EXPERIENCE OF ORGANIZATION OF PERIODICAL MEDICAL EXAMINATIONS WITH USING MOVABLE CLINICAL DIAGNOSTIC LABORATORIES

The expediency of introducing the system of movable clinical diagnostic laboratories for well-timed medical service of high quality for workers with high level of occupational risk has been grounded in this work, the efficiency of their activity in carrying out obligatory medical examinations of workers of harmful occupations in the period of making the home system of obligatory insurance against accidents in industry and occupational disease has been proved

THE PROBLEMS OF OCCUPATIONAL PATHOLOGY AND REHABILITATION TREATMENT OF WORKERS WORKING AT HARMFUL CONDITIONS OF LABOR

It is necessary to create the low of RF (the Decree of the government of RF) which will clearly define the order of organization and carrying out medical examinations of workers of harmful occupations and. their financing. For the organizations of prevention of occupational diseases and. medical rehabilitation of patients with occupational diseases during working out the order of financial security of preventive measures for reducing occupational diseases. It is necessary: to include into the list of preventive measures profound medical examinations of workers in the centres of occupational pathology, rehabilitation treatment of workers from the group of "risk" and patients with initial displays of occupational diseases in the centres of occupational pathology (rehabilitation centres); to insert the changes into the Federal Law no 125-03, supplementing the list of kinds of financial security for insurance of medical rehabilitation of the insured patients in the centres of occupational pathology (the centres of rehabilitation); to include into the Federal programme of compulsory medical insurance occupational pathology help

PECULIARITIES OF OCCUPATIONAL ILLNESS FORMATION IN ROSTOV REGION

The data base on occupational illness in Rostov region in 2002—2011 has been formed. Branch and occupational structure and. dynamics of relative indices of occupational illness with the economics branch consideration have been analysed. The tendency of reducing occupational illness indices in Rostov region has been revealed, it being caused by incomplete revealing the patients with occupational illness. Coal mining industry, in which the high level of occupational illness is caused by the extremely unfavourable conditions of labor, is an exception. It is necessary to increase the efficiency of periodical medical examinations, especially for agricultural workers, in order to reveal the real level of occupational illness

ESTIMATION OF THE EFFICIENCY OF MEDICAL REHABILITATION OF PATIENTS WITH OBSTRUCTIVE DUST BRONCHITIS

Проведен ретроспективный анализ 200 историй болезни больных пылевым обструктивным бронхитом получавших одинаковые комплексы медикаментозного и восстановительного лечения. Выявлены наиболее динамичные клинико-функциональные и лабораторные показатели. Разработаны критерии эффективности медицинской реабилитации

Randomized Controlled Parallel-Design Clinical Study of the Efficacy and Safety of Intranasal Interferon gamma in Treatment of Influenza-Like Infections

Background: Influenza is a highly variable infection that can cause fatal complications. Universal approaches, such as general stimulation of the immune system to activate its natural antiviral capacities, seem to be a rational measure. Methods: A total of 410 patients with influenza-like infections (ILI) were randomly assigned to one of three treatment groups and one control group. Interferon gamma (IFN-γ) was administered by intranasal introduction of 1 to 3 drops into each nostril 5 times per day daily for 5 days. The first dose of investigational medicine was given within 48h of the onset of the influenza-like symptoms. One drop of the solution contains 1,000 IU of active substance. All patients received basic complex therapy without any antiviral or immunomodulating agents. The patients were followed up for 7 days. Treatment efficacy was evaluated by the mean duration of symptoms (MDS), the period of viral antigen detection (VAD) measured after 1-2 and 4-5 days of treatment, and the incidence of complications. We used conventional indicators to evaluate the safety of IFN-γ in the treatment of ILI. Results: The administration of 2 or 3 drops of IFN-γ in each nasal passage led to better outcomes manifested in the considerable (P<0.05) reduction of all acute respiratory symptoms, and therefore to a more rapid recovery. In these treatment groups, statistically significant decreases for MDS values, VAD period, and incidence of complications were registered. Intranasal IFN-γ in complex therapy of ILI was considered to be well tolerated and safe

The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Worldwide, both the incidence and death rates of pancreatic cancer are increasing. Evaluation of pancreatic cancer burden and its global, regional, and national patterns is crucial to policy making and better resource allocation for controlling pancreatic cancer risk factors, developing early detection methods, and providing faster and more effective treatments. Methods: Vital registration, vital registration sample, and cancer registry data were used to generate mortality, incidence, and disability-adjusted life-years (DALYs) estimates. We used the comparative risk assessment framework to estimate the proportion of deaths attributable to risk factors for pancreatic cancer: smoking, high fasting plasma glucose, and high body-mass index. All of the estimates were reported as counts and age-standardised rates per 100 000 person-years. 95% uncertainty intervals (UIs) were reported for all estimates. Findings: In 2017, there were 448 000 (95% UI 439 000\u2013456 000) incident cases of pancreatic cancer globally, of which 232 000 (210 000\u2013221 000; 51\ub79%) were in males. The age-standardised incidence rate was 5\ub70 (4\ub79\u20135\ub71) per 100 000 person-years in 1990 and increased to 5\ub77 (5\ub76\u20135\ub78) per 100 000 person-years in 2017. There was a 2\ub73 times increase in number of deaths for both sexes from 196 000 (193 000\u2013200 000) in 1990 to 441 000 (433 000\u2013449 000) in 2017. There was a 2\ub71 times increase in DALYs due to pancreatic cancer, increasing from 4\ub74 million (4\ub73\u20134\ub75) in 1990 to 9\ub71 million (8\ub79\u20139\ub73) in 2017. The age-standardised death rate of pancreatic cancer was highest in the high-income super-region across all years from 1990 to 2017. In 2017, the highest age-standardised death rates were observed in Greenland (17\ub74 [15\ub78\u201319\ub70] per 100 000 person-years) and Uruguay (12\ub71 [10\ub79\u201313\ub75] per 100 000 person-years). These countries also had the highest age-standardised death rates in 1990. Bangladesh (1\ub79 [1\ub75\u20132\ub73] per 100 000 person-years) had the lowest rate in 2017, and S\ue3o Tom\ue9 and Pr\uedncipe (1\ub73 [1\ub71\u20131\ub75] per 100 000 person-years) had the lowest rate in 1990. The numbers of incident cases and deaths peaked at the ages of 65\u201369 years for males and at 75\u201379 years for females. Age-standardised pancreatic cancer deaths worldwide were primarily attributable to smoking (21\ub71% [18\ub78\u201323\ub77]), high fasting plasma glucose (8\ub79% [2\ub71\u201319\ub74]), and high body-mass index (6\ub72% [2\ub75\u201311\ub74]) in 2017. Interpretation: Globally, the number of deaths, incident cases, and DALYs caused by pancreatic cancer has more than doubled from 1990 to 2017. The increase in incidence of pancreatic cancer is likely to continue as the population ages. Prevention strategies should focus on modifiable risk factors. Development of screening programmes for early detection and more effective treatment strategies for pancreatic cancer are needed. Funding: Bill &amp; Melinda Gates Foundation

DNA STRUCTURE, REPLICATION AND GENOME VARIABILITY CORRELATION

The study of special features of a new molecular DNA structure synthesis based on the fact that monomers transpositions can occur in the backbone of polymer chains according to the mathematical law known as a Fibonacci numerical series and «the Golden ratio» was performed. The example of the formation of a new DNA model demonstrates that there are dimers of three types in DNA structure: • Dimers with phosphodiester bond P-O-C, [(s-p) + (s-p)]; [(p-s)+(p-s)]; • Dimers with phosphatic bond P-O-P, [(s-p) + (p-s)]; • Dimers with glycosidic bond C-O-C, [(p-s)+(s-p)]. Dimers of the [(s-p) + (p-s)] type are of special importance for the process of replication. For example, if an enzyme catalyst (DNA polymerase) interacts in the backbone of matrix thread with a dimer of [(s-p) + (p-s)] type during the replication process it leads to a thread break. The growth of the daughter thread does not occur until the enzyme catalyst finds the transition point to another matrix thread of DNA, which contains in its backbone monomers similar to those, necessary for the activity of the given DNA polymerase. Thus, during the process of replication the genetic material is redistributed in the cell, and each daughter thread gets the information about genes belonging to both matrix threads of DNA molecule. This pattern of cell genome changing may manifest itself in phenotype or genotype of the body in different ways

PHARMACOECONOMIC ANALYSIS OF THE IMPACT ON THE BUDGET COSTS OF ADDING DEXMEDETOMIDINE (DEXDOR) INTO THE LIST OF VITAL AND ESSENTIAL DRUGS

Analysis of  four pharmacoeconomic replacement models for  midazolam, propofol and  phentanyl with dexmedetomidine for sedation in resuscitation and intensive care unit (RICU) shows increase of the annual costs (at current prices) by 14-28 million rubles (at prices of the reference country – by 9-23 million rubles). The calculation of the RICU stay cost in the rates of the health care providers rather than in that of the Compulsory Health Insurance (CHI) effects a saving of up to 1 billion rubles at current prices and up to 3.5 billion rubles at prices of the reference country

ФАРМАКОЭКОНОМИЧЕСКИЙ АНАЛИЗ ВЛИЯНИЯ НА БЮДЖЕТНЫЕ РАСХОДЫ ВКЛЮЧЕНИЯ ДЕКСМЕДЕТОМИДИНА (ДЕКСДОР) В СПИСОК ЖИЗНЕННО НЕОБХОДИМЫХ И ВАЖНЕЙШИХ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ

Analysis of  four pharmacoeconomic replacement models for  midazolam, propofol and  phentanyl with dexmedetomidine for sedation in resuscitation and intensive care unit (RICU) shows increase of the annual costs (at current prices) by 14-28 million rubles (at prices of the reference country – by 9-23 million rubles). The calculation of the RICU stay cost in the rates of the health care providers rather than in that of the Compulsory Health Insurance (CHI) effects a saving of up to 1 billion rubles at current prices and up to 3.5 billion rubles at prices of the reference country. Анализ четырёх фармакоэкономических моделей замены дексмедетомидином мидазолама, пропофола и фентанила для седации в отделении реанимации и интенсивной терапии (ОРИТ) показывает увеличение годовых расходов (при нынешних ценах) на 14-28 млн руб. (при ценах референтной страны - на 9-23 млн руб.). Расчёт стоимости пребывания в ОРИТ по тарифам не ОМС, а медучреждений даёт экономию до 1 млрд руб. при нынешних ценах и до 3,5 млрд руб. - при ценах референтной страны