The article presents the characteristics of the main risk factors and shows the need to involve the family, educational and medical resources, depending on the features of risk factors affecting different stages of human life. It was found that high medical awareness does not affect negotiability of citizens in medical institutions and adherence to a healthy lifestyle. The high frequency of individuals (35.1%), knowledgeable about the principles of health preservation and able to carry them out, but do not applying their medical knowledge and skills in practice, was revealed. One of the ways to improve adherence of health saving behavior of the population is a dynamic monitoring of the implementation of health recommendations according to the primary accounting documents.
In modern conditions of the development of public health it is necessary to introduce organizational measures to improve the system of formation of hygiene awareness at all stages of the life activity. Purpose of the study is to determine characteristics of the shaping of medical knowledge and skills of health preservation in main periods of the life and substantiation of organizational and preventive measures to advance the system of informing and motivating to the health-saving behavior and to improve the quality of life. Material and methods. With the help of a complex study program among the urban and rural population (n=1710) characteristics of the formation of health-saving behavior were studied and organizational and preventive measures to improve the quality of life were substantiated. Results. According to results of the cluster analysis, subjects were divided into risk groups by the level of motivation to health-saving behavior (well-being, the relative and absolute risk). Periods of the formation of medical awareness were designed with account of leading determinant of the risk of stages of the life activity. A high level of hygiene awareness provides more favorable indices of the health and quality of life in urban and rural residents. Under the implementation of the discriminant analysis there were identified most significant indices of health-saving behavior under the impact on the quality of life. Conclusion. the study shows the insufficient efficacy of the existing system of the shaping health-saving behavior. At that health-saving behavior should be considered as a dynamic process that develops at stages of the life activity and on the life-support levels, with the priority role of health professionals in the formation of hygiene awareness. There was proposed the regional model of organizational and administrative activity, methods of the formation of the system of hygiene awareness and health-saving behavior recommended to be included as part of programs of the prevention of diseases.
Purpose: This study analyzed the effectiveness of minimizing surgical trauma, reducing the severity of the stress reaction, and restoring the normal functioning of the body after planned gallbladder operations under an enhanced recovery program. Materials and Methods: This prospective comparison study included 30 patients from the surgical department of Irkutsk Clinical Hospital No. 1 who had been diagnosed with cholelithiasis in 2019-2020. All 30 patients completed the study and were randomly assigned to one of two groups: the FTS group (group I, n = 15) and the standard group (group II, n = 15). The comparison groups were statistically homogeneous in terms of preoperative parameters. All patients underwent prescribed surgeries. In the early and late postoperative period, there were no cases of mortality or significant complications. Results: A comparison of the groups with respect to the effectiveness of treatment according to established criteria showed good treatment results for 13 (86.6%) patients in group I and 2 (13.3%) patients in group II (p = 0.016). The FTS treatment protocol was a significant predictor of treatment success (OR 3.1; 95% CI 0.2; 6.0; p = 0.033). Conclusion: The fast track surgery protocol gave superior results for surgical treatment in comparison with the standard protocol in patients with cholelithiasis.
Modern socially-oriented policy in Russia prioritizes the complex of prevention activities with the use of modern health-saving technologies. At that it is necessary to substantiate methodologically and methodically integrated quantitative and qualitative characteristics, based on which evaluation of the types of functioning and conditions of life affecting health and quality of human life is possible. On the basis of specially developed complex program (15 scales) the study of the quality of life and health of the urban working population of St. Petersburg (n=2276) was executed. The method of the determination of the risk groups according to types of functioning and health groups was developed. Performed medico-social and clinical-statistical study allowed to identify changes of the quality of life indices according to the type of functioning at various conditions and characteristics of life and health. According to indices of the quality of life there was revealed the high proportion of urban residents in groups of relative and absolute risk. Especially significant decrease in the quality of life indices in these groups was noted on indices of socio-hygienic functioning, socio-economic well-being, socio-psychological comfort, social adaptation, recreational activities, medico-social activity and prevention activities. There was established a higher probability of the formation of chronic disease and the decrease in the satisfaction with the quality of life in urban residents in groups of the absolute risk with dissatisfaction with the living conditions and livelihoods. The proposed scales and types of functioning in the structure of health-related quality of life can be used in a comprehensive hygienic studies implemented on the basis of a risk assessment methodology, under comparison of indices of livelihoods and satisfaction with living conditions, in complex evaluation of the efficiency of medical preventive, social and environmental programs
Objective: Acute limb ischemia (ALI) manifests as sudden lower limb ischemia that, regardless of the underlying cause, can lead to amputation unless there is an appropriate treatment.The study aims to analyze predictors of the lower limb occlusive thrombosis with the acute ischemia development (ALLI), depending on the localization under specifically recommended prophylaxis. Materials and methods: The researchers performed a retrospective analysis of clinical cases with a confirmed diagnosis of acute lower limb ischemia (ALLI) for 2019. During this period, 20 patients met the study criteria. Results and Discussion: A multivariate analysis (predictors with a p<0.1) established hyperglycemia as a significant predictor of ALLI development under specific prophylaxis (RR 2.2; 95% CI -8.2; 8.4; p = 0.097). It indicates a double risk of ALLI for patients with hyperglycemia. Conclusion: The results indicate the need to correct glycemic parameters to reduce the risk of acute lower limb ischemia, even under antiplatelet or anticoagulant prophylaxis. It is also necessary to analyze the management protocols currently used for such patients to correct the recommended antiplatelet or anticoagulantschemes. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.637-641
Introduction: The standard treatment for prostate cancer is radical prostatectomy (RP). This surgical technique results in typical complications such as intraoperative blood loss, urethral strictures (vesicourethral anastomosis), urinary incontinence, erectile dysfunction, lymphocele, and the ureter or rectum injury. The study aims to analyze the development of complications after radical prostatectomy. Materials and methods: The article presents a retrospective analysis of clinical cases with an established diagnosis of prostate cancer from 2012 to 2018 in Irkutsk, Russian Federation. During this period, 52 patients met the study criteria. A multivariate analysis established Non-Nerve-sparing RRP (OR-0.9; 95% CI-1.9; -0.07; p=0.035) as a significant incontinence predictor after 2 years. Results: Multivariate analysis also established previous transurethral operations as a significant predictor of the vesicourethral anastomosis stricture (OR 6.09; 95% CI 0.71; 11.4; p=0.026), which indicates a six times risk of developing a vesicourethral anastomosis stricture if the patient already had one or more transurethral surgery. Obesity (OR 0.12; 95% CI 0.03; 0.21; p = 0.008), diabetes (OR 2.3; 95% CI 0.45; 4.2; p = 0.015) and coagulopathy (OR 3.1; 95% CI 0.5; 5.7; p = 0.019) became independent predictors of lymphocele development. Conclusions: The study revealed some new information on the possible predictors of such complications as urinary incontinence in the late period, the lymphocele, and stricture of the vesicourethral anastomosis. Some of the results require further study and confirmation.
In the first one and a half decades of the 21st century, there is observed an intensive development of the medical prevention in health care facilities. New preventive treatment facilities and subdivisions were created and a new feature - preventive counseling was imputed to a wide range of doctors. This work included the evaluation of the preventive activity, lifestyle and health state of 221 health care providers, analysis of results of the preventive check-up of 154 nurses and analysis of the workplace assessment of 200 health workers. The results of the work showed just doctors to perform most of the preventive health care for patients. Only half of the surveyed physicians and one third of nurses noted that they gained knowledge about medical prevention in the process of training in a medical school. Most health care providers stated that they keep a healthy lifestyle. At once, a quarter of surveyed nurses answered that they smoke and more often do it at work. It should be noted that there was much less smokers among doctors. Nurses and doctors justified the cause of smoking by to the necessity to relieve work-related stress. A large part of health care providers noted a lack of physical activity, poor diet and insufficient sleep. An objective assessment of working conditions based on the analysis of workplaces assessment showed the increased work intensity and low lighting at the workplace of health care providers. Based on the findings it can be concluded health care providers to be motivated to perform work on preventive medicine. However, the training of physicians and nurses in the field of health lifestyle promotion and disease prevention requires the improvement. The personal commitment of health workers to the disease prevention for their own health preserving cannot be considered to be sufficient. A comprehensive approach to the training of health professionals and the organization of their work will allow to enhance of the professional activity health of care providers in the field of the disease prevention and improving their health.
Проанализированы закономерности формирования неблагоприятного профиля медико-биологического и социально-поведенческого риска, способствующего развитию таких массовых неинфекционных заболеваний, как артериальная гипертензия, ишемическая болезнь сердца, ожирение и сахарный диабет. По данным первичной учетной документации проанализированы результаты скринингового тестирования 2007 посетителей одного из центров здоровья Санкт-Петербурга. Установлено, что наиболее весомый вклад в процесс формирования неблагоприятного интегрального профиля кардиометаболического риска вносит повышение индекса массы тела (38%) и гиперхолестеринемия (36%). Менее весомое влияние оказывают повышение уровня систолического АД (24%) и гипергликемия (20%). Число имеющихся у индивидуума поведенческих факторов нездорового образа жизни оказывает непосредственное влияние на количественный профиль медико-биологических факторов риска (р < 0,001). Учитывая общность патогенетического воздействия на организм медико-биологических и социально-поведенческих факторов риска, главной задачей обучения населения в школах здоровья является информирование о том, что для минимизации риска развития и прогрессирования неинфекционных заболеваний необходима нормализация показателей артериального давления (АД), общего холестерина (ХС), глюкозы (ГЛ), индекса массы тела (ИМТ), а также рационализация питания, оптимизация уровня физической активности и отказ от пагубных привычек.Ключевые слова: центр здоровья, первичная профилактика, охрана здоровья, факторы риска, неинфекционные заболевания, медицинская информированность.Analyzed patterns of formation of adverse health profile of biomedical and socio-behavioral risk, contributing to the development of such mass noncommunicable diseases such as hypertension, coronary heart disease, obesity and diabetes. Based on data from primary records we examined the results of a screening test 2007 people's Health Center in St. Petersburg. Found that the most significant contribution to the quantitative profile of cardiometabolic risk factors contributes increasing BMI (38%) and hypercholesterolemia (36%), lessincrease of systolic blood pressure (24%) and hyperglycemia (20%). The number of individual behavioral factors of unhealthy lifestyle has a direct impact on the quantitative profile of biomedical risk factors (p < 0,001). Given the commonality of pathogenic effects on the biomedical and social and behavioral risk factors, the main task of training of the population health in schools is to inform about the need to normalize blood pressure, cholesterol, glucose, weight, rational nutrition, optimization of physical activity and non-destructive habits to minimize risk of development and progression of non-communicable diseases.
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