RESUMO
An analysis of 658 medical records of inpatient treatment from 15 hospitals of St.Petersburg was made using a computer-aided technology of the assessment of medical care quality. It was revealed that a proper quality of medical care in craniocerebral trauma was only in 52.9% cases. Different defects of medical care were noted in the rest of observations. It influenced on the condition of the patients (1.0%), the delivery and assessment of health care (40% and 38%, respectively), health resources (18%), social resources (1.0%). Defects of medical records were indicated in 38% patients. It caused a reduction of medical care. Risks of occurrence of medical care defects are low in children hospitals in the case of combined craniocerebral trauma.
Assuntos
Traumatismos Craniocerebrais , Hospitalização/estatística & dados numéricos , Prontuários Médicos , Qualidade da Assistência à Saúde , Adulto , Criança , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Craniocerebrais/terapia , Pesquisas sobre Atenção à Saúde , Humanos , Prontuários Médicos/normas , Prontuários Médicos/estatística & dados numéricos , Avaliação das Necessidades , Avaliação de Resultados em Cuidados de Saúde/métodos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde/normas , Qualidade da Assistência à Saúde/estatística & dados numéricos , Federação RussaRESUMO
A retrospective analysis of diagnostics and surgical treatment was made in 440 patients with polytrauma, who were on the treatment in hospitals in Saint-Petersburg, Syktyvkar and Omsk during 2009-2012. The neurotrauma was the dominating damage. The patients were divided into two groups: the main and the control group, using the equal quantitative ratio according to the sex, age, circumstances of trauma and type of damages. The strategy of programmed multistage surgical treatment ("damage control surgery") was used in the main group (220 patients, average age 31.7 +/- 5.2 years). The traditional strategy of treatment was applied in the control group (220 patients, average age 30.7 +/- 5.4 years). The damage control surgery allows the reduction of lethality in neurotrauma by 15.0% and improvement of social adaptation of patients by 12.7%.
Assuntos
Traumatismo Múltiplo/cirurgia , Procedimentos Neurocirúrgicos/métodos , Guias de Prática Clínica como Assunto , Traumatismos do Sistema Nervoso/cirurgia , Adulto , Feminino , Humanos , Masculino , Procedimentos Neurocirúrgicos/normas , Estudos Retrospectivos , Federação Russa , Índices de Gravidade do Trauma , Traumatismos do Sistema Nervoso/diagnóstico , Resultado do TratamentoRESUMO
The retrospective analysis of surgical and rehabilitation treatment of 172 patients with neurotrauma was made. The patients were treated in Russian Polenov Neurosurgical Institute and Municipal hospital of St. Elizabeth in the period since 2009 till 2012. Rehabilitation of different types of neurotrauma presented the system of surgical and recovery methods of treatment, which should be used in a short term after damage. Means of internal cerebral decompression, including drainage of ecephalocoel and cerebral basal cistern and the tentoriotomy, should be used in acute period of craniocerebral trauma according to morphometric data of beam inspection. Management of wound by means of laser or LED radiation, SHWF-therapy, magnetic and electrostimulation were the effective methods of neurorehabilitation. It is noted, that 73 (43,4%) patients returned to a former employment rate among 172 victims, though 26 patients had a moderate invalidization. An average figures of Glasgow scale outcomes were 1,9+/-0,2.
Assuntos
Procedimentos Neurocirúrgicos/reabilitação , Reabilitação , Traumatismos do Sistema Nervoso/cirurgia , Adulto , Avaliação da Deficiência , Intervenção Médica Precoce , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/métodos , Período Pós-Operatório , Recuperação de Função Fisiológica , Reabilitação/classificação , Reabilitação/métodos , Reabilitação/estatística & dados numéricos , Estudos Retrospectivos , Tempo para o Tratamento , Resultado do TratamentoRESUMO
The study deals with the current topical problem in the development of a laboratory algorithm for the detection of early stages of HIV infection and for the creation of a monitoring system on this basis for the spread of drug-resistant HIV-1 strains. The paper presents the results of experimental examination of the most accessible health care methods for the differential diagnosis of early HIV infection, by using the test systems in Russia and gives practical recommendations on their application.
Assuntos
Western Blotting/métodos , Imunofluorescência/métodos , Infecções por HIV/diagnóstico , HIV-1/isolamento & purificação , Fármacos Anti-HIV/farmacologia , Diagnóstico Diferencial , Farmacorresistência Viral , Diagnóstico Precoce , Anticorpos Anti-HIV/sangue , Proteína gp41 do Envelope de HIV/imunologia , Infecções por HIV/sangue , HIV-1/efeitos dos fármacos , HIV-1/imunologia , Humanos , Sensibilidade e Especificidade , Ureia/química , Carga ViralRESUMO
An analysis of work of neurosurgical service in Saint Petersburg for 2000 through 2006 has shown that the state of the system of organization of medical care needs reorganization and higher quality that can be realized by preferable hospitalization of such patients to specialized hospitals with successive treatment and observation of all stages of treatment and united medical strategy.
Assuntos
Atenção à Saúde/organização & administração , Doenças do Sistema Nervoso/cirurgia , Neurocirurgia/organização & administração , Procedimentos Neurocirúrgicos/tendências , Humanos , Estudos Retrospectivos , Federação RussaRESUMO
The epidemiology of injuries to the spine and spinal cord (ISSC) in Saint Petersburg and its dynamics in 1994 to 1996 were studied. The incidence of ISSC in the city was 0.44 cases per 10,000 (0.64@1000 for males; 0.28@1000 for females). During the period analyzed, there were increases in the incidence of ISSC by 1.8 times and in the frequency of admissions by almost 2 times. An epidemiological survey of ISSC made it possible to propose some measures to improve the organization of medical aid to ISSC patients in Saint Petersburg.