О СОСТОЯНИИ ЗДРАВООХРАНЕНИЯ В РЕГИОНАХ СИБИРИ И ВЫПОЛНЕНИИ ПОСЛАНИЯ ПРЕЗИДЕНТА РОССИЙСКОЙ ФЕДЕРАЦИИ ФЕДЕРАЛЬНОМУ СОБРАНИЮ РОССИЙСКОЙ ФЕДЕРАЦИИ ОТ 12 ДЕКАБРЯ 2013 ГОДА

The aim of the study was to identify the key problems of regional health services in the Siberian Federal district and justification of the priority directions of their decision. For the first time using the method of expert estimations conducted a study of health problems in the Federal district, identified key issues, as well as justifies the priority directions of their decisions. The study was conducted on the basis of statistical materials of the health authorities of the regions of Siberian Federal district, as well as expert assessments. Identified key health issues and priorities of their decision. Based on the systematic work of the expert community and across government levels defined key for the regions of Siberia health problems and justify the priority directions of their solutions tailored to focus efforts in the social sphere, which will allow to coordinate policies in the health sector on the territory of the Siberian Federal district, which in turn, will increase its effectiveness.Целью исследования было определение ключевых проблем регионального здравоохранения в Сибирском федеральном округе (СФО) и обоснование приоритетных направлений их решения. Впервые с использованием метода экспертных оценок проведено изучение проблем здравоохранения в федеральном округе, выявлены ключевые проблемы, а также обоснованы приоритетные направления их решения. Исследование проведено на основе статистических материалов органов управления здравоохранением регионов СФО, а также экспертных оценок. Определены ключевые проблемы здравоохранения и приоритетные направления их решения. На основе системной работы экспертного сообщества и органов государственного управления разных уровней определены ключевые для регионов Сибири проблемы здравоохранения и обоснованы приоритетные направления их решения с учетом фокусных усилий в социальной сфере, что позволит скоординировать политику в сфере здравоохранения на территории СФО, что, в свою очередь, позволит повысить ее эффективность

СИНТЕЗ ДВОКООРДИНАТНОЇ СЛІДКУЮЧОЇ ЕЛЕКТРОМЕХАНІЧНОЇ СИСТЕМИ НА БАЗІ ДИСКРЕТНОГО ЧАСОВОГО ЕКВАЛАЙЗЕРА

The synthesis of two-coordinate servo system by the method of discrete time equalizer is carried out in this article. An inverse reference model of the control object with this approach is supplemented by a transfer function of typical dynamic link, which provides a modification of the structural schemes symmetry principle. It was found that the accuracy of the reference signal reproduction depends on the performance of discrete time equalizer and the error decreases by reduction of quantization period.У статті виконано синтез двокоординатної слідкуючої системи методом дискретного часового еквалайзера. Обернена еталонна модель об’єкта керування при такому підході доповнюється передатною функцією типової динамічної ланки, що забезпечує модифікацію принципу симетрії структурних схем. Встановлено, що точність відпрацювання сигналу завдання залежить від швидкодії дискретного часового еквалайзера і при зменшенні періоду квантування похибка зменшується

Вареная колбаса, обогащенная необходимыми питательными веществами для желудочно-кишечного тракта

The article has developed a formulation for cooked sausage enriched with deficient essential nutrients. В статье разработана рецептура вареной колбасы, обогащенная дефицитными необходимыми питательными веществами

DIAGNOSTICS AND SURGICAL TREATMENT OF DEEP VENOUS THROMBOSIS LOWER LIMBS AND PELVIS

OBJECTIVE. Based on our own experience and analysis of the literature, we want to demonstrate the features of diagnosis and treatment of ascending deep phlebothrombosis of the lower limbs and pelvis.MATERIAL AND METHODS. During the period from October 2008 to September 2016, in the First Clinic of Surgery (postgraduate medical education) of ”Military Medical Academy named after S. M. Kirov” we analyzed the results of treatment of 44 patients with this pathology. Selective surgical tactics was based on the evaluating of general status, activity of the patient, the presence of concomitant pathology, complications of the disease. Implantation of the cava-filter was performed in 23 patients. In active patients, without significant concomitant pathology, open thrombectomy operations were performed from the deep veins of the lower limbs or from the inferior vena cava and iliac veins (21 patients). In some of these patients, a removable cava-filter was implanted before thrombectomy (8 patients). Thrombectomy from the deep veins of the lower limbs was supplemented in 12 patients by the plication of the main vein.RESULTS. This tactic made it possible to achieve favorable results in the majority of patients (27 patients, 87 %) – there were no signs of recurrence of venous thromboembolic complications, there was complete or almost complete (more than 90 %) recanalization of thrombosed veins, venous insufficiency was limited by the presence of transient edema. Small hemorrhagic complications were noted in 2 patients. Relapses of venous thromboembolic complications occurred in a distant period in 3 patients. In order to prevent fatal pulmonary embolism, patients with ascending deep phlebothrombosis need surgical treatment.CONCLUSION. The choice of surgical treatment (cava filter implantation, deep vein thrombectomy) should be determined depending on the general status, patient activity, the presence of concomitant pathology, complications of the disease, and also individually in each specific clinical situation

The Effects of Telmisartan and Its Combinations on Office Blood Pressure: Results of Prospective Observational Study TAINA

Aim. To evaluate the effectiveness and safety of telmisartan, used in monotherapy or in combination with hydrochlorothiazide or amlodipine, in real clinical practice in patients with diagnosed arterial hypertension who have not reached the target levels of blood pressure (BP).Material and methods. The study was a non-intervention, prospective, multicenter, comparative, observational, epidemiological program, which was carried out in Russian medical institutions. The total patient population in which the prescribed therapy was administered included 1933 people (758 men and 1175 women, mean age 57.0-59.3 years). Participants were followed-up for 12 weeks. The change in office BP was evaluated on the 4th and 12th week.Results. Significant (p<0.001 in all cases) change in office BP compared with the initial data were recorded in all study groups of therapy already at 4 weeks of treatment and became even more pronounced at 12 weeks. In the telmisartan monotherapy group, BP decreased from 155.7±10.7/92.2±7.6 mm Hg to 131.4±12.1/80.8±7.3 mm Hg at the end of the 4th week and to 125.3±7.6/78.2±6.1 mm Hg – at the end of the 12th week. Similarly, after treatment with the combination of telmisartan and hydrochlorothiazide, BP decreased from 162.7±12.6/94.3±7.9 mm Hg to 133.2±12.5/81.6±8.4 mmHg at the end of the 4th week and to 126.0±7.8/78.4±6.7 mm Hg – at the end of the 12th week. In telmisartan/amlodipine group, a decrease in BP also occurred, from 162.5±13.2/94.6±8.6 mm Hg to 132.8±14.5/81.3±7.5 mm Hg on the 4th week and to 125.4±8.7/78.4±5.6 mm Hg at the end of follow up (12 weeks). The proportion of patients who reached the target BP (<140/90 mm Hg) after treatment with telmisartan as monotherapy was 91.7%, after treatment with telmisartan+hydrochlorothiazide – 89.6%, after treatment with telmisartan+amlodipine – 92.8%. Throughout the program, prescribed therapy was well tolerated by patients. During the study, 47 adverse events (AEs) were recorded in 36 patients: 31 AEs with telmisartan monotherapy, 5 AEs with telmisartan/hydrochlorothiazide combination, and 11 AEs with telmisartan/amlodipine combination. Most of the AEs registered during the trial resolved by the end of the study, in four cases the date of AEs resolve is unknown, in two cases, at the time of completion of the study, AEs continued.Conclusion. In the TAINA study a high antihypertensive efficacy and a comparable favorable safety and tolerability profile of telmisartan, used as monotherapy and in combination with hydrochlorothiazide or amlodipine was determined