CURRENT CLINICAL SCIENCE ISSUES
The obesity prevalence in children and adolescents is epidemic. We report two clinical cases of adolescent constitutional exogenous obesity. A patient with progressing obesity, complicated by dyslipidemia, diabetes mellitus type 2, proteinuria, polyneuropathy, arterial hypertension, steatohepatitis, multiple ulcers of stomach and disseminated hemorrhagic gastritis. Another patient with obesity, complicated with arterial hypertension, succeeded in body mass index normalization following recommendations on diet and physical activity.
The aim of the study was to evaluate efficiency anticoagulant therapy control in primary healthcare setting. The prospective, controlled study involved 301 patients with «non-valvular» atrial fibrillation, receiving various anticoagulant drugs in 2013–2015. After discharge the patients were advised to visit anticoagulant therapy control department. The risk of thromboembolic complications and the risk of bleeding were assessed with CHA2DS2VASc scale HAS-BLED, respectively. Major bleeding was assessed with TIMI scale. The time in therapeutic range for Warfarin was assessed for the patient taking warfarin. The study involved 301 patients with non-valvular atrial fibrillation taking anticoagulants: warfarin – 49 (16%), rivaroxaban – 34 (11%), apixaban – 81 (28%) and dabigatran –137 (45%). Minor bleeding was found in all groups. Large bleeding was found in patients receiving warfarin, dabigatran and rivaroxaban.
The paper describes a case of dengue virus and viral hepatitis A co-infection in a Russian male who traveled in Dominican Republic.
The increase in the endometrial hyperplasia prevalence in postmenopausal women calls for early diagnostics with non-invasive (pelvic ultrasound tests) and minimally invasive (office hysteroscopy, aspiration biopsy) methods. The Treatment and Diagnostic Department, F.M. Snegirev Clinic of Obstetrics and Gynecology did a complex study to optimize the diagnosis of endometrial pathologies in asymptomatic postmenopausal patients in primary health care setting. The study findings suggest that early diagnostics with non-invasive and minimally invasive methods in primary health care setting can reveal early pathological changes in uterine mucous membrane enabling timely and personalized treatment.
The present paper summarizes the literature and the facility experience on the effectiveness of anti-Candida therapy in HIV patients and suggests the ways of its optimization.
HEALTH MANAGEMENT
This article discusses the importance of competence building in managerial health care staff, and the development of appropriate competence building models (competence profiles). The authors did expert interviews of 16 professors of the organizational departments at Razumovsky Saratov State Medical University. We determined importance of the competencies presented in the State educational standard for «Health care organization and public health» programs for the department heads; deputy heads (vice-head) and head physicians (chiefs) of medical organizations, as well as what future graduates need «to know», «be able to» and «to have», i.e. formulated appropriate competence building models. These models can be used both to develop training programs and healthcare personnel policy.
The article discusses the training of students at the department of disease prevention and healthy lifestyle at a medical university.
The article discusses the standards of residency programs at a medical university, and in particular, the role and place of «Public health» in the base part of curriculum. The article analyzes the competences in the field of public health and health care in the residency programs in «Surgery», «Therapy» and «Transfusiology».The article proposes the list of topics within «Public health» program.
This article describes pharmacoeconomic analysis methods of which follow themodern requirements to this type of health technology assessment. Special attention is paid to the adaptation of pharmacoeconomic analysis methods to a specific nosology. The present paper demonstrates that each pharmacoeconomic study requires an individual approach, which takes into account both a specific disease peculiarities and the burden it poses on the patient, the community and the society.
DISEASE PREVENTION
The increasing level of medical waste generation jeopardizes sanitaryepidemiological and ecological wellbeing of metropilitan areas and urges new aproaches. The article presents an innovative medical waste management system for the Moscow region, that ensures the safety of staff, patients and the general public.
In the Russian Federation, cardiovascular diseases (CVD) accounts for about 57% of adult mortality. The aim of the study was to evaluate the CVD prevention effectiveness in the patients attending «Schools of Health» at Health Centers in Tula and the Tula region. The study analyzed the major risk factors in arterial hypertension (AH) patients in «Schools of Health» in 2014. The study findings suggest that the priority AH risk factors were increased body mass index, elevated total cholesterol level and low physical activity. The study demonstrated that education programs fo AH patients at «Schools of Health» in Tula and the Tula region can not only inform the raise public awareness about the disease, the AH key risk factors, a modern drug and non-drug AH therapy, but also improve patients' quality of life, prevent AH progression and reduce the risk of serious complications (e.g., stroke, myocardial infarction, etc.) which may result in disability and mortality in patients.
HISTORY OF MEDICINE
This article discusses the importance of competence building in managerial health care staff, and the development of appropriate competence building models (competence profiles). The authors did expert interviews of 16 professors of the organizational departments at Razumovsky Saratov State Medical University. We determined importance of the competencies presented in the State educational standard for «Health care organization and public health» programs for the department heads; deputy heads (vice-head) and head physicians (chiefs) of medical organizations, as well as what future graduates need «to know», «be able to» and «to have», i.e. formulated appropriate competence building models. These models can be used both to develop training programs and healthcare personnel policy.
ISSN 2658-3348 (Online)