According to WHO, the number of elderly and senile people by 2050 will amount to more than 2 billion people. The period 2020-2030 is designated by WHO as the «Decade of Healthy Aging¼ with a program according to which healthy aging is designed to delay the dependence of this age group on outside help, to promote their long healthy life. Such a statement of the problem indicates an understanding of the relevance of the development of functionally comfortable and aesthetically designed clothing and footwear designs that provide this contingent with independence in self-service and contribute to their successful longevity. The purpose of the study is to substantiate recommendations for the development of clothing and footwear designs, the formation of a wardrobe for elderly and senile people to facilitate the process of self-service and movement. A questionnaire has been developed, with the help of which an examination by specialists and a survey of 60 patients aged 60-87 years who underwent social rehabilitation in the clinic of the 1Federal Scientific Center for Rehabilitation of Disabled People named after G.A.Albrecht. Information was obtained about the diseases of these patients, about the limitations in self-service and mobility, preferences in choosing standard designs of clothing and shoes, claims and wishes for their characteristics in the aspect of self-service. The main recommendations on the compilation of a wardrobe for the elderly and senile age have been developed and formulated, the need for the development of functionally new forms and designs of both clothes and shoes to create for the elderly and senile the convenience of using these products, hiding morphological defects and deformations (figures and feet) and at the same time meeting the aesthetic requirements of fashion and personal preferences has been substantiated the user. The rehabilitation effect of using functionally new forms and designs of these products is to provide self-management of clothing and footwear for patients with significantly pronounced diseases, functional disorders, defects and deformations of the musculoskeletal system, that is, to reduce their dependence on outside help in the process of self-service and movement.
Aging , Healthy Aging , Aged , Humans , Shoes , Longevity
OBJECTIVE: To analyze the health resort care (HRC) system for people with disabilities and provide the rationale of the HRC system improvements. MATERIAL AND METHODS: A content analysis of the regulatory framework and analysis of data from the Forms of Federal Statistical Monitoring of Rosstat, the Russian Ministry of Health, and the Russian Ministry of Labor were performed. RESULTS: The 19 main legal and regulatory documents are presented, and the 16 main areas of legal regulation on the HRC organization are highlighted. For 2014-2018, a twofold decrease in the number of people with disabilities whose individual rehabilitation and habilitation program included recommendations for HRC was observed. In 2019 and 2020, an increase in this indicator was recorded. An overall decrease in the number of persons (including children) with disabilities who received HRC was demonstrated. CONCLUSION: Ways to improve the HRC system for people with disabilities was identified.
Disabled Persons , Health Resorts , Child , Delivery of Health Care , Humans , Russia
Development of medical rehabilitation technologies are the investments into «human capital¼. The effectiveness criterion of the scientific institutions work dealing with the problems of rehabilitation is the scientific publication activity of their employees in this subject in high-ranking international databases (DB).Purpose of the study. Analysis of the state of the scientific publication flow in the field of rehabilitation. MATERIAL AND METHODS: Data from the Web of Science and Scopus databases for November 2019, depth from 1991 to 2018 were used. RESULTS: It was revealed that the high level of the publication rating of Russia, which was noted in 1991-1992, has not yet been achieved in the Scopus database for medical rehabilitation. Measures have been identified to enhance it by increasing the growth rate of the Russian publication flow. It also noted the necessity to reduce Russia's dependence on the monopoly of foreign publishing corporations by creating domestic Russian resources and borrowing the experience of foreign colleagues. CONCLUSION: The necessary measures should be taken at the level of authors, scientific organizations, the scientific community and the State in order to increase the Russian scientific publication flow in the direction of «Rehabilitation¼ in foreign top-rated databases. Authors of interdisciplinary articles need to correctly present metadata indicating the relation of the work to the problem of rehabilitation. The necessity is substantiated not only to increase the share of Russian scientific journals in international databases, but also to create domestic high-rating databases, as well as to harmonize the existing regulatory legal acts in regards of terms and definitions in the field of rehabilitation, to bring the headings of the Universal Decimal Classification aligned with the headings of high-ranking international databases. Given the high social significance of the «Rehabilitation¼ area, it is necessary to include it in the priority list and funded areas at a level corresponding to global trends.
Bibliometrics , Publishing , Humans , Russia
According to the World Health Organization, human life expectancy has increased significantly around the world over the past century, but this process is inevitably accompanied by aging. Therefore, persons who have reached the elderly and senile age often become infirm, especially physically. As a result, such people find it increasingly difficult to make movements related to self-service and movement when using standard clothing and shoes. In a study of 55 patients (from 60 to 87 years), conducted for the first time from the point of view of medical and social rehabilitation, data were obtained that reveal the nature of physical limitations of this group of people, which significantly complicate them use of standard clothing and shoes. The main conclusion of the work is the relevance of the development of medical and technical requirements for the design and production of clothing and footwear specifically for the elderly and senile taking into account their changed anthropometric parameters and their characteristic functional limitations.
Aging , Geriatrics , Aged , Humans , Life Expectancy , Shoes
The formation of a high-tech healthcare system is provided for by national projects. The expected effectiveness of the implementation of these projects is possible only with full-fledged scientific support, which is reflected in the publication scientific rating of Russia in highly rated international databases (DB). THE PURPOSE: Of this work is to analyze the Russian scientific publication stream on medical rehabilitation against the background of the world array of publications and its forecast for the near future. MATERIAL AND METHODS: The data of Web of Science and Scopus DB has investigated. Analysis of Russian scientific publications was carried out at various hierarchical levels of the DB: for Web of Science - across the entire DB (5 sections), under the section «Life Sciences and Biomedicine¼, under the subsection «Rehabilitation¼; for Scopus - in the division of knowledge «Medicine¼ (SUBJAREA (medi)), as well as in the subject area «Rehabilitation¼. The publication scientific rating of Russia was evaluated against the background of the world rating. Analysis of DB information was carried out for the period 1991-2018. RESULTS AND CONCLUSION: For the period 1991-2018, the highest quantity of domestic publications on rehabilitation in the international rating databases Web of Science and Scopus was in 1991: 5.5% (3rd place out of 53 in the world ranking) and 2.3% (6th place out of 64), respectively. The forecast of the dynamics of the quantity, taking into account the data of this period, showed that Russia has practically reached this high level in Scopus, and at the current rate of growth in the publication activity of Russian scientists, in the Web of Science, it can only reach it by 2028.
Publications , Publishing , Russia
Background: Chronic acrodermatitis continua of Hallopeau (ACH) is a rare form of pustular psoriasis predominantly affecting the distal phalanges of the fingers and toes. The disease manifests by pustular rash with marked infiltration, fissures, and often results into severe dystrophy of nail plates. ACH is refractory to most of psoriasis standard of care (SOC) therapies. Objective: The objective of this study is to assess the prospects of secukinumab therapy of ACH based on current clinical observation. Methods: We observed a female patient with ACH. Number of SOC treatments were applied in that case including local PUVA therapy, systemic retinoids, methotrexate, and biologic agents. Result: Secukinumab, a IL-17 inhibitor, demonstrated pronounced clinical effect in the case of ACH refractory to other SOC therapies. Conclusion: IL-17 inhibition provided by secukinumab was linked to clinically meaningful improvement in the heavily pretreated ACH. Further exploration and clinical studies may be important to provide more data on secukinumab effects in ACH.
BACKGROUND: The term dermatitis artefacta (factitious dermatitis, pathomimia) is reserved for the most severe variant of factitious physical disorder and is characterized by exaggerated lying (pseudologia fantastica), sociopathy, geographic wandering (peregrinating) from hospital to hospital, and seeking to be in the patient role. OBJECTIVE: This report aims to give attention to the importance of accurate and detailed history, and conducting an appropriate physical examination in patients with life-threatening diseases when the underlying cause is not apparent. The diagnosis of dermatitis artefacta must always be upheld. CASE PRESENTATION: We present a unique case of a 52-year-old male who presented to clinic with skin lesions on scrotum and shaft of his penis and that were very distinct and suggestive of pyoderma gangrenosum which he developed 3 months after previous discharge from the clinic. Clinical response to treatment and the absence of laboratory findings confirmed a dermatitis artefacta. CONCLUSION: Dermatitis artefacta is a factitious disorder that involves falsification of psychological or physical signs or symptoms caused entirely by the patients themselves, in a clear state of consciousness, in order to play the role of a sick person. The correlation of anamnestic data and clinical and para-clinical exams was essential for the diagnosis of dermatitis artefacta in this case. To the best of our knowledge, pyoderma gangrenosum-like lesions have never been reported in a patient with dermatitis artefacta. Herein, we describe a rare case report of self-inflicted genital injury in a 52-year-old male.
Efficacy of combined and potentiated methods of anesthesiological support of operative interventions on the organs of pancreatoduodenal zone was estimated. In 43 consequently treated patients operative interventions was performed for malignant tumors and fibrous-degenerative changes of pancreatic gland. Efficacy and interchangeability of various methods of anesthesiological support for reduction of the operative risk stage and the risk of intraoperative iatrogenic injury was studied.
Anesthesia/methods , Duodenum/surgery , Pancreas/surgery , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy/methods , Androstanols , Duodenum/pathology , Female , Fentanyl , Fibrosis , Hemodynamics/physiology , Humans , Intraoperative Complications/pathology , Intraoperative Complications/prevention & control , Lidocaine , Male , Middle Aged , Pancreas/pathology , Pancreatic Neoplasms/pathology , Precision Medicine , Propofol , Risk , Rocuronium
In a frame of new conceptual approach to the operative risk lowering, the innovative methods of a personified perioperative support were presented. Among them: dynamical stress-monitoring, antinociceptive narcose potential, methods of transfusional and the stress-correction.
Perioperative Care/psychology , Psychophysiology/methods , Stress, Psychological/prevention & control , Anesthesia, General/methods , Anesthesia, Local/methods , Humans , Pain Management/methods , Pain Management/psychology , Perioperative Care/methods , Precision Medicine
The paper describes a clinical case of primary eosinophilic enterocolitis in a 41-year-old female patent. It presents a brief review of the literature on the problem of primary eosinophil-associated gastrointestinal diseases.
Enteritis/diagnosis , Enterocolitis/diagnosis , Eosinophilia/diagnosis , Gastritis/diagnosis , Adult , Female , Humans
Algorithm of determination of energetic status for calculation of variants of nutritive support while performing operations in patients, depending on their functional state, was proposed, basing on literature data and results of own clinical investigations.
Enteral Nutrition/methods , Surgical Procedures, Operative , Energy Metabolism/physiology , Female , Humans , Male , Oxygen Consumption/physiology , Precision Medicine , Sex Factors , Stress, Physiological , Trauma Severity Indices
A concept of organ protective anesthesiological support of operative intervention was elaborated, basing on analysis of a literature data and clinical investigations of their own. A new, adjusted for clinical application, method of perioperative energetic biometric monitoring was proposed in the frame of also new conceptual approach to anesthesiological supply and perioperative energetic correction. The method permits in a current regimen to determine the degree of nosoinduced affection of organism, for quantitative estimation of the changing intraoperatively operative trauma severity and to prognosticate the patients treatment outcome.
Anesthesia/standards , Monitoring, Physiologic/methods , Severity of Illness Index , Surgical Procedures, Operative/standards , Energy Metabolism , Homeostasis , Humans , Perioperative Period , Prospective Studies , Retrospective Studies
A new method of energobiometric monitoring, which is realized, using the applied computeric programm, was proposed. Energobiometric monitoring permits to determine quantitatively the energetic deficiency level and to correct it in time for the perioperative morbidity minimization. The patients, suffering uncomplicated operational trauma, presenting in two groups and differing for the anesthesy method applied, have took part in the clinical investigation.
Anesthesia, Conduction/methods , Anesthesia, Inhalation/methods , Energy Metabolism , Homeostasis , Monitoring, Intraoperative/methods , Adaptation, Physiological , Energy Metabolism/physiology , Homeostasis/physiology , Humans , Oxygen/blood , Perioperative Care , Respiration, Artificial
A new method of energobiometric monitoring, quantitative estimation of metabolic changes in organism was proposed, basing on literature data and own clinical investigations conduction. Comparing the indices of real and necessary consumption of oxygen, as well as its delivery, permits to reveal precisely the energy deficiency level and in time to correct it for the perioperative complications rate reduction. Two groups of patients, suffering non-complicated operative trauma, were included in the investigation, in whom various methods of anesthesiological support were used. The results of clinical investigations in perioperative period have shown, that adjusting of ratio between delivery and consumption of oxygen constitutes a most important task for modern diagnostic and treatment measures, mainly determining the definite result of treatment.
Anesthesiology/methods , Oxygen/administration & dosage , Adolescent , Adult , Female , Humans , Male , Perioperative Care , Young Adult
The educational medium in varying secondary educational establishments of Samara was comparatively analyzed in accordance with the sanitary regulations SanPiN 2.4.2.1178-02 "Hygienic requirements for teaching conditions in general educational establishments". The study demonstrated that the teaching conditions at schools primarily required that school load be rationalized and the ergonomic parameters offurniture and artificial illumination improved.
Schools/standards , Students , Teaching/organization & administration , Cities , Humans , Hygiene/standards , Russia , Schools/organization & administration , Teaching/standards , Urban Population
Diagnosis, Computer-Assisted/instrumentation , Diagnosis, Computer-Assisted/methods , Foot Deformities/diagnosis , Podiatry/instrumentation , Podiatry/methods , Child , Child, Preschool , Female , Foot Deformities/epidemiology , Foot Deformities/pathology , Humans , Infant , Male , Mass Screening/instrumentation , Mass Screening/methods
The main provisions gomeostasis preserving intensive care patients, operated on the delayed effects of traumatic tissue injuries in conditions of regional anesthesia are presented. There are key indicators that characterize the stability of the homeostasis system during the intensive care unit.
Homeostasis/physiology , Monitoring, Intraoperative , Plastic Surgery Procedures/methods , Surgical Flaps , Adolescent , Adult , Energy Metabolism/physiology , Hemodynamics/physiology , Humans , Oxygen/blood , Soft Tissue Infections/etiology , Soft Tissue Infections/surgery , Soft Tissue Injuries/complications , Surgical Flaps/blood supply , Young Adult
