Vol 20, No 1 (2017)

Articles

THE BENEFITS OF COMBINED MINIMALLY INVASIVE TREATMENT IN REHABILITATION OF PATIENTS WITH CHRONIC HEMORRHOIDS

Rodoman G.V., Kornev L.V., Shalaeva T.I.

Abstract

Currently, the post-surgical rehabilitation of patients with hemorrhoidal disease is a serious medical and social problem. The authors proposed a comprehensive method of the management of hemorrhoids, combining seam artery ligation under Doppler ultrasound control with subdermal-submucous laser destruction of internal and external hemorrhoids. There was executed the comparative study of the safety and efficiency of both this method and the closed hemorrhoidectomy, with the use of linear stapler, in patients with chronic hemorrhoids at the stage II and III. The combined method of HAL + laser was shown to be potent of both improving the quality of life for patients during the rehabilitation period and significantly diminishing its duration. This method eliminates the risk of wound complications, reduces the risk of urinary retention by 7 times, and significantly relief from the pronounced pain in the postoperative period.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(1):4-8
pages 4-8 views

PECULIARITIES OF THE CORRELATIONSHIP BETWEEN SOMATOGENIC AND PSYCHOGENIC COMPONENTS IN THE CHRONIC PAIN STRUCTURE (ON THE EXAMPLE OF THE ISCHEMIC HEART DISEASE AND SOMATOFORM DISORDERS)

Ishinova V.A., Mityakova O.N., Povorinskiy A.A., Serdyukov S.V.

Abstract

The results of the research of the chronic pain structure of somatogenic and psychogenic origin were presented in this article. Psychogenic component was revealed in the structure of the anginal pain of chronic character in patients with coronary heart disease (CHD). The content of a psychogenic component was expectedly lower in CHD patients than in patients with chronic pain of the psychogenic origin. At the same time, somatogenic component was discovered in patients with psychogenic pain that could confirm the mixed nature of chronic pain of the psychogenic origin. The determination of the chronic pain structure allows to understand mechanisms of its formation better and to find more effective methods of its management.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(1):9-14
pages 9-14 views

THE IMPACT OF THE CHOICE OF TREATMENT OF PROXIMAL FEMUR FRACTURES ON LIFE QUALITY OF ELDERLY PATIENTS: MEDICAL AND SOCIAL ASPECTS

Liadova M.V., Liadova A.V.

Abstract

Subject of research is the impact of the tactics of treatment of fractures of the proximal femur on the quality of life in elderly patients. Most of experts note a positive trend in the state of the patients, which were made an operational intervention in the 1st day. However, according to data of foreign research, indices of the quality of life in such patients in the postoperative period to a large extent depend also on demographic, medical and social factors which fail to be adjusted in the course of early surgical intervention. Therefore, for the rational and effective from the point of the assessment of the quality of life, the use of active surgical tactics in the treatment of patients of the elderly age group with fractures of the proximal femur, as well as reducing the legal risks, it is necessary to take into account the factors identified both during the operational stage and in the postoperative period during the implementation of rehabilitation measures.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(1):15-18
pages 15-18 views

FACTORS DETERMINING THE EMPLOYMENT OF DISABLED PERSONS WITH SIGNIFICANT HEALTH PROBLEMS

Starobina E.M., Vladimirova O.N., Davydov A.T., Razumovsky M.I., Kozhushko L.A.

Abstract

Disabled people with significant impairments of body functions, make up more than 10% in the structure of the total disability prevalence rates across the regions of Russia. Some of them may be included in the labor force with the considerable help of others in specially created circumstances, such as educational or medical-industrial workshops. The purpose of research is the study of the complex of biopsychosocial factors determining the labor activities of disabled persons of various ages with significant health problems. There were observed 128 people. There were investigated the peculiarities of employment of persons with disabilities working in the medical-industrial workshops in St. Petersburg and the Leningradskaya region. There was used the method of expert and rehabilitation diagnostics, aimed at the study of the functioning of persons with disabilities with the help of processes of health domains and health-related domains systematized according to the International Classification of Functioning, Disability and Health (ICF). There were revealed specific features of the functioning, activity and participation as well as affecting on them environment factors specific to working activity of «severe» psychiatric and ophthalmic disabled, as well as cases with disorders of the musculoskeletal system, capable of working in educational and medical-industrial workshops with the considerable help of other persons. In the course of the study there was determined the pronouncement of persistent disorders of mental and sensory functions and disorders of the musculoskeletal system, when people with such disabilities can be sent to the medical and educational-production workshops institutions of different departmental subordination.There were pointed out the barriers disrupting «severe» people with disabilities be employed, as well as to facilitate career and personal factors that providing a more effective integration of disabled people into the work. Involvement in the feasible work of the «severe» cases with disabilities prevent their discrimination, promote social and economic effectiveness of rehabilitation
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(1):19-24
pages 19-24 views

THE SCORE FOR THE ASSESSMENT RESULTS OF THE MANAGEMENT OF ADULT PATIENTS WITH CRANIOPHARYNGIOMA

Kutin M.A., Konovalov A.N., Kalinin P.L., Kadashev B.A., Serova N.K., Zaytsev O.S., Sidneva Y.G., Astaf’eva L.I., Mazerkina N.A., Fomichev D.V., Sharipov O.I., Voronina I.N., Klochkova I.S., Zhadenova I.V., Savateev A.N., Strunina Y.V., Sidoruk E.V.

Abstract

In the article the authors presented a modified score for the evaluation of the management of adult patients with craniopharyngioma. Its application allows to estimate dynamics of patients before and after surgery, and in following-up observation. The main advantage of the score is the possibility of its application in patients with impaired self-esteem, which is very important in cases of craniopharyngioma. The application of the proposed scale is possible in scientific research on groups of patients, during the medical-social examination and evaluation of the effectiveness of rehabilitation
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(1):25-30
pages 25-30 views

PECULIARITIES OF THE MORPHO-FUNCTIONAL STATUS OF YOUNG FEMALE STUDENTS ON THE COMPLIANCE FOR TYPES OF TESTING OF THE COMPLEX «READY FOR LABOR AND DEFENSE» («GOTOV K TRUDU I OBORONE» - GTO, IN RUSSIAN) 2014

Shteynerdt S.V., Achkasov E.E., Mashkovskiy E.V., Narkevich A.N.

Abstract

Aim of the study. The identification of the variability of morphofunctional status of female students (16-20 years) between surveys in 20 years with the development of ways to optimize medical monitoring and improvement programs improving physical culture in preparation for the implementation of standards of the all-Russian sports complex «Ready for labour and defence» (ARSC GTO) in 2014. Material and methods. The normative results of the various test types and test program, the GTO period 1970-1980-ies «Ready for labor and defense of the USSR» - in 1987 and ARSC GTO - 2014. Results. For analysis and comparison for compliance with the physical health of students in the framework of preparations for civil defense (GTO), the GTO selected two different periods, the period of the USSR 1970-1980-ies that used the all Union physical culture complex «Ready for labour and defence of the USSR» (VFK GTO USSR) - 1987 period TRP in Russia - all-Russian sports complex «Ready for labour and defence» (ARSC GTO) in 2014. In the study, it was found that some kinds of testing under ARSC GTO - 2014 simpler and easier to execute (compared to the requirements of VFK GTO USSR - 1987), for example, running 100 meters, long jump, 500- and 700-gram throwing ball, ski races, cross-country, swimming and shooting. You should pay attention to the fact that the total number of trials of ARSC GTO - 2014 less than in the system VFK GTO USSR - 1987. Conclusion. Standards of performance standards of ARSC GTO - 2014 complete easier and simpler in most tests compared with the Soviet period in the framework of VFK GTO USSR - 1987. A study of anthropometric and morphofunctional characteristics of female students (16-20 years old) showed that our results require careful analysis for compliance with the physical development and health of young people aged 16-20 years with the requirements for the standards system of ARSC GTO - 2014.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(1):31-36
pages 31-36 views

THE VIEW OF THE CLINICIAN ON FEATURES OF THE CLINICAL COURSE AND ISSUES OF VACCINAL PREVENTION OF VIRAL HEPATITIS A

Burgasova O.A., Volkova V.M., Tetova V.B., Belyaeva N.M.

Abstract

The article is devoted to peculiarities of the clinical course of hepatitis A. There is presented the modern view of the immunopathogenesis of hepatitis A virus (HAV) infection. The attention is focused on possibilities of the development of severe, fulminant course especially in patients of the old age category. The authors give the analysis of the main causes of severe fulminant forms of the disease. There are pointed out clinical and laboratory criteria for the assessment of the severity of the course of HAV infection. This article includes information on current aspects of vaccination against HAV, with the indication of the population, especially needed of vaccination
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(1):37-45
pages 37-45 views

PRINCIPLES OF FORMATION OF MEDICAL CONCLUSION. CLINICAL DIAGNOSIS

Puzin S.N., Shurgaya M.A., Memetov S.S., Shevchenko S.B., Smol’nikov E.V., Goncharova O.V.

Abstract

The effectiveness of medical practice determines the precise, reliable diagnosis. In this regard, the clinical diagnosis cannot be identified only from the list of patient disease entities, complications, symptoms, and it should reflect all lesions most fully. After reading of the diagnosis the essence of the disease state should be clearly understood. The article covers basic principles of the diagnosis, the diagnosis of the structure (underlying disease, complications, accompanying, concomitant and competing pathology of the underlying diseases), requirements for its registration. Properly formed the basis of the diagnosis is the clinical and expert opinion, the definition of the effective therapy and adequate rehabilitation methods of the existing pathology. Completeness of the shaping of the structure of the diagnosis is the condition for achieving of the commonality needed for the proper keeping track of the statistical morbidity and disability rate of citizens.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(1):46-49
pages 46-49 views

HISTORICAL STAGES OF DEVELOPMENT AND FORMATION OF SERVICE OF MEDICO-SOCIAL EXAMINATION IN RUSSIA

Puzin S.N., Dmitrieva N.V., Shevchenko S.B., Osadchuk M.A., Suvorov V.G.

Abstract

The principles of the social protection of the population in Russia began to take shape in the late 10th century, along with the adoption, in 988, of Christianity in Russia. The modern history of institutions of medico-social examination began on 27 April 1918 when the people’s Commissariat of public scorn was transformed into the Commissariat of social security, and began the formation of the medical labor commissions of the predecessors of the modern institutions of medico-social examination. Thus, the system of medico-social expertise of the Russian Federation in 2017 has reached the age of 99. As the formation and development of the social insurance, social welfare and health care and improved system of medical-social expertise, strengthen its scientific base. Currently, medical-social examination has formed in a special branch of scientific knowledge and practical activities. The way of the development, passed by the medical-social examination starting from the medical-labor expertise, creation, formation and development of the medical-social examination on the entire territory of Russia can be divided into a number of stages determined by peculiarities of its political and socio-economic status.
Medical and Social Expert Evaluation and Rehabilitation. 2017;20(1):50-54
pages 50-54 views

NINA VASIL'EVNA DMITRIEVA (k 75-letiyu so dnya rozhdeniya)

Abstract

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Medical and Social Expert Evaluation and Rehabilitation. 2017;20(1):55-55
pages 55-55 views

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