-infectious diseases. The relevance of the problem is substantiated, the results of sociological research aimed at identifying the most significant information and communication channels are given.
109-111
Staffing and training of medical personnel in the budgetary health care institution of omsk region
摘要
The aim of the work was to conduct a comprehensive analysis of the personnel policy of the Ministry of Health of the Russian Federation, to characterize the application of modern technologies of advanced training and retraining as a condition for their professional development of medical workers, to identify the problems of the state personnel policy in the health care system and to outline the ways of their solution on the example of the budgetary health care institution of the Omsk region “Russko-Polyanskaya central district hospital”
Results. Staffing in the “Russko-Polyanskaya Central District Hospital” is achieved due to compatibility of positions, which leads to the deterioration of health of medical personnel, reducing the quality of work and efficiency of medical care, as well as labor productivity. Low wages and insufficient incentives lead to a significant increase in staff turnover.
Conclusion. The formulation of goals and objectives of personnel policy is aimed at strengthening the role of health care workers in protecting and promoting public health. In addition, the personnel policy should ensure the possibility of using its components as a basis for management decision-making. At the same time, it is important not only to solve the identified problems taking into account the existing potential, but also to direct the efforts of the authorities to create the necessary conditions for solving the identified problems. This is undoubtedly aimed at increasing the social role of medicine and doctors in society.
112-115
Estimation of economic damage from mortality of able-bodied population of omsk region for the period from 2018 to 2022
摘要
The article presents the medical and demographic indicators of health of the population of Omsk region for the period from 2018 to 2022. The analysis of the structure of mortality of able-bodied population, calculation and estimation of economic losses of the region from mortality by three differentiating features: sex, age and class of causes of death according to ICD-10 are carried out.
116-118
Epidemiologic manifestations of tuberculosis infection in the Tavrichesky district of Omsk region
摘要
The epidemiologic manifestations of tuberculosis infection in Tavrichesky district of Omsk region are described. The main indicators characterizing the work of the phthisiatric service are analyzed. The main existing organizational approaches to detection of tuberculosis among children and adults are presented, the directions of work of phthisiatric service in Tavrichesky district of Omsk region are highlighted.
119-121
The relevance of alcoholic psychosis in the population of omsk region
摘要
The article considers the dynamics of the primary morbidity of alcoholic psychosis in the Omsk region, as well as the number of first-time detected alcoholic psychosis in Russia for the period 2018-2022.
122-124
Assessment of risk factors of health disorders in the working population to justify priority measures for their prevention
摘要
The article presents theoretical aspects of the assessment of risk factors for the health of the working population, as well as methods and legal bases of such an assessment. Risk factors, including physical factors and morbidity of infectious diseases, are analyzed in order to identify the main problems and trends in this area.
125-127
Assessment of adherence to treatment and prophylaxis of tuberculosis patients in a 24-hour hospital setting
摘要
The article presents the results of a study to assess the level of adherence to treatment and prevention of tuberculosis using the questionnaire QAA-25 in patients of tuberculosis dispensary who were on inpatient treatment. Recommendations to increase the level of patients' adherence to treatment and prevention of tuberculosis are offered.
128-130