[About standardization of specialized medical care].

The article presents materials of studying of such important problem of health care as standardization of specialized medical care provided in conditions of hospital and modernization of regional health care. The issues of standardization of specialized medical care are considered in medical, economic and social aspects. The implementation of medical standards was determined as one of main tasks of the regional program of modernization of health care. The program was developed with direct involvement of the authors of article. The comparative analysis of classes of diseases and nosologic forms on main indices of hospitalized morbidity and lethality was used for substantiation of priority of implementing medical standards in the region. The questionnaire survey was carried out on sampling of 510 patients of hospitals. The sociological questionnaire survey was applied to sampling of 8732 patients comprised by system of mandatory medical insurance. Such an approach determined reliability of derived results. The expertise of medical standards was implemented by 124 experienced and competent physicians participating in implementation of medical standards. The results of expertise confirmed expediency of implementation of medical standards. Kepy following shortcomings were established: inadequate financing; lacking of modern equipment and analysis techniques in hospitals, etc. The article presents evidences of effectiveness of process of standardization of specialized of medical care provided in hospital conditions. The basis of such an assumption was reliable increasing of level of satisfaction of quality of its organization and achievement of planned indices of "road map" in the section of increasing of salary of medical workers and decreasing of mortality of population because of controllable causes.

[The content of selen in blood plasma in patients with acute Q-wave myocardial infarction].

The level of blood plasma selenium was analyzed by microfluorimetric method in in-patients and out-patients with acute coronary syndrome with ST-elevation resulting in acute Q-wave myocardial infarction. 72 patients, 40-75 years old, with acute Q-wave myocardial infarction were followed during a month. The initial decreased concentration of blood plasma selenium was recorded in most patients in the acute period of the myocardial infarction: deficiency of the microelement (< 90 mcg/l) was found in 30 subjects, the critical ranges (< 70 mcg/l) were stated in 33 patients. Just 2 patients had optimal concentration and 7 patients had a suboptimal one (90-114 mcg/l). Blood plasma level of the microelement increased in 2 weeks after myocardial infarction (in subacute stage) but it was still within deficient or critical levels. No difference was detected in selen concentration depending on gender, age, location on myocardial infarction, accompanying diseases, presence of some risk factors (smoking, alcohol abuse, hereditary predisposition to coronary artery disease). At the same time we revealed a significant Spearman rank correlation in patients with Q-wave myocardial infarction between basal level of blood serum selenium on the one hand, and electrocardiography indices (reflecting the rate of myocardial lesion and necrosis), echocardiography. data (which characterize myocardium reparation processes and remodeling), CPK (a prognostic marker of the myocardial necrosis), HDL-cholesterol (lipid profile index), blood potassium level and BMI on the other.

[Clinical assessment of dietary correction of metabolic syndrome by using specialized food product enriched with chrome].

Effectiveness of Laminaria jam enriched with chromium has been investigated in ambulatory patients with metabolic syndrome. 50 patients ranging in age from 30 to 65 years (mean age 53.4 +/- 7.5) were under observation during 6 months. 30 patients from comparison group were given recommendations on modeling of lifestyle (diet, reduced and controlled dosed physical loading) and they received medical treatment. Main group of patients (20 people) in addition received dietary product--Laminaria jam, enriched with chromium, which daily dose (20 g) contain 280 microg of iodine and 66 microg of chromium. In both groups declines of overweight, improving clinical and laboratory parameters, adaptive organism reserves and quality of life has been registered. Patients from the main group referred good organoleptic properties of dietary product, it was well tolerated by patients without causing unwanted side effects. After 6 months of a dietary correction mean relative body mass reduction in the main group amounted to 5.0% while in the comparison group--3.0%. Positive dynamics of the circumference of the waist in patients accounted for 5.9% in main group and 3.1% in comparison group. Systolic and diastolic blood pressure decreased in the main group, an average of 20.5 and 24.2%; in the comparison group--10.5 and 13.3% respectively. The average reduction in LDL-C reached 28.3% in the main group and 18.3% in the comparison group. Triglyceride levels decrease was an average of 18.9% in the studied group, that was significantly higher than in the control group (3.7%). The dynamics of OGTT in main group amounted to 13.1% while in the comparison group--8.6%. Differences between group indices were statistically significant for most of the variables. The inclusion of the dietary product in a range of therapeutic and preventive activities under metabolic syndrome has been shown to improve clinical and metabolic indicators (body mass, arterial pressure, lipid and carbohydrate metabolism parameters) compared with standard therapy.

[Use of the microalgae Spirulina platensis and its selenium-containing form in nutrition of patients with nonspecific ulcerative colitis]. / Ispol'zovanie mikrovodorosli spiruliny platensis i ee selensoderzhashcheé formy v pitanii bol'nykh nespetsificheskim iazvennym kolitom.

The vitamin security and selenium status were measured in the patients with unspecific ulcerative colitis. There were used food microalgae Spirulina platensis and it's preparation enriched with selenium as auxiliary tools of dietetic treatment for these patients. It's shown that there is a combined deficiency of beta-carotene and selenium and occasionally some other micronutrients in a significant part of the patients. The doses used of said food supplements were not enough sufficient for a dietary correction of deficiency of micronutrients with antioxidative properties.