Vol 26, No 1 (2023)

BACKGROUND: Understanding the dynamics and regional features of primary disability formation is crucial for developing organizational and managerial measures to improve the provision of medical care and the system of rehabilitation measures to reduce the level of disability in the population.

OBJECTIVE: The study aimed to assess the state and dynamics of primary disability due to ophthalmopathology in the adult population of the Krasnoyarsk Region from 2007 to 2021.

MATERIALS AND METHODS: Data sources include forms № 7-SOBES (Information on the medical and social examination of persons aged 18 years and older), statistical collections of the Federal State Budgetary Institution Medical and Social Expertise of the Ministry of Labor of Russia, and reporting documents of the Main Bureau of Medical and Social Expertise in Krasnoyarsk territory from 2007 to 2021. The comparative characteristics of the analyzed data were carried out for three periods: 2007–2011, 2012–2016, and 2017–2021.

RESULTS: For 2007–2021, 5,708 people were recognized as disabled for the first time due to the pathology of the eye. The dynamics of primary disability was characterized by unevenness. The values of the intensive indicator of primary disability ranged from 1.7 to 2.6 (mean 1.9) per 10,000 population aged 18 and above. Among those initially recognized as disabled, individuals at retirement age prevailed with an increased instance of 8.5% every subsequent five years. People with disabilities were mainly residents of the cities in the region. Compared with 2007–2011 and 2012–2016 in the last 5 years, the share of IDPs in groups I and II increased (27.1% [524/1,930] and 43.4% [837/1930]), while the proportion people with disabilities of group III decreased (29.5% [569/1930]). The leading cause of disability was glaucoma (32.0% [606/1,891], 30.1% [569/1,887], and 31.1% [599/1,930] in groups I, II, and III, respectively). Second place in the list is occupied by age-related macular degeneration (15.7% [298/1,891], 20.3% [383/1,887], and 27% [522/1,930] in groups I, II, and III, respectively), and the third is myopia (14.1% [268/1,891], 11.2% [211/1,887], and 11.9% [231/1,930] in groups I, II, and III, respectively).

CONCLUSION: The dynamics of primary disability due to eye pathology in the adult population of the Krasnoyarsk Territory in 2007–2021 are variable, partly associated with an increase in the number of people with disabilities of retirement age. There was an increase in disability groups during 2017–2021. Therefore, improving the efficiency of preventive medicine and providing the region with medical personnel can help reduce the level of primary disability in the region.

BACKGROUND: Perinatal lesions of the central nervous system (CNS) prevail among other diseases of the nervous system in children, and are an economic burden on society and public health systems. The challenge in these cases is improving the quality of life of children with perinatal hypoxic pathology, which requires long-term nursing, treatment, and rehabilitation. The level of childhood disability remains consistently high, so improving the assistance to children with disabilities is an important state task.

OBJECTIVE: The analysis of the results of rehabilitation treatment.

MATERIALS AND METHODS: The study utilized 150 case histories of children with perinatal lesions of the CNS, all of whom underwent commercial rehabilitation. The study of the cards was carried out post rehabilitation, which typically spanned 30 days. The study included 85 (57.0%) boys and 65 (43.0%) girls. Congenital pathologies, perinatal encephalopathy, organic lesions of the CNS, and cerebral palsy were diagnosed in 19 (13.0%), 25 (17.0%), 36 (24.0%), and 69 (46.0%) cases, respectively. The rehabilitation process included hydrokinesitherapy, Vojta therapy, exercise therapy, and massage. The assessment on the effectiveness of rehabilitation was based discharge summaries, considering the results of an objective assessment and data from additional examination methods. At the end of treatment, a survey was conducted on 95 parents of the children to assess their satisfaction level in regards to the quality and effectiveness of the rehabilitation. The survey was conducted anonymously and on a voluntary basis.

RESULTS: Positive dynamics was observed in 115 (77.0%) cases. In 27 (18.0%) cases, there was no dynamics, and in 8 (5.0%) cases, it was negative. The survey results showed that the average satisfaction score from visiting the rehabilitation center was 9.6 (the maximum possible level was 10). The estimates and results obtained differed in families with different social statuses.

CONCLUSION: The study proved the importance and effectiveness of comprehensive rehabilitation for children with perinatal lesions of the CNS. It also emphasized the necessity of considering the medical and social characteristics of families raising such children.

BACKGROUND: The pressing issue of the primary diagnosis of oncopathology in later stages of cancer hinders effective implementation of treatment and rehabilitation measures and leads to the disability of the patient. In this aspect, the crucial factor lies in the population’s engagement to medical organizations for examinations according to the road map for the prevention of socially significant diseases.

OBJECTIVE: The study aimed to investigate the risk factors for late detection of cancer of the female reproductive system based on the results of a survey on contingents of women with diagnosed cancer of three localizations (cancer of the ovaries, body, and cervix) in the Chechen Republic.

MATERIALS AND METHODS: Sample: Female patients diagnosed with cancer of the reproductive system (299 women). Observation units: patients diagnosed with ovarian cancer, uterine body cancer, and cervical cancer. Research base: Republican Oncological Dispensary, Grozny. Research design: face-to-face individual questionnaire survey (2020–2022). Research methods: Initially, survey, statistical, and graphical analysis of the data was conducted. Finally, ranking of risk factors for detection of the disease at late stage and the construction of a decision tree.

RESULTS: The key factors with an increase in the risk of late diagnosis of cancer of the female reproductive system to 100.0% were the diagnosis of ovarian cancer, the absence of vaginal discharge outside of menstruation/in menopause, an increase in the size of the abdomen, and late treatment (100.0% absolute risk). In the contingent diagnosed with ovarian cancer, all cases were detected late, while in 22.7% of cases aggregate of patients presented two other nosologies. Among patients who did not notice an increase in the abdomen, late diagnosis of cancer was noted in 26% of patients. Conversely, among those who noted this change, all cases were diagnosed at an advanced stage (p <0.05). Regarding the target indicator “The disease was detected at a late stage” seven risk classes were identified (risk from 7.5% to 100.0%). The high-risk class was characterized by a combination of factors: “Noted pain in the lower abdomen during intercourse (No),” “Blood relatives revealed tumor diseases (No),” and “I noticed an increase in the size of the abdomen (Yes)” (100.0% risk).

CONCLUSION: The relevance of the problem of oncogynecology is associated with the need for extensive educational work among the female population with an emphasis on the need for active participation in preventive examinations. Justifying the use of the strategy of “coercion to health” is essential in identifying risk factors and cancerous lesions of the organs of the female reproductive system in the early stages. This will prevent the progression of the malignant tumors and will contribute to effective medical and social prevention of disability.