The article presents the pharmacoeconomic rationale for the inclusion of vaccination against varicella in the regional calendar of preventive vaccinations on the example of the Penza region. Varicella remains one of the most common infectious diseases in the studied region and in the Russian Federation as a whole. With the limited amount of budget funds allocated for the program of vaccination, it is necessary to assess their economic efficiency. For the economic evaluation, there was developed the algorithm of calculations contained in the software based on MS Excel in order to get the result when you change the source of regional data. As a result of calculations, the vaccination in the Penza region was revealed to be a profitable investment. The sustainability of the two-time vaccination of a cohort of children aged 1 year against the Varicella held in 2016, will come in for 2018, and further savings (prevented damage) will increase steadily. By the end of 2029, “net economic benefit” will be about 246.5 million rubles, the damage prevented would exceed the cost of the vaccination of a cohort of 6 times.
The relevance of the topic is due to insufficient awareness of doctors about neurofibromatosis, which leads to a delay in diagnosis and the development of complications. The diagnostic criteria characteristic of this disease, features of the clinical course, possible complications, methods of treatment, features of dispensary observation are described. A clinical case of neurofibromatosis type I with astrocytoma of the brain is described. The diagnosis of neurofibromatosis type I (NFI) was established in a patient aged 4 years 3 months. The peculiarity of the manifestations of this clinical case is the absence of family history; the combination of cutaneous manifestations, multiple lesions of the nervous system, complicated by chronic subdural hematoma, endocrine disorders and extra-cutaneous manifestations (eye symptoms, hearing and speech disorders); the absence of significant positive dynamics despite repeated surgical treatment and long-term polyochemotherapy. Despite the stabilization of clinical manifestations of the disease, this patient has an unfavorable prognosis with possible progression of the pathological process. For early clinical detection of patients with NFI, using for this purpose diagnostic criteria recommended by the International Committee of experts on neurofibromatosis, continuity of management and adequate measures of primary and secondary prevention of complications of NFI is important knowledge of this pathology by primary health care physicians, including pediatricians, district and family doctors, neurologists, dermatologists, ophthalmologists and surgeons.
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