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1.
Sud Med Ekspert ; 64(2): 4-9, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33739060

RESUMO

The paper presents the results of a comparative epidemiological study of thermal injury and fatal hypothermia based on the results of consolidated reports of the Bureau of Forensic Medicine of the Moscow Department of Health for 2017-2019. It was analyzed the archival material for three calendar years. It was used a continuous retrospective research method with an assessment of the general aggregate of the death incidence from thermal injury and hypothermia in Moscow in 2017-2019 by means of nonparametric statistical methods. Deaths from thermal injury and hypothermia are the most often accidents. The incidence of this type of death is characterized by ups and downs depending on the season. May, January and December are the most dangerous for burns. A similar pattern, with the exception of May, was noted for hypothermia. It was found that men aged 50-70 and women of 70-90 years old die most often. It was determined that most social characteristics (education, being married, etc.) alter the average age when deaths occur. The results obtained provide statistical justification for further more thorough study of thermal injury and hypothermia.


Assuntos
Queimaduras , Hipotermia , Idoso , Idoso de 80 Anos ou mais , Queimaduras/epidemiologia , Queimaduras/etiologia , Feminino , Medicina Legal , Humanos , Hipotermia/epidemiologia , Hipotermia/etiologia , Masculino , Moscou , Estudos Retrospectivos
2.
Zootaxa ; 4908(4): zootaxa.4908.4.11, 2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33756608

RESUMO

The new testate amoeba species Meisterfeldia bitsevi is described from the linden-tree trunk hollow in the urban park in Moscow (Russia). New species is characterized by elongated ovoid bilaterally symmetrical shell, which is laterally not compressed. The shell is composed of proteinaceous material without mineral particles. Almost circular subterminal aperture is placed on ventral side. The key to the species of the genus Meisterfeldia is developed.


Assuntos
Amoeba , Amebozoários , Animais , Moscou , Parques Recreativos , Federação Russa , Árvores
3.
Vestn Otorinolaringol ; 86(1): 58-62, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33720653

RESUMO

The article presents modern methods of surgical treatment of chronic dacryocystitis, a brief historical review of various options for endonasal endoscopic dacryocystorhinostomy is carried out. The method of plastic seamless formation of dacryocystostomy, which does not require intubation of the lacrimal passages and/or using of silicone stoma dilators, is described. Between 2010 and 2019 at The State Budgetary Healthcare Institution of Moscow Area Moscow regional research clinical institute n.a. M.F. Vladimirskiy, according to the developed technique, 32 patients (32 eyes) with chronic dacryocystitis were operated on. According to the results of observation 1 year after surgical treatment, all 100% of patients recorded a positive result (absence or significant decrease in lacrimation, good anatomical visualization of dacryocystostomy with a good tear passage, both passive and during washing the lacrimal passages).


Assuntos
Dacriocistite , Dacriocistorinostomia , Ducto Nasolacrimal , Dacriocistite/diagnóstico , Dacriocistite/cirurgia , Endoscopia , Humanos , Intubação , Moscou , Ducto Nasolacrimal/cirurgia , Plásticos , Resultado do Tratamento
4.
Klin Lab Diagn ; 66(2): 122-128, 2021 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-33734647

RESUMO

Globally, about 70 million people are infected with the hepatitis C virus (HCV), and about 400 thousand people die annually from chronic hepatitis C complications. The management of patients with chronic hepatitis C may require HCV genotyping, since the efficiency of some widely used antiviral drugs strongly depend on the viral genotype and/or subtype. The most prevalent HCV circulating recombinant form, RF1_2k/1b, is misclassified as genotype 2 by many commercial HCV genotyping kits, based on the RT-PCR analysis of the 5' untranslated region of the HCV genome. This leads to inappropriate patient treatment, since the accepted treatment schemes for HCV genotype 2 are ineffective for the RF1_2k/1b. Here we describe a method for detecting the RNA HCV RF1_2k/1b in blood samples by RT-PCR analysis of two regions in HCV genome (5'UTR and NS5b). The method was tested on 240 blood serum samples from HCV infected patients, in which HCV genotype was defined as 2 or mixed (2+1 or 2+3) by the two commercial genotyping kits "OT-Hepatogen-C genotype" ("DNA-Technology", Moscow) and "RealBest RNA HCV-1/2/3" ("Vector- Best ", Novosibirsk). 50 (20.8%) RF1_2k/1b cases were revealed, including three mixed infections: RF1_2k/1b + 1a, RF1_2k/1b + 3a, RF1_2k/1b + 1b. In all cases, the accuracy of HCV typing by the proposed method was confirmed by Sanger sequencing and phylogenetic analysis. The method is easy to implement into clinical practice and may be used in clinical settings equipped for RT-PCR analysis to correctly identify the recombinant variant RF1_2k/1b.


Assuntos
Hepacivirus , Hepatite C , Genótipo , Hepacivirus/genética , Hepatite C/diagnóstico , Hepatite C/genética , Humanos , Moscou , Filogenia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise de Sequência de DNA , Soro
5.
Lancet ; 397(10275): 671-681, 2021 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-33545094

RESUMO

BACKGROUND: A heterologous recombinant adenovirus (rAd)-based vaccine, Gam-COVID-Vac (Sputnik V), showed a good safety profile and induced strong humoral and cellular immune responses in participants in phase 1/2 clinical trials. Here, we report preliminary results on the efficacy and safety of Gam-COVID-Vac from the interim analysis of this phase 3 trial. METHODS: We did a randomised, double-blind, placebo-controlled, phase 3 trial at 25 hospitals and polyclinics in Moscow, Russia. We included participants aged at least 18 years, with negative SARS-CoV-2 PCR and IgG and IgM tests, no infectious diseases in the 14 days before enrolment, and no other vaccinations in the 30 days before enrolment. Participants were randomly assigned (3:1) to receive vaccine or placebo, with stratification by age group. Investigators, participants, and all study staff were masked to group assignment. The vaccine was administered (0·5 mL/dose) intramuscularly in a prime-boost regimen: a 21-day interval between the first dose (rAd26) and the second dose (rAd5), both vectors carrying the gene for the full-length SARS-CoV-2 glycoprotein S. The primary outcome was the proportion of participants with PCR-confirmed COVID-19 from day 21 after receiving the first dose. All analyses excluded participants with protocol violations: the primary outcome was assessed in participants who had received two doses of vaccine or placebo, serious adverse events were assessed in all participants who had received at least one dose at the time of database lock, and rare adverse events were assessed in all participants who had received two doses and for whom all available data were verified in the case report form at the time of database lock. The trial is registered at ClinicalTrials.gov (NCT04530396). FINDINGS: Between Sept 7 and Nov 24, 2020, 21 977 adults were randomly assigned to the vaccine group (n=16 501) or the placebo group (n=5476). 19 866 received two doses of vaccine or placebo and were included in the primary outcome analysis. From 21 days after the first dose of vaccine (the day of dose 2), 16 (0·1%) of 14 964 participants in the vaccine group and 62 (1·3%) of 4902 in the placebo group were confirmed to have COVID-19; vaccine efficacy was 91·6% (95% CI 85·6-95·2). Most reported adverse events were grade 1 (7485 [94·0%] of 7966 total events). 45 (0·3%) of 16 427 participants in the vaccine group and 23 (0·4%) of 5435 participants in the placebo group had serious adverse events; none were considered associated with vaccination, with confirmation from the independent data monitoring committee. Four deaths were reported during the study (three [<0·1%] of 16 427 participants in the vaccine group and one [<0·1%] of 5435 participants in the placebo group), none of which were considered related to the vaccine. INTERPRETATION: This interim analysis of the phase 3 trial of Gam-COVID-Vac showed 91·6% efficacy against COVID-19 and was well tolerated in a large cohort. FUNDING: Moscow City Health Department, Russian Direct Investment Fund, and Sberbank.


Assuntos
/efeitos adversos , /prevenção & controle , Vacinas Sintéticas/efeitos adversos , Vacinas Sintéticas/imunologia , Adulto , Anticorpos Antivirais/sangue , Método Duplo-Cego , Feminino , Humanos , Imunização Secundária , Injeções Intramusculares , Masculino , Pessoa de Meia-Idade , Moscou , Glicoproteína da Espícula de Coronavírus/genética , Glicoproteína da Espícula de Coronavírus/imunologia
6.
Stomatologiia (Mosk) ; 100(1): 19-23, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33528951

RESUMO

AIM: To compare dental and psychological status in athletes of Olympic teams and the population of Moscow. MATERIALS AND METHODS: In order to study the features of the dental rehabilitation of Olympic athletes, a comparative study of the dental and psychological status of 132 athletes was carried out when they were included in the Olympic teams and 104 residents of Moscow of the same age. Clinical x-ray examination was supplemented by «Hamburg testing¼ of the masticatory apparatus and psychological examination using common questionnaires and scales. RESULTS: The study revealed a difference in the status of dental status, the results of the "Hamburg Testing" and psychological examination between athletes of the Olympic reserve and the population of Moscow of the same age. Athletes showed a lower quality of previous treatment of caries and its complications, insufficient oral hygiene, more frequent detection of chronic periodontitis, diseases of the oral mucosa, secondary deformations of the dentition, pathological phenomena of the temporomandibular joint, masticatory apparatus dysfunction according to the results of the "Hamburg Testing". Athletes also established psychological status features: higher rates of reactive and personal anxiety, the presence of depressive manifestations, lower quality of sleep and quality of life. CONCLUSION: The revealed patterns can provoke muscle hyper-tone and muscular-articular dysfunction of the maxillofacial region, which must be taken into account during the dental rehabilitation of athletes of Olympic teams.


Assuntos
Cárie Dentária , Esportes , Atletas , Cárie Dentária/epidemiologia , Humanos , Moscou/epidemiologia , Qualidade de Vida
7.
Stomatologiia (Mosk) ; 100(1): 79-83, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33528961

RESUMO

The purpose of the study was to analyze the types and volumes of treatment and prophylactic services provided to the adult population with infectious diseases in the dental office of a multidisciplinary hospital. MATERIALS AND METHODS: The types and volumes of dental care provided to the adult population with infectious diseases in a multidisciplinary hospital have been analyzed. RESULTS: The study showed that dentists use 49 types of services when treating adults with infectious diseases, which corresponds to 29.88% of the compulsory medical insurance classifier in Moscow. Provided services can be conditionally divided into 4 groups: consultation, diagnostic, preventive and medicinal manipulations. The share of consulting services corresponds to 18.16±0.41% of the total volume of services provided; on average patients made 320.8 visits to the dentist's doctors per year, which corresponds to 2.38 visits for each patient. The proportion of medicinal manipulations, diagnostic and preventive services corresponds to 68.64±0.49%, 7.02±0.27% and 6.17±0.26%, respectively. Services related to the diagnosis and treatment of diseases of the oral mucosa and salivary glands dominate with 69.3%, on average 5.51 services are provided per visit. CONCLUSION: The compulsory medical insurance program for the city of Moscow should provide services for the diagnosis, treatment and prevention of dental diseases, provided by doctors specializing in «dentistry¼, for patients with infectious diseases who are undergoing treatment in inpatient conditions.


Assuntos
Doenças Transmissíveis , Assistência Odontológica , Adulto , Humanos , Moscou/epidemiologia
8.
Artigo em Russo | MEDLINE | ID: mdl-33591660

RESUMO

The spinal muscular atrophy is neuromuscular disease caused by mutations in SMN1 gene. The clinical picture of disease is characterized by progressive muscular weakness and atrophy associated with degeneration of spine, and in severe cases by affection of motor neurons of lower bulbar cells. The spinal muscular atrophy progressing course resulting in disability and infant mortality. Actually, specific treatment is at the stage of clinical trials. However, patients are needed in permanent symptomatic arresting of manifestations and pathogenetic treatment preventing development of disease. The article presents calculations of direct medical costs for treatment in pediatric patients (0-17 years old) in Moscow with the main types of spinal muscular atrophy. It is established that the cost of specialized medical care of children with spinal muscular atrophy per single under age patient in Moscow consisted 7,131,185.84 rubles annually, including primary diagnostic, treatment and rehabilitation and medicinal treatment. In total, according to data for 2020 in Moscow, where number of children patients is 144, the cost of specialized medical care of children with spinal muscular atrophy is estimated as 1,024,580,269.16 rubles. At that, data takes into account only direct medical costs for out-patient and in-patient care of children with spinal muscular atrophy, excluding number of exacerbations of disease. Taking into account average numbers of hospitalizations per year because of illness, the cost of in-patient care of single child amounts to 7,844,304.42 rubles annually and 1,127,018,732.08 rubles for all children with spinal muscular atrophy in Moscow (according data of 2020).


Assuntos
Atrofia Muscular Espinal , Adolescente , Criança , Pré-Escolar , Hospitalização , Humanos , Lactente , Recém-Nascido , Moscou/epidemiologia , Atrofia Muscular Espinal/terapia , Mutação , Coluna Vertebral
9.
Artigo em Russo | MEDLINE | ID: mdl-33591672

RESUMO

The article considers problematic issues in hospital-replacing out-patient mental care management on the basis of the Psychiatric Hospital № 13 in 2015-2017. The analysis covered structure of mental patients, their age and social status. Also, patients under active dispensary monitoring and compulsory continuous out-patient treatment were analyzed. The new management component - «the out-patient psychiatric module¼ - is proposed to be introduced into the structure of mental dispensary.


Assuntos
Transtornos Mentais , Pessoas Mentalmente Doentes , Hospitais Psiquiátricos , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Moscou , Organizações , Pacientes Ambulatoriais
10.
Artigo em Russo | MEDLINE | ID: mdl-33580766

RESUMO

OBJECTIVE: To study the prevalence of somatic diseases in patients with mental disorders based on the results of medical examination in Moscow mental health clinics in 2018. MATERIAL AND METHODS: A retrospective analysis of the results of the clinical examinations of 6492 outpatients, which accounted for 79.5% of patients who underwent medical examination in this time period. RESULTS: Comorbid somatic diseases were found in 4883 (75%) patients. Hypertension and non-insulin-dependent diabetes mellitus were most frequent with the prevalence higher than in the general population of the Russian Federation. Patients with diagnosed schizophrenia, along with hypertension and diabetes mellitus, have found to be at increased risk of diseases of the endocrine system and metabolic disorders. The incidence of the mentioned diseases is not higher than that reported in literature. CONCLUSION: The higher prevalence of socially relevant diseases (hypertension, diabetes mellitus) among patients with mental disorders demands the development of strategies for prevention, early detection and treatment of these diseases in psychiatric patients.


Assuntos
Transtornos Mentais , Esquizofrenia , Comorbidade , Humanos , Transtornos Mentais/epidemiologia , Moscou/epidemiologia , Estudos Retrospectivos , Federação Russa/epidemiologia , Esquizofrenia/epidemiologia
11.
Artigo em Russo | MEDLINE | ID: mdl-33591655

RESUMO

In Moscow (as of January 1, 2020), the number of population made up to 12,678,079, and out of them the elderly population made up to 2.8 million. Up to the end of 2020, the number of the elderly will reach 3.3 million requiring implementation of corresponding preventive measures due to mass prevalence of coronavirus infection. The COVID-19 pandemic demonstrated that despite restructuring of functioning of industry, social security and health care, quarantine and self-isolation occurred to be exactly the effective measures. The self-isolation regimen also revealed aggravation of harmful effects of stress factors, hypodynamia, hypooxygenation and decreasing of immunological resistance. It is especially important to organize leisure activities and to create the most comfortable conditions for isolated living of the elderly as most susceptible to infection. The experience demonstrated that properly chosen set of activities during self-isolation regimen both disciplines and permits to apply surplus of free time to intensify health potential and to consolidate family relationships.


Assuntos
Pandemias , Idoso , Humanos , Moscou , Quarentena , Isolamento Social , Tecnologia
12.
Artigo em Russo | MEDLINE | ID: mdl-33605130

RESUMO

Moscow in modern borders is the largest metropolitan area in the country with a fairly high and unevenly distributed population density. This predetermines the need to address environmental regulation of urbanization in order to create the most comfortable living conditions for the population. Health care and the maintenance of health of all age groups are the leading role in the list of the most important tasks to ensure the social well-being of citizens. In the bowels of the Moscow region there are natural therapeutic resources: low-mineralized (M 3-5 g/l) sulfate sodium-magnesium-calcium drinking mineral water and chloride sodium bromine brine. The article presents the characteristics of the natural therapeutic resources of the Moscow region, the area of their therapeutic use, justified the possibility of wider use based on the available scientific data on the effect on the body of these waters and their analogues. All this provides an opportunity to achieve the main goal of medical resortology - the use of mineral water as a means of therapy, rehabilitation and prevention of most existing human diseases.


Assuntos
Água Potável , Água Subterrânea , Águas Minerais , Água Potável/análise , Humanos , Águas Minerais/análise , Moscou , Turismo
13.
Artigo em Russo | MEDLINE | ID: mdl-33338345

RESUMO

The article discusses results of complex cross-sectional and anthropometric medical check up in the M. V. Lomonosov Moscow State University in 2002-2003 and 2013. The sampling covered 494 students aged 18-23 years. The check up included basic anthropometric measurements and cardiovascular parameters. The pulse pressure and Bayevsky adaptation potential were calculated. Results. The secular trend in body mass increasing was established. So, decade variations was +3.3 kg in young men (p=0.021) and +1.8 kg in girls (p=0.098). The cardiovascular system parameters degraded over ten years: occurrence of bradycardia and tachycardia increased significantly for both genders. In most observed participants in 2002-2003 the sufficient adaptation according Bayevsky was established (75.1% in young men and 71.6% in girls). Over ten years, this proportion decreased to 44.1% in young men (p=0.0000) and to 51.7% in girls (p=0.034). The percentage of adaptation failure cases increased. Conclusions. The analysis of decade dynamics demonstrated deterioration of physical development and somatic health parameters of modern youth. The established trends should be considered in planning health improving programs targeted to early prevention of cardiovascular diseases and development of adaptive capabilities of modern youth.


Assuntos
Doenças Cardiovasculares , Adaptação Fisiológica , Adolescente , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Moscou/epidemiologia , Fatores de Risco , Adulto Jovem
14.
Ter Arkh ; 92(8): 37-42, 2020 Sep 03.
Artigo em Russo | MEDLINE | ID: mdl-33346460

RESUMO

BACKGROUND: In 819% of patients with atrial fibrillation (AF) with anticoagulant therapy (ACT), hemorrhagic complications occur, including due to excess doses of AC. At the same time, ACT is necessary for patients with AF, since anticoagulants effectively reduces the risk of ischemic stroke. To make a decision on the appointment of ACT, it is necessary to correlate the risks of ischemic stroke and bleeding, this requires knowledge of current clinical using ACT recommendations and instructions. Among patients admitted to hospital, 30% receive ACT, so increasing adherence to clinical recommendations for prescribing AC to patients with AF by doctors of various profiles is an urgent task. AIM: To analyze the adherence of physicians to recommendations for prescribing ACT before and after the introduction of decision support system (DSS) in patients with AF in a multi-specialty hospital. MATERIALS AND METHODS: A single-center non-randomized study with historical control to assess adherence to recommendations based on the analysis of medical prescriptions and the structure of drug errors in patients with AF in a multi-specialty hospital in Moscow before and after the introduction of DSS. Compliance with the recommendations of physicians was evaluated in the sections indications /contraindications to AC and dosage regimen of AC. The presence of deviations from the clinical recommendations /instructions for medical use of AC was regarded as management of the patient with non-compliance with recommendations. Physicians adherence level to recommendations was calculated as the ratio of cases of compliance with recommendations to the total number of cases. RESULTS: In the control and experimental groups, there was a significant increase in the proportion of POAC at discharge in comparison with admission to hospital: from 54.5 to 76.8% (p=0.0005) and from 63 to 85.7% (p=0.0002), respectively. However, only in the experimental group it was possible to significantly reduce the number of patients without a prescribed ACT (if there are indications) from 7.6 to 1% (p=0.04) in comparison with admission. During the study, it was possible to significantly increase physicians adherence level to the recommendations for the AC dosage regimen in patients with AF from 59% (44 discrepancies for 107 prescriptions) to 84.6% (16 discrepancies for 104 prescriptions); p0.005. Before the introduction of the DSS, the analysis of drug prescriptions revealed 56 drug errors (0.5 errors per patient), after the introduction of the DSS, the number of drug errors significantly decreased to 21 (0.2 errors per patient); p0.05. After the introduction of DSS, the number of sub-therapeutic doses of AC was reduced from 31 (27.7%) to 8 (7.6%); p0.05. CONCLUSION: The level of adherence to the recommendations for prescribing ACT to patients with AF in the hospital is high. The use of DSS increases the level of adherence to the recommendations on the AC dosage regimen in patients with AF, as well as eliminates errors in calculating the risk of ischemic stroke and systemic thromboembolic complications, and contributes to reducing the frequency of prescribing sub-therapeutic doses of AC.


Assuntos
Fibrilação Atrial , Acidente Vascular Cerebral , Administração Oral , Anticoagulantes/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Hospitais , Humanos , Moscou , Padrões de Prática Médica , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle
15.
Ter Arkh ; 92(8): 86-94, 2020 Sep 03.
Artigo em Russo | MEDLINE | ID: mdl-33346467

RESUMO

AIM: Study of the current state of problems of treatment of patients with tuberculosis based on literature data and their own experience. MATERIALS AND METHODS: In the Russian Federation, the number and proportion of patients with co-infection with HIV/tuberculosis continues to increase against the background of improvement in the main epidemiological indicants for tuberculosis. In 2017, 20.9% of newly diagnosed tuberculosis patients had HIV infection. The combination of the two infections significantly complicates the further improvement of the situation with tuberculosis, and the appearance of drug-resistant strains of Mycobacterium tuberculosis sometimes completely neutralizes the results of chemotherapy. The article describes the schemes of modern tuberculosis chemotherapy taking into account HIV/tuberculosis co-infection, as well as MDR in combination with surgical treatment methods, as well as analyzes the data of epidemiological monitoring of treatment of 1115 tuberculosis patients newly diagnosed in 2017 in Moscow, 360 tuberculosis patients with MDR MBT (cohort 20132014), the results of treatment with the use of new chemotherapy regimens for tuberculosis (bedaquiline, linezolid, moxifloxacin) in 36 patients, the effectiveness and safety of surgical methods in 192 patients. RESULTS: The application of new individualized anti-TB chemotherapy schedules in patients with HIV co-infection/tuberculosis with MDR-MBT has allowed to improve the treatment efficacy. The surgical intervention combined with modern chemotherapy regimens in patients with HIV/tuberculosis co-infection with MDR MBT has been proved to be effective and safe, contributes to the improving the results of treatment for this category of patients. CONCLUSION: The confluence of two global problems of co-infection HIV/TB and MDR TB, significantly prevents from the end of the tuberculosis epidemic in the world. At the same time, advances in the development and implementation of new anti-TB drugs and surgical treatment methods give hope for significant progress for resolving this situation.


Assuntos
Infecções por HIV , Mycobacterium tuberculosis , Tuberculose , Antituberculosos/uso terapêutico , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Moscou , Federação Russa/epidemiologia , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia
16.
Artigo em Russo | MEDLINE | ID: mdl-33338356

RESUMO

The article is devoted to the biography and scientific contribution of Miron Semyonovich Vovsi, the eminent Soviet internist, organizer of army internal medicine. For the first time, the materials of his personal records from the Yuriev (Tartu) University and verified date of his birth are publicly introduced. Miron Semyonovich (Meer Simonovic) Vovsi was born on May 12 (24) 1897, in the township of Kreslavka (actually Kraslava, Latvia). In 1915, he entered the medical faculty of Yuriev (actually Tartu) University. In 1918 he was transferred to the Moscow University. He, after serving as military doctor, studied and worked under the guidance of D. D. Pletnev, I. M. Wiechert and V. F. Zelenin. In 1934, he moved to the Botkin hospital and after defending his doctoral thesis, became the head of the Department of internal medicine in the Central institute of advanced medical training, where he worked for more than 30 years. During the Second World War, he was the chief internist of the Red Army. He was engaged in the organization and improvement of army internal medicine. In 1952, during the so-called "physicians case", he was arrested and tortured for 5 months. After his release, he returned to teaching, medical and scientific activities. He died in 1960. His major areas of scientific contribution to medicine are nephrology, cardiology and army internal medicine.


Assuntos
Medicina Interna/história , Militares , Docentes de Medicina , História do Século XX , Humanos , Masculino , Moscou , II Guerra Mundial
17.
Urologiia ; (6): 5-10, 2020 12.
Artigo em Russo | MEDLINE | ID: mdl-33377671

RESUMO

Severe Acute Respiratory Syndrome (SARS-CoV-2) has spread rapidly throughout the world, causing high morbidity and mortality. Analysis of clinical and autopsy data may allow to understand this disease. The results of pulmonary and renal autopsies in 37 deceased patients from COVID-19 are presented. MATERIALS AND METHODS: An autopsy was performed in Moscow in 37 deceased patients aged from 28 to 94 years. The microscopic features of the lungs and kidneys were examined using hematoxylin and eosin staining. RESULTS: Important findings include diffuse alveolar injury, pulmonary thrombosis and microangiopathy, as well as acute kidney injury in all cases, varying in severity. CONCLUSIONS: We report the presence of acute kidney injury in all cases, which requires correction of renal function in patients with SARS-CoV-2, with control of serum creatinine levels, urine volume, proteinuria and hematuria.


Assuntos
Lesão Renal Aguda , Lesão Renal Aguda/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Autopsia , Humanos , Pessoa de Meia-Idade , Moscou
18.
Urologiia ; (6): 11-18, 2020 12.
Artigo em Russo | MEDLINE | ID: mdl-33377672

RESUMO

AIM: to analyze the learning curve of surgeons while performing laparoscopic partial nephrectomy in patients with localized renal parenchymal lesions by calculating the MIC (negative surgical margin, ischemia, and complications) index depending on tumor complexity according to the R.E.N.A.L. and PADUA nephrometric scores. MATERIALS AND METHODS: the retrospective study included the results of laparoscopic partial nephrectomies in 320 patients with localized renal parenchymal lesions. The procedures were carried out by four surgeons from the Institute of Urology and Human Reproductive Health of FGAOU VO I.M. Sechenov First Moscow State Medical University, Moscow, Russia (EC-1; ESH-4; EB-7; ME-13) from January 2014 to June 2019. At baseline, all operators had experience of performing at least 30 laparoscopic interventions. In addition to the standard preoperative examination, a 3D virtual planning was carried out using the Amira 3D modeling program. In all cases, the nephrometric assessment of complexity was performed according to the R.E.N.A.L. and PADUA scores. The learning curve was assessed based on the results of operations based on the MIC index. All surgical interventions were divided into eras. In the era, 40 consecutive procedures for each operator were evaluated. Acquired skills were assessed over two eras. RESULTS: The average age of patients, of which 191 (59.7%) were men, was 54.4+/-11.37 years. The average body mass index was 28.55+/-3.85 kg/m2, the absolute volume of kidney lesions was 26.72+/-43.72 cm3, the average Charlson comorbidity index was 1.46+/-1.29, the average R.E.N.A.L. and PADUA scores were 6.38+/-1.75 and 7.92+/-1.51, respectively, the average duration of procedure was 150.36+/-50.18 min, the average blood loss was 227.94+/-280.22 ml, the average time thermal ischemia was 13.28+/-7.82 min. Postoperative complications were seen in 36 (11.2%) cases, of which grade III and more according to Clavien-Dindo developed in 8 patients (2.5%). A positive surgical margin was found in 4 (1.2%) patients. The overall MIC index was achieved in 243 (75.9%) cases; in era 1 it was seen in 71.9% cases in comparison with 80% in era 2. With the 1st degree of complexity (152 (47.5%) patients), MIC was achieved in 80.9% of cases, compared to 76.6% and 56.8% in patients with 2nd degree of complexity (n=124, 38.8%) and 3rd degree of complexity (n=44, 13.8%), respectively. Rate of MIC achievement in eras 1 and 2 for different surgeons were as following: 65% and 72.5%, 75 and 80%, 87.5 and 85% and 60 and 82.5%, for operator 1, 4, 7 and 13, respectively. Age, tumor complexity, R.E.N.A.L. score and PADUA score were the most significant parameters for determining MIC, identified on the basis of the criterion of equality of group means of discrete analysis. CONCLUSION: In all surgeons, the MIC index increased with the accumulation of experience in performing laparoscopic partial nephrectomy, but was lower with an increased degree of complexity of procedures. The minimum number of laparoscopic partial nephrectomies required to achieve an MIC more or equal 70% should be at least 40.


Assuntos
Neoplasias Renais , Laparoscopia , Adulto , Idoso , Humanos , Rim/diagnóstico por imagem , Rim/cirurgia , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Curva de Aprendizado , Masculino , Pessoa de Meia-Idade , Moscou , Nefrectomia , Estudos Retrospectivos , Federação Russa
19.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 28(Special Issue): 1056-1061, 2020 Oct.
Artigo em Russo | MEDLINE | ID: mdl-33219758

RESUMO

Prevention of strokes and the fight against their consequences require not only the work of the healthcare system, but also the self-preserving behavior of the population, which is largely motivated by competence in this sphere. The study of public awareness on this issue and the development of recommendations on information policy were the main objectives of the study. In October-December 2019 two surveys were conducted in Moscow, the sample of each was 800 people. The study found an increase between the waves in the number of those who think they know the signs of a stroke (up to 65%). Despite the mainly correct answers, this self-evaluation is not always backed-up by real knowledge: e.g. a stroke was sometimes confused with an ischemic heart disease, a heart attack and epilepsy. Less competency is demonstrated by men and people with primary/secondary education, younger respondents. 94% of the respondents will call an ambulance when they see signs of a stroke, 16% will begin to provide assistance on their own, and in general their actions will be correct, although there are a number of misconceptions. Among the main risk factors of a stroke the respondents consider bad habits. The population receives information about signs of a stroke mainly from relatives/friends (25%) and on the Internet (22%). The study found necessity for the right information about strokes. There is a need for some greater presentation of peer-reviewed information materials in the information field.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Acidente Vascular Cerebral , Conscientização , Humanos , Masculino , Moscou/epidemiologia , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia , Inquéritos e Questionários
20.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med ; 28(Special Issue): 1062-1067, 2020 Oct.
Artigo em Russo | MEDLINE | ID: mdl-33219759

RESUMO

This article presents the results of a study on the relationship between indicators of accessibility of citizens to primary health care (PHC), based on the data of the Unified medical informational analytical system of Moscow (EMIAS) and the results of the survey of physicians of medical institutions of the state healthcare system, providing primary care to adults. The analysis of scientific publications has shown that when assessing the availability and quality of medical care, taking into account public opinion, the main attention is paid to sociological surveys of citizens and less often the opinion of medical personnel who provide medical care to citizens is studied. The analysis of the information from foreign sources has shown that the availability of primary health care is a hot topic in many countries all over the world, including the countries with a high level of GDP per capita. The survey of medical men, which was attended by more than 500 doctors, was conducted in six medical organizations in Moscow that provide primary health care to adults. The questionnaire contained 26 questions, the answers to which reflect the personal opinion of doctors about their attitude to the improvement of their professional skills, satisfaction with working conditions, the organization of PHC and its accessibility to the population, etc. EMIAS The data were used to calculate individual indicators that characterize the population's access to PHC. The results of this scientific study confirmed the existence of a high correlation between the responses of doctors and indicators calculated on the basis of EMIAS data, which indicates the feasibility of using the opinion of medical personnel to make timely and effective management decisions aimed at optimizing organizational processes to ensure public access to medical care.


Assuntos
Médicos , Atenção Primária à Saúde , Adulto , Assistência à Saúde , Humanos , Masculino , Moscou , Inquéritos e Questionários
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