No 11 (2003)

Endemic diseases cause considerable growth of regional health care expenses. In Voronezh Region such a disease is urolithiasis. Taking into account some recommendations elaborated at scientific and practical conferences considering the issues of health care standardization (Moscow, 1999-2001), orders No 12/2 of 19.01.98 and No 23/3 of 24.01.02 of the RF Ministry of Health and the RF Federal Mandatory Medical Insurance Fund it is possible to conclude that optimal management of health care delivered to patients with urolithiasis in Voronezh Region and its economic provision may be obtained only basing on standardization of diagnostic and treatment approaches. Non-observance of examination principles leads to inefficient treatment and its cost increase. The time necessitates obtaining maximum objective approach to method selection of urolithiasis treatment basing on examination standards and development of well-defined criteria for selection of patients. To solve this problem there should be a Report of urolithiasis patients’ management with the records of required volume and sequence of diagnostic and treatment measures depending on clinical condition. Standards of health care management have been developed for the welfare of patients and to be counted in the future. If this condition is met they will correspond to the modern level of demonstrative medicine, will contribute to efficiency increase everywhere, to improvement of urolithiasis patients’ treatment in Voronezh Region, to efficient usage of budgetary funds in districts and to introduction of advanced medical technologies at the initial stages of urolithiasis diagnosis and treatment.

The literary data have been summarized on the most perspective methods of pharmacotherapeutic prevention of diabetic nephropathy development in childhood. The essential role has been emphasized of intensive insulinotherapy, early application of pathogenetic correction methods of kidney microangiopathy and adequate treatment of concomitant infection of urinary tracts. Possible treatment perspectives have been discussed for diabetic nephropathy in children.

In the experiment with laboratory animals (dogs and rats) the role of hyperbaric oxygen was studied in the restoration of functional and metabolic disorders, taking place at local and general hypoxia of an organism: restoration of myocardial contractive capacity, electrolytic metabolism in cardiac muscle and brain tissues, oxygen homeostasis and centrogenous regulation mechanisms. Sano-genetic features of hyperbaric oxygen, providing for universal adaptation reactions in pathological conditions, allow the assumption that they serve as a correction factor for metabolic, regulatory and executive systems, capable to maintain optimal homeostasis under terminal conditions.

Neurohistomorphological features of cerebellar cortex cells exposed to low frequency pulse electromagnetic field (frequency - 50 Hertz, ultra-short duration pulses - 15-40 nanosec. applied during 5,7 and 10 months in different pulse modes) have been reported. The investigations conducted have proved that long-time exposure to pulse electromagnetic field leads to the complex of neurocyte changes of different type, having the phase character and certain biotropy of its parameters.

Work objective: searching and identification of psychological, psycho-social and behavioral risk factors of coronary heart disease (CHD). 147 patients above 55 years old with stable angina pectoris (functional class II-III) were involved into the examination. The criterion of alexithymia identification and grouping of patients was the index above 75 scores according to Toronto alexithymia scale. The patients were divided into three groups. The first group included the patients with alexithymia, who along with the basic treatment of stable angina pectoris were administered a two-week course of melatonin, in a daily dose of 3 mg taken before night sleep; the second group - alexithymia patients, who did not receive melatonin; the third group - patients without alexithymia, prescribed melatonin in addition to the basic therapy. After two weeks of combined treatment with melatonin statistically significant improvement have been marked of all the assessed criteria of psychological state and most criteria of objective status

Conclusions. Intensive therapy applied to patients with severe craniocerebral injury in conditions of computer-based monitoring of major parameters of systemic hemodynamics enables to normalize efficiently general oxygen transport and its consumption by tissues, to eliminate apparent hypermetabolism, specific for the acute period of craniocerebral injury.

Logistic regression equation was used to define a risk identification model of gynecological sickness prevalence, which described the relation between risk factors and probable outcome and enabled to set the actual diagnosis similar to the probabilistic assessment. Minimum number of the most significant risk-factors has been selected, giving quite thorough description of social and hygienic conditions in general.

The objective included analysis of relations between obstetric and gynecological pathology met in women employed at metallurgical plant and conditions of their work and life, identification of the main factors, affecting their health indices. Such anamnestic data as number of abortions and sexual life regularity have been proved to influence mostly the state of reproductive function in workwomen. Of social and hygienic factors the major are: difficulty of work done, satisfaction with medical services and notion of the due number of children in the family.

The issues of intensive teaching methods have been discussed, such as testing, management games and training sessions, explored in the course of student education at the Advanced Nursing Faculty in the Department of Public Health and Health Care Management while delivering the science Management and Leadership , Staff Management" course.