Medicine of Extreme Situations
Scientific and Practical reviewed Journal
of FMBA of Russia

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№2, 2014 (June)

Some results of health care reforms in the Russian Federation and measures to improve it`s efficiency.

Year: 2014 (June) Number: №2 Pages: 6-12

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: V.M. Chernyshev.

Organization: FGBHI «Siberian Regional Medical Center» FMBA, Novosibirsk.

Annotation:

The article analysis measures taken by the government over the recent years to improve health care system and the reforms outcome. Within the national project of high priority «Zdorovie» and the Federal Program on Healthcare System Modernization the material and technical base of the industry has greatly improved, along with an increase of the medical professionals base salaries. Yet, it is obvious that the reforms could be more systematic and comprehensive thus have a better outcome. The article suggests some rationalization ideas for the industry to address first priority issues.

Keywords:

Health care, reform, efficiency.

Improving the efficiency of medical care provided to the contractual patients at Medical Sanitary Units as part of the Healthcare System reform.

Year: 2014 (June) Number: №2 Pages: 13-19

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: Yu.A. Goltsev, V.N. Kulyga.

Organization: FSBHI (Federal State Budgetary Healthcare Institution) Central Regional Hospital №119 FMBA.

Annotation:

The aim was to study operation of 10 medical units – subsidiaries of FSBHI Central Regional Hospital №119, FMBA in terms of health care reform and ways to improve the efficiency of medical care provided to contractual patients. The operational analysis showed some changes in: legislative change contractual patients system; increased the number of contracted patients from contracted facilities; various accessibility for the public to health care services in mentioned medical unit; competition with municipal and other medical institutions for quotas in the MHI system from the authorized territorial health authorities, as well as for the optimal number of contracted patients considering single-channel financing. Dramatically increased database for the system of Mandatory Health Insurance (MHI) and people insured in the system of Voluntary Health Insurance (VHI). Via simplification of requirements in normative document, there was selected the first priority patients category, called – the main contingent. The main contingent comprises employees of a contracted enterprise (some industries with highly hazardous work conditions) and bodies entitled to the contractual medical service. Manuals and recommendations were developed and introduced into practice of the medical unit along with the new information technologies (database «Attach», and the automated system «Contingent»). Taking into account the observed operational principles, we suggested an approach to improve the efficiency of medical units for the transitional reform period, that suggests operational methods as for «closed» so for «public» medical units; providing full scale provision for employees and residents of Closed Administrative-Territorial Unit (CATU).

Keywords:

Efficiency, contractual patients, quality of medical care, information technologies, reforms.

How early detection and treatment of hypertension influence the severity of ischemic heart disease and cerebrovascular diseases.

Year: 2014 (June) Number: №2 Pages: 20-24

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: A.R. Tukov, I.L. Shafranskiy, G.I. Gneusheva, S.B. Okov, V.M. Deryabin.

Organization: Federal State Budgetary Institution, State Research Center – Federal Medical Biophysical Center named by A.I. Burnazyan, Federal Medical Biological Agency, Moscow. Federal State Budgetary Healthcare Institution Clinical Hospital №50 FMBA, Sarov. Federal State Budgetary Healthcare Institution Central Regional Hospital №15 FMBA, Snezhinsk.

Annotation:

Purpose – how an early detection and treatment of hypertension among Rosatom employees was beneficial for their health.

Materials and methods – circulatory system health profile for the employees of two federal nuclear centers.

Results. Early detection and treatment of hypertension resulted in a tendency to reduce mortality from chronic diseases of the circulatory system.

Conclusions. It is necessary to extend measures of primary and secondary prevention and early treatment of the circulatory system diseases among personnel.

Keywords:

Circulatory system diseases, hypertension, CHD, cerebrovascular diseases, early detection.

Leucotriene receptor antagonists in asthma control.

Year: 2014 (June) Number: №2 Pages: 25-30

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: V.M. Troshin, E.K. Beltyukov, K.P. Bratukhin, S.D. Khrebtov.

Organization: Federal State Healthcare Institution Medical Sanitary Station №70 – Training Center for Occupational Retaining by U.A. Brusnitcin FMBA, Ekaterinburg. Federal State Educational Institution Highest Vocational Education Ural State Medical Academy – Ministry of Health, Russia, Ekaterinburg. Federal State Healthcare Institution, Central Regional Hospital №91 FMBA, Lesnoy.

Annotation:

Despite progress in bronchial asthma control, many patients still suffer from poorly controlled asthma and poor quality of life. It is known that bronchial asthma associated with allergic rhinitis (50–80% of cases) aggravates the progression of the disease. Montelukast antileukotriene drug controls inflammation as in the bronchial tree so in the nose. SABA and antileukotriene drugs when taken together gain cumulative effect thus increasing the treatment efficiency when asthma is associated with allergic rhinitis.The purpose of this study was to evaluate the effectiveness of the Montelukast – antileukotriene drug in complex therapy of patients with bronchial asthma.

Keywords:

Uncontrolled asthma, antileukotriene medications.

Current issues of the close followup on the psychîlogical and functional state of athletes in pre contest preparation.

Year: 2014 (June) Number: №2 Pages: 31-39

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: O.S. Morozov.

Organization: Federal State Budgetary Healthcare Institution, Sports Medicine Center, FMBA.

Annotation:

This article considers ways and methods to improve existing methodology in psychological diagnostics, provided counseling and psychological help, given the current issues of national athlete teams preparing for international contests, as well as raising the competitiveness of high qualification Russian athletes on the international arenas.

Keywords:

Psychological and functional state, dynamic monitoring, qualified athletes, autonomic nervous system, central nervous system, current functional state, psychological consultation.

Nutritional status and lifestyle choises of employees working with sources of ionizing radiation and how that effects their health status (Message 2).

Year: 2014 (June) Number: №2 Pages: 40-46

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: I.V. Kobelkova.

Organization: FSBHI (Federal State Budgetary Healthcare Institution) FMBA Head Center of Hygiene and Epidemiology, Moscow.

Annotation:

About half of the employees are systematically violate the dietary regime, starting with not having Breakfast before work. An excessive body weight and obesity were often caused by high consumption of oils, fats and meat products. Employees were physically very inactive, the mean physical activity coefficient (PAC) was 1.47. Employees who were regularly exercising, had significantly lower body mass index and 2 times less frequently had complains about their cardiovascular system. Some 43.7 per cent of the employees were smokers. Among non-smoking employees only 2.6% had chronic pulmonary disease, and in the Smokers group 37.8 percent suffered from various bronchopulmonary pathology.
Conclusions. The Results of this study confirm the relationship between nu trition, physical activity and main parameters of health status. There was a clear correlation between the consumption of fats and oils, meat products, lack of physical activity, increased body weight and obesity, along with the issues with the cardiovascular system. There is a proven association between smoking and CLD. IT is necessary to develop an educational program on healthy lifestyle and healthy nutrition, for the employees working in harmful and hazardous conditions.

Keywords:

Lifestyle, health, physical activity, treatment and prophylactic nutrition, diet №1, sources of ionizing radiation.

Beryllium oxide toxicity in simulated long-term exposure.

Year: 2014 (June) Number: №2 Pages: 47-54

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: V.E. Zhukov, I.P. Skalich, I.G. Frolova.

Organization: Federal State Unitary Enterprise «Research Institute for Hygiene, Toxicology and Occupational Pathology» at Federal Medical and Biological Agency, Volgograd.

Annotation:

The goal of the research was to study toxic properties of beryllium oxide (BeO) in simulated long-term exposure. Intoxication was simulated through the contact between the metal plates covered with beryllium oxide (BeO) (simulating surface of technological equipment) and bare skin of white outbred rats. Effectiveness of the compound was evaluated using complex of values correlating with condition of various organs and systems of laboratory animals.
Results. The conducted research has proven that chronic poisoning is extremely dangerous for the health. The limit of chronic contact (Limacintegr) was identified by the «dose – effect» dependence. It was observed that long-term BeO exposure causes disturbance of the central nervous system (CNS), the cardiovascular and the immune systems along with metabolism disbalance.

Keywords:

Beryllium oxide, simulated conditions of exposure, chronic exposure limits.

Biological properties of phytoestrogen genistein (review of publications).

Year: 2014 (June) Number: №2 Pages: 55-68

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: R.A. Tarumov, A.N. Grebenyuk, V.A. Basharin, V.Yu. Kovtun.

Organization: Military Medical Academy named after S.M. Kirov (MMA), Russia, St.Petersburg. Research and Production Center «Pharmzaschita» of Federal Medical and Biological Agency, Khimki Moscow region.

Annotation:

The review presents the results of phytoestrogen genistein biological properties studies conducted by national (Russian) and foreign authors. This review focused on toxicity, pharmacodynamics, pharmacokinetics and mechanisms of action of genistein and the potential application in clinical medicine. A separate section of the review provides detailed data on genistein application as a preventive medication in pathological conditions caused by ionizing radiation.

Keywords:

Genistein, 4,5,7-trihydroxyisoflavone, phytoestrogen, antioxidant, biological properties, application.

Health resorts in recovery programms for children living in unfa high radiation background.

Year: 2014 (June) Number: №2 Pages: 69-79

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: L.N. Shvedunova.

Organization: FGBHI (Federal Governmental Budgetary Healthcare Institution) Scientific Research Center of Balneology and Rehabilitation of Federal Medical Biological Agency» (Pyatigorsk, Russia).

Annotation:

The goal of the study was to develop scientifically proven various methods of holistic rehabilitation treatment including consumption of various mineral waters and for children living in radiation contaminated lands. The study used following methods: a clinical examination, gastric pH monitoring (Linara method), esophagogastroduodenoscopy, sigmoidoscopy, copro gram, ultrasound, hepatobiliary system ultrasound, pancreas and thyroid gland ultrasound, ECG, an autonomic function test (autonomic tone), vegetative maintenance of activity, psychological tests with a memory function, attention and performance tests, radio-immune tests for (cortisol, insulin, triiodothyronine, thyroxine), immunology tests for: lysozyme, phagocytosis, IgA, IgG, IgM, blood glucose. In children's health resorts in Caucasian Mineral Waters [«Dubovaya Roscha» named by N.K. Krupskaya, «Salute» (Zheleznovodsk), «Uonost’» (Essentuki)], as well as in Children's Hospital FGBI PGNIIK FMBA Russia there were examined some 350 children 7–14 y/o, who were admitted after the accidents in Russian regions (300 children – 86%), Belarus (35 people – 10%) and Ukraine (15 children – 4%). The control group consisted of 100 similar patients living in exceeding radiation free locations in the same regions. This control group helped to identify initial condition of children who had sustained (at least 3 years) exposure to radionuclides. This study allowed us to examine hormonal status and metabolism regulation in children with a history of radiation exposure. Tests showed typical prolonged cortisol elevation and lowering of insulin level with simultaneous excessive production of the thyroid hormones. This change in hormonal activity may be viewed as a post exposure chronic metabolic process. New data show that in children living exposed to high radiation, functional disorders of the digestive system combined with signs of dystonia and psycho-emotional disorders. It was proven that rehabilitation of children with the syndrome of environmental maladjustment using drinking mineral waters designated in the complex spa treatment is reasonable and possible.

Keywords:

Children, ionizing radiation, health resort treatment, medicinal/mineral waters.

Clinical, functional and psichological characteristics of high performance athletes with joints and periarticula tissues pahology.

Year: 2014 (June) Number: №2 Pages: 80-86

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: E.V. Titskaya, I.I. Antipova, L.V. Barabash, N.G. Abdulkina, A.O. Naumov, O.V. Dostovalova, E.V. Zamulina, S.V. Alaitseva.

Organization: Federal State Budgetary Institution of Science «Tomsk research Institute of Balneology and Physiotherapy Treatment of Federal Medical Biological Agency», Tomsk, Russia.

Annotation:

The conducted researches revealed the prevalence of bursitis and secondary (posttrauumatic) osteoarthrosis in pathology of joints and periarticular tissues among high performance athelets. These pathological processes are associated with increased catabolism, active lipid peroxidation, potentiated inflammation in the joints connective tissues, impaired cellular immune response, deterioration of neuromuscular apparatus in the affected limbs, poor exercise capacity, increased situational and personal anxiety. In fact, each examined athlete keeps body balance well, mainly due to the good contractility of myofibrils in skeletal muscles, muscles function remains well and is not depressed, athletes report to be active, positive and in a good health, able tolerate well a psycho-traumatic stress. The results obtained may be used for the development of methodological approaches in comprehensive rehabilitation programs for athletes with joints injuries and periarticular tissues diseases caused by degenerative-dystrophic processes.

Keywords:

High performance athletes, joints and periarticular tissues pathology of inflammatory and degenerative-dystrophic origin, clinical functional and psychological characteristics.

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