Aim. Determination of the actual spectrum of pathogenic microorganisms to which medical workers of mobile teams of emergency medical care (EMC) are exposed, and scientific justification of the class of the working conditions of this professional group in terms of the biological factor. Materials and Methods. Data of the electronic journal of the automated Ambulance Service control system for infectious patients, and records of the register for infectious diseases among workers of the municipal emergency medical care station of Ryazan (300 medical assistants, 64 doctors) for 2016-2019 were used. Results. The average amount of calls to patients with infectious pathology in 2016-2019 made 2178.5221.3 per year. Most emergency calls were for intestinal infections, common cases were varicella, erysipelas, viral hepatites, tuberculosis infection, herpes zoster. The main load in servicing these calls fell on linear (from 63.7 to 77.4%) and pediatric (from 24.8 to 35.1%) teams; calls of resuscitation teams to patients of such profile were sporadic. The level of infectious morbidity of doctors made 0.78 cases per 100 doctors which is 1.2-fold higher than the level of medical assistants (t=3.79; р=0.0003). Conclusion. The confirmed cases of diseases of the studied group of workers resulting from professional contacts with sources of infections of Group III pathogenicity permits to refer the working conditions of medical workers of mobile teams of emergency medical care stations to hazard Class II. However, a high probability for professional contact with high pathogenicity strains of group A influenza, HIV-1 and HIV-2, hepatitis C, D, E viruses belonging to Group II pathogenicity, and existence of the evident contacts with SARS-CoV-2, permit to raise the class of the working conditions to hazard Class III.
The aim of the study is to study the prevalence, structure and nature of injuries, to identify the frequency of deaths at the stage of medical evacuation, and to determine the number of injured people who need medical care in medical organizations (LMO), according to the data on requests of the population of the Ryazan region and the city of Ryazan for emergency medical care (SMP). Materials and methods of research. Statistical data on the requests of victims with injuries for emergency medical care in the Ryazan region and the city of Ryazan are analyzed. Materials of the study – maps of calls of the SMP teams in Ryazan and statistical data for the Ryazan region for 2017-2019. The results of the study and their analysis. The most frequent causes of injuries, their nature, the frequency of requests of the population of the Ryazan region and the city of Ryazan for emergency medical care, the number of deaths and the frequency of hospitalizations for injuries were determined.
The study objectives were to investigate the prevalence and to determine the most frequent causes of coma in patients in Ryazan; to determine the frequency of fatal outcomes at the stage of medical evacuation and the frequency of hospitalizations; to identify the features of emergency medical care in the prehospital period. Materials and methods. We analyzed statistical data on the number of witnesses who applied for emergency medical aid in cases of disturbance of consciousness in patients who were subsequently diagnosed as comatose patients; we revealed main causes and types of comatose states, number of fatal outcomes and frequency of hospitalizations in Ryazan. Materials of the study – cards of calls of ambulance crews in Ryazan in 2016-2020. Results of the study and their analysis. Analysis of statistical data for Ryazan in 2016-2020 showed a steady increase in the number of ambulance calls to patients in coma. In Ryazan, as in Russia as a whole, cerebral coma prevailed, with diabetic coma in second place and toxic coma – in third. In 2016-2020, the proportion of coma-related deaths was 2.7% in the prehospital period and had no upward trend. In 84% of cases patients were hospitalized in medical treatment organisations, patients with hypoglycemic coma sometimes refused hospitalization, there was no tendency in increase of the number of refusals. In the prehospital period, ambulance care for patients with coma was provided in accordance with the algorithms, average time to reach the call was 12.4 min, which corresponds to the respective norms for emergency calls for Ryazan.
Gestational diabetes mellitus (GDM) is a serious medical and social problem, because it greatly increases the frequency of adverse pregnancy outcomes for mother and fetus. The frequency of GDM in the general population of different countries varies from 1% to 14% and average 7%, in Russia this figure is estimated at 4.5%. Aim. To evaluate the prevalence of GDM in Ryazan Regional clinical perinatal center for the last 3 years and examine its influence on the course and outcome of pregnancy. Materials and Methods. The analysis of the birth history data and exchange cards of 1690 pregnant women from 2015 to 2017 at Ryazan Regional clinical perinatal center. Results. GDM was diagnosed in 193 women (prevalence – 11.4%), with 62 pregnant women on the basis of the results of oral glucose tolerance test performed in the period of 24-30 weeks. It was established that the course of pregnancy and delivery in patients with GDM was characterized by a high percentage of complications (late gestosis – 18.1%, anemia – 11.3%, swelling – 11.9%, early toxicosis – 4.6%, poly-hydramnios – 12.4%, chronic pyelonephritis – 5.1% and threatened miscarriage – 3.6%). Pregnancy outcome study revealed that the majority – 60.6% of pregnancies ended in natural births. Preterm birth was noted in 15% of cases, of which 2 cases were of perinatal fetal death. The frequency of delivery by cesarean section – 39.4%. The frequency of childbirth large fetus was 21.8%, higher than in women with normal blood glucose levels. Conclusions. The prevalence of GDM in Ryazan Regional clinical perinatal center for the last 3 years was 11.4%. Complications during pregnancy were observed in 153 women (79.2%) of with GDM. The most frequent complications were; late gestosis, pregnancy anemia, edema, early toxemia, polyhydramnios, chronic pyelonephritis, and threatened miscarriage. In pregnant women with GDM, adverse outcomes of pregnancy were more common than in women with normoglycemia. Significant differences were obtained in the frequency of premature birth, macrosomia of the fetus and asphyxia during childbirth.
Гестационный сахарный диабет (ГСД) представляет серьезную медико-социальную проблему, т.к. в значительной степени увеличивает частоту нежелательных исходов бере-менности для матери и для плода. Частота ГСД в общей популяции разных стран варьирует от 1% до 14% и составляет в среднем 7%; в России этот показатель оценивается в 4,5%. Цель. Оценить распространенность ГСД в Рязанском перинатальном центре за последние 3 года и изучить его влияния на течение и исходы беременности. Материалы и методы. Проведен анализ историй родов и обменных карт 1690 беременных женщин за 2015-2017 гг. в областном клиническом перинатальном центре г. Рязани. Результаты. ГСД был диагностирован у 193 женщин (распространенность -11,4%), при этом у 62 беременных -на основании результатов перорального глюкозотолерантного теста, выполненного на сро-ке 24-30 недель. Течение беременности и родов у пациенток с ГСД характеризовалось вы-соким процентом осложнений (поздний гестоз -18,1%, анемия беременных -11,3%, отеки -11,9%, ранний токсикоз -4,6%, многоводие -12,4%, хронический пиелонефрит -5,1%, угроза прерывания беременности -3,6%). У большинства (60,6%) женщин беременность завершилась естественными родами. Преждевременные роды отмечались в 15% наблюде-ний, из них 2 случая перинатальной гибели плода. Частота родоразрешения путем опера-ции кесарева сечения -39,4%. Частота родов крупным плодом составила 21,8%, что выше, чем у женщин с нормальным уровнем глюкозы крови. Выводы. Распространенность ГСД в Рязанском перинатальном центре за последние 3 года составила 11,4%. Осложнения в пе-риод беременности наблюдались у 79,2% женщин с ГСД, при этом наиболее часто встреча-лись поздний гестоз, анемия беременных, отеки, ранний токсикоз, многоводие, хрониче-ский пиелонефрит и угроза прерывания беременности. При ГСД суммарные неблагоприят-ные исходы беременности встречались чаще, чем у женщин с нормогликемией; статисти-чески значимые различия получены по частоте преждевременных родов, макросомии плода и асфиксии во время родов.
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