Оказание медицинской помощи пациентам с акне. Результаты экспертизы качества медицинской помощи

Goal. To obtain information on typical errors in medical aid rendered to acne patients in dermatovenerology dispensaries in St. Petersburg in order to develop measures to improve the quality of medical aid rendered to this group of patients. Materials and methods. The authors conducted a special expert examination of 55 patients with acne who received treatment at St. Petersburg dermatovenerology dispensaries in 2013. The quality of medical aid was assessed using the Automated Expert Examination Technique (hereinafter referred to as AEET). Major results. The percentage of cases when medical aid of due quality was rendered to acne patients was 49%. Treatment and diagnostics errors prevailed in the structure of errors in medical aid. Errors in treatment were mainly a wrong combination of drugs, simultaneous administration of external and systemic antibacterial drugs, delayed comedolytic therapy and pathogenically infeasible therapy. Errors in diagnostics included absence of indications of the form and/or severity of acne. The most important error in the collection of information was absence of gynecology examinations for women to determine whether peroral contraceptives were necessary including in case of the administration of isotretinoin. Conclusion. The similarity of errors in medical aid rendered for acne as well as high percentage of errors relating to medical aid rendered to patients demand the development of consistent measures to improve the quality of medical aid rendered to such patients and repeated expert examination using preliminary (prompt) control of the quality of medical aid.Цель. Получение информации о типичных ошибках оказания медицинской помощи пациентам с акне в кожно-венерологических диспансерах (КВД) Санкт-Петербурга для разработки мер, направленных на улучшение качества медицинской помощи (КМП) данной группе пациентов. Материал и методы. Проведена тематическая экспертиза КМП 55 наблюдений пациентов с акне, которые получали лечение в КВД Санкт-Петербурга в 2013 г. Изучение КМП проводилось с применением Автоматизированной технологии экспертизы КМП. Результаты. Доля случаев оказания медицинской помощи надлежащего качества пациентам с акне составляла 49%. В структуре ошибок оказания медицинской помощи преобладали ошибки лечения и диагноза. Ошибки лечения были представлены преимущественно неверным сочетанием препаратов, наиболее часто одномоментным назначением антибактериальных препаратов для наружного и системного применения, поздним назначением комедолитической терапии, а также применением патогенетически необоснованной терапии. Ошибками постановки диагноза считали отсутствие указаний на форму и/или степень тяжести акне, наиболее важными ошибками сбора информации - отсутствие обследования женщин у гинеколога для решения вопроса о необходимости применения комбинированных оральных контрацептивов, в том числе и при назначении изотретиноина. Заключение. Сходство характера ошибок медицинской помощи при акне, а также их высокий удельный вес при оказании медицинской помощи пациентам требуют разработки системных мероприятий по улучшению КМП этим больным и повторной экспертизы с применением индикаторов промежуточного (оперативного) контроля КМП

Ribosomal RNA of metchnikovellids in gregarine transcriptomes and rDNA of microsporidia <i>Sensu Lato</i> in Metagenomes

Numerous nucleotide sequences of microsporidia sensu lato, mainly belonging to the “Cryptomycota” (Rozellida, Rozellomycota, Rozellosporidia, treated here as synonyms), are found in metagenomes, transcriptomes, and amplicon libraries used for metabarcoding. In this study, we describe rDNA sequences of hyperparasitic metchnikovellid microsporidia found in the transcriptomes of unicellular protists belonging to Apicomplexa (Alveolata). The transcriptome of the eugregarine Polyrhabdina sp. (GenBank SRX6640468) contains the cDNA of Metchnikovella incurvata, the transcriptome of the archigregarine Selenidium pygospionis (GenBank SRX6640459) contains the cDNA of Metchnikovella dogieli, and in the transcriptome of the blastogregarine Siedleckia cf. nematoides (GenBank SRX6640464) we find cDNAs originating from a yet undescribed species representing a novel metchnikovellid family. We have modeled the secondary structure of the “ITS2” region of identified and unidentified metchnikovellids taking into account the covariant nucleotide substitutions. Based on the predicted secondary structure of rRNA, mapping of reads from cDNA libraries, and the absence of the endoribonuclease Las1 (PF04031), we conclude that there is no ITS2 processing in metchnikovellids, and the mature “5.8S”- and “28S”-like (LSU) rRNA are covalently fused, similarly to the LSU rRNA in the other microsporidia sensu stricto. We discuss several previously proposed (Chytridiopsis typographi, BAQA065) and new candidates for the sister group of microsporidia sensu stricto, and compare the reduced rRNA genes of microsporidia and the lengthened rRNA genes with group I introns of parasitic and lichen fungi in the context of neutral and adaptive evolutionary processes

H-LIKE AND He-LIKE SPECTRUM IN LOW AND HIGH DENSITY PLASMAS

Les raies satellites des raies de résonances du Phosphore à un et deux électrons ont été observées dans le dispositif DELPHIN (plasma créé par laser) au Lebedev Institute de Moscou. L'analyse de certains domaines du spectre est effectuée en construisant un spectre théorique qui est ajusté au spectre observé. Différents modèles du plasma (équilibre thermodynamique local ou équilibre collisionnel radiatif) doivent être considérés pour obtenir un bon ajustement.Satellite lines of the Phosphorus H-like and He-like resonance lines have been observed in the DELPHIN plasma laser device at the Lebedev Institute in Moscow. Analysis of some wavelength ranges is carried out by adjusting a theoretical spectrum to the observed one. Different plasma conditions (collisional radiative equilibrium or local thermodynamical equilibrium) are assumed to obtain a good fit of various parts of the observed spectrum. A fitting of the whole spectrum may be used to obtain a density diagnostic

THEORETICAL AND EXPERIMENTAL INVESTIGATION OF THE SATELLITE STRUCTURE OF 1s2 1So - 1s3p 1P1 LINE IN He-LIKE IONS

Les raies satellites de la deuxième raie de résonance des ions héliumoïdes 1s2-1s3p du P, K, Fe, Cu sont étudiées. La résolution du spectre du phosphore est supérieure à celles des spectres du K, Fe et Cu obtenus par une technique expérimentale différente. Les paramètres atomiques nécessaires à l'analyse des spectres précédents, obtenus par deux méthodes théoriques différentes, sont comparés.Satellite lines of the He-like second resonance lines (i.e. 1s2-1s3p) of P, K, Fe, Cu are studied. The spectral resolution of P is better than those of K, Fe, Cu, obtained by a different experimental set-up. The atomic parameters, required for the spectral analysis and obtained by two different theoretical methods, are compared