The OBJECTIVE was improving the results of diagnostics and assessment of the severity of patients with mechanical jaundice (MJ) at various stages of its development.METHODS AND MATERIALS. The basis of clinical and laboratory research was the data of 537 patients who were admitted during the period from 2010 to 2019. Principles of separation at the stage of the course of mechanical jaundice of non-tumor Genesis.RESULTS. Analysis of clinical and laboratory studies showed characteristic signs of various complications of cholelithiasis, accompanied by mechanical jaundice. Then, on this basis, specific symptoms characteristic of each stage of mechanical jaundice of non-tumor Genesis were determined.CONCLUSION. The course of mechanical jaundice, which develops with complications of cholelithiasis, has a phase-stage character, beginning with extrahepatic cholestasis, then-joining hepatocytolysis and ending with cholangitis. Initially, cholestasis and cytolysis are functional, which is confirmed by biochemical tests, so these processes are labile and reversible. This makes it possible to effectively use biliary decompression methods and infusion therapy with detoxification during treatment. Cholangitis is characterized by destructive morphological manifestations, so it is verified by specific clinical symptoms and laboratory tests characteristic of inflammatory-septic reactions and progresses to sepsis. Differentiation of stages of mechanical jaundice allows to personify surgical and conservative treatment of such patients.
Features and nature of the perception of medical institutions by the Moscow city youth have been considered. According to the results of a quantitative study (questionnaire method, N = 622) of the attitude of Moscow youth to service in medical institutions, it was concluded that, in general, young people are not sufficiently trustful of medical institutions. Among the main reasons for such a cautious attitude, respondents call insufficient equipment of clinics with high-quality equipment and organization issues. Relief gender differences have been defined: in general, according to the sample, young girls not only visit polyclinics more often than young boys, but are also more demanding to the quality of medical services provided and service. Informing the population about the positive changes in the health care system, new possibilities of medicine can serve as an incentive to change the attitude of young people to prevention and timely treatment.
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