The article presents the main principles of lean manufacturing, experience and results of lean production launch in a large city outpatient clinic as part of the Ministry of Health pilot project “Lean outpatient clinic”. In the clinic, redistribution of space, optimization of e-document management and registry workflow were performed. It reduced queueing time and time of blood sampling, simplified arranging a visit to General practitioner and other physicians, increased time of doctor and patient interaction, which allowed to serve much more patients with the same amount of resources, save time of medical staff and patients, and increase their satisfaction.
The significance of the problem of acute intestinal infections (AII) to date is associated with both their prevalence and high rate of adverse effects in the outcome of the disease. In modern literature there is enough information about the frequent occurrence in AII patients microbiota disorders, immune system imbalances, identifying signs of reactive changes ofpancreatic tissue and functional disorders of biliary tract, lactase deficiency, long-term disorders of functional activity of the digestive system. The data about AII as one of the factors of forming the gastrointestinal tract pathology, including irritable bowel syndrome have been accumulated.
В статье представлены результаты работы по оценке влияния кисломолочных продуктов питания, фер-ментированных и неферментированных пробиотиками, на антропометрические данные, общеклинические параметры и показатели функциональной активности кишечной микробиоты у детей раннего возраста. По результатам первичного обследования в выборку вошли 103 ребенка, которые были разделены на группы: группа детей, получавших ферментированные пробиотиками (Bifidobacterium longum, Streptococcus termophillus) продукты (1-я группа, n = 36, получала биоряженку, 2-я группа, n = 34 -биопростоквашу), группу сравнения, n = 33, дети которой получали неферментированный детский кефир. Результаты ис-следований в динамике через 4 нед показали, что прием всех кисломолочных продуктов сопровождается положительной адекватной прибавкой массы и роста за период наблюдения и не вызывает нарушений показателей красного ростка крови. Но именно ферментированные пробиотиками продукты оказывают достоверно значимое положительно влияние на показатели метаболической активности кишечной микро-биоты -короткоцепочечные жирные кислоты в кале -в отличие от группы сравнения.Ключевые слова: дети раннего возраста, короткоцепочечные жирные кислоты в кале, кисломолочные продукты прикорма.The article presents the results of the evaluation of the influence of fermented and non-fermented sour milk food products with probiotics on anthropometric data, general clinical parameters and indicators of the functional activity of intestine microbiota in infants. Based on the results of initial examination 103 children were chosen and divided into the following groups: the main group receiving products fermented with probiotics (Bifido bacterium longum, Streptococcus termophillus) (subgroup 1, n = 36, received bioryazhenka, subgroup 2, n = 34, received bioprostokvasha); the control group received non-fermented baby kefir. The results of research in dynamics in 4 weeks showed that intake of all sour milk products was accompanied with positive adequate growth in height and weight (within the period of observation) and doesn't cause disturbances in indicators of red blood cells and hemoglobin. But it's the fermented with probiotics products have a sufficient positive influence on the metabolic activity of intestine microbiota -short-chained fatty acids in feces -in contrast to the control group.
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