Zdravookhranenie Rossiyskoy Federatsii

.002-003
THE CONDITIONS, OCCUPATIONAL SAFETY AND ON-THE-JOB TRAUMATISM IN RUSSIA
Izmerov N.F., Tikhonova G.I., Churanova A.N., Gorchakova T.Yu.

The research institute of occupational medicine of the Russian academy of medical sciences, Moscow
Abstract: In the Russian Federation, since 1990, the registered level of on-the-job traumatism is decreasing with high rate against the background of deteriorating labor conditions and labor safety. The article demonstrates that this decrease is conditioned to a considerable degree by industry accidents hiding fi rst and foremost the cases of light and mean severity. During last years, at the small-scale enterprises the rate of accidents with lethal outcomes was 2.4-3.2 times higher as compared with large-scale and mean-scale enterprises. In particular types of economic activity the sixth time exceeding was achieved that indicates the worsened labor conditions and work safety in small business. Based on the International Labor Organization adapted technique «Evaluation of validity of statistics data of on-the-job traumatism in the countries with incomplete registration» the probable total numbers of injured persons in Russia under various hypotheses were assessed. It is demonstrated that among causes of inadequate registration of on-the-job accidents a signifi cant place belongs to the labor legislation which does not promote objective and full registration of on-the-job traumatism.
Keywords: условия труда, уровень производственного травматизма, малые предприя- тия, методика МОТ по оценке достоверности статистики производствен- ного травматизма, labor conditions, on-the-job traumatism, minor enterprise, International Labor Organization, evaluation of validity of statistics, Array

.002-008
THE APPROACHES TO MEASUREMENT AND THE TOOLS OF ASSESSMENT OF SCIENTIFI C INNOVATIVE ACTIVITIES POTENTIAL
Vyalkov A.I., Glukhova E.A., Potyemkin E.L.

The research institute of public health and health management of The I.M. Sechenov fi rst Moscow medical university, Moscow
Abstract: The article deals with study of the essence of scientifi c innovative activities potential at the level of research (medical) organization. The defi nition of the notion and the analysis of the structure of potential are given. The requirements and the empirical system of indicators to evaluate the potential are developed. The approaches to measurement are considered including instruments to evaluate potential of research innovative activities at the level of organization to function successfully and to support a stable concurrent advantage.
Keywords: научная (медицинская) организация, интеллектуальные ресурсы, научно-ин- новационный потенциал, система сбалансированных показателей оценки, менеджмент качества потенциала, research (medical) organization, intellectual resource, scientifi c innovative potential, system of balanced evaluation indicators, quality management of potential

.002-011
THE QUALITY OF CODING THE CAUSES OF DEATH BECAUSE OF DIABETES MELLITUS IN RUSSIA
Sabgayda T.P., Roshchin D.O., Sekryeru E.M., Nikitina S.Yu.

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Abstract: The article analyzes the causes of death of population of Russia in 2010. The purpose of study consisted in analysis of rate of diabetes-associated and unspecifi ed diagnoses of death because of diabetes mellitus to establish the sources of possible underestimation of mortality during its registration. It is demonstrated that under recoding of diabetes-associated causes the indicator of population mortality because of diabetes mellitus increased 2.6 times among males and 1.6 times among females. Such an underestimation of mortality level is explained by inadequate competence of medical professionals concerning the rules of coding of death causes. The percentage of unspecifi ed diagnoses of death because of diabetes mellitus consists 13.1% cases of death of males and 14% cases of death of females. This situation is explained by inadequate intravital examination of the deceased and careless attitude to diagnostics of death causes.
Keywords: недоучет смертности от сахарного диабета, коды причин смерти, не- уточненные причины смерти, качество кодирования причин смерти, лица, устанавливающие причину смерти, первоначальная причина смерти, диа- бетассоциированные причины, Array

.002-015
ON THE CAUSES OF DEATH OF FOR THE FIRST TIME IDENTIFI ED PATIENTS WITH LUNG TUBERCULOSIS
Tzybikova E.B.

ФГБУ Центральный НИИ организации и информатизации здравоохранения, Москва
Abstract: In Russia, the spreading of tuberculosis associated with HIV-infection resulted in signifi cant alterations in the structure of causes of death of for the fi rst time identifi ed patients with lung tuberculosis. The percentage of patients with lung tuberculosis died because of HIV-infection reached 23.4% in 2010. This situation resulted in decreasing of indicators of mortality because of tuberculosis and in simultaneous increasing of indicator of mortality because of HIV-infection.
Keywords: туберкулез, ВИЧ-инфекция, коинфекция, смертность, корреляционный анализ, tuberculosis, HIV-infection, coinfection, mortality, correlation analysis

.002-019
THE GUILLAIN-BARRÉ SYNDROME IN CITIES OF THE RUSSIAN FEDERATION: EPIDEMIOLOGY,DIAGNOSTIC AND THERAPEUTIC POSSIBILITIES OF REGIONAL POLYCLINICS
Suponeva N.A., Piradov M.A., Gnedovskaya E.V.

The research center of neurology of the Russian academy of medical sciences, Moscow
Abstract: The Guillain-Barré syndrome is a disease of nervous system demanding the application of complex of intensive therapy including artifi cial ventilation of lungs. The analysis was applied to the data of hospital register (2010) of 49 hospitals in 28 cities of the Russian Federation. The Guillain-Barré syndrome morbidity in 7 cities and 2 subjects of the Russian Federation consisted from 0.34 to 2.5 of 100 000 of population. In 92% of hospitals less than one patient with The Guillain-Barré syndrome (M=4) was treated. The possibilities of 94% clinics are at the suffi ciently high level in respect of diagnostics of The Guillain-Barré syndrome. In therapy, the preference is given to plasmapheresis (87%), but in 51% of clinics the discrete technique is applied not allowing removing needed volumes of plasma. Regardless of international recommendations, the steroids are continuing to be applied. The experience of immunotherapy has 86% of clinics, but in 48% of them the choice of pharmaceuticals is erroneous because of application of medicines with low content of IgG. The medical care to patients with the Guillain-Barré syndrome is not rendered only in 10% of hospitals. This situation causes the hospitalization in these medical institutions of patients only with moderate severity of disease at the stage of regression of symptomatic. The patients with severe forms can be hospitalized in 84% of hospitals but in every third of these hospitals the pathogenic therapy is provided in insuffi cient volume. The clinics have no high-dose intravenous immunoglobulins or apply plasmapheresis using discrete technique. The full-fl edged care in case of severe forms The Guillain-Barré syndrome can be rendered only in 62% of hospitals. The modes are proposed to enhance the quality of medical care under this rare disease associated with benevolent prognosis.
Keywords: синдром Гийена—Барре, Российская Федерация, заболеваемость, лечение, возможности больниц, качество медицинской помощи, The Guillain-Barré syndrome, the Russian Federation, morbidity, treatment, possibilities of hospitals, quality of medical care

.002-025
THE CRITERIA OF SELECTION OF PATIENTS WITH PATHOLOGY OF LOCOMOTOR APPARATUS TO PROVIDE HIGH-TECH MEDICAL CARE
he Saratov research institute of traumatology and orthopedics of Minzdrav of Russia T, aratov S, Array Array

The Saratov research institute of traumatology and orthopedics of Minzdrav of Russia, Saratov
Abstract: The article deals with the results of analysis of primary documentation from 24 regions of the Russian Federation concerning patients in need of big joints replacement arthroplasty. The total sampling included 3185 packages of medical documents. The analyzed documents included 23% without any defects. The criteria of selection of patients for total replacement arthroplasty are proposed to optimize the medical care.
Keywords: патология опорно-двигательного аппарата, высокотехнологичная меди- цинская помощь, критерии отбора, pathology of locomotor apparatus, high-tech medical care, criteria of selection

.002-028
THE SYSTEM ANALYSIS OF FACTORS IN PUBLIC HEALTH
Karyakin N.N., Mukhin P.V.

The Nizhny Novgorod research institute of traumatology and orthopedics of Minzdrav of Russia, Nizhny Novgorod
Abstract: The article contends that the modernization of public health in Russia consists not only in equipping the medical institutions with medical technologies, construction and reconstruction of buildings but fi rst of all it provides the structural reorganization i.e. reapportionment of powers between the authority levels and with their concentration at the regional level. The indicators of mortality due to public health causes and primary morbidity are established as the main criteria of effectiveness of public health system. The applied analysis revealed the statistically signifi cant relationships between mortality and level of fi nancing. The relationship between mortality and morbidity was not established. The close correlation between level of hospitalization and number of hospital beds was established. These results testify in favor of ineffective occupation of bed capacity.
Keywords: организация здравоохранения, модернизация, смертность, заболеваемость, ресурсы здравоохранения, public health, modernization, mortality, morbidity, public health resources

.002-031
THE METHODOLOGICAL AND IDEOLOGICAL APPROACHES TO HYGIENIC TRAINING AND ANTINARCOTIC EDUCATION IN COMPREHENSIVE SECONDARY SCHOOLS
Lyakhovich A.V., Lozovskaya A.S.

The Research Institute for Health Organization and Informatics of Minzdrav of Russia, Moscow
Abstract: The increase of level of prevalence of drug abuse in school environment dictates the necessity of activation of counterdrug policy in the conditions of comprehensive secondary school. The effective programs of preservation and promotion of students’ health are demonstrated. The methodological and ideological principles of implementation of these activities in education process using modern educational technologies are considered.
Keywords: школьники, общеобразовательная школа, гигиеническое обучение и воспи- тание, ПАВ, методологические принципы, идеология профилактики, меди- ко-педагогическая деятельность, типологизация аудиторий, здоровьесбе- регающие технологии, компьютерная обучающая с тестированием знаний программа профилактики ПАВ, students, comprehensive secondary school, ideology of prevention, hygienic training and education, methodological principles, medical pedagogical activity, typologization of auditorium, health-preserving technologies, computer educational program with prevention knowledge testing

.002-036
THE EVALUATION OF IMPACT OF EDUCATION IN "THE ASTHMA SCHOOL" UPON THE QUALITY OF LIFE OF CHILDREN WITH BRONCHIAL ASTHMA
Lyapunova E.V., Popova I.V., Tokarev A.N., Belyakov V.A.

The Kirov state medical academy of Minzdrav of Russia, Kirov
Abstract: Then article deals with the results of study of quality of life in 40 children aged 12-16 years having bronchial asthma. The mean age consisted 14.7±0.55 years. The children were separated on two groups. The fi rst group (n=40) went through education in "The asthma school" and second group was monitored in polyclinic. The quality of life of patients assessed by the survey results using the adapted questionnaire CAQ C prior to education and three months after educational course. It is demonstrated that the education in "The asthma school" impacts the course of disease, promotes the decrease of rate of attacks, increases the quality of life of patients, as compared with children who did not educated in "The asthma school".
Keywords: дети, бронхиальная астма, Астма-школа, качество жизни, children, bronchial asthma, the asthma school, quality of life

.002-040
THE STATE AND DYNAMICS OF HEALTH OF CHILDREN VISITING PRESCHOOL EDUCATIONAL INSTITUTIONS
Shestakov G.S., Baysultanov I.Kh.

The I.M. Sechenov fi rst Moscow medical university, Moscow The Gudermes central district hospital, Gudermes
Abstract: The article deals with actual approaches to the estimation of resource support of he acute medical care station of municipality in rural area. This is a complicated task because of differences between districts ofservice, level of appealability and other factors. These characteristics demand to develop new methods of management of acute medical care station and to assess its activities.
Keywords: станция скорой медицинской помощи, ресурсное обеспечение, управление и оценка деятельности, acute medical care station, resource support management, assessment of activities

.002-042
THE ACTUAL ISSUES OF THE RESOURCE SUPPORT AND OPTIMIZATION OF MANAGEMENT OF THE ACUTE MEDICAL CARE STATION OF MUNICIPALITY IN RURAL AREA
Shestakov G.S., Baysultanov I.Kh.

The I.M. Sechenov fi rst Moscow medical university, Moscow The Gudermes central district hospital, Gudermes
Abstract: The article deals with actual approaches to the estimation of resource support of he acute medical care station of municipality in rural area. This is a complicated task because of differences between districts of service, level of appealability and other factors. These characteristics demand to develop new methods of management of acute medical care station and to assess its activities.
Keywords: станция скорой медицинской помощи, ресурсное обеспечение, управление и оценка деятельности, acute medical care station, resource support management, assessment of activities

.002-045
THE EXPERIENCE OF APPLICATION OF MEDICAL AND ORGANIZATIONAL INNOVATIONS IN THE RYAZAN OBLAST CLINICAL PERINATAL CENTER
Petrova E.I., Mikityuk E.N., Karausheva L.E., Efanova L.V.

The Ryazan oblast clinical perinatal center, Ryazan
Abstract: The article deals with the primary results of implementation of technological, organizational and medical innovations into the Ryazan oblast clinical perinatal center activities. This implementation provides the opportunity to enhance the quality and availability of medical care provided in Ryazan oblast to pregnant women mainly of group of higher obstetric risk. The newborns including delivered infants with extremal low body mass (up to 1000 g) and patients with reproductive health problems are also involved.
Keywords: инновации в родовспоможении и неонатологии, мониторинг беременных высокой группы акушерского риска, проблемы репродуктивного здоровья, innovation, obstetrics, neonatology, monitoring, pregnant woman, group of higher obstetric risk, reproductive health

.002-049
ABOUT THE ISSUE OF INTENSIFI CATION OF BED STOCK OF MULTI-TYPE CHILDREN HOSPITAL
Prytyko A.G., Prytyko D.A.

The Moscow research practical center of children medical care, Moscow
Abstract: The article presents the data concerning the experiments of Minzdrav of USSR targeted to the intensifi cation of bed stock. The costs of reducing period of stay of patients in hospitals over two years consisted 6.9 million of rubles (in prices of 1986-1988) and period of stay reduced to 1.5 bed-days. In children hospitals, the results of several clinical tests of medicinal treatment with involved laser therapy are presented. With minimal costs of purchase of national laser devices the period of stay of children in hospitals reduced at the average to 4-6 days. The higher effectiveness and safety of laser therapy in pediatrics is mentioned.
Keywords: интенсификация коечного фонда в педиатрии, лазерная терапия, intensifi cation, bed stock, pediatrics, laser therapy

.002-052
THE REMARKABLE AND JUBILEE DATES OF HISTORY OF PUBLIC HEALTH OF RUSSIA IN 2013
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.002-055
ABOUT THE ISSUE OF ORGANIZATION OF DIAGNOSTICS OF NEOPLASMS OF SPHENOIDAL SINUS
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Первый МГМУ им. И. М. Сеченова, Array
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Keywords: клиновидная пазуха, новообразования, опухоли, эндоскопическая эндоназаль- ная хирургия, эндоскопическая эндоназальная биопсия, КТ, МРТ, трансэт- моидальная сфеноидотомия, трансназальная сфеноидотомия, sphenoidal sinus, neoplasms, tumors, endoscopic surgery, endoscopic endonasal biopsy, computerized axial tomography, magnetic resonance imaging, trans-ethmoidal sphenoidotomy, transnasal sphenoidotomy