The results obtained in the previous research and the author’s analysis of the ways and experience of solving similar organizational and methodological problems have identified the need for structural and logical systematization and their generalization for the sound development of structural-functional model (SFM) medical care for children 0-3 years old with bronchopulmonal dysplasia (BPD) and children of older age groups dysplastic dependent pathology of broncho-pulmonal system. The urgency of such development is conditioned by the existing socio-medical significance of the problem of health preservation, first of all prematurely born children with low and low body weight, high levels of their disability and morbidity. The aim of the study: to substantiate and develop a systematic complex of regulatory and legal support for SFM of medical care for children with BPD and dysplastic-dependent pathology of the bronchopulmonary system, in particular with regard to the introduction of health-improving measures. The author provides the legal and legal support for the components of the SFM assistance to children with BPD and dysplastic dependent pathology of broncho-pulmonal system, in particular regarding the improvement of health technologies in regional health systems. In order to improve this area of legislative and regulatory support, in 2014-2016 the directions of implementation of the legislative initiative were determined. The substantiated, submitted for consideration seven legislative acts of Ukraine, which improved the regulatory and legal support of the SFM components.
Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 361-367
This study was aimed at assessing the quality of life of 52 former fire-fighters of the Chornobyl nuclear power plant disaster with comorbidity of essential hypertension and gastroesophageal reflux disease. The subjects were divided into two groups similar by the sex and age (I group included 26 individuals with essential hypertension and II group included 26 individuals with comorbidity of essential hypertension and gastroesophageal reflux disease), their average age was 58,5±0,8 years. All patients received standard therapy (in accordance with the nosological form) added by the preparation Actovegin "Takeda Austria GmbH" in a dose of 200 mg once a day. The model, which underlies the designing of scales and total measurements of the SF-36 questionnaire, has three levels: 36 questions, 8 scales, formed by 2-10 questions; 2 total measurements, which are combined into scales. After calculating each indicator for separate scale, it was necessary to calculate the value of general indicators for the physical component and the psychological component of health taking into account the Z-value. In addition, when assessing the quality of life, three levels of assessment were conditionally identified: the minimum level ranged from 0 to 40 scores, satisfactory level – from 41 to 70 scores and the optimal ranged from 61 to 100 scores. The patients of the first group when having completed the therapy demonstrated statistically significantly improved indicators from 61.1 (0-100) scores to 71, 3 (0-100) (p ≤ 0.05) that consequently means the restrictions in role functioning due to physical condition (PF) decreased, overall health (OH) improved (scores increased from 42.7 (35-47) to 52.1 (47-60)) as well as the role functioning due to emotional state (ER) from 67.9 (0-100) to 76.5 (0-100) points. The second group when having completed the standard therapy added with Actovegin demonstrated statistically significantly improved indicators for most of the scales, and as a result, the subjective assessment of their quality of life was improved (p ≤ 0.05).
Thus, the study has shown including Actovegin into standard therapy significantly improves most of the life quality parameters in both groups of the former fire-fighters of the Chornobyl nuclear power plant disaster. But, it should be noted that the indicators of pain scales and the state of overall health as parameters of life quality for the patients with comorbidy of hypertension and gastroesophageal reflux disease were fount at a minimum level compared with the patients having essential hypertension that indicates more significant restrictions in some fields of daily life activity for patients with comorbid pathology.
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