Vol 28, No 5 (2020)

Full Issue

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Articles
Euthanasia as a worldwide dilemma of modern times
Moskvicheva L.I., Agamov Z.K.
Abstract
Nowadays, the most important place in medicine is occupied by ethical and legal aspects of organization of medical care and the provision of qualitative medical services to citizens. The main mechanism of functioning of the patient-centric health care system is implementation of the rights of patients as described in our country within the framework of international legal acts, the Constitution of the Russian Federation, the Civil, the Civil Procedure and Criminal Codes of the Russian Federation, as well as the Legislation on the protection of health of citizen.Since the mid of twentieth century, in many countries was widely discussed possibility of ensuring one of the most controversial and non-obvious rights of patient - the right to death. In medical practice, the mechanisms implementing this right are the acts of euthanasia, the assisted suicide, the voluntary death (refusal of water and food), “murder out of sympathy”, terminal sedation and the phenomenon of “double effect” as well.The article presents review of scientific publications presented in national and international databases, highlighting prerequisites of implementation of euthanasia into practice and international experience of applying this mechanism of demise as well.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):867-876
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The actual problems of traumatism in the Russian Federation
Schepin V.O., Shishkin E.V.
Abstract
In 2005-2018, marked decreasing of morbidity of trauma, intoxications and other outcomes of impact of external causes in the Russian Federation was registered. In the Ural Federal Okrug, the rate of decreasing was the lowest and made up to 1.3%. In the subjects of the Federal District, the highest rates are registered in the Kurgan and Chelyabinsk Oblast.In 2010-2017, mortality from external causes decreased most intensively in the North Western Federal Okrug - up to 40.6% and least intensively in the South Federal Okrug up to 28.4%. The mortality of traffic accidents decreased most markedly up to 2.1 times from 22.4 to 10.5 cases per 100 thousand of the population.There is decreasing in indices of traumatism and trauma mortality in most territories of the Russian Federation. In recent years, slowdown of this trend is present that testifies the necessity of further development of measures targeting organization of medical care of the injured based on organization of traumatological centers for all injured, and not only those ones of traffic accidents.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):877-882
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Is the health care system ready to apply gene therapy preparations?
Omelianovsky V.V., Musina N.Z., Lemeshko V.A., Gorkavenko F.V., Antonov A.A.
Abstract
The gene therapy is totally new approach to treatment of patient. It has significant therapeutic potential for wide range of diseases, including those caused by genetic disorders. The in vivo therapy is one of types of gene therapy meaning that impact on gene apparatus of somatic cells occurs straight within organism of patient. Among significant advantages of of this kind of therapy is potential opportunity of treatment of diseases which previously had no effective therapy or only supportive symptomatic therapy was administered. The article describes international approaches to classification of gene therapy preparations. The review of in vivo gene therapy preparations currently registered in different countries. Also, the features of their development, production and registration are analyzed. For many in vivo gene therapy preparations, due to small number of patients, clinical evidence base is limited, especially in terms of long-term clinical effect that complicates process of registration and economic evaluation for subsequent their inclusion in the system of state funding. It should also be noted that gene preparations currently registered abroad have extremely high cost that limits their widespread implementation into clinical practice. The production of gene therapy preparations requires a number of additional measures targeted to supporting product quality that complicates process of their production and registration. Due to absence of necessity in large production capacities, gene therapy preparations are produced centrally that results in their logistic complexities. It is actual to analyze international experience of distribution of in vivo gene therapy preparations in order to optimize approaches to regulation, assessment and financing of gene technologies in the Russian Federation.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):883-892
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The analysis of detection of rare diseases not included into listings of orphan diseases with preferential medication support
Komarov I.A., Krasilnikova E.I., Zhulev I.A., Zinchenko R.F.
Abstract
The study was carried out to analyze detection of rare diseases that are not included into listings of rare (orphan) diseases to be treated at the expense of budget resources of the Russian Federation Russian Federation (hereinafter referred as rare diseases out of reimbursement).The analysis of detection of patients with rare diseases out of reimbursement in Russian Federation was carried out. The information was collected and summarized on the basis of open sources by the way of formalized personal request to the heads of patient and public organizations providing care of patients with rare diseases out of reimbursement.It is established that in the Russian Federation (85 subjects) reside patients with more than 250 forms and groups of rare diseases and only 28 out of them are included into the Federal registries of patients. Actually, there are more than 8 000 nosologic forms of rare diseases that are known thus far. The monitoring permitted to collect data concerning 30 particular nosological forms and groups of rare diseases out of reimbursement. Among them, 23 out of 30 analyzed pathologies have genetic nature. And only for 24 out of 30 diseases the registration of patients is applied.It is necessary to organize modern system of registration of patients within the framework of the Federal registry that includes full and actual data about patients, course of disease, therapeutic interventions that will permit to determine prevalence, disability, mortality, lethality, necessary medicinal maintenance and also to establish spectrum of diseases that are to be included into drug reimbursement programs.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):893-902
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The regional characteristics of indices of mortality of adult population and life expectancy
Gasaynieva M.M., Abdurashitova L.V., Zagoruychenko A.A.
Abstract
The article analyzes the demographic situation in the Republic of Dagestan and presents analysis of indices of population mortality and life expectancy. It is established that number of deaths per 1000 people of the Republic of Dagestan is one of the lowest not only in the Northern Caucasus, but in the country at large. At the same time, high mortality indices are determined in elder age groups both in Dagestan and on average in Russia. The main causes of death in the Republic of Dagestan are diseases of circulatory system and respiratory system, neoplasms, accidents, poisoning and traumas, which account almost three quarters of all cases of deaths. However, mortality indices in Dagestan from diseases of circulatory system, neoplasms, digestive system diseases, infectious and parasitic diseases are significantly lower as compared to the national average level. In Dagestan, one of the highest indices of life expectancy is observed as compared with other subjects of the Russian Federation (2nd place in the Russian Federation) - on 6 years exceeding the national average level (in males, difference in values of indicator amounted to 7.5 years). In Dagestan, during analyzed period, life expectancy at birth increased more than on 5 years.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):903-908
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The analysis of concomitant pathology in ophthalmologic practice based on electronic medical records data
Manyakov R.R., Osmanov E.M., Zhabina U.V., Berseneva E.A., Efimov D.V., Garaeva A.S., Zhernakova N.I., Bunova S.S.
Abstract
The study substantiates possibility of using data retrieved from electronic medical records (EMR) for analyzing comorbidity under diseases of the eye and its adnexa. The purpose of the study is to analyze prevalence and evaluate risk of development of comorbidity in patients with ophthalmologic pathology, based on the data presented in EMR. The total number of patients included into comprised 12 120 individuals. The 653 diagnoses were established and 122 703 requests for medical care were registered. The calculation was applied concerning prevalence, comorbidity index, relative risk of comorbidity. The study established prevalence and level of relative risk of development of opportunistic diseases characteristic for senile cataract and glaucoma. The obtained data on comorbidity may testify in-depth mechanisms of interaction of diseases at cellular, protein or genetic levels. The understanding of mechanisms of interaction of main and concomitant diseases can result in development of new methods of diagnostic, treatment and prevention of diseases. Thus, establishment of glaucoma diagnosis can induce physician to look for possible presence or high probability of development of prostate neoplasm that implies periodic control of prostate-specific antigen. The presented results demonstrate how EMR data can be used to identify, estimate prevalence and risk of comorbidity and also reveals pathogenic mechanisms of interaction between primary and recurrent diseases that can be applied in clinical practice.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):909-915
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The disorder of cerebral circulation in patients of able-bodied age
Brynza N.S., Proklova T.N., Lebedeva D.I., Dyachkov S.M., Elfimova I.V., Svistunova A.I.
Abstract
The study was organized to evaluate influence of risk factors on hospital mortality in patients with acute stroke because incidence of stroke in patients of able-bodied age is increasing. All cases of in-patient care of patients of able-bodied age with acute stroke (n=4118) in the Tyumen Oblast clinical hospital № 2 during 2010-2018 were analyzed. The study was based on sampling data from hospital medical records. During the analyzed period, decreasing of in-patient lethality up to 34.9% in patients of able-bodied age was observed. During the period of “therapeutic window” 60% of patients of able-bodied age admitted died. The multivariate analysis was applied to assess influence of different factors on in-patient mortality. The presence of coronary heart disease increases risk of mortality up to 47.5%, Exp(Beta)=1.475, employment - up to 66.8%, Exp(Beta)=1.668 as compared to baseline risk. The presence of arterial hypertension and remoteness of symptom onset in ln (hours) (hospital admission) decreases mortality risk up to approximately 39.7%, Exp (Beta)=0.603 and up to 24.0%, Exp (Beta)=0.760, respectively (specificity - 75.86%, sensitivity - 72.18%; overall diagnostic accuracy - 75.23%). In patients of working age the presence of coronary heart disease and elder age are risk factors of stroke. The presence of coronary heart disease and employment are risk factors of in-patient mortality. Whereas presence of hypertension and employment decreases risk of lethal outcome.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):916-921
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THE COVID-19 PANDEMIC: DEPRESSION, ANXIETY, STIGMA AND IMPACT ON MENTAL HEALTH
Lipai T.P.
Abstract
World Health Organization (WHO) declared the COVID-19 «outbreak a public health emergency of international concern», characterized it as a pandemic in order to emphasize the gravity of the situation and urged to take actions in detecting the infection and preventing its spread. The article considers the issues related to the occurrence of fear, depression, and stigmatization, analyses the causes of these phenomena, and identifies practical solutions for addressing mental health issues related by the precipitate coronavirus (COVID-19 Pandemic). During the quarantine, taking care of your mental health is essential more than ever, as one needs to remain calm, not stressed, and promote a positive well-being. Fear and self-stigmatization in both long-term and brief periods of isolation and loneliness can have negative consequences on both physical and mental well-being. Stigma can also create mental distress following the quarantine. Social and emotional support should be given to family members by mental health professionals.In addition, the author concludes that in order to maintain the mental health, it is necessary to examine the unique contribution of the salience of positive aspect stigma. A number of concrete scientific and organizational approaches to improve the actual situation were proposed.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):922-927
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The gender and age characteristics of morbidity of thyroid cancer
Puzin S.N., Pogosyan G.E., Shurgaya M.A., Idrisova L.S., Lyalina I.V., Philippov V.V.
Abstract
The thyroid cancer is the most prevalent oncologic disease of endocrine organs, characterized by multi factorial risk of development. The purpose of the study was to analyze dynamics of indices of thyroid cancer morbidity of population of the Russian Federation, considering gender and age differences in 2008-2018. The increase of “rough” indicator of thyroid cancer morbidity of male population made up to 56.6%, and of female population - 48.3%. The dynamics of standardized indicator in gender contingents was characterized by increasing up to 48.7% in males and up to 43.9% in females. There is an increasing of thyroid cancer morbidity with age and prevalence of the morbidity in females as compared with males in all age categories. The highest morbidity was established in male population aged 65-69 years (8.3 per 100,000 population) and in females aged 55-64 years (27.3 per 100,000 population). In the territories of the Russian Federation, in the gender aspect, variations in thyroid cancer morbidity were established. both in male and female populations, maximal thyroid cancer morbidity was established in the North Western and Siberian Federal Okrugs, and morbidity below national level was registered in the Privolzhskiy and North Caucasian Federal Okrugs. It is necessary to take into account differentiation of the territories of the Russian Federation in terms of the thyroid cancer morbidity in different gender and age groups for development of rational measures of early identification of risk factors, diagnosis and treatment of patients.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):928-933
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The medical statistical characteristics of children received services in ultrasound diagnostic in out-patient conditions
Krotov I.A., Konovalov O.E., Terletckaia R.N.
Abstract
The purpose of the study was to estimate contingent of children that underwent ultrasonography in outpatient conditions of children hospital and to investigate reserves for improvement of actual ultrasonography service. The method of expert evaluation was applied to analyze medical documentation of 1171 children aged 0-18 years that underwent ultrasonography. The analysis was applied to demographic data, number of previous ultrasonography, specialty of physician involved into investigation, children chronic diseases and type of ultrasonography applied. The wide range of ultrasonic examinations were carried out in out-patient conditions of multidisciplinary children hospital was established. Their spectrum was determined by the age of patients. Children were most often referred to ultrasonography by cardiologist, pediatrician and gastroenterologist. In examined patients dominated diseases of digestive organs, congenital abnormalities, diseases of nervous and urinary systems, circulatory system. In the structure of morbidity, proportion of diseases of endocrine system, circulatory and digestive systems increased with age and the proportion of diseases of nervous, musculoskeletal systems and congenital abnormalities decreased. Among the types of ultrasonic examination, the first places in frequency took studies of circulatory system, abdominal organs, kidneys and retroperitoneal space. The large proportion of patients underwent ultrasound testing again. The comparative analysis demonstrated increasing of proportion of ultrasound studies of endocrine and reproductive organs and decreasing of musculoskeletal system and brain. It is proposed to apply received results in studying particularities of children that underwent ultrasonography in the inpatient and outpatient conditions. The received data can be used in planning of required volume of different diagnostic services at different levels.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):934-940
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The motivation of citizen to follow healthy life-style by means of forming leader qualities in future medical specialists
Garanina I.A., Tregubov V.N.
Abstract
In actual conditions health care priority is in increasing population size and its life expectancy including duration of healthy life, reducing morbidity, mortality and disability of population, observance of rights of citizens related to health protection that can effectively be achieved by adherence of healthy lifestyle.In order to determine possibility of improving motivation of population to lead healthy lifestyle, through formation of leadership qualities in medical specialists, the study applied such methods as expert evaluation, questionnaire survey, interview, monographic and statistical techniques. The sampling consisted of 46 employees of the I. M. Sechenov First Moscow State Medical University as experts, 107 students of this educational organization were involved in questionnaire survey and interviewing, and 68 of them were included in the group with pronounced leadership qualities, and 39 respondents consisted the control group.Involving population into healthy lifestyle is priority task of all medical specialists that is regulated by work functions of their professional standards. The effective direction of this work is to influence internal motivation of citizens. The presence of leadership qualities in future medical specialists increases their ability to motivate the population to lead healthy lifestyle at the level of theoretical training by 33.3% and practical training by 65.5% as compared to control group. The main directions of improving motivational work to involve population into healthy lifestyle by future medical specialists is refusal by students’ bad habits, teaching them specialized topics in all related disciplines, formation of students' leadership potential. To develop student’s leadership skills, training program can be applied in the laboratory of excellence “Factory of health leaders”, implemented at the N. A. Semashko Department of public health and health care.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):941-947
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The increase level of somatic health in students by multi directional means of fitness
Bocharova V.I., Kondakov V.L., Kopeykina E.N., Smirnova D.E., Verzunova L.V., Shumakov I.A.
Abstract
The purpose of the study is to substantiate methodology of using multidirectional fitness tools to improve level of somatic health, and as a result, physical and mental efficiency of students. The study sampling included 186 students (106 girls, 80 boys). Two groups were formed: control group (n=85: 47 girls, 38 boys) and experimental group (n=101: 59 girls, 42 boys) in the content of educational program were included experimental method. The study demonstrated that Pilates stabilizes and topes up muscles of entire body, improves coordination abilities, improves physique, favors reducing back pain, improves cardio-respiratory system and reduces psycho-emotional tension. The step aerobics positively effect on cardio-respiratory system and entire musculoskeletal system, as well as has a on physical performance. The somatic health of students in experimental group after experiment improved from “below average” to “average”. In control group, before and after the experiment, level of somatic health made to “below average”. After experiment, physical performance indicators in experimental group improved. The indices of students of control group remained at the same level. In experimental group, all indices of mental performance increased and began to have regular character.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):948-953
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The parents evaluation of accessibility of out-patient ophthalmologic care in Chelyabinsk
Berdnikova E.V., Soliannikova O.V., Cherniak O.V.
Abstract
Every year number of eye diseases among children and adolescents is steadily increasing. The most possible causes of this process are sedentary life-style, computerization of society and school curriculum characteristics. The survey of 209 parents of children and adolescents was organized and carried out. The study established that modern children spend much more time at screens than it is recommended by regulatory documents. The pathology of eye was diagnosed in 46.9% of children, 39.2% of children are regularly observed by ophthalmologist. 53.6% of children are regularly observed by an ophthalmologist. Among parents whose children are monitored by ophthalmologist, 55.3% mentioned inaccessibility of medical appointments, that makes impossible regular corresponding medical check-ups and results in progressing of diseases present and development of new ones. The ophthalmologist plays key role in maintaining visual analyzer health. To effectively prevent visual organ pathology, it is necessary to achieve comprehensive interaction of ophthalmologist, teachers (preschool teachers), parents and children themselves.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):954-958
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The methodical principles of quality management of medical activities on particular territory
Lindenbraten A.L., Ludupova E.I., Grishina N.K., Serdiukovsky S.M.
Abstract
The article, on the basis of experience of development of the Republic's first territorial system of medical quality management, presents basic organizational systemic principles of building quality management of medical activity and organizational model of system functioning. The listing of criteria and indices of assessing effectiveness of territorial system of managing quality and safety of medical activity is presented too. The purpose of developing such a system is formulated. The evidence base for actuality and feasibility of its organization is presented.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):959-963
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On methods of evaluation and calculation of production potential of medical organization providing specialized medical care in conditions of around-the-clock hospital
Khalfin R.A., Orlov S.A., Madianova V.V., Stolbov A.P., Kachkova O.E.
Abstract
The article presents basic methods of assessing and calculating production potential of medical organization. providing specialized medical care in round-the-clock hospital. The described techniques are used to develop standards of provision of medical care as part of territorial program of state guarantees of free medical care for citizens and to improve organizational processes of provision of medical car that allows to more efficiently apply available resources of medical organization.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):964-969
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The integrated approach to implementation of expertise of medical interventions
Aleksandrova O.Y.
Abstract
The article analyzes and systematizes legislative rules of the medical care quality expertise. The paramount place of clinical recommendations in development of legal acts regulating expertise and assessment of medical care quality, quality control and safety of medical activity is determined.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):970-974
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The quality of coding medical information as component of system of management of medical activities quality
Kolomiychenko M.E., Vaisman D.S.
Abstract
The reliable statistical information is undoubtedly an important point in making any management decisions. The main instrument for recording and analyzing health data is international statistical classification of diseases and related health problems, 10th revision. The article presents results of study of quality of coding information concerning hospital morbidity and mortality of patients of palliative care department of multidisciplinary hospital.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):975-980
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The modern technologies of vitaminization in diseases prevention: publications review
Mingazova E.N., Gureev S.A., Sidorov V.V.
Abstract
The article presents review of publications and official documents of international state, departmental and public organizations related to implementation of targeted programs of enrichment of vitamins and minerals with food rations and food products, including application of up-to-date technologies. The data is presented about practical implementation of developments in the field of problems of modern molecular nutrition, nutrigenomics, investigating effect of human nutrition on gene expression, and as well as on bioinformation approaches of nutrigenomics, intestinal microbiota metagenome, gene regulation or gene expression in a microbiome.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):981-986
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The conceptualization of continuum of oncologic care in situation of disease in context of integrated system of regional health care
Erugina M.V., Krom I.L., Shmerkevich A.B., Balakina D.D.
Abstract
The achievements of modern medicine resulted in an increase of number of patients living with chronic diseases that turned out as significant burden for national economics. The oncologic diseases are one of the most widespread ones, determining patient vital prognosis. The modern achievements in medicine determine possibility of optimizing clinical prognosis and chronic course of disease. In modern Russia, the health care system functions in accordance with model of urgent, fragmented medical care that does not meet current needs of patients with chronic diseases.In Russia, actual procedures of medical care of oncologic patients do not consider interdisciplinary continuum scenario. Therefore, the need for its conceptualization. The article proposes model of continuum of oncologic care of patients in the context of an integrated health care system, that presupposes complex interdisciplinary follow-up of patients with chronic disease in situations of disease.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):987-993
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The lean polyclinic: aspects of optimization of medical processes
Metelskaia A.V., Kamynina N.N.
Abstract
The article considers main issues of implementing the lean polyclinic project in practice of Russian polyclinic institutions. The main problems that can be solved by implementing the principles of economical production, optimizing operations and eliminating losses, including financial ones, are identified.It is concluded that saved funds can be distributed to motivate employees in the form of higher salaries and bonuses, as well as to provide training opportunities, to attend conferences by specialists. This approach results in reasonable use of the Federal funds, the mandatory medical insurance Fund, and regional budgets.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):994-999
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About experience of developing concept of personnel policy in health care at the level of the subject of the Russian Federation
Gaidarov G.M., Makarov S.V.
Abstract
The personnel policy is one of priority areas of developing national health care. Its effective implementation requires evidence-based development of relevant program documents, the most important of which is the Concept of health care personnel policy that currently exists only in a number of regions of the Russian Federation. In this regard, the purpose of the study was to develop approaches to scientific justification and development of the Concept of health care personnel policy at the level of region of the Russian Federation, as exemplified in the Irkutsk oblast. The article describes progress of this large-scale and lengthy study, its main results included. The developed approaches resulted in comprehensive organizational technology of development corresponding Concept. The results of this experience can be implemented in other regions of the Russian Federation. Therefore, it is of scientific and practical interest for all potential developers of similar program documents and wide range of specialists in health care organization.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):1000-1005
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The carrier attitudes of graduates of medical university
Amlaev K.R., Koichueva S.M., Khripunova A.A.
Abstract
The article considers issues of professional orientation of future medical students. Their professional and career attitudes were identified. The percentage of students (19%) was determined who already at the stage of education have no plans to work in health care area, partly due to disappointment in their choice of profession. It is established that primary professional career paths for graduates of medical universities are admission to clinical residency (67%) and work in hospital. It is noted that the percentage of graduates wishing to work in private sector of medical services reached 20%. The respondents indicated among causes of problematic employment of graduated professionals lack of experience, lack of knowledge, low wages and overrated expectations of graduates themselves. It is recommended to improve quality of professional selection of applicants, to increase the degree of possession of practical skills and applied knowledge, to ensure increasing of accessibility of clinical residency training and to expand financial support of graduates of medical universities.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):1006-1010
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The restoration or formation? The post-war reform of the Soviet health care
Zatravkin S.N., Vishlenkova E.A.
Abstract
The article considers main directions of health care reform in the USSR during first post-war decades. The brief description of the state of health and health care in the USSR on the eve of the reform is presented. The main transformations implemented in 1945-1965 are adduced and analyzed. The corresponding impact on changes in medical demographic indices is demonstrated.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):1011-1016
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The penicillin support of medical institutions in the USSR during second half of 1940s
Sherstneva E.V.
Abstract
The article, on the basis of declassified archival documents, considers the issue of centralized state distribution of penicillin in the USSR in the second half of 1940s. The mechanism of determining the need in medication using special coefficient is presented. It is demonstrated that in conditions of acute shortage, this approach became an attempt to ensure physical accessibility of medication for patient. However, by the end of 1940s, when acute shortage was overcome, free state supplies created preconditions for mismanagement and misuse at national and local levels, that affected timing and volume of supplies of antibiotic to medical institutions, as well as quality of medication supplied to patient. The district hospitals of provincial towns occurred in the worst condition. The article presents the facts testifying that penicillin supply solved not only health problems, but also domestic and foreign policy problems of the post-war USSR.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):1017-1022
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The section of physician’s everyday life at the Pirogov Congresses.Report I. The problems of material and legal status of Russian physicians
Egorysheva I.V., Chalova V.V.
Abstract
The article is devoted to the history of organization and functioning of the section of physician everyday life at the sessions of the Congress of the Society of Russian Physicians in memory of N. I. Pirogov (Pirogov Society). The section, going beyond everyday life and occupational problems, considered issues related to economic and legal status of physicians. The section, having no hope in government assistance, tried to organize public organizations protecting interests and rights of physicians and loan-society as well.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):1023-1026
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The organizational forms of the Soviet Mongol cooperation in the area of medicine and health care in 1920s-1930s. Part I. Formation of two approaches
Bashkuev V.I., Ratmanov P.E.
Abstract
In 1920s - late 1980s, active cooperation between the USSR and Mongolia in the field of medicine and health care had been occurred. The Mongolian People's Republic was the first country to which the USSR exported its organization of health care system, using it as a means of geopolitical influence and instrument of the socialist transformation of traditional nomadic society. At the same time, assistance to Mongolia began when the USSR itself had not yet completed the organization of new health care system, including needed medical personnel and resources, receiving assistance from Germany and other European countries. The article discusses the reasons of the Soviet leadership's hasty decision to force assistance to the Mongolian People's Republic in the field of medicine and health care. Two approaches to its implementation are singled out and explained: the evolutionary one, when experienced Soviet doctors were selected and sent to the Mongolian Department of Health care, and the forced one - through organization of expeditions of the People's Commissariat of Health of the RSFSR, which simultaneously studied the medical and sanitary situation in the country and organized medical institutions where the assistance was needed the most.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):1027-1032
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The scientific practical input of academician N. O. Milanov in development of national plastic surgery: To the Seventieth anniversary
Stochik A.A.
Abstract
Nikolai Olegovich Milanov, the academician of the Russian Academy of Medical Sciences, leading Russian surgeon, Merited Scientist of the Russian Federation, is one of the pioneers of development of reconstructive microsurgery in our country. He made immense contribution to development of modern plastic and reconstructive microsurgery. He is the author of unique developments that inputted significantly into successive achievements in treatment of traumatic and iatrogenic tissue defects and congenital pathology. The priority areas of his research were replantation of fingers, hands and larger segments of limbs in adults and lower extremities in children, abjuncted because of wheeled traumas, auto-transplantation of revasculized tissue complexes in post-traumatic, congenital and acquired pathologies in adults and children, in oncologic diseases, in extensive tracheal defects, reconstructive microsurgery of blood and lymph vessels and peripheral nerves, reconstructive microsurgery in male and female infertility. He introduced to clinical practice great number of new surgical interventions based on micro-surgical auto-transplantation of various tissue complexes. He achieved brilliant successes in scientific and practical activities during 39 years of work. He was the first in the world who underwent a successful re-implantation of lower limb, amputated at the level of upper third of leg by train wheel in 2.5-year-old child. He also was the first surgeon who performed unique operation of simultaneous replantation of two limbs, amputated at the level of middle third of leg in 7-year-old child. N. O. Milanov used the micro-surgical technique of applying direct lymphatic venous anastomoses in lymphatic edema. He developed innovative methods of multiple transplantation of toes to hand and transplantation of omentum, for example, to close defects of the scalp in basal cell carcinoma. This brilliant surgeon can be called the founder of clinical auto-transplantology. He actively participated in resolving problem of “prefabrication” of various tissue complexes with desired properties for their subsequent auto-transplantation. Under the direction of N. O. Milanov, the new scientific school was formed that included such well-known surgeons as R. T. Adamyan, A. I. Nerobeev, I. V. Reshetov and many others.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):1033-1037
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The Kazan therapist Nikolai Andreevich Vinogradov (1831-1886) and his role in becoming of therapeutic clinic in Russia
Borodulin V.I., Albitcky V.I., Abrosimova M.I., Topoliansky A.V.
Abstract
The article highlights the course of life, scientific, pedagogical and social activities of Nikolai Andreevich Vinogradov, the eminent therapist of the XIX century and the disciple of S. P. Botkin.
Problems of Social Hygiene, Public Health and History of Medicine. 2020;28(5):1038-1042
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National research Institute of public health named after N. A. Semashko

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