ESTIMATION OF AN EPIDEMIOLOGICAL SITUATION ON DIPHYLLOBOTHRIASIS IN PERM KRAI

The article reviews the problems of prevalence of diphyllobothriasis in Perm. Krai. The territories of risk on the diphyllobothriasis morbidity are revealed

Объективизация оценки качества труда и материального стимулирования медицинского персонала в стационаре

We propose and substantiate criteria of objective assessment of quality of work of medical staff in a hospital facility in order to restrict a length of inpatient treatment, to improve work of a doctor and a whole department and to achieve adequate material stimulation and appropriate wages. The criteria consider economic, medical and social aspects, allow computerized analysis of a doctor's and a department work, systematic analysis on clinical conferences and disclosure of factors worsening the quality of inpatients treatment.В статье предложены и обоснованы критерии объективной оценки качества работы медицинского персонала стационарного лечебно-профилактического отделения с целью сокращения сроков стационарного лечения, улучшения работы конкретного врача и отделения в целом, а также с целью оптимизации адекватного материального стимулирования и соответствующей качеству работы оплаты труда. Критерии учитывают экономические и медико-социальные аспекты и позволяют производить компьютерный анализ деятельности конкретного врача и отделения, при систематическом анализе на врачебных конференциях выявлять факторы, отрицательно влияющие на качество стационарного лечения больных

Characteristic of water of the Lena River and health of the population of the Republic of Sakha (Yakutia)

In the article results of sanitary epidemiological characteristics of water of the Lena River, including on indicators of parasitic safety and physiological full value are analysed. It is established that the adverse effect of water of a water source on health of the population is connected with its physiological inferiority which is caused by the low maintenance of a number of biologically active elements. The received value of factor of "utility of water» in 47 times below recommended value

Создание и устойчивое развитие специализированных центров как способ повышения качества медицинской помощи

Quality of care is evaluated on the completeness of the survey, the correct diagnosis, treatment efficacy, and its duration. Improving the quality and efficiency of medical care for children with paroxysmal disorders of consciousness is one of topical problems of neurology.Aim. The aim of the work is to justify the relationship between improving the quality of health care and sustainable development in the modern conditions of specialized medical centers on the example of the work on the identification and treatment of children with paroxysmal disorders of consciousness of the Center for diagnosis and treatment of epilepsy, and sleep disorders in children and adolescents at the department neurology, neurosurgery and medical genetics SPbGPMU.Materials and methods. For more accurate diagnosis and treatment at the Center conducted a comprehensive examination, including video-EEG оf 527 children aged 1 month to 18 years. A clinical trial study included medical cases, assessment of neurological and somatic status, the study of seizure types and forms of the disease. Instrumental methods of examination were determined by EEG and MRI studies of the brain.Main results. Comprehensive survey of sick children with monitoring video-EEG revealed that 317 children (60,1%) had epileptic paroxysms and 210 children (39,8%) – non-epileptic paroxysms. Correction treatment was performed in 284 (89,5%) children with epileptic paroxysms and altered the treatment in 190 (90,4%) children with epileptic paroxysms.Conclusion. The presented clinical data show the high effectiveness of the Centre in the diagnosis and treatment of children with paroxysmal disorders of consciousness. The accumulated experience in the Center confirms the relevance of the creation of the structure of scientific and educational institutions specialized centers in which patients will be given to high-quality medical care.Качество медицинской помощи оценивается по полноте обследования, правильности постановки диагноза, эффективности терапии и ее продолжительности. Повышение качества и эффективности медицинской помощи детям с пароксизмальными расстройствами сознания является одной из актуальных проблем неврологии.Цель исследования – обоснование взаимосвязи между повышением качества медицинской помощи и устойчивостью развития в современных условиях специализированных медицинских центров на примере работы по выявлению и лечению детей с различными пароксизмальными нарушениями сознания в Центре по лечению эпилепсии и нарушений сна у детей и подростков.Материал и методы. Для уточнения диагноза и назначения лечения в Центре проведено комплексное обследование, включающее видеоэнцефалографию (видео-ЭЭГ) 527 детей в возрасте от 1 мес до 18 лет. Клиническое исследование больных включало изучение анамнеза заболевания, оценку неврологического и соматического статуса, изучение типа приступов и формы заболевания. При инструментальных методах обследования определялись показатели ЭЭГ и магнитно-резонансной томографии (МРТ) головного мозга.Результаты. Комплексное обследование больных детей с проведением мониторинга видео-ЭЭГ позволило установить, что 317 детей (60,1%) имели эпилептические пароксизмы и 210 детей (39,8%) – неэпилептические пароксизмы. Коррекция лечения проведена у 284 (89,5%) детей с эпилептическими пароксизмами, и изменено лечение у 190 (90,4%) детей с неэпилептическими пароксизмами.Заключение. Представленные клинические данные свидетельствуют о высокой эффективности используемых в Центре методов диагностики и лечения детей с пароксизмальными расстройствами сознания. Накопленный в Центре опыт подтверждает актуальность создания в структуре научно-образовательных учреждений специализированных центров, в которых пациентам будет оказываться качественная медицинская помощь

Creating and sustainable development of specialized centers as a way to improve quality of medical care

Quality of care is evaluated on the completeness of the survey, the correct diagnosis, treatment efficacy, and its duration. Improving the quality and efficiency of medical care for children with paroxysmal disorders of consciousness is one of topical problems of neurology.Aim. The aim of the work is to justify the relationship between improving the quality of health care and sustainable development in the modern conditions of specialized medical centers on the example of the work on the identification and treatment of children with paroxysmal disorders of consciousness of the Center for diagnosis and treatment of epilepsy, and sleep disorders in children and adolescents at the department neurology, neurosurgery and medical genetics SPbGPMU.Materials and methods. For more accurate diagnosis and treatment at the Center conducted a comprehensive examination, including video-EEG оf 527 children aged 1 month to 18 years. A clinical trial study included medical cases, assessment of neurological and somatic status, the study of seizure types and forms of the disease. Instrumental methods of examination were determined by EEG and MRI studies of the brain.Main results. Comprehensive survey of sick children with monitoring video-EEG revealed that 317 children (60,1%) had epileptic paroxysms and 210 children (39,8%) – non-epileptic paroxysms. Correction treatment was performed in 284 (89,5%) children with epileptic paroxysms and altered the treatment in 190 (90,4%) children with epileptic paroxysms.Conclusion. The presented clinical data show the high effectiveness of the Centre in the diagnosis and treatment of children with paroxysmal disorders of consciousness. The accumulated experience in the Center confirms the relevance of the creation of the structure of scientific and educational institutions specialized centers in which patients will be given to high-quality medical care

Opposite roles of metastasin (S100A4) in two potentially tumoricidal mechanisms involving human lymphocyte protein Tag7 and Hsp70

We compare the physical and functional interactions between three widespread multifunctional proteins [metastasin (Mts1/S100A4), innate immunity-related Tag7/PGRP-S, and Hsp70] in two experimental models relevant to host–tumor relationships on humoral and cellular levels. (i) Tag7 and Hsp70 in solution or in a lymphocyte make a stable binary complex that is highly cytotoxic for some tumor cells. Here, we show that Mts1 prevents Tag7·Hsp70 assembly in solution, and an excess of Mts1 disrupts the existing Tag7·Hsp70 complex; accordingly, Tag7·Hsp70 cytotoxicity (exemplified with L929 cells) is diminished in the presence of excess Mts1. (ii) Tag7 exposed on a specialized subset of lymphokine-activated killer cells makes specific contact with Hsp70 exposed on some HLA-negative tumor cells, thus enabling FasL/Fas-mediated induction of apoptosis. Here, we show that some CD4+CD25+ cells coexpose Mts1 with Tag7 and FasL, that Mts1 and Tag7 closely contact the same Hsp70 molecule on the target K562 cell (as evidenced by cross-linking), and that killing of such targets is abolished by Mts1-specific antibodies (or selective removal of Mts1-exposing lymphocytes). Thus, this phenotype active against immunoevasive cancerous cells is defined as CD4+CD25+, FasL+, Tag7+Mts1+ (≈0.5% of total lymphocytes in culture). Remarkably, similar effectors with at least the same activity are often found in fresh donor blood samples (≈104 effectors/mL). Thus, our models suggest that interactions between the three proteins in different situations may have opposite functional outcomes as regards antitumor defense, immune escape, and metastasis