Vol 17, No 3 (2014)


Modern approaches in the medical and social rehabilitation of patients with chronic heart failure

Puzin S.N., Shurgaya M.A., Chandirli S.A., Polyanichko V.V., Baleka L.Y.


Currently, chronic heart failure (CHF) is one of the most relevant health and social problems. This is stipulated by its high prevalence, morbidity growth (annually develops about 0.5 million new cases) and poor prognosis. CHF is the final stage of cardiovascular continuum, which causes most of the mortality and high rates of disability in the population. Treatment of CHF requires considerable spending in many countries around the world - up to 1 to 2 % ofall health care facilities and 10.8% of the total budget allotted to the treatment of cardiovascular diseases. Approximately 70 % of this amount is spent on the treatment ofpatients hospitalized in the hospital with worsening heart failure. Low survival at this stage, on the one hand, and the high costs of hospital care, on the other - the need to define the optimization approaches to medical and social rehabilitation of patients with chronic heart failure. This article, the first of a planned series of articles that will highlight current issues of epidemiology, etiopathogenetic formation, clinical expert diagnosis, therapy and prevention of heart failure.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):4-10
pages 4-10 views

The practical application of the International classification of functioning, disability and health of patients with cardio - vascular pathology

Sergeeva V.V., Vladimirova O.N., Nurgazizova A.K.


The possibility of applying the codifier for health assessment, indicators related to health, as well as the necessary measures for the rehabilitation of patients with cardio-vascular pathology on the example of a patient with the specified diagnosis. Interrelation assessed domains in one patient and the need to evaluate not only the disturbedfunctions, structures, activity and participation, but also environmental factors for comprehensive assessment of health needs in social protection measures in case of disability. It is shown that the environment can both positively and negatively influence the need in the rehabilitation events. Presents the relationship between disturbed domains and necessary measures of medical, professional and psychosocial rehabilitation, as well as the needs in technical means of rehabilitation
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):11-16
pages 11-16 views

The functioning profile of patients in the late period of spinal cord injury: planning the stages of hospital rehabilitation using the international classification of functioning, disability and health

Vasilchenko E.M., Filatov E.V., Kislova A.S., Surodeyeva Y.S., Lyakhovetskaya V.V., Zoloyev G.K.


We analyzed the functional status of patients with spinal cord injury (late period) using the profile with the International classification of functioning, disability and health (ICF) categories. We identified the changes in bodyfunctions, body structures, activity and participation that can be corrected in the rehabilitation hospital.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):16-21
pages 16-21 views

The influence of intraosseous blockades on neuropsychological impairment and cerebral blood flow in the rehabilitation process of patients with chronic pain in the neck

Kornilova L.E., Sokov E.L.


We observed 182 patients with chronic pain in the neck. 93 patient study group received a course of intraosseous blockades, 89 patients of the control group received a course ofparavertebral blockades. Efficacy of treatment was assessed by changes in pain intensity values, cognitive tests, hemodynamic. Patients treated with the use of intraosseous blockades, pain, cognitive and hemodynamic disorders regressed to a greater extent than in patients treated with a course of treatment with paravertebral blockades. Higher therapeutic efficacy of intraosseous blockades in the rehabilitation ofpatients with chronic pain in the neck was detected.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):21-25
pages 21-25 views

Psychological examination of the child with X-concatenated adrenoleukodystrophy during the medical examination in mixed profile bureau of medical-social expertise

Akopjan T.A., Samarin B.A., Dashina M.G., Timoshnikova N.N., Akimov E.I.


This article seeks to improve approaches to expert examination of sick children in the mixed profile bureau of medico - social examination to the identification and assessment of mental dysfunctions in patients with lesions of the brain. The difficulties encountered in the process of medical and social assessment of people with this disorder were analyzed. The use of the experimental psychological examination for the detection of cognitive and regulatory violations, the objectification of the severity and persistence of mental disorders was justified. A case of expert practice, which caused significant difficulties in determining the disorders of the body (type, severity, and persistence ), certain restrictions on the major categories of life, the formulation of clinical andfunctional diagnosis and expert determination was presented. The need to develop common criteria and approaches to assessment of mental dysfunctions is shown.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):26-28
pages 26-28 views

Advices on conducting of medicalsocial expertise of epilepsy

Trekin S.V., Beresneva O.V.


Authors of the article propose to amend the procedure of the III group disability determination due to epilepsy that is based not on counting of documented paroxysms but on establishment of an emotional and volitional deviations ’ degree by a medical psychologist from a bureau of medico-social expertise.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):29-32
pages 29-32 views

The analysis of total disability in children population of North Caucasus Federal District in 2008-2012

Grishina L.P., Hasiev M.S., Hramov I.S.


The paper analyses general disability in children in all regions of the North Caucasus Federal District, taking into account the different age groups in the dynamics over 5 years - 2008-2012.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):33-35
pages 33-35 views

Structure of primary disability according to the disease classification in children population of the Chechen Republic for 2006-2012 years

Hasiev M.S.


This article provides a detailed analysis of the primary disability for all diseases classes and major disease forms in children of the Chechen Republic in dynamics for 2006-2012 years. Defined ranking places disability in various types of disease, the dynamics of the proportion ofpersons with disabilities by primary diseases, and explored gender-specific disability.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):35-40
pages 35-40 views

Prior disability caused by digestive diseases among adult population of the Belgorod in the period 2000-2012

Dmitrieva T.V., Dmitriev V.N.


Prior disability caused by digestive diseases has been studied with consideration of age, disability grade and occurrence among adult population of the Belgorod region from 2000 to 2012. In general, despite the growth of the population, and its ageing the level of prior disability caused by digestive diseases decreased. Such cohort mostly includes employable population with disability of 2nd and 3rd grades. A negative trend related to prior disability manifests as increasing ratio ofpersons with disability of the 1st grade. Prior disability becomes more severe with age.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):40-43
pages 40-43 views

Regional features of primary disability of military servants in the Altai region

Kuzivanova T.J., Vladimirova I.A.


The analysis ofprimary disability dynamics in military service of the Altai region for 2008-2011 is represented. Investigated The level and structure ofprimary disability of citizens for the analyzed period is examied.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):43-45
pages 43-45 views

Analysis of primary disability due to tuberculosis in Rostov region. Dynamics for 5 years (2009-2013)

Abol' A.V.


The article analyzes the primary disability due to tuberculosis in the Rostov region. The level and structure of disability in different age groups and different disability categories was calculated. 5years observation period (2009-2013).
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):45-47
pages 45-47 views

Obesity - a factor that worsens the prognosis and quality of life in patients with type 2 diabetes

Ametov A.S., Doskina E.V., Abaeva M.S., Nazhmutdinova P.K.


We evaluated the choice of glucose lowering therapy on visceral fat mass in patients with type 2 diabetes. Material and Methods. The study included 70 patients with DM 2. Within 6 months received combination vildagliptin and metformin (n =40) and metformin and glibenclamide (n =30). At baseline and after 6 months of therapy the following indicators were determined: fasting plasma glucose, glycated hemoglobin, free fatty acids, insulin. Visceral fat was calculated at five lumbar vertebrae by magnetic resonance imaging. Results. After six months of therapy, glycated hemoglobin decreased on average by0.6% in both groups. In the group with metformin and vildagliptin HOMA-IR decreased by an average of 3,17 ± 6,26 (p < 0.001), body weight by 2.4kg(p < 0.009), visceral fat area was significantly reduced at the level of the lumbar vertebrae (L1p < 0,005; L2 p < 0,001; L3 p < 0,001; L4 p < 0,001; L5 p < 0,05). In metformin and glibenclamid significant changes in body weight and visceral fat were observed. Conclusion. Treatment with drugs incretion effect in patients with type 2 diabetes and overweight slows the progression of the disease. The therapy improves glucose metabolism and decreases visceral fat mass.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):48-52
pages 48-52 views

About unity of expert approaches in implementation of medico-social and military-medical expertise

Starovoytova I.M., Sarkisov K.A., Potekhin N.P., Shumeyko T.V.


The present article is devoted to questions of carrying out medico-social and military-medical expertise. In the presented material the modern concept and methodology of medico-social expertise is considered, the factors being the basis for recognition of the person by the disabled person and proving the expert decision are allocated, the principles of creation of the clinical-functional diagnosis are defined, regulations, classifications and the criteria used at implementation of medico-social examination are specified. The main categories of activity of the person and degree of expressiveness of restrictions of these categories are presented; the assessment of restriction of ability to work, actual for persons of able-bodied age is given. The regulations defining the purposes and an order of carrying out military-medical expertise and establishing uniform categories of the validity to military service by results ofphysical examination are considered, the subject of military-medical examination is defined, its basic laws and the criteria proving the expert decision are considered. Classification of degree of expressiveness of functional violations by which the military-medical commissions, in comparison to the conclusion about corresponding to this type of violations of category of the validity are guided in the activity is presented. The order of carrying out medico-social and military-medical expertise, and also the criteria used at establishment of disability groups and category definition of the validity to military service are analysed. The general expert approaches at implementation of expert actions concerning civilians and the military personnel, distinctly expressed legal character of expert opinions with certain social consequences of the examined persons are revealed.
Medical and Social Expert Evaluation and Rehabilitation. 2014;17(3):53-57
pages 53-57 views

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