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Dessau, M. I., S. L. Nikolaenko e D. A. Lioznov. "The effectiveness of treatment depending on an adherence to dispensary observation and antiretroviral therapy in patients with HIV infection". HIV Infection and Immunosuppressive Disorders 16, n.º 1 (17 de abril de 2024): 36–44. http://dx.doi.org/10.22328/2077-9828-2024-16-1-36-44.
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Aim. Determination of the causes of deaths and analysis of the survival of people living with HIV, depending on an adherence to dispensary observation and treatment. Materials and methods. The analysis of socio-demographic characteristics and clinical and laboratory data of 284 adult HIV patients observed in 1999–2011 at the Lomonosov Interdistrict Hospital named after I. N. Yudchenko was carried out. Patients who followed the prescribed monitoring regimen (at least 2 times a doctor’s visit during the year) were considered committed to dispensary supervision. Patients who observed the regularity and continuity of monitoring and receiving antiretroviral therapy (ART) were considered committed to treatment. Among the patients included in the study, 115 people were committed to treatment or follow-up and 169 patients were non-committed. Objective (biological) indicators of adherence and effectiveness of treatmentwere the number of CD4 lymphocytes and the level of HIV viral load. Based on the method of comparing survival curves, factors related to the life expectancy of HIV patients were assessed, taking into account the gender of patients, their adherence to monitoring and treatment, indicators of HIV viral load and the number of CD4 lymphocytes and the outcome of the disease from the moment of registration at the dispensary and over the next 120 months (after 3 months, 6 months, 1.5 years, 2 years, 5, 7 and 10 years). Results and discussion. Significant differences were found in the survival curves of patients who received and did not receive ART (117.9 and 91.4 months, p<0.005) and patients who were committed and non-committed to therapy (116.9 and 83.8 months, p<0.005). Regardless of adherence to outpatient follow-up and therapy, the survival time of women compared to men for the entire follow-up period was longer (105.0 and 92.4 months, respectively, p<0.005). Among those committed to treatment, 21% of patients died due to concomitant somatic pathology, 5% from injuries incompatible with life. In the group of those committedto follow–up, the causes of deaths in 12% were various somatic pathology, brain lymphoma — in 1% and injuries incompatible with life — in 3% of cases. The highest mortality rates were recorded among patients who were not exposed to ART (71%) and the routine of follow-up (52%). Almost half of these patients (49%) died from secondary HIV infections, of which 85% of cases were posthumously diagnosed with tuberculosis, mainly the pulmonary form of the disease. The second most common cause of death was violent death, including drug poisoning. Conclusion. Regular dispensary observation, timely initiation of ART and adherence to therapy make it possible to control the disease, prevent the development of opportunistic pathology, and improve the quality and life expectancy of patients with HIV infection. Despite the increased availability of ART and strategies for active involvement and retention of patients in dispensary care, issues of patient adherence to therapy remain key in the management of HIV patients.
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Buchkova, T. N., N. I. Zriachkin, G. I. Chebotareva e O. V. Tihnenko. "CASE OF NEUROFIBROMATOSIS TYPE I WITH ASTROCYTOMA OF THE BRAIN IN THE PRACTICE OF PEDIATRICIAN". Journal of Volgograd State Medical University 75, n.º 3 (30 de setembro de 2020): 138–44. http://dx.doi.org/10.19163/1994-9480-2020-3(75)-138-144.
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The relevance of the topic is due to insufficient awareness of doctors about neurofibromatosis, which leads to a delay in diagnosis and the development of complications. The diagnostic criteria characteristic of this disease, features of the clinical course, possible complications, methods of treatment, features of dispensary observation are described. A clinical case of neurofibromatosis type I with astrocytoma of the brain is described. The diagnosis of neurofibromatosis type I (NFI) was established in a patient aged 4 years 3 months. The peculiarity of the manifestations of this clinical case is the absence of family history; the combination of cutaneous manifestations, multiple lesions of the nervous system, complicated by chronic subdural hematoma, endocrine disorders and extra-cutaneous manifestations (eye symptoms, hearing and speech disorders); the absence of significant positive dynamics despite repeated surgical treatment and long-term polyochemotherapy. Despite the stabilization of clinical manifestations of the disease, this patient has an unfavorable prognosis with possible progression of the pathological process. For early clinical detection of patients with NFI, using for this purpose diagnostic criteria recommended by the International Committee of experts on neurofibromatosis, continuity of management and adequate measures of primary and secondary prevention of complications of NFI is important knowledge of this pathology by primary health care physicians, including pediatricians, district and family doctors, neurologists, dermatologists, ophthalmologists and surgeons.
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Akpysharov, N. "Improving Mental Health Care as the Most Pressing Public Health Issue". Bulletin of Science and Practice 6, n.º 5 (15 de maio de 2020): 184–94. http://dx.doi.org/10.33619/2414-2948/54/22.
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Mental disorders are an acute public health problem in the WHO European region, affecting 25% the entire population every year. WHO activities in the area of mental health promotion at the level of individuals and society as a whole are aimed at improving human mental well-being, preventing mental disorders, protecting human rights and caring for people with mental disorders. The WHO European Conference on Mental Health (2005), 66th Session of the World Health Assembly (2013), 63rd Session of the WHO European Regional Committee (2013) have focused on mental health. In the Kyrgyz Republic, the State policy to change the system of assistance to persons with mental disabilities, to establish a unified mental health service and to change the attitude of society towards mental health and the mentally ill is reflected in the National Program Mental health of the population of the Kyrgyz Republic for 2001–2010, the National Health Reform Program of the Kyrgyz Republic Den Sooluk for 2012–2018, for the Sustainable Development Goals up to 2030, adopted at the Summit by UN members, the Program for Mental Health Protection of the Population of the Kyrgyz Republic for 2018-2030. Given the negative trends in the mental health care system, an important element in addressing the shortcomings is the increased use of new institutional forms of mental health care, such as the Medical Rehabilitation Unit, Intensive Mental Health Care Unit, Psychiatric Dispensaries and Outpatient Psychiatric Rooms, in dispensary monitoring. Priority in the further development of psychiatric care should be given to the most effective and less costly forms of its provision, ahead of the development of outpatient level, inter-agency interaction and integration of psychiatric service with other levels of regional health and social protection.
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Piskur, Z. I., L. I. Pylypiv, O. M. Shvets, O. P. Kostyk e M. I. Sakhelashvili. "The profile of drug resistance of Mycobacterium tuberculosis and clinical features of extrapulmonary resistant tuberculosis among children living in Lviv region, Ukraine". Modern pediatrics. Ukraine, n.º 6(126) (29 de outubro de 2022): 16–22. http://dx.doi.org/10.15574/sp.2022.126.16.
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Pediatric tuberculosis (TB) is a serious infectious disease that affects many children worldwide and is more likely to be extrapulmonary than adult TB. The purpose - to analyze the profile of drug resistance of Mycobacterium tuberculosis and clinical features of extrapulmonary resistant (EPR) TB among children from Lviv region, Ukraine. Materials and methods. We analyzed all cases of EPR TB (n=23) and extrapulmonary sensitive (EPS) TB (n=24) among 478 medical charts of children, who were hospitalized in the Lviv Anti-TB hospital during 2013-2020. Results. It was found out that EPR TB was diagnosed significantly more often at the age of 1 year and up to 3 years old than EPS TB and significantly less often - among children aged 4-7 years. The children with EPR TB were significantly more likely to live in rural areas and they were significantly more likely to be from families with less than 2 children, compared to EPS TB. The children with EPR TB were more often diagnosed with meningeal and central nervous system (CNS) TB, less often - with TB of the bones and joints, only they had TB of the intestine, compared to EPS TB. Miliary pulmonary TB and the predominance of bilateral process were more common at EPR TB. Among children with EPR TB, rifampicin-resistant TB was significantly more common found than the risk of multidrug-resistant TB (MDR-TB) and monoresistant TB. The resistance profile of MDR-TB showed that 17.4% are resistant to the combination of HR (H-isoniazid, R-rifampicin), 8.6% - to HRES (E-ethambutol, S-streptomycin), 4.3% - to НRS. Among 43.5% of children with EPR TB the contact with a TB patient was not established. At the same time, only a third of children who had came into contact with bacterial exсretors were under dispensary observation and only about 9% received chemoprophylaxis. Conclusions. In order to prevent the development of EPR TB, it is necessary to improve TB prevention measures among the most vulnerable segments of the population. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
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Simakhodsky, Anatoly S., Ludmila D. Sevostyanova, Yulia V. Lukashоva, Natalya V. Petrova e Oleg A. Simakhodsky. "Dynamics of Some Medical and Demographic Indicators in St. Petersburg During the Period from 2018 to 2023". Current Pediatrics 23, n.º 3 (12 de julho de 2024): 168–73. http://dx.doi.org/10.15690/vsp.v23i3.2758.
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Background. There have been negative trends in the birth rate and population growth decline in recent years. Forecasts from demographers are also not so encouraging as the next generation of childbearing age is one from the end of the last century which is characterized by low birth rate. Population mortality exceeded the birth rate during the years of challenging and questionable economic reforms. Moreover, there was a high level of chronic morbidity in child population, and physical development had the trend to retardation. Meanwhile under these circumstances, the President of Russian Federation and the Government adopted regulatory documents (decrees, dedicated programs) that determined the directions of state social policy on improving the situation with children in Russian Federation until 2000.Objective. The aim of the study is to evaluate the dynamics of several medical and social indicators of 2018–2023 characterizing demographic trends direction, with proposals on improving medical care in the maternal and child health care system.Methods. The study has covered reporting form No. 19 of Russian Federal State Statistics Service (Rosstat) for children’s outpatient clinics, form No. 14 for children’s hospitals, form No. 030/у “Check-list of dispensary observation”. The study has used the materials of the Presidential Coordination board meeting from November 15, 2016. Statistical data was obtained from the “Office of the Federal State Statistics Service for St. Petersburg and the Leningrad Region” (Petrostat) and the Center for Analysis and Forecast of Mother and Child Health at Health Committee of St. Petersburg, Medical Information and Analytical Center (“Major results in the field of health care in St. Petersburg”, 2019, 2020, 2021, 2022). Statistical processing was carried out via variational statistics methods (Pearson’s criterion, Fisher’s angular transformation criterion) and data from the automated system of prophylactic medical examination, registration certificate FSR No. 2009/05279, corresponding to the order of the Ministry of Health of Russian Federation No. 514н dated August 10, 2017.Results. The analysis of study results confirms the negative demographic patterns in St. Petersburg like the all-Russian. Increase assisted reproductive technologies was noted alongside with birth rate decrease. There are still high rates of stillbirth and perinatal mortality, as well as increased infant mortality rate. The correlation of depopulation processes with children’s health worsening and increasing disability is emphasized.Conclusion. The problems raised in this paper do not have an straightforward solution and require multimodal approach.
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Pinfield, A., K. Lai e S. Jones. "Initial observations on the impact of implementation of automated dispensing cabinets for Human Normal Immunoglobulin on data and inventory management". International Journal of Pharmacy Practice 31, Supplement_2 (30 de novembro de 2023): ii44—ii45. http://dx.doi.org/10.1093/ijpp/riad074.054.
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Abstract Introduction Human Normal Immunoglobulin (HNIg) is a plasma-derived blood product used to treat a variety of diseases. Global supply problems1 have increased focus on HNIg stewardship, including mandatory recording of HNIg usage on the National Immunoglobulin Database2 (NIgD). This is a dispensary-based process and determines HNIg stock allocation and remuneration. Departmental audits identified significant delays and inconsistencies in data uploaded to NIgD. Inventory management issues caused a number of stock losses in the last financial year. A paper-based HNIg recording system was replaced with the use of Automated Dispensing Cabinets (ADCs). This enabled the development of an electronic ADC batch number report, from dispensing data, that matched fields required for electronic upload to NIgD, making the process more robust and proficient. Aim To measure the impact of implementation of ADCs for HNIg on data and inventory management. Objectives included identifying: Percentage of HNIg dispensed uploaded accurately to NIgD within one month of dispensing; Number of HNIg stock adjustments; Staff time required for activities associated with HNIg management. Methods Approval was obtained from the Trust Pharmacy Research and Audit Committee. The need for ethical submission was waived. Pre-implementation (May-July 2022) and post-implementation (February-April 2023) HNIg dispensing data was compared to the data uploaded to the NIgD for discrepancies. Electronic inventory reports were generated to identify the number of unexplained stock adjustments made. Time and motion methods were used to observe staff time associated with dispensing, stock management of HNIg in ADCs and data upload activities. Results Pre-implementation: 20.7% (3762.5g/18,217g) of HNIg (23.7% of dispensing episodes; 66/279) were inaccurately uploaded or absent on the NIgD and three stock adjustments were made. Post-implementation: 12% (2325g/19,347g) of HNIg (10.8% of dispensing episodes; 31/286) were inaccurately uploaded or absent on the NIgD and zero stock adjustments were observed; Mean time for dispensing HNIg reduced from 17 minutes/prescription to 8 minutes/prescription; Time spent uploading data to NIgD reduced from 5 hours to 1.75 hours/month. Discussion/Conclusion The use of ADCs has improved accuracy and completeness of data upload to NIgD. Direct observations have cited unregistered or finished patient episodes, dispensing procedural compliance, and user familiarity with the system as common reasons for incomplete data uploads to NIgD. Training is vital in assuring data quality and completeness. The new ADC process had unexpected consequences of forcing dispensing procedure compliance to improve uploads, whilst reducing dispensing times. It led to improved stock control and removed upload burden from dispensers. ADC stock discrepancy alerts allowed staff to proactively resolve discrepancies in real time. Time taken for additional processes to support management of stocks in ADCs, including monthly cycle counts, were important considerations for implementation. The key advantage of using ADC batch number reports is being able to upload as a single batch monthly without having to log into individual patient records on the system. It facilitates early identification of failed upload attempts, supporting resolution. Further work focusing on fully aligning naming conventions to NIgD should deliver additional efficiencies; minimising manipulations currently required prior to upload. References 1. Solís-Díez G, Turu-Pedrola M, Roig-Izquierdo M, Zara C, Vallano A, Pontes C. Dealing With Immunoglobulin Shortages: A Rationalization Plan From Evidence-Based and Data Collection. Front Public Health. 2022, 10:893770. 2. NHS England, The National Immunoglobulin Database, Medical Data Services and Solutions, 2023, Available at: https://igd.mdsas.com/ig-database/
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Kosovtsova, G. V., S. I. Turchina e Т. P. Коstenko. "Prediction of the course of hypoandrogenism in adolescent boys". Modern pediatrics. Ukraine, n.º 6(126) (29 de outubro de 2022): 37–41. http://dx.doi.org/10.15574/sp.2022.126.37.
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The most pathological conditions that adversely affect the reproductive function in men of mature age is formed precisely in adolescence as a result from hypoandrogenism (HA), - a decrease in the production of male sex hormones (androgens) below the age norm. Therefore, the ability to predict the course of HA in adolescent boys allows to prevent serious health problems in the future. Purpose - to determine significant prognostic criteria for adverse course of HA in adolescent boys with delayed sexual development. Materials and methods. Were examined 157 boys 14-17 years old with signs of androgen deficiency, the degree of which was based on the assessment of total testosterone (TT). The levels of gonadotropic hormones, estradiol, their ratios were studied by enzyme-linked immunosorbent assay, and the content of thyroid-stimulating hormone and free thyroxine, their ratio was determined. The lipid spectrum of blood was studied. On the basis of X-rays of the non-dominant hand and wrist determined bone age and ossification deficiency. Сonditionally unfavorable course of HA was formed in adolescent boys with severe androgen deficiency (HA 3 degree) at the level of total testosterone <4 nmol/l. Favorable course of HA was considered to be the presence of clinical signs of hypoandrogenism in adolescents with normal TT, levels more than 12 nmol/l (HA 0 degree). Results. Based on the study was identified the most informative features and calculated their prognostic coefficient. It is proved that significant informative signs of HA in adolescent boys are such as body mass index abnormalities, bone age deficit, levels and ratios of gonadotropic hormones, estradiol values and testosterone / estradiol, testosterone / luteinizing hormone ratios, thyroid stimulating hormone / free thyroxine, changes in lipid profile. To the most prognostically significant negative prognostic criteria for adverse HA in adolescent boys are excess body weight by body mass index level, significant deficit of bone age (more than 3 years), decreased luteinizing hormone levels, decreased luteinizing hormone / follicle stimulating hormone ratio, hyperestrogenism, pronounced androgenic-estrogenic disbalance, the presence of minimal thyroid dysfunction, disorders of the lipid profile. Conclusions. The developed prognostic criteria for adolescent boys with HA will make it possible to predict the further course of the disease (in the early stages of its formation pathology), what will carry out timely treatment and rehabilitation measures in adolescent boys, and this will help to improve their health. Teens with HA, who show prognostically unfavorable signs, need more careful dispensary observation of an endocrinologist. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
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Kostenko, Natalya A., Igor V. Bukhtiyarov, Evgenij V. Zhovnerchuk, Vasilij V. Serikov e Dmitrij E. Khatin. "Working conditions, medical support and morbidity of stress-related neurotic disorders among Russian Railways employees". Russian Journal of Occupational Health and Industrial Ecology 63, n.º 6 (12 de junho de 2023): 379–85. http://dx.doi.org/10.31089/1026-9428-2023-63-6-379-385.
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Introduction. Shift work, as the main stress factor, leads to the development of desynchronosis and other neurotic diseases. The production necessity with such a work schedule requires increased provision of mental health specialists.
The study aims to analyze the long-term dynamics of morbidity of employees of JSC "Russian Railways" with neurotic diseases associated with stress and somatoform disorders, depending on the intensity of work, availability of specialists responsible for psychoprophylactic work.
Materials and methods. Scientists investigated the working conditions and their influence on the functional state of employees of JSC "Russian Railways". The authors have carried out a retrospective analysis of information from the Unified Medical Information and Analytical System from 2012–2021 for JSC "Russian Railways" and the Ministry of Health of Russian Federation. The analysis of morbidity in mental pathology included nosological units assigned by ICD-10 to F40–F48.
Results. Work in the system of JSC "Russian Railways" is associated with the impact of a complex of unfavorable production factors, the key of which are psycho-emotional stress and shift work schedule — work in night shifts. Railway transport workers face various stressful factors on a daily basis, such as: desynchronosis due to shift work schedules, waiting for an emergency situation with a "system call", "broken" schedules, and related difficulties. The psychogenic factor, which is an etiological factor in the occurrence of neurotic disorders, constantly affects railway transport workers. Based on the analyzed data, it can be assumed that professionally conditioned factors of the working environment contribute to the formation of occupational stress and the formation of neurotic disorders among this category of workers. There is a connection with the growth of neurotic diseases and the annual trend of declining positions of psychologists and psychotherapists in the system of JSC "Russian Railways". There was a significant increase in the incidence of railway transport workers (p=0.043) and a decrease in specialists associated with the prevention of neuropsychiatric diseases for ten years (p=0.0001).
Limitations. Limitations are presented in the form of a small sample of employees of JSC "Russian Railways", insufficient depth of study of materials of foreign literature on the issue under study.
Conclusions. Neurotic disorders in persons who are under dispensary supervision in the system of JSC "Russian Railways" have a pronounced, statistically significant growth trend. There is a significant decrease in the number of medical specialists engaged in the diagnosis, treatment and prevention of psychogenic diseases of workers. Based on the results of the study, we have revealed a link between the growth of neurotic diseases of railway transport workers and the annual decline trend of psychologists and psychotherapists in JSC "Russian Railways".
Ethics. This study was carried out in accordance with the rules of good clinical practice and the Helsinki Declaration and did not require the conclusion of the ethics committee.
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Salter, Amber, Gary Cutter, Ruth Ann Marrie, Kathryn Nichol, Joshua R. Steinerman, Karry M. J. Smith e Robert J. Fox. "Sources of Cannabis Information and Medical Guidance for Neurologic Use". Neurology: Clinical Practice 12, n.º 2 (20 de janeiro de 2022): 102–12. http://dx.doi.org/10.1212/cpj.0000000000001155.
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Background and ObjectivesAs cannabis products become increasingly accessible across the United States, understanding how patients obtain medical information on cannabis and view the role of their health care provider in providing information is important.MethodsParticipants with multiple sclerosis (MS) from the North American Research Committee on Multiple Sclerosis registry completed a supplemental survey on Δ9-tetrahydrocannabinol-containing cannabis use between March and April 2020. Participants reported dialogue with health care providers regarding cannabis use, information sources used to make product decisions, and expenditure on cannabis. Findings are reported using descriptive statistics.ResultsOverall, 3,249 participants responded (47% response rate), of whom 31% ever used cannabis and 20% currently used cannabis for MS. To determine presumed cannabis contents, respondents who had ever used cannabis (ever users) most often used dispensary-provided information (39%), word of mouth/dealer/friend (29%), and unregulated product labels (24%). For general information on cannabis for MS, ever users most often used dispensary staff (38%) and friends (32%). The primary source of medical guidance among ever users was most often “nobody or myself” (48%), followed by a dispensary professional (21%); only 12% relied on their MS physician, although 70% had discussed cannabis with their MS physician. Most current users (62%) typically sourced their cannabis from a dispensary. The most common factor in selecting a cannabis product was perceived quality and safety (70%).DiscussionParticipants most often received information on cannabis for MS from dispensaries, unregulated product labels, and friends; only a small proportion used health care providers. Evidence-based patient and physician education is needed.
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Sljapic, Ziva, e Miljana Sljapic-Roganovic. "Child care in Vrsac and its development". Medical review 55, n.º 9-10 (2002): 431–35. http://dx.doi.org/10.2298/mpns0210431s.
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Documents concerning history of medicine during the Turkish reign (1552-1716) are very rare. However, there is evidence of plague epidemic in 18th century and cholera epidemic in the 19th century. The first medical institutions: The German Communal Hospital, The Serbian Hospital and the Pharmacy were founded in the second half of the 18th century. In the year 1803, children were vaccinated against variola. The first Serbian book about child care ? "Cadoljub" was written by Dr. Gavrilo Pekarovic (1812-1851) during his studies of medicine in Budapest. In 1927 the city founded a dispensary for the newborn. The Polyclinic for schoolchildren was established as a part of the Health Center in 1934. After World War II, Children's Department was opened in the Health Center, later on it was turned into Mother and Child Center. At the beginning of 1955, a provisional children's ward with 18 beds was established in the former sanatorium, whereas till the end of the year it had 49 beds. In May 1965, it was moved into a new hospital building. After integration of Hospital and the Health Center into a Medical Center in 1967, a department for children was founded and it consisted of the emergency center and a hospital. Parents counseling, dispensary for children and dispensary for schoolchildren were founded in August 1971. .
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Lopatina, A. L. "GOMEL REGIONAL CLINICAL CARDIAL DISPENSARY - 25 YEARS SERVING HUMAN HEALTH". Health and Ecology Issues, n.º 4 (28 de dezembro de 2008): 126–32. http://dx.doi.org/10.51523/2708-6011.2008-5-4-27.
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This article represents the history of Gomel Regional Clinical Cardial Dispensary formation and development. It describes the way in which the optimal organizational and functional structure of the dispensary is built. This structure enables efficient diagnostics, curative and preventive treatment of patients with cardiovascular diseases, as well as proper level of aftercare and clinical examination. The material and technical basis of the dispensary is actively enhanced, new modern equipment is obtained and special attention is paid to the professinal skills and experience of the medical stuff.
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Horrell, Jeffrey. "DEVELOPMENT COMMITTEE". Art Documentation: Journal of the Art Libraries Society of North America 4, n.º 4 (dezembro de 1985): 159. http://dx.doi.org/10.1086/adx.4.4.27947499.
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Meizner, Karen L. "DEVELOPMENT COMMITTEE". Art Documentation: Journal of the Art Libraries Society of North America 6, n.º 1 (abril de 1987): 22–23. http://dx.doi.org/10.1086/adx.6.1.27947707.
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Rumyantseva, M. A., e N. V. Isaeva. "Influence of some socio-behavioral and medical factors on probability of developing gonococcal infection". Perm Medical Journal 36, n.º 6 (30 de janeiro de 2020): 64–71. http://dx.doi.org/10.17816/pmj36664-71.
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Aim. To analyze and assess the influence of some socio-behavioral and medical factors on probability of developing gonococcal infection
Materials and methods. The study was carried out among the patients of State Budgetary Institution of Healthcare of Perm Krai Regional Clinical Dermatovenerologic Dispensary. It involved 292 persons. To evaluate the influence of socio-behavioral and medical factors on gonococcal infection sickness rate, the ratio of odds to 95% confidence interval was calculated. Multinominal logit and multi-factor correlation regression analysis were used. Nonparametric criteria were applied to compare quantitative signs.
Results. The factors, influencing the development of gonococcal infection were determined. Socio-behavioral factors absence of work, early onset of sexual life, use of psychoactive substances elevate the risk of gonococcal infection development by 2.44.8 times. The most significant medical factors untimely visit to a doctor, full elimination of causative agent after treatment the first dispensary examination, on the day 14th after full elimination of causative agent the second dispensary examination that increases risk for development of gonococcal infection by 1.157.65 times. Significance of the following factors was stated: age and family status; the younger is respondent, the higher is morbidity risk; the same situation is observed when there is no a constant sexual partner. When comparing persons with a single episode of disease and those who were ill twice and more frequently, the most essential factors were registration at detmatovenerologic dispensary, elimination of causative agent, deregistration on the day 42nd after elimination of causative agent, indication of source of disease, examination of sexual partners, treatment of sexual partners, examination and treatment of partners.
Conclusions. The priority risk factors were the following: socio-behavioral nonworking persons, who started their sexual life early (under 16) and use psychoactive substances. Medical risk factors: full elimination of causative agent after antibiotic therapy (Clinical Recommendations of Russian Society of Dermatovenerologists and Cosmetologists) the first dispensary examination, and the day 14th after confirmed full elimination of causative agent the second dispensary examination.
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Борисова, Ю. А. "Organization of tuberculosis care in Petrograd/ Leningrad in 1918 – early 1920s". All-Russian Scientific and Practical Journal of Social and Humanitarian Research, n.º 3(10) (29 de setembro de 2023): 47–52. http://dx.doi.org/10.46741/sgjournal.2023.10.3.006.
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В статье анализируется процесс организации противотуберкулезной помощи и становления противотуберкулезных учреждений в Петрограде/ Ленинграде в 1918 – начале 1920-х гг., показана роль туберкулезного подотдела (отделения) Губздрава Исполкома Петроградского губернского совета, рассматриваются основные направления противотуберкулезной работы (диспансерное, санаторно-больничное и санитарно-просветительное). The article analyzes the process of organizing anti-tuberculosis care and establishing anti-tuberculosis institutions in Petrograd/Leningrad in 1918–- early 1920s, shows the role of the tuberculosis sub-department (department) of the Gubzdrav Executive Committee of the Petrograd Provincial Council, and discusses key directions of anti-tuberculosis work (dispensary, sanatorium-hospital and sanitary-educational).
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Scroggins, Leann. "Diagnosis Development Committee". International Journal of Nursing Terminologies and Classifications 18, n.º 1 (janeiro de 2007): 32–33. http://dx.doi.org/10.1111/j.1744-618x.2007.00046.x.
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Scroggins, Leann. "Diagnosis Development Committee". International Journal of Nursing Terminologies and Classifications 18, n.º 3 (julho de 2007): 113. http://dx.doi.org/10.1111/j.1744-618x.2007.00060.x.
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Thornton, Edward C. "Professional Development Committee". GSA Today 18, n.º 6 (2008): 55. http://dx.doi.org/10.1130/1052-5173(2008)18[55:pdc]2.0.co;2.
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Lagman, Lawrence H., Lynn Whalen, Les Meyers, Alan Hanks, Jim Ault, Tom Layloff, Gayle A. Lancette et al. "Professional Development Committee". Journal of AOAC INTERNATIONAL 82, n.º 2 (1 de março de 1999): 556. http://dx.doi.org/10.1093/jaoac/82.2.556.
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Lagman, Lawrence H., Lynn Whalen, Les Meyers, Alan Hanks, Jim Ault, Tom Layloff, Gayle A. Lancette et al. "Professional Development Committee". Journal of AOAC INTERNATIONAL 82, n.º 2 (1 de março de 1999): 556. http://dx.doi.org/10.1093/jaoac/82.2.556a.
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Lagman, Larry, K. A. Boehm, A. R. Hanks, J. Hurst, A. V. Jain, T. P. Layloff, A. MacDonald et al. "Professional Development Committee". Journal of AOAC INTERNATIONAL 80, n.º 1 (1 de janeiro de 1997): 238. http://dx.doi.org/10.1093/jaoac/80.1.238.
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Lagman, Lawrence H. "Professional Development Committee". Journal of AOAC INTERNATIONAL 81, n.º 1 (1 de janeiro de 1998): 269. http://dx.doi.org/10.1093/jaoac/81.1.269.
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Popova, N. V., A. P. Goydin e O. L. Fabrikantov. "Retinopathy of Prematurity. Review". Ophthalmology in Russia 18, n.º 3 (1 de outubro de 2021): 399–407. http://dx.doi.org/10.18008/1816-5095-2021-3-399-407.
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Retinopathy of prematurity (RP) is a complex pathology among prematurely born children, which requires a comprehensive approach, including both prevention of the development of more severe stages of the disease, leading to poor vision and irreversible loss of visual functions, and the organization of dispensary observation and rehabilitation. Modern organization of dispensary observation, which is based on a detailed study of the etiology, pathogenesis, as well as the interaction of local and systemic factors on visual functions, can significantly reduce the visual disability of children as a result of this disease.
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Livzan, M. A., O. V. Gaus, M. A. Lisovskiy, S. I. Mozgovoi, V. A. Rubtsov e M. N. Parygina. "Clinical supervision of chronic atrophic gastritis". Experimental and Clinical Gastroenterology, n.º 3 (25 de julho de 2023): 148–55. http://dx.doi.org/10.31146/1682-8658-ecg-211-3-148-155.
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Patients with chronic gastritis (CG) with the development of atrophy of the gastric mucosa are at an increased risk of developing gastric cancer (GC). In the management of such patients, the development of high-grade dysplasia and invasive gastric cancer should be defined as adverse outcomes that must be prevented. To this end, patients with a diagnosis of «Chronic atrophic fundic/multifocal gastritis» are subject to dynamic dispensary observation to assess the achievement of target indicators, take into account information about changes in the diagnosis and concomitant diseases, emerging complications, as well as to enter data on ongoing therapeutic and preventive measures. This article presents the main aspects of prevention and dispensary monitoring of patients with an increased risk of gastric cancer.
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Mykhalchuk, V. M., Z. V. Gbur, O. K. Tolstanov e K. V. Shchyrina. "MEASURES TO COMPLETE THE BASIC TASKS OF THE SKIN-VENEROLOGICAL DISPENSER AND RESULTS OF THE POSSIBLE RISK ANALYSIS TO IMPROVE EFFICIENCY AND EFFICIENCY OF EFFECTIVENESS". PRECARPATHIAN BULLETIN OF THE SHEVCHENKO SCIENTIFIC SOCIETY Pulse, n.º 6(58) (26 de dezembro de 2019): 91–99. http://dx.doi.org/10.21802/10.21802/2304-7437-2019-6(58)-91-99.
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In the scientific article the directions of activity of modern skin and venereological dispensary are described. Measures to improve the work of the institution are proposed: optimization of the number of staff; making changes to the organizational structure in accordance with the new financing and management system; planning, organizing and controlling the activities of the institution within the functions of financial management. The priority measures of reforming the activity of the skin and venereological dispensary were singled out, taking into account the current state of development of the health care system. The main methods of realization of tasks of skin and venereological institutions are given and characterized are administrative, legal, economic, social and motivational. A number of external risks have been identified that could adversely affect the activities of the skin and venereological dispensary, namely: risks related to the situation on the labor market, in particular; risks related to the current state of health care, in particular; risks associated with the medical and demographic crisis in Ukraine.
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Mykhalchuk, V. M., Z. V. Gbur, O. K. Tolstanov e K. V. Shchyrina. "MEASURES TO COMPLETE THE BASIC TASKS OF THE SKIN-VENEROLOGICAL DISPENSER AND RESULTS OF THE POSSIBLE RISK ANALYSIS TO IMPROVE EFFICIENCY AND EFFICIENCY OF EFFECTIVENESS". PRECARPATHIAN BULLETIN OF THE SHEVCHENKO SCIENTIFIC SOCIETY Pulse, n.º 6(58) (26 de dezembro de 2019): 91–99. http://dx.doi.org/10.21802/2304-7437-2019-6(58)-91-99.
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In the scientific article the directions of activity of modern skin and venereological dispensary are described. Measures to improve the work of the institution are proposed: optimization of the number of staff; making changes to the organizational structure in accordance with the new financing and management system; planning, organizing and controlling the activities of the institution within the functions of financial management. The priority measures of reforming the activity of the skin and venereological dispensary were singled out, taking into account the current state of development of the health care system. The main methods of realization of tasks of skin and venereological institutions are given and characterized are administrative, legal, economic, social and motivational. A number of external risks have been identified that could adversely affect the activities of the skin and venereological dispensary, namely: risks related to the situation on the labor market, in particular; risks related to the current state of health care, in particular; risks associated with the medical and demographic crisis in Ukraine.
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Maidan, A. V., e M. S. Artemieva. "History and modern problems of providing dispensary drug treatment". Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery), n.º 1 (1 de janeiro de 2021): 64–73. http://dx.doi.org/10.33920/med-01-2101-06.
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The article presents an analysis of the history of development and identified problems in the system of outpatient drug treatment. The main issues of providing drug treatment to the population and possible prospects for the development of the system of outpatient drug treatment are considered.
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Scroggins, Leann M. "Diagnosis Development Committee Report". International Journal of Nursing Terminologies and Classifications 17, n.º 3 (julho de 2006): 149–51. http://dx.doi.org/10.1111/j.1744-618x.2006.00038.x.
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Nouri, Fiona. "Research and Development Committee". British Journal of Occupational Therapy 51, n.º 8 (agosto de 1988): 268. http://dx.doi.org/10.1177/030802268805100806.
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Russell, Donna L., e David A. Stephenson. "GSA Foundation's Development Committee". GSA Today 19, n.º 8 (2009): 22. http://dx.doi.org/10.1130/1052-5173-19.8.22.
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Gardner, Sue. "Service Development Sub-Committee". Clinical Psychology Forum 1, n.º 28 (agosto de 1990): 34–35. http://dx.doi.org/10.53841/bpscpf.1990.1.28.34.
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Myotoku, Michiaki, Yumi Tomida, Yoko Murayama, Emiko Igarashi, Akiko Nakanishi, Tomoko Fukao, Noriko Fujihara, Kazunori Shimomura, Syunichi Kawaguchi e Hisayuki Haji. "Development of a Dispensary Inspection System for Injecions and Its Usefulness". Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences) 29, n.º 4 (2003): 421–26. http://dx.doi.org/10.5649/jjphcs.29.421.
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Pervyshin, Nikolay, Alexandr Lebedev, Elena Lebedeva e Rudolf Galkin. "ALGORITHM FOR ASSESSING THE RISK OF MICROVASCULAR COMPLICATIONS IN PATIENTS WITH DM FOR A DOCTOR'S DECISION SUPPORT SYSTEM". Social Aspects of Population Health 69, n.º 2 (2023): 12. http://dx.doi.org/10.21045/2071-5021-2023-69-2-12.
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Relevance: most experts agree that regular and high-quality dispensary monitoring of patients with diabetes mellitus at the outpatient stage is a necessary condition for preventing the development of vascular complications. The solution of this problem is closely connected with the development and widespread clinical implementation of digital healthcare tools, automated workplaces of doctors, decision support algorithms. Objective: to improve the quality and effectiveness of outpatient care for patients with type 2 diabetes mellitus by digitalizing outpatient admission, using the software of the automated workplace of an endocrinologist (AWPE DM), developing an algorithm for assessing the risk of microvascular complications as an element of a decision support system. Materials and methods: based on the analysis of the results of clinical experience in the use of ARME DM, an algorithm for assessing the risk of microvascular complications has been developed, which allows optimizing the complex of measures for dispensary observation of patients with type 2 diabetes mellitus. Results: demonstrated an increase in the efficiency and quality of medical care for patients with type 2 diabetes mellitus when using AWPE DM in clinical practice; developed a digital algorithm for assessing the risk of microvascular complications, providing stratification of the risks of their development according to the selected criteria for each of the classes; determination of a sufficient minimum of dispensary laboratory and instrumental studies, taking into account the level of credibility of recommendations; personalized correction of therapeutic goals of treatment taking into account the individual characteristics of the patient, including the stage of chronic kidney disease and diabetic retinopathy. Conclusions: the clinical application of the algorithm for assessing the risk of vascular complications, developed taking into account current domestic and foreign clinical recommendations, allows objectively in numerical values to assess the probability of progression of certain classes of microvascular complications of diabetes mellitus in a particular patient, to determine the activities of a personalized program of dispensary observation and rehabilitation. For laboratory and instrumental verification, examinations with the greatest diagnostic significance and suitable for storage and processing in digital format are proposed. Based on the results of the risk assessment directly during the outpatient appointment, the algorithm forms recommendations for the differentiated choice of therapeutic treatment goals, which makes it possible to optimize the personalized program of dispensary observation of the patient.
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Ufimtseva, M. A., A. S. Shubina, V. V. Petkau, N. L. Struin, D. E. Emel'janov e E. A. Levchenko. "Interdisciplinary model of patient care for groups at risk for malignant tumors of the skin". Bulletin of Siberian Medicine 18, n.º 3 (27 de outubro de 2019): 238–44. http://dx.doi.org/10.20538/1682-0363-2019-3-238-244.
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Introduction. Malignant skin tumors (MST) are an important interdisciplinary problem. Neoplasia data refer to tumors of apparent localization, therefore, they are found in the clinical practice of doctors of different profiles. The duration of the diagnostic period, as well as the prognosis, depends on the coordinated work of specialists.Aim. Development, implementation and evaluation of the effectiveness of an interdisciplinary model for managing patients at risk for malignant skin tumors.Materials and methods. A descriptive study included a study of the proportion of people at risk for developing MST, the nosological structure of the revealed MST among patients referred to the dermatological oncology room of the Sverdlovsk Regional Dermatovenerologic Dispensary for the period from 01.01.2016 to 31.12.2017 (total 3,275 patients), as well as 208 patients examined in the Sverdlovsk Regional Oncology Dispensary (SROD). The data of the “ONKOR” regional oncological information system were used.Results. An interdisciplinary model of managing patients at risk has been developed, including patient routing andtraining of specialists in various fields. As a result of the implementation of the model, 208 patients were examined, 208 of whom were diagnosed with skin cancer, 123 of whom had skin cancer, 11 cases of melanoma, Kaposi’s sarcoma in 2 cases, skin lymphomas in 4 patients, lymphosarcoma in 1 patient, amounted to 67.8% of the diagnoses of MST confirmed in the Sverdlovsk Regional Dermatovenerologic Dispensary of the Sverdlovsk Regional Oncology Dispensary. 9.6% of patients had dysplastic nevi, confirmed histologically. 1987 patients at risk of developing MST were taken under the dispensary observation by a dermatologist and venereologist.Conclusion. Тhe introduction of the algorithm of interdisciplinary interaction contributes to the improvement of the quality and accessibility of medical care to the population, the identification of patients at risk for the occurrence of MST, reducing the burden of non-core patients on oncology services.
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Kutumova, Olga Yu, L. I. Kononova, A. V. Shulmin, E. A. Dobretsova, K. M. Korotkova e T. V. Rossieva. "Tobacco addiction and economic efficiency of treating tobacco addiction in patients of the Krasnoyarsk regional oncological dispensary". Russian Journal of Oncology 21, n.º 3 (15 de junho de 2016): 140–45. http://dx.doi.org/10.18821/1028-9984-2016-21-3-140-145.
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Smoking tobacco was proved to be the one of the most critical risk factors contributing to the development of malignant neoplasm in the respiratory system. In 2015, lung cancer morbidity rate and the threat in the Krasnoyarsk Region were 1,3 times higher for men and 1,5 times higher for women in comparison to standardized figures per hundred thousand of population in Russia. The economic expenditures associated with diagnostics and treatment of such patients are enormous. That is why the significance of studies in this area is beyond doubt. The goals of this work is the study of the prevalence rate as well as duration and frequency of smoking among patients of the Krasnoyarsk Regional Oncologic Dispensary, calculation of relative and population attributable risks of oncological diseases development and estimation of the economic expenditures associated with smoking in the studied group. Data were collected by using of the questionnaire survey method. 389 patients of the oncologic dispensary were questioned. The data obtained were processed statistically. Relative and population attributable risks were calculated with the help of the corresponding formulas. Data analysis shows that the half (49.9%) ofpatients of the oncologic dispensary have either never smoked, 30% do not smoke now but used to smoke in the past and 20.1% continue smoking. Patients dispensary (65.9% in men and 87.7% - in women). About the half of the patients (41.6%) smoke 11-20 cigarettes a day. Calculations of the population attributable risks show that smoking is the cause of 21.3% of oncological disease incidences, of which lung cancer accounts for 73.7%. The total expenses for health system connected with smoking in oncological diseases in a year made 140 million 527 thousand rubles. These are the expenses that would not have been incurred if there were no impact of the risk factor.
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Zemtsov, M. A., e V. V. Chebotarev. "On the 90th anniversary of the dermatovenerology service of the Stavropol territory". Vestnik dermatologii i venerologii 89, n.º 2 (15 de abril de 2013): 85–93. http://dx.doi.org/10.25208/vdv584.
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The article discloses archival materials describing the establishment of the Dermatovenerology Institute and Dispensary in the Stavropol Territory as well as their growth and development. The article includes documents as of the 1920s and present-day photos.
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Herrin, Gary D., Charles K. Anderson e Majid Jaraiedi. "Development of an Overexertion Injury Surveillance System". Proceedings of the Human Factors Society Annual Meeting 29, n.º 8 (outubro de 1985): 794–98. http://dx.doi.org/10.1177/154193128502900816.
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The frequency and severity of occupational injuries have been recognized as a major health problem within many industries for a long time. Conventional injury/illness reporting systems such as OSHA, Worman's Compensation, etc., offer no guidance for the concerned professional to identify root causes of these injuries or suggest ways to minimize consequences. The study reported on injuries at the dispensary visit level which would permit incidents to be correlated with physical job stresses across five industries. This paper compares the experiences between and within plants and shows that minor injury experiences can be used to predict more severe cases.
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Cheng, C., K. Lai e C. McKenzie. "Initial observations on the impact of implementation of a seven-day clinical pharmacy service on dispensary activity and performance". International Journal of Pharmacy Practice 30, Supplement_2 (30 de novembro de 2022): ii13—ii14. http://dx.doi.org/10.1093/ijpp/riac089.014.
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Abstract Introduction The need for seven-day clinical pharmacy services is widely acknowledged, although limited, in the acute sector of the National Health Service.1,2 Timely medicine supply is integral to provision of improved clinical pharmacy services to patients across seven-days, and is essential in effective discharge planning. There is a paucity of evidence for implementation of seven-day clinical pharmacy services, including the impact of service transformation on dispensary activity and performance. This limits planning and development of seven-day pharmacy services. Aim To assess the impact of a seven-day clinical pharmacy service on dispensary activity and performance, at the main site of a tertiary-referral teaching hospital. Methods A seven-day clinical pharmacy service was implemented in October 2021. Prior to this, pharmacy services were largely dispensary-based with clinical pharmacy services for acute and neurosciences admission and limited ward-based services in other specialities. At implementation, clinical pharmacy technicians and pharmacists (n=16) provided patient-facing pharmaceutical care for 7.5-hours/day across all specialities over the weekend; this included medicines reconciliation, preparation of discharge-medication lists, independent prescribing, counselling and clinical review of prioritised patients. The weekend dispensary staffing, skill-mix and shift patterns were redesigned to facilitate staff release from the dispensary rota. Dispensing activity data were obtained from Ascribe for six months pre- and post-implementation (April 2021-March 2022). Data were categorised as inpatient/discharge and the mean number of items dispensed per month analysed using Microsoft Excel. Discharge turnaround performance was calculated as percentage of discharge prescriptions dispensed within two-hours of dispensary receipt and obtained from the Prescription Tracking System. Verbal staff feedback was sought 4-months post-implementation. The study was deemed a service evaluation by the Pharmacy Research and Audit Group and so ethical approval was not required. Results Twelve dispensing staff and one pharmacist were rostered to one of three daily 3.75-hour dispensary shift patterns. Following implementation, mean total inpatient dispensing activity increased from 12799 to 13250 items/month (3.5% increase) and mean weekend activity from 2184 to 2677 items/month (22.6% increase). Mean weekday inpatient activity was stable at 10615 to 10573 items/month. The mean discharge dispensing activity increased from 9065 to 9837 items/month (8.5% increase): mean weekday discharge from 8498 to 8622 items/month (1.5% increase); mean weekend activity from 569 to 1215 items/month (114% increase). Discharge turnaround performance remained stable with 85% discharge prescriptions dispensed within 2-hours, versus 84% pre-implementation. Weekday performance also remained stable - from 84% to 83% and the weekend performance increased from 85% to 92%. Dispensary staff fed-back that weekend shift patterns were effective, activity was manageable and shifts usually ran smoothly and finished on time. Discussion/Conclusion Introduction of a seven-day clinical pharmacy service led to an increase in weekend dispensary activity, which was not offset by decrease in weekday activity. Importantly, the dispensary performance was not negatively impacted and weekend discharge performance improved. Increases could be because of weekend medicines reconciliation, pro-active medication ordering and pharmacist-led preparation of discharge-medicine lists. Dispensary activity in Winter 2020 was atypical because of COVID-19, thus it was not feasible to compare data. Further review, including 12 months data would reduce impact of seasonal variations in NHS activity. Limitations include that patient data including length of stay and time to discharge were not within scope. References 1. Anon. Transformation of seven day clinical pharmacy services in acute hospitals. 2016. http://www.england.nhs.uk/wp-content/uploads/2016/09/7ds-clinical-pharmacy-acute-hosp.pdf. Accessed 29 July 2022. 2. Anon. RPS professional standards for hospital pharmacy services. 2017. http://www.rpharms.com/recognition/setting-professional-standards/hospital-pharmacy-professional-standards. Accessed 29 July 2022.
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Yubrina, Irina V., Ludmila N. Degtyareva e Igor A. Bozhkov. "The viral myocarditis with cardiac аrrhythmia as complication of COVID-19 in the practice of family doctor of the tuberculosis dispensary". Russian Family Doctor 25, n.º 3 (18 de novembro de 2021): 41–49. http://dx.doi.org/10.17816/rfd77027.
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BACKGROUND: About 70% of TB dispensary patients have chronic somatic diseases which not only prevent effective treatment of TB but also take progressive course themselves.
AIMS: To timely detect and treat acute and chronic somatic disease combined with TB.
MATERIALS AND METHODS: since 2020 the algorithm of patient complex investigation by specialists of therapeutic profile was developed in the Tuberculosis Dispensary No. 5, among them the general practitioner was the coordinator of the patients medical route. This became especially relevant during the COVID-19 pandemic.
RESULTS: In accordance with the developed algorithms of diagnostic search the patient was comprehensively examined. There were no signs of tuberculosis were in him, however the general practitioner involving to specialists team could diagnose signs of complex cardiac arrhythmia the probable cause which was a new coronavirus infection that he had had six weeks before.
CONCLUSIONS: The organization of a new form of medical service for phthisiatric patients allowed general practitioner to reveal serious cardiac pathology directly at the TB dispensary, to refer the patient for consultation to the cardiologist-arrhythmologist, to follow the patient and perform recommended cardiologic treatment simultaneously with measures or medical supervision over persons contacting with tuberculosis.
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Khramtsova, Natalia Anatolyevna. "CARDIOLOGICAL SERVICE OF THE IRKUTSK REGION - RESULTS OF 2022 AND DIRECTIONS OF DEVELOPMENT". Baikal Medical Journal 2, n.º 3 (10 de setembro de 2023): 13–15. http://dx.doi.org/10.57256/2949-0715-2023-3-13-15.
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At the end of 2022, there were several positive trends in the performance of the cardiology service. Thus, mortality from circulatory system diseases (CVD) in the Irkutsk region, according to Rosstat, decreased by 4.3% compared to 2021 and amounted to 676.3 per 100,000 population. The mortality rate from MI also decreased and reached 52.9 per 100,000 population. According to the results of the year, a decrease in the total number of deaths from myocardial infarction by 145 people was noted. The proportion of hospitalizations in specialized departments of PSO and RSC increased by 6.2%, which led to a significant decrease in the number of patients who died from myocardial infarction (MI) outside the specialized departments (-54.3%). The total number of patients with acute coronary syndrome (ACS) hospitalized in specialized departments (RCC and PSO) out of all patients with ACS increased by 13.9%. The number of patients with ST-elevation ACS who underwent reperfusion therapy, both primary PCI up to 52.6%, and after thrombolytic therapy (TLT) increased. The number of X-ray endovascular interventions on the coronary arteries for medical purposes increased by 35%, on an accrual basis by the end of the year, the figure was 3952 manipulations. At the end of the year, there was a decrease in mortality from MI by 12.7%, and the figure was 10.3%, which is one of the lowest values in the Siberian Federal District. A decrease in hospital mortality from MI was recorded both in the medical organizations of the region by 2.4%, and in PSO and RSC - by 3.3%. The coverage of dispensary observation and preferential drug provision for patients after MI, coronary artery bypass grafting, radiofrequency ablation, coronary artery stenting and stroke was 92.2%. A remote ECG system for planned patients has been introduced in the region (more than 20,000 consultations have been carried out). The format of round-the-clock reception and interpretation of ECG in patients with ACS is preserved to determine the tactics of management and routing of patients. These possibilities are necessary for making decisions on timely thrombolytic therapy at the stages of evacuation of a patient with ACS and ST segment elevation. Of the problematic aspects, there is a continuing increase in mortality from coronary heart disease by 8.1% and an increase in the number of deaths from coronary artery disease outside medical organizations. The problem of increasing mortality from chronic cardiovascular diseases is due to defects in medical examination and dispensary observation at the outpatient stage. Shortcomings in the work of primary care resulted in high mortality from coronary artery disease, myocardial infarction, CHF at home, insufficient coverage of patients with CVD by dispensary observation and poor quality of dispensary appointments. Of the main priority areas in the work of the cardiological service for the next year, the following should be highlighted: control over the implementation of clinical guidelines (recurring training and testing of doctors, paramedical personnel according to clinical recommendations, multi-level examination of the quality of medical care, the introduction of medical decision support services into practice); optimizing the routing of patients with ACS and other cardiovascular diseases to the specialized departments of the region (organization of interaction between the emergency medical service, the center for disaster medicine and medical organizations in the region, eliminating time losses during the evacuation of patients with ACS, daily monitoring of hospitalizations of the region's ACS); increase in the number of pre-hospital thrombolysis in patients with ACS with ST-segment elevation (training of paramedics and doctors of mobile ambulance teams in ECG interpretation skills and first aid skills in ACS (simulation-training cycles), the widespread introduction of a “second opinion” on ECG, the presence of thrombolytics in packing SMP, daily monitoring of prehospital thrombolysis by heads of medical organizations); development of remote telemedicine technologies; control over preferential drug provision (organization of succession between the hospital and the clinic, ensuring timely (within 72 hours) placement for dispensary observation of patients of the category of Order No. 639n, control of adherence to the prescribed therapy, exclusion of unreasonable de-escalation of doses, cancellation / replacement of drugs. at the outpatient stage, maintaining a register of DLO); dispensary observation (DN) of patients with CVD (registration in MIS of certain groups of patients with CVD for the possibility of automatic generation of lists for DN, proactive invitation to DN of patients with CVD according to a pre-formed list for examination as soon as possible). Thus, the main areas of work for primary care physicians are focused on quantitative and qualitative indicators of medical examination and dispensary observation, with the creation in each polyclinic of a system for monitoring subsidized drug provision and a system for registering high-risk patients. For the ambulance stage, strict adherence to the routing and rapid delivery of patients with ACS is required, with pre-hospital thrombolysis, training of doctors / paramedics in emergency cardiology and the introduction of a remote ECG system. At the inpatient stage of medical care, continue work to improve the profile of treatment of CVD patients by minimizing hospitalizations in therapeutic departments, for this purpose, the creation of interdistrict cardiology departments, the introduction of clinical recommendations on cardiology into wide practice and control over the continuity of care with the outpatient link.
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Manakina, E. S., O. V. Medvedeva, I. I. Manakin e O. V. Kazaeva. "ORGANIZATIONAL PROBLEMS OF DISPENSARY OBSERVATION OF INDIVIDUALS ENGAGED IN PHYSICAL CULTURE AND SPORTS, IN THE RYAZAN REGION". NAUKA MOLODYKH (Eruditio Juvenium) 9, n.º 1 (31 de março de 2021): 170–75. http://dx.doi.org/10.23888/hmj202191170-175.
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The article is devoted to the organizational aspects of the activity of the Ryazan regional medical and physical culture dispensary for the medical support of the population engaged in physical culture and sports. Specially emphasized is the need to modernize medical support of people engaged in physical culture and sports in the Ryazan region, which is determined by a significant imbalance between the increasing burden on the specialists of the medical and physical culture dispensary and the high rate of commissioning of new sports facilities, and, as a result, a significant increase in the number of people engaged in physical culture and sports. The real costs of working time of specialists were determined, which made it possible to develop and realize a plan of measures aimed at reduction of the time of direct examination by a doctor, the time spent by athletes at the examination stage and, accordingly, increasing their number per unit time. Conclusion. The reasonability of optimization of the structure of the medical and physical culture dispensary of the Ryazan region, development of methods for planning its activities, formation of a unified concept of sports and wellness medicine within the framework of the preventive direction with the creation of a branch development program is identified, which will improve both the quality of medical care provided at the outpatient stage, and will result in reduction of morbidity, probability of sudden death, and of cases of premature retirement from sports.
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Pawlak, Kim. "Elevate Your Board Development Committee". Successful Fundraising 30, n.º 7 (6 de junho de 2022): 6. http://dx.doi.org/10.1002/sfr.31979.
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Monzon, J. E. "From the chapter development committee". IEEE Engineering in Medicine and Biology Magazine 25, n.º 4 (2006): 7. http://dx.doi.org/10.1109/memb.2006.1657775.
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Craft, Alma. "The school curriculum development committee". Studies in Educational Evaluation 13, n.º 3 (janeiro de 1987): 257–61. http://dx.doi.org/10.1016/s0191-491x(87)80040-8.
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Nicoteri, Jo Ann L. "The development of an in-house dispensary in a college health center". Journal of the American Association of Nurse Practitioners 28, n.º 4 (abril de 2016): 224–26. http://dx.doi.org/10.1002/2327-6924.12347.
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Alekhin, Igor N., Nadezhda S. Apkhanova, Ekaterina V. Dushina e Maria L. Prokopyeva. "Regional features of the incidence of mental disorders in the population (on the example of the Irkutsk region): a retrospective study". Kuban Scientific Medical Bulletin 28, n.º 5 (30 de outubro de 2021): 79–97. http://dx.doi.org/10.25207/1608-6228-2021-28-5-79-97.
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Background. Mental and behavioural disorders pose a pressing challenge in healthcare as pertaining to socially significant diseases. The significance is conditioned by high morbidity rates, including temporary and permanent disability, high fi nancial burden of medical care andregular social subsidy to target groups. According to the World Health Organisation, mental burden currently aggravates to entail serious social, human-rights and economic impact around the globe.Objectives. A study of regional dynamics of mental and behavioural morbidity in the Irkutsk Region over a seven-year period.Methods. A retrospective descriptive study used statistics data on primary and overall morbidity of definitely diagnosed mental and behavioural disorders (other than substance use disorders; F00–F09, F20–F99). The analysis of mental and behavioural illness incidence was based on statistical reports over the period of 2013–2019. The inclusion criterion was definite diagnosis of a mental and behavioural disorder (other than substance use disorder; F00–F09, F20–F99) in children, adolescents and adults. The main study indicators were the regional mental morbidity rate and prevalence, mental and behavioural morbidity rates among “dispensary care” and “medical counselling” outpatients, and primary morbidity rates by mental and behavioural nosology groups.Results. The article reports the regional traits of mental morbidity dynamics exhibiting a growing trend in Irkutsk Region. The morbidity traits of primary diagnoses have been analysed in dispensary care and medical counselling outpatients. Growing psychoneurologic visits are observed along with the institutional redirection of fi rst diagnoses towards decreasing the numbers of dispensary care vs. medical counselling outpatients. Thus, the structure of fi rst mental diagnoses changed towards prevailed medical counselling. Primary morbidity rate in male population is higher almost 1.5-fold in the study period. Primary morbidity elevated in both men and women. A primary morbidity analysis in different age cohorts reveals its growth in ages 0–14, 40–59 and >60 years.Conclusion. Our analyses reveal a lowering primary morbidity rate of mental disorders in outpatients taken for dispensary care, given the overall higher incidence. This may occur due to an institutional and instructional change in medical care provided to this patient category, including ineffective diagnosis, poor aid access and visit rate, statistical reporting design and possible changes in the criteria of taking for dispensary care. This fact requires improvements in the legal regulation of outpatient management of mental and behavioural illness at psychoneurologic institutions and the development of clear criteria of registering for dispensary care.
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Новиков, М. К., Е. Н. Коровин, Е. И. Новикова e М. А. Сергеева. "DESIGN OF A MEDICAL INFORMATION SUBSYSTEM FOR DISPENSARY OBSERVATION". СИСТЕМНЫЙ АНАЛИЗ И УПРАВЛЕНИЕ В БИОМЕДИЦИНСКИХ СИСТЕМАХ 23, n.º 1 (29 de março de 2024): 120–25. http://dx.doi.org/10.36622/1682-6523.2024.23.1.018.
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В настоящее время в РФ проводится всеобщая диспансеризация взрослого населения. Диспансеризация и диспансерное наблюдение необходимы для профилактики, раннего выявления и в дальнейшем квалифицированного лечения хронических неинфекционных заболеваний. Все хронические заболевания развиваются постепенно и не на пустом месте. Условия, при которых вероятность возникновения заболевания становится выше, называются факторами риска. Факторы риска можно выявить задолго до того, как возникнут первые симптомы заболевания, а их коррекция позволяет значительно снизить и даже полностью предупредить развитие заболевания. К тому же выявить эти факторы значительно проще и дешевле, чем потом диагностировать и лечить уже развившийся недуг. Кроме того, выявление заболевания на ранних стадиях его развития позволяет значительно быстрее и эффективнее провести лечение и даже достигнуть полного выздоровления. Для разработки подсистемы для диспансерного наблюдения была построена контекстная диаграмма деятельности и диаграммы декомпозиции, диаграммы классов, и разработана структурированная база данных. С помощью данной подсистемы работник медицинского учреждения сможет регистрировать новых пациентов, заносить их в общую базу, назначать прием, формировать отчеты, а также отображать информацию в цифровом виде на экране монитора, а также в бумажном печатном виде Currently, the Russian Federation is conducting a general medical examination of the adult population. Clinical examination and clinical observation are necessary for prevention, early detection and further qualified treatment of chronic non-infectious diseases. All chronic diseases develop gradually and not out of nowhere. Conditions that make the disease more likely to occur are called risk factors. Risk factors can be identified long before the first symptoms of the disease appear, and their correction can significantly reduce and even completely prevent the development of the disease. In addition, identifying these factors is much easier and cheaper than later diagnosing and treating an already developed disease. In addition, identifying the disease in the early stages of its development allows treatment to be carried out much faster and more effectively and even to achieve complete recovery. To develop a subsystem for clinical observation, a contextual activity diagram and decomposition diagrams, class diagrams were built, and a structured database was developed. Using this subsystem, a healthcare worker will be able to register new patients, enter them into a common database, make appointments, generate reports, and display information digitally on a monitor screen, as well as in printed paper form
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Belov, S. A. "Development of tuberculosis surgical service in Primorsky krai". Pacific Medical Journal, n.º 2 (15 de junho de 2023): 98–100. http://dx.doi.org/10.34215/1609-1175-2023-2-98-100.
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To the 65th anniversary of the thoracic department of the Primorsky Regional Tuberculosis DispensaryThe paper reviews the main stages of the sixty-five-year history of the Thoracic Surgical Department of Primorsky Krai TB Dispensary. During this time, the department has handled all the difficulties of establishing the TB service, turning it to a platform for mastering new technologies in close cooperation with leading research institutions of Russia. Due to high professionalism and considerable efforts of managers, doctors and whole staff, the department is rapidly developing in the field of practical medical care and scientific work. All these historical chapters are inextricably interlinked with people whose respectful work and personal talents serve as an example for new generations of specialists.
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Textor, Robert B. "From the Resource Development Committee Chair". Anthropology News 44, n.º 3 (março de 2003): 51. http://dx.doi.org/10.1111/an.2003.44.3.51.1.
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Textor, Robert B. "From the Resource Development Committee Chair". Anthropology News 44, n.º 3 (março de 2003): 51. http://dx.doi.org/10.1111/an.2003.44.3.51.2.
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