Том 68, № 1 (2024)

Purpose. To economically substantiate the developed technology of information management of the quality of dispensary observation of patients with coronary heart disease using dynamic monitoring and evaluation of digital personalized data on the provided medical care.

Materials and methods. To improve the efficiency of dispensary observation for angina pectoris, since 2018, the regional health care system of the Orenburg region has been implementing a technology for managing the quality of dispensary observation based on the analysis of big data on medical services and information integration “emergency medical care (EMC), hospital — Territorial Compulsory Medical Insurance Fund + Medical information-analytical center — polyclinic”. To assess the effectiveness of this technology in a group of angina pectoris patients with dispensary observation in the amount of 13,208 patients, we compared the results for 2017 and 2019.
the total cost of treatment per year in the polyclinic, EMC, and hospital, economic losses from deaths and financial costs per unit of efficiency. Angina pectoris patients without a myocardial infarction during the observed period of time was taken as a unit of effectiveness. The data were processed using linear statistics and parametric comparison methods. The Statistica 10 software package was used.

Results. Financial costs for the treatment of angina pectoris for 2017 and 2019 did not differ significantly from each other. The economic losses from premature death have been almost the same over the years. At the same time, the financial costs per unit of efficiency in angina pectoris patients in 2019 accounted for only 76% of the same indicator for 2017, the difference in this indicator was significant.

Limitations. To assess the effectiveness of information management technology, we analyzed the clinical and economic results of dispensary follow-up for two years in 13,208 patients with angina pectoris, which is a sufficient reference sample.

Conclusion. The technology of information management of the quality of dispensary observation in coronary artery disease is cost-effective, manifested by a significant reduction in financial costs per unit of efficiency. The analysis of large databases of electronic data on medical services is a tool for economic evaluation of the effectiveness of healthcare management technologies.

Compliance with ethical standards. The study does not require submission of the opinion of the biomedical ethics committee or other documents.

Contribution of the authors:
|Nazarov A.M. — concept and design of the study, writing the text, collecting and processing material, statistical data processing;
Kicha D.I. — research concept and editing;
Goloshchapov-Aksenov R.S. — research design and analysis of material, statistical data processing, compilation of a list of references.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

 Received: February 17, 2022 / Accepted: April 14, 2022 / Published: February 26, 2024

Introduction. The negative impact of congenital hearing loss on child’s development, education and socialization can be reduced by early identification and intervention as a result of universal newborn hearing screening. The screening program needs continuous improvement by monitoring of outcomes and correction of algorithms. The SWOT analysis can be applied to make effective decisions.

The purpose of the study is to identify strategies for the improvement of the Russian newborn hearing screening program based on SWOT analysis.

Materials and methods. The study was based on the experience of two pediatric audiological centres in Novosibirsk and St. Petersburg.
At the first stage, in accordance with the SWOT methodology, internal and external factors, the strengths and weaknesses of the Russian hearing screening program were identified, as well as the opportunities and threats that can affect the audiological care for children. At the second stage, pairwise analysis of strengths, weaknesses, opportunities and threats was carried out.

Results. The strengths of the Russian hearing screening program are national level implementation, high coverage of newborns in maternity hospitals, the use of modern objective audiological methods. Weaknesses are associated with a lack of medical personnel, need to equipment replacement, number of cases lost to follow-up. Opportunities are the availability of high-quality domestic diagnostic equipment, possibility for active interaction of specialists and families. The threats are caused by an imperfect legal framework and funding mechanisms, low awareness of parents, related professionals and society about the problem of congenital hearing loss.

Limitations. The study results are limited by the expertise of the authors without involving the wide range of stakeholders.

Conclusion. The developed strategies can increase timely audiological service to hearing impaired children and their families and to plan the necessary resources in the face of modern challenges.

Compliance with ethical standards. Research does not require the submission of a biomedical ethics committee opinion or other documents.

Contribution of the authors:
Kreisman M.V., Tufatulin G.Sh. — research concept and design, collection and processing of material, writing the text, compilation of the list of literature;
Chibisova S.S. — collection and processing of material, writing the text, compilation of the list of literature;
Tsigankova E.R., Tsytsorina I.A., Artyushkin S.A., Tavartkiladze G.A. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgments. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: January 4, 2023 / Accepted: January 19, 2023 / Published: February 26, 2024

Introduction. Along with the correct diagnosis of the disease, the stage of choosing the means of pharmacological correction is important, as well as the correct registration of the application to the pharmacy and ensuring the patient’s access to the necessary medication.

The purpose of the study is the pharmacological examination of prescription forms received by pharmacy institutions of the Republic of Crimea for the period 2020–2021.

Materials and methods. The object of the study was a random sample of three hundred thirty two scanned copies of prescription forms No. 148-1/u-04 (L), No. 107-1/u. Additionally, we conducted a survey of pharmacy staff (n = 46). The questionnaire included questions on the analyzed error groups, and also assumed a subjective assessment of the impact of the fact of incorrect prescriptions on the work process. Over the course of the study, methods of analysis, descriptive statistics, comparison, and survey were used.

Results. The main violations identified in the analyzed prescription forms were incorrect indications of the dosage forms (DF) of the prescribed drugs, as well as inaccuracies in their single and/or daily dosages. In 74 of the received recipes, errors were made when specifying the DF. The study of the frequency of prescribing medication of the certain pharmacological groups allowed determining the largest number of prescriptions to be written for drugs of the anxiolytic group, nootropic drugs, antidepressants. The result of a survey of employees of pharmacy chains revealed to be faced with incorrectly issued prescription forms on a daily basis.

Limitations. During the pharmaceutical examination of copies of prescription forms received from pharmacy chains of the Republic of Crimea, 322 prescription forms were analyzed, which is a sufficient reference sample.

Conclusion. When studying individual prescription forms, a sufficient number of various errors were revealed, which may entail a decrease in the quality of medical care for patients on the one hand, and on the other hand, suggests the occurrence of certain difficulties in the work of pharmaceutical workers.

Compliance with ethical standards. The study was approved by the Local Ethics Committee of the Order of the Red Banner of Labor of the Medical Institute named after S.I. Georgievsky of the Federal State Autonomous Educational Institution of Higher Education “Crimean Federal University” (protocol No. 10 of November 16, 2023). Written voluntary consent was received from all participants.

Contribution of the authors:
Egorova E.A. — research concept and design;
Useinova A.N. — research concept and design, editing;
Shtyrkova L.V. — material collection and processing, statistical processing, compilation of the list of literature;
Radkovskij V.A. — material collection and processing, statistical processing, compilation of the list of literature.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: August 23, 2022 /Accepted: October 19, 2022 / Published: February 26, 2024

Introduction. A potential factor that significantly reduces the social activity of older people is visual impairment due to various diseases. Visual impairment caused by cataract and diabetic retinopathy changes the social activity of people with the above-mentioned pathology, but it is extremely rarely analyzed by specialists and researchers, which does not allow identifying the limitations of patients in the social sphere and providing targeted medical and social care.

The purpose of the study is to study social activity in older patients with diabetic retinopathy and cataract.

Materials and methods. According to a special questionnaire, one hundred fifteen 60–74 years patients suffered from cataract and diabetic retinopathy and 60–74 years 102 people without ophthalmic diseases were surveyed based on the S.N. Fedorov National medical research center «MNTK Eye Microsurgery», Tambov.

Results. The average score of social activity in patients with cataract and diabetic retinopathy is statistically was found to be significantly lower, amounting to 3.10 ± 0.08 points versus 5.38 ± 0.09 points in people without ophthalmopathology. The main reasons that reduce social activity in patients with visual impairment are problems with making various purchases and using public or private transport. Factor analysis confirmed the contribution of these causes to the decline in social activity to be the highest and amounts to 0.876 and 0.708, respectively.

Limitations. The study was carried out just in one territory, which makes it difficult to extrapolate data to other regions.

Conclusion. It is recommended to increase social assistance to patients with cataract and diabetic retinopathy in solving problems of using transport and buying various goods.

Limitations of the study. The study was carried out in one territory, which makes it difficult to extrapolate data to other regions.

Compliance with ethical standards. The study was approved by the committee on Biomedical Ethics of the S.N. Fedorov National medical research center «MNTK Eye Microsurgery», Tambov (protocol no. 421-э, dated 21.10.2021).

Contribution of the authors:
Agarkov N.M. — design development, article editing;
Lev I.V. — collection of data, preparation of an article;
Osmanov R.E. — data processing, preparation of an article.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgements. The study had no sponsorship.

Conflict of interests. The authors declare no conflict of interest.

Received: April 5, 2022 / Accepted: June 16, 2022 / Published: February 26, 2024

Introduction. Currently, occupational skin diseases remain one of the important medical problems. In this regard, the search for new modern, promising methods for the prevention and treatment of skin diseases is relevant.

The purpose of the study is to evaluate the effectiveness of treatment and preventive measures among industrial workers with occupational allergic dermatoses.

Materials and methods. Two groups of patients with occupational allergic dermatoses (seventy seven cases) were examined and treated. In the control group (37 people), only traditional treatment was carried out; in the main group (40 people), the complex of treatment measures, in addition to conventional therapy, included the procedure of intravenous laser blood irradiation (ILBI). Biochemical and immunological studies were carried out using standard and unified methods.

Results. The use of ILBI in patients with occupational dermatoses had a positive effect on the state of cellular and humoral immunity: the number of CD3⁺ and CD4⁺ lymphocytes increased by 1.2–1.5 times, the CD4⁺/CD8⁺ immunoregulatory index normalized, the content of B cells in the bloodstream decreased, and levels of immunoglobulins IgG, IgE up to 1.6 times and inflammatory mediators (interleukin -10, -4, tumour necrosis factor-α) by 1.5–2.3 times. There was a 1.3-fold decrease in the content of ceruloplasmin, a protein in the acute phase of inflammation, and a 1.3–1.4-fold increase in the activity of catalase and neutrophil myeloperoxidase. A more rapid regression of rashes, a decrease in erythema, and the disappearance of itching was noted in the main group. The duration of the relapse-free period in this group is 1.9 times longer than in the control group.

Limitation: study of the effectiveness of laser therapy in the treatment of patients with occupational allergic dermatoses according to clinical and laboratory parameters.

Conclusion. The ILBI technique has shown its effectiveness and positive impact on the pathogenetic links in the development of occupational skin pathology, in comparison with traditional drug treatment. As a result, it can be used for immunorehabilitation, prevention, and treatment of this pathology.

Compliance with ethical standards. The study was approved by the Local Ethics Committee of the Federal Scientific Center of Hygiene named after F.F. Erisman of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing (dated of April 7, 2021) and performed with the informed consent of the surveyed employees.

Contribution of the authors:
Krasavina E.K. — concept, design of research, collection and processing of material;
Kryuchkova E.N. — writing, editing, formatting of the text;
Yatsyna I.V. — approval of the final version of the article.
All authors are responsible for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: April 21, 2023 / Accepted: June 7, 2023 / Published: February 26, 2024

Introduction. Weather, climatic conditions, and technogenic pollution of the habitat can determine the characteristics of the response of the organism of various groups of the population.

Purpose — assessment of the morbidity of persons of an organized team in conditions of ecological trouble in the Subarctic climatic zone.

Materials and methods. The object of observation is the prevalence (including primary incidence) according to ICD-10 for 2016–2021 among military personnel serving under contract in Norilsk (n = 200).The observed male cohort was a newcomer population, engaged in mental work;the share of persons with work experience in the specialty in this climatic zone of 3–10 years was 80.0%.We compared the incidence rates of the observed group and the adult population of Norilsk.Assessed working conditions according to the intensity of the labour process.

Results. The working conditions are harmful, the class of working conditions is 3.3. In the subarctic zone, under anthropogenic load, the prevalence of diseases and primary morbidity in people of mental labour are 1.7 times and 24.0% higher than in the adult population of Norilsk; in the 6 leading classes (with the exception of injuries), the primary incidence exceeded that in the adult population of the Krasnoyarsk Territory by 1.9–10.8 times. In the long-term trend, the prevalence and incidence increased with absolute values, respectively, by 63.8‰ and 57.5‰, deviations from the base value of 1.7% and 6.1% per year.

Research limitation. Male persons from among the alien population engaged in mental work in an organized team in a dysfunctional environment.

Conclusion.To prevent the morbidity of the population in adverse living conditions, it is necessary not only to assess the weather and environmental troubles to develop preventive measures to reduce the anthropogenic load, prevent cold risk, but also to analyze the incidence in the management of labor in a particular production.

Compliance with ethical standards. The study does not require submission of the opinion of the biomedical ethics committee or other documents.

Contribution of the authors:
Narutdinov D.A. — collection and processing of material, compilation of a list of references;
Rakhmanov R.S. — development of research design and concept, article writing;
Bogomolova E.S. — editing, approval of the final version of the article;
Badeeva T.V. — statistical analysis of the material.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgments. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: June 28, 2022 / Accepted: November 28, 2022 / Published: February 26, 2024

Introduction. The problem of continuous professional development of medical specialists with higher and secondary medical education is especially relevant at the present stage, when medical knowledge, technologies, and drugs are being improved every day.

Purpose. Analysis of the forms of conducting cycles of continuous medical education in the field of health care management and public health at the Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation for the development of the most popular and perfect form of its implementation.

Materials and methods. An analysis of the main directions of the mnagement of the process of continuous medical education of medical workers in general and in public health and health care in the Federal State Autonomous Educational Institution of Higher Education of the Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation.

Results. Since 1977 a continuous medical education was started in the USSR. A course for advanced training of doctors in social hygiene was opened at the Department of Social Hygiene and Health Organization of the 2^nd Medical Institute. Within the framework of the specialty “Organization of Health Care and Public Health”, the department conducted cycles of professional retraining (PP-504 hours), advanced training: 144 hours (PC-144), 72 hours and 36 hours. Continuing medical education is aimed at obtaining the competencies necessary to perform a new type of professional activity. The plans for further improvement of continuing medical education by the department provide for the renewal of work programs, the creation of distance and new relevant cycles.

Limitations of the study. An analysis of professional retraining cycles of students of various durations for the acquisition of new qualifications, qualitative expansion of the field of knowledge, skills and abilities in the period 2017–2022 was carried out.

Conclusion. The presented data indicate the expediency of managing advanced training within the framework of the specialty “Organization of Health Care and Public Health” using short cycles of advanced training of full-time and distant forms of training of students.

Compliance with ethical standards. The study does not require the submission of an opinion of the biomedical ethics committee or other documents.

Contribution of the authors:
Buslaeva G.N. — concept and design of the study, writing the text, compiling a list of references, statistical data processing;
Polunin V.S. — text writing, statistical data processing, editing;
Opryshchenko S.A. — collection and processing of material.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: October 2, 2023 / Accepted: October 18, 2023 / Published: February 26, 2024

Introduction. During 2015–2019, there was a tendency to decrease mortality rates from respiratory diseases in the Russian Federation. The COVID-19 pandemic, began in 2020, significantly increased the burden on public health.

The purpose is to compare standardized mortality rates from respiratory diseases for the period from 2014–2020 and to determine the contribution of individual nosologies to mortality from respiratory diseases in the Krasnodar Territory.

Materials and methods. The study was conducted on the basis of statistical reporting forms S-51 over 2014–2020. The causes of death related to respiratory diseases (class J00–J47) and the causes of death from COVID-19 (codes U07.1, U07.2) for 2020 were selected, standardized mortality rates were calculated.

Results. The lowest value of the standardized mortality rate from respiratory diseases was registered in 2019 as 10.3, the rate of decline compared to 2014 — 31.3%. The highest value of the standardized mortality rate from respiratory diseases is 40.3 in 2020, the growth rate compared to the previous year is 268.6%. The proportion of the standardized mortality rate from COVID-19 for 2020 amounted to 7.02%, which is 2.9% higher than from respiratory diseases in general.

Limitations of the study. When studying the regional characteristics of respiratory diseases mortality, official statistical data for 2014–2020 were used, which is a sufficient reference sample.

Conclusion. The leading causes of death from respiratory diseases in the Krasnodar Territory over 2015–2020 were pneumonia, other chronic lung diseases and purulent and necrotic conditions of the lower respiratory tract.

Compliance with ethical standards. The study does not require the submission of the conclusion of the Biomedical ethics committee or other documents.

Contribution of the authors:
Bolotova E.V. — writing text, editing;
Red’ko A.N. — concept and design of research, collection and processing of material;
Dudnikova A.V. — writing text, statistical data processing, compiling a list of references.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

 Received: September 19, 2022 /  Accepted: January 13, 2023 / Published: February 26, 2024

The formation of transfusiology in our country, in particular the foundation by Alexander A. Malinovsky (Bogdanov) the world first special Institute of blood transfusion, could not have happened without a “strong foundation” accumulated over centuries of trial and error. The article chronologically reconstructs the pathway of the development of the use of blood for medicinal purposes, starting from ancient times and the Middle Ages, when there were mentions of the use of drinks from human blood, until October 1, 1926 (the beginning of the real clinical and research work of the Institute of Blood Transfusion), which directly became the “foundation” for the emergence and development of transfusion blood in Russia already in modern times. The most “saturated” period in the development of transfusiology is considered — the New Time, at the beginning of which the prejudices of past eras about the benefits of drinking drinks from human blood were still preserved. W. Harvey discovered blood circulation, published an Anatomical study of the movement of the heart and blood in animals, which refuted the then dominant teaching of Galen. The English theologian Potter, who was present at the experience of W. Harvey, expressed the idea of blood transfusion. There have been critical statements questioning the benefits of blood transfusion. D. Blundell together with G. Klein began to study the effect of transfusion from person to person, which allowed D. Blundell to be considered the founder of modern transfusiology. The period of the late XIX–early XX centuries is analyzed, including the discovery of K. Landsteiner and the experiences of our compatriots — V.A. Yurevich, N.K. Rosenberg, V.N. Shamov and others. After the discovering blood circulation by W. Harvey, there is a gradual transition first to experiments on blood transfusion from one animal to another, then from animal to human and from human to human, and further use of blood for medicinal purposes, naturally, with “varying success”.

Contribution of the authors:
Serebryany R.S. — concept and design of research, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article;
Kamelskikh D.V. — idea of the study, collection and processing of material, writing text, compiling a list of literature.

Acknowledgment. The study had no sponsor support.

Conflict of interests. The author declares absence of conflict of interests.

 Received: January 29, 2023 / Accepted: February 16, 2023 / Published: February 26, 2024