Risk factors associated with the occurrence of early complications of acute myocardial infarction after cardio-intervention treatment.

OBJECTIVE: The aim of our study was to identify the main risk factors for the occurrence of early complications of acute myocardial infarction after cardio-interventional treatment and to evaluate prognostic risk indicators. PATIENTS AND METHODS: Materials and methods: Risk factors of myocardial infarction were determined by copying the case history data and calculating on their basis of the odds ratio and ±95% confidence interval. After it, we made a prediction of the risk of early complications of AMI with cardiovascular intervention by using a Cox regression that took into account the patient's transportation time by ambulance. RESULTS: Results: Thus, the factors that increase the chances of their occurrence were: summer time of year; recurrent myocardial infarction of another specified localization (I122.8); the relevance of the established STEMI diagnosis; diabetes mellitus; renal pathology; smoking; high rate of BMI. Factors that reduce the chances of their occurrence: men gender - in 35%; the age over of 70 - by 50%; the timely arrival of an emergency medical team - by 55%. The factors that increase the chances of their occurrence were: age over 70 years; subsequent myocardial infarction of unspecified site; diabetes mellitus. Using of a Cox regression analysis, it was proved that the cumulative risk of early complications of AMI with cardio-intervention treatment increased from the 10th minute of ambulance arrival at place, when ECG diagnosis (STEMI), presence of diabetes mellitus, smoking and high BMI. CONCLUSION: Conclusions: As a result of the conducted research, the risk factors for early complications of AIM with cardio-interventional treatment were identified.

Risk factors of smoking among students of higher medical educational establishments of ukraine.

OBJECTIVE: Introduction: Studies of domestic scientists show the unsatisfactory state of health of the population of Ukraine. This is due to a number of socio-economic, political, environmental problems, a low level of material support for the majority of the population, as well as the prevalence of bad habits. Of particular interest is the spread of bad habits among young people, in particular smoking, its connection with various social factors and the impact on health. The aim: The main aim of the study is studying of the factors that cause the spread of smoking among students of higher medical educational establishments of Ukraine and their dependence on the social and economic situation of young people; to investigate the root causes of smoking among students; to analyze the level of the desire to lead a healthy lifestyle and quit smoking in the studied educational establishments. PATIENTS AND METHODS: Materials and methods: 435 questionnaires of students of two higher medical educational establishments were analyzed: the Bogomolets` National Medical University, Kiev - 180 and the HSEE of Ukraine «UMSA¼, Poltava - 255. RESULTS: Results:The study showed that of all respondents, have they tried to smoke once, 268 (61,6%) gave a positive response, and 167 (38,4%) indicated that they had no experience of using tobacco. Among all respondents 162 smoke for the sake of curiosity and in percentage terms it is 37,2%. The personal drama went to the second place and this reason was named by 43 respondents and this is 9,9%. The third position was a combination of two factors of curiosity and drama and is 3,0%. CONCLUSION: Conclusions: As a result of the study, there is a significant difference between students on smoking daily- 36,7% versus 27.8% (p = 0,05). Some differences among the students of the study groups regarding the visit to entertaining establishments - 56,7% of students of the Bogomolets NMU were determined against 53,7% of the students from the UMSA, but these data are not reliable (р=0,33).

Planning of effective evaluation of the activities of hospital district at the example of poltava region.

OBJECTIVE: Introduction: Increasing of the availability and quality of health care in rural areas is one of the priority directions of public health and regional development policy. The need for reforming of the network of secondary health care facilities is due to the fact, that they are unable to meet the needs of the population in this specialized type of medical care in the conditions of the existing structure and funding system. The aim: to analyze the existing legislation regulating the establishment and operation of hospital districts; to determine the methodology for monitoring and evaluating of the activity of the hospital district on the example of the Poltava region. PATIENTS AND METHODS: Materials and methods: In this work a set of methods is used: system approach, bibliosemantic, legal, logical modeling. RESULTS: Review: A managerial tool capable of tracking the process and demonstrating the impact of projects, programs and development policies is monitoring and evaluation. The basis of evaluation is the creation of different indicators and indexes. The system of these indicators provides an opportunity to assess the social, medical, economic and environmental aspects of development of hospital district. The monitoring and evaluation program should include monitoring of implementation (contributions and activities) and monitoring of the results of work of the hospital districts (short-term and long-term). CONCLUSION: Conclusions: Hospital districts are created with the aim of optimizing of the organization and functioning of the network of health facilities. The Management Board's decision should be based on valid, reliable information on the development of the hospital district. Compliance with the monitoring and evaluation methodology makes it possible to provide the health care system with qualitative and timely data at all stages of its reformation.

Medical evaluation of efficiency of optimized models for early detection and primary prevention of cardiovascular diseases.

INTRODUCTION: Nowadays cardiovascular disease occupies a leading place in the structure of the prevalence, incidence, disability causes and mortality of the adult population in Ukraine and in the whole world. The prevalence of hypertension in the adult population ranges from 25 - 40%, coronary heart disease is almost 20% of people aged 50-59 years while 24.3% of them have a form of silent coronary artery disease. The feasibility of study is justified by the need to perform health institutions Law of Ukraine dated 07.07.2011 year №3611-VI ≪On Amendments to the Basic Laws of Ukraine on health care on improvement of care" and MoH of Ukraine from 24.07.2013 № 621/60 "On the system of cardiac care in health facilities of Ukraine" therefore extremely important is to develop an optimized model of early detection and primary prevention of cardiovascular diseases at primary level of health care. The aim of the research is to develop methods and evaluation models optimized for early detection and primary prevention of cardiovascular diseases at a general practitioner of family medicine. MATERIAL AND METHODS: The methodical apparatus is of complex of medical and social research methods that meet the requirements of public health: bibliosemantyc, systematic approach and analysis, statistical, expert evaluations. To determine the effectiveness of medical evaluation was conducted in its 33 clinics of general practice in Poltava region, including 7 urban and 26 rural. In expert opinion is taken 825 patients, of which 175 urban and 650 in rural areas. The results of the study found that 193 patients (23.4%) achieved target blood pressure through the implementation of the recommendations concerning the optimization behavior towards of risk factors, lifestyle.