Vol 14, No 2 (2011)

Model of the organization of complex rehabilitation of invalids in a large industrial region, characteristic of the basic links of the model, estimated criteria of its realization are presented in the article.

Features of determination of disablement groups in patients with Parkinson's disease with various age of the disease onset were analyzed. We examined 86 patients with PD registered at the Nizhniy Novgorod office on assistance to the patients with extrapyramidal pathology including early and late onset of the disease. Slower tempo of progressing was characteristic for the patients with early onset, and their disablement developed in later terms from the moment of the disease development than in patients with late onset. Earlier disablement of the patients with late onset of the disease depended on more rapid development of postural instability, vegetative and cognitive disturbances. Medico-social examination demands taking into account the specificity of the disease course depending on the age of its onset.

The essential scientific trends of rehabilitation due to the psychic diseases based on bio-psycho-social concept of psychic diseases and psychiatric rehabilitation were considered in the article. Systemic approach underlied the coverage of this problem.

The problem of social adaptation of the elderly patients at the gerontopsychiatric center was considered. Subjective and objective factors of social adaptation of elderly patients with psychic disturbances were presented as well as the stages of social adaptation. The participation of different specialists in the realization of the social adaptation process was shown.

The results of study of clinical expert work of municipal polyclinics were presented. High level of appeal for medico-social problems solution was detected. The structure of the patients' appeal was presented including the rural regions. Time necessary for medical expertise by the commission of experts was determined.

The indices of primary and general tuberculosis incidence and indices showing the phthisiologic service in Krasnodar Territory are presented for the 5-year period.

Regional features of primary disablement structure of the Nizhniy Novgorod Region adult population according to groups of disablement for the 18-year period were studied. Mean annual values were calculated and dynamics of invalids rate of I, II, II groups in structure of contingent of primarily determined invalids due to certain classes of diseases (general number of follow-up units - 674 137 primarily determined invalids at Medico-Social Expertise Units for the period 1992-2009). Classes of diseases with the most severe incapacitating consequences (circulatory system diseases, malignant neoplasms, psychic and behavioral disorders, tuberculosis) were determined. Knowledge of regional features of the disablement formation process is necessary for optimal management decision-making in forming an efficient, regionally orientated policy in spheres of healthcare and social protection of population.

Congenital malformations are one of the leading causes of infantile disablement and infantile mortality. In the structure of primary disablement in Murmansk Region congenital malformations take the second place. Maldevelopments of circulatory system predominate among congenital malformations.

Treatment and rehabilitation of elderly patients are very often complicated by combined pathology. Chronic diseases, absence of acute clinical picture, pharmacological pathomorphosis, simultaneous or consecutive multi-causal monosymptomatology, alternating pharmacokinetics and pharmacodynamics of drugs condition the development and introduction of new forms and methods of complex rehabilitation into practice.

The investigation of cardiac rhythm variability features in patients and invalids with cardiovascular pathology was aimed at studying possibilities of using indices for evaluation of the severity of state and degree of cardiovascular system disturbances and functioning as a whole. It was shown that disturbances of cardiac rhythm neurohumoral regulation were characteristic for the examined patients; significant deviations from norm corresponded to the severity of state increase according to clinical features that confirmed its informative significance for the functional state and functional reserves of the organism characteristic.

Practical recommendations on introduction of a new organizational-methodical registration form for the disabled patients staying in psychoneurologic hostels were designed and given as psychological rehabilitation record of the patient showing basic clinical-demographic, social-environmental and psychological dispositions of the patient.