THE ROLE OF PUBLIC ORGANIZATIONS IN THE ORGANIZATION OF MEDICAL CARE: ACCORDING TO A SURVEY OF PARENTS OF CHILDREN SUFFERING FROM ORPHAN DISEASES

The activities of public patient organizations are multifaceted: providing legal support to patients in order to protect their legal rights; information and educational work, conducting “schools”, providing specific types of assistance that can provide those involved in the problem. Public patient organizations are the “voice” of all patients with orphan diseases in solving their problems at the level of the highest echelons of power. From 2016-2017 years in the Reference center of congenital hereditary diseases, genetic disorders, orphan and other rare diseases of GBUZ “Morozovskaya DGKB DZM” on a specially designed questionnaire conducted a sociological study on awareness of parents of children suffering ABOUT the public patient organizations. Public organizations provide information and legal support, contact with pharmaceutical companies, participate in solving the problems of patients at the state level. Taking into account the rights and opportunities of public associations, it is necessary for doctors to inform parents about the existence of charitable organizations and their involvement in public patient organizations, as well as to participate in the work of health schools for parents

Z3_3-graded differential geometry of quantum plane

In this work, the Z$_3$-graded differential geometry of the quantum plane is constructed. The corresponding quantum Lie algebra and its Hopf algebra structure are obtained. The dual algebra, i.e. universal enveloping algebra of the quantum plane is explicitly constructed and an isomorphism between the quantum Lie algebra and the dual algebra is given.Comment: 17 page

Remote clinical quality management of endovascular care

Aim. To assess the effectiveness of remote clinical quality management of endovascular care.Methods. The system of clinical quality management of medical care in myocardial infarction (MI) including the quality of remote control of endovascular care was developed and introduced into the health care system of the Moscow Region as a part of the comprehensive study in 2008–2020. The number of people under the study was 8375. The ground for assessing the effectiveness of remote clinical management in 2019–2020 was the health care system of megapolis. Based on the analysis of 2966 endovascular procedures protocols, the treatment tactics effectiveness of intraoperative decisions was studied after an emergency coronary angiography (ECA) had been performed by interventional cardiologists. The system of remote clinical quality management of endovascular care included a complex of audiovisual communications, computer system processes, mentoring and the algorithm for making an intraoperative decision. The effectiveness of remote clinical quality management of endovascular care was investigated on the number of percutaneous coronary interventions (PCI) in MI, mortality of patients with MI in the Regional vascular center in 2019–2020. The T-criteria was used to assess the reliability. The material statistical processing was carried out in the Statistica 6.0 package calculating adequate statistical indicators and their reliability at p≤0.005.Results. Ratio PCI/ECA in 2019, January-March 2020 counted up to 48.95%. In AprilDecember 2020 it increased up to 71.6% (p<0.001). The frequency of performing PCI increased by 1.46 times (p<0.001). Hospital mortality from MI decreased during the following period 2019, April-December 2020 from 9.7% to 8.2% (p = 0.005).Conclusion. Remote clinical management based on telemedicine and mentoring process technologies contributes to improving the quality of endovascular care in MI.Aim. To assess the effectiveness of remote clinical quality management of endovascular care.Methods. The system of clinical quality management of medical care in myocardial infarction (MI) including the quality of remote control of endovascular care was developed and introduced into the health care system of the Moscow Region as a part of the comprehensive study in 2008–2020. The number of people under the study was 8375. The ground for assessing the effectiveness of remote clinical management in 2019–2020 was the health care system of megapolis. Based on the analysis of 2966 endovascular procedures protocols, the treatment tactics effectiveness of intraoperative decisions was studied after an emergency coronary angiography (ECA) had been performed by interventional cardiologists. The system of remote clinical quality management of endovascular care included a complex of audiovisual communications, computer system processes, mentoring and the algorithm for making an intraoperative decision. The effectiveness of remote clinical quality management of endovascular care was investigated on the number of percutaneous coronary interventions (PCI) in MI, mortality of patients with MI in the Regional vascular center in 2019–2020. The T-criteria was used to assess the reliability. The material statistical processing was carried out in the Statistica 6.0 package calculating adequate statistical indicators and their reliability at p≤0.005.Results. Ratio PCI/ECA in 2019, January-March 2020 counted up to 48.95%. In AprilDecember 2020 it increased up to 71.6% (p<0.001). The frequency of performing PCI increased by 1.46 times (p<0.001). Hospital mortality from MI decreased during the following period 2019, April-December 2020 from 9.7% to 8.2% (p = 0.005).Conclusion. Remote clinical management based on telemedicine and mentoring process technologies contributes to improving the quality of endovascular care in MI

CATEGORY OF MARKETING OF RELATIONS IN MEDICAL ORGANIZATIONS

The need for intensification of health care, raises the issue of improving the efficiency of medical organizations. The article analyzes the current management technology: “marketing relationships in medical organizations”. The aim of the research was to find the correct “definition of the concept and professional fullness” of the content of relationship marketing in medical organizations. The authors defined the marketing of relations in medical organizations as “the relationship (mutual relation) of the subjects of medical care at the level of “doctor-patient”, “administration-personnel”, “relations between medical organizations and counterparts”, in order to improve the efficiency of activities and the quality of medical care, patients and medical personnel. The results are obtained on the basis of a comparative analysis of scientific literature data and authors’ own research. In the formulation of the research, methods of content analysis of bibliographic data, the sociological method and the authors’ own experience were used. Based on the results of the research, the role of the individual characteristics of patients (gender, age, occupation, relationship to the composition of patients, transport accessibility, organization of admission) in the formation of relations between consumers and providers of medical services is shown. In conclusion, based on the results of the study, the development of marketing relationships at the level of medical organizations of different ownership forms and the need to improve marketing of communications, social networks and distant forms of work with potential and real patients are justified. Conceptual bases of the marketing relationship concept in medical organizations of different ownership forms have been developed

Experimental study of the pattern of genes activated by multi-day intermittent hypoxia in the rat pancreas

Intermittent hypoxia affects a variety of pathological conditions in the body and is used in medicine to reproduce the sanogenic therapeutic effect. Intermittent hypoxia is used for clinical indications to improve lung function; increase the body’s adaptive capacity; in obstructive sleep apnoea syndrome; in anaemia, diabetes mellitus. In cancer radiotherapy, intermittent hypoxic training helps to increase the sensitivity of the tumour to treatment. Intermittent hypoxia is useful in rehabilitation medicine to improve the physical recovery of patients after surgery or injury to improve the body’s functional capabilities. However, to date, the activity of regulatory genes, that activate the molecular mechanisms of the above-mentioned sanogenic effects of intermittent hypoxia has not been sufficiently studied. The aim of the study: to determine the expression of hypoxia-related genes in pancreas of Wistar rats under intermittent hypoxia. Materials and methods. The CFX-96 Touch™ real-time reverse transcription polymerase chain reaction (PCR) (Bio-Rad, USA) and the RT2 Profiler™ PCR Array Rat Hypoxia Signalling Pathway kit (QIAGEN, Germany) were used to analyse gene expression in experimental animals, where 84 genes involved in the hypoxia signalling pathway identified in the pancreas were studied. Results. According to the results of PCR analysis of pancreatic samples from intact animals and animals exposed to hypoxic training, the activity of the gene panel can be distributed as follows: genes with high expression compared to the intact group of animals, genes with low expression compared to the intact group of animals and genes in which no significant changes were detected in the samples compared to the intact group of animals. We have found, that the genes Cops5, F10, Jmjd6, Lgals3, Rbpjl, Vegfa have high expression activity compared to the intact group of animals. Conclusions. The increase in the expression of Cops5 by 10.29 times, Lgals3 by 2.94 times and Rbpjl by 5.73 times as a result of intermittent hypoxia can be regarded as an activating factor for the increase in the proliferation of endocrine and exocrine pancreatic cells and the growth of their antiapoptotic potential. The 3.20-fold increase in Jmjd6 gene expression under intermittent hypoxia can be interpreted as a regulatory effect through protein dehydroxylation and promotion of antiapoptotic protein activity in endocrine and exocrine pancreatic cells. The 5.99-fold increased level of Vegfa expression may promote angiogenesis in the pancreas under intermittent hypoxia

Neuroprotective coordination of cell mitophagy by the ATPase Inhibitory Factor 1

The mitochondrial ATPase Inhibitory Factor 1 (hereafter referred to as IF1) blocks the reversal of the F1Fo-ATPsynthase to prevent detrimental consumption of cellular ATP and associated demise. Herein, we infer further its molecular physiology by assessing its protective function in neurons during conditions of challenged homeostatic respiration. By adopting in vitro and in vivo protocols of hypoxia/ischemia and re-oxygenation, we show that a shift in the IF1:F1Fo-ATPsynthase expression ratio occurs in neurons. This increased IF1 level is essential to induce accumulation of the PTEN-induced putative kinase 1 (PINK-1) and recruitment of the mitophagic ubiquitin ligase PARK-2 to promote autophagic “control” of the mitochondrial population. In IF1 overexpressing neurons ATP depletion is reduced during hypoxia/ischemia and the mitochondrial membrane potential (ΔYm) resilient to re-oxygenation as well as resistant to electrogenic, Ca2+ dependent depolarization. These data suggest that in mammalian neurons mitochondria adapt to respiratory stress by upregulating IF1, which exerts a protective role by coordinating pro-survival cell mitophagy and bioenergetics resilience

Joule Heating and Current-Induced Instabilities in Magnetic Nanocontacts

We consider the electrical current through a magnetic point contact in the limit of a strong inelastic scattering of electrons. In this limit local Joule heating of the contact region plays a decisive role in determining the transport properties of the point contact. We show that if an applied constant bias voltage exceeds a critical value, the stationary state of the system is unstable, and that periodic, non-harmonic oscillations in time of both the electrical current through the contact and the local temperature in the contact region develop spontaneously. Our estimations show that the necessary experimental conditions for observing such oscillations with characteristic frequencies in the range $10^8 \div 10^9$ Hz can easily be met. We also show a possibility to manipulate upon the magnetization direction of a magnetic grain coupled through a point contact to a bulk ferromagnetic by exciting the above-mentioned thermal-electric oscillations.Comment: 9 pages, 6 figures, submitted to Physical Review