[Dynamics of the mortality indicator of the population of the Irkutsk region from cerebrovascular diseases in age and gender aspect]. / Dinamika pokazatelya smertnosti naseleniya Irkutskoi oblasti ot tserebrovaskulyarnykh boleznei v vozrastno-polovom aspekte.

OBJECTIVE: To study and analyze the dynamics of the mortality rate of the population of the Irkutsk region from cerebrovascular diseases (CVD) in 2010 and 2020 in terms of age and gender. MATERIAL AND METHODS: The study included all registered deaths among the population of the Irkutsk region in 2010 and 2020 years in age and gender groups from CVD. The grouping of the material was carried out by distributing the deceased by sex and five-year age intervals (from 15 to 85+ years) with the subsequent calculation of mortality tables. The method of analysis of the time series was used with the calculation of indicators of absolute increase, rate of increase, growth rate, the content of 1% increase in the mortality rate in cases. RESULTS: A significant increase in the 1% increase in mortality among males both in 2010 and in 2020 years was observed starting with the age group 55-59 years. The 1% increase in mortality was 1.24 and 1.69 deaths, respectively. Among females, a significant increase in the 1% increase in mortality was recorded in the 60-64 age group in 2010 year and in the 65-69 age group (1.25 and 1.31 deaths, respectively). In 2020 year, compared to 2010 year, both among females and males in almost all age groups, there was a decrease in the intensity of the 1% increase in mortality cases, except for the 55-59 age group among males. gender and except for age groups 40-44 years old and 55-59 years old among females. CONCLUSION: In the Irkutsk region, among males, the decrease in the mortality rate from CVD compared with females from 2010 to 2020 years was less pronounced. During the study period of observation, the intensity of the ratio of the increase in the mortality rate from CVD in men to women increased. So, in 2010 year, the maximum ratio was 2.1:1, in 2020 year - 5.0:1. The exponent 1% increase in deaths in males was higher than in females.

[Intracorporeal anastomosis in laparoscopic right-sided hemicolectomy]. / Ispol'zovanie intrakorporal'nogo anastomoza pri laparoskopicheskoi pravostoronnei gemikolektomii.

OBJECTIVE: To compare short-term results of intracorporeal (IA) and extracorporeal anastomosis (EA) in laparoscopic right-sided hemicolectomy. MATERIAL AND METHODS: A retrospective and prospective analysis included 105 patients who underwent laparoscopic right-sided hemicolectomy with intracorporeal and extracorporeal anastomosis between 2016 and February 2021. RESULTS: We analyzed 105 patients including 64 women and 41 men. Mean age of patients was 62.8±1.5 years in the EA group and 64.7±3.9 years in the IA group. Mean BMI was 24.8±0.5 kg/m2 in the EA group (range 19 - 34.5) and 24.3±1.0 kg/m2 in the IA group (range 21 - 30.4). Intracorporeal anastomosis was performed in 33 patients, extracorporeal anastomosis - in 72 ones. Surgery time was 180.0±7.3 min in the EA group and 214.2±17.7 min in the IA group. There were 8 complications in the EA group (p=0.046). No mortality was observed. Redo surgery rate was 4.16% in the EA group, while there were no redo procedures in the IA group. Postoperative hospital-stay was 12.2±0.5 days in the EA group and 8.8±1.0 days in the IA group. CONSLUSION: Intracorporeal anastomosis is a safe approach for laparoscopic right-sided hemicolectomy.

[The evaluation of polyclinic rehabilitation after prosthetic arthroplasty].

The study considers quality of assessing functioning, limitation of vital activity and patient participation in outpatient stage of rehabilitation according traumatology and orthopedics profile. The sampling included 712 out-patient records of patients with complete endoprosthesis replacement of hip (299 or 42%) and knee (413 or 58%) joints. The study analyzed application of the Haris, Leken and Rankin scales, hospital anxiety and depression scale (HADS), quality of life questionnaire (EQ-5D), recommended as mandatory examination tools in case of rehabilitation after endoprosthesis replacement. The statistical data processing was performed using software IBM SPSS Statistics version 23. It is established that Harris and Leken scales, hospital anxiety and depression scale (HADS) were not applied to any patient. The functional structural deformation of joint and/or limb with detailed elaboration of degrees and centimeters is described in 10% of medical records, but it completely matches data from hospital case records. At completion of rehabilitation cycle, 55.9% of all primary complaints are repeated in final diaries. What is regarded 39.3% of primary complaints, there is no information about their elimination. In 25.9% of patients in their final diaries the complaints are present that were not indicated after primary and subsequent examinations. The evaluation according both modified Rankin scale (13.1% of patients) and the quality of life questionnaire (EQ-5D) (6.9% of patients) was implemented only in case of referral to medical social expertise examination. The out-patient rehabilitation cycle was uncompleted in 26% of patients.

[Metabolic disorders in chronic non-communicable diseases and ways of their correction during the medical examination of the population.]

In the study, comparative analysis before and after the air cryotherapy for the following parameters: total cholesterol (using a set of reagents CHOL_2, automatic biochemical analyzer ADVIA 2400( Siemens), glucose (using a set of reagents Glucose Hexokinase II, automatic biochemical analyzer ADVIA 2400 (Siemens), cholesterol of low-density lipoproteins (using the set of reagents of L-HDL, automatic biochemical analyzer ADVIA 2400 (Siemens). The number of oxidized lipoproteins (LP) was determined by the method of the Muzya G. I., the amount of LP resistant to oxidation was determined by the Ragino Yu.I. The clinical group consisted of 30 people with a verified diagnosis of metabolic syndrome, the average age of which was 45.3±3.7 years. Patients of the clinical group received a course of cryotherapy by the method, including the presence in the pre -chamber at t0 -600C for 30 seconds, then in the main chamber at t 0-110-1200C for 180 seconds. Procedures were released again with an interval of 20 minutes, daily within 10 days. Statistical processing of the obtained data was carried out according to conventional methods with the determination of the arithmetic mean, the mean error using the program STADIA version 6.0. The significance of differences in the clinical group before and after the correction was judged by the Student's t-test value after checking the distribution for normality. Differences corresponding to the probability error p<0.05 were considered statistically significant. In patients of the clinical group with metabolic syndrome before treatment, elevated levels of total serum cholesterol by 24.3% and glucose by 12.8% relative to normal values were found. After the course of General air cryotherapy, the total number of low-density lipoproteins decreased by 15.47%, total serum cholesterol by 32.30%, while the serum glucose level decreased by 11.8% compared to the indicators registered in the clinical group before cryotherapy.

[The Activities Concerning Improvement of Dispensary Observation].

The analysis of deficiencies of organization of dispensary observation detected by the original study permitted to develop corresponding eradication measures within the framework of natural experiment. The experiment was implemented on the basis of the clinical diagnostic Center № 3 of the Moscow Health Care Department. The evaluation of measures was carried out by means of comparing criteria of efficiency of dispensary work prior and after implementation of mentioned measures. At the 18th month of measures implementation decreasing of average number of emergency hospitalization, average number of visits for acute care, percentage of patients mentioning exacerbation was established. Alternatively, increasing of percentage of patients registered for dispensarization during 10 weeks after diagnosis establishment, pending reception in waiting list lesser than 20 minutes and also patients of Dispensary groups underwent adequate medical examination, knowing expected results of treatment, treatment scheme and time of next planned visit addressing within planned terms with prevention purpose was established too.