Stimulation of platelets results in the liberation of arachidonic acid (AA) which is further metabolized via the cyclooxygenase or lipoxygenase (LPG) pathway. We have examined the effect of inhibition of LPG on (i) the ADP-induced increase of cytoplasmic Ca2+ concentration and (ii) platelet aggregation. Lipoxygenase inhibitors, nordigidroguaiaretic acid (NDGA) and BW-755C, both suppressed ADP-induced Ca2+-signals and aggregation in a dose-dependent manner, with an IC50 value of 1 2 microM for NDGA. Qualitatively the same effect was obtained with 4-bromophenylacyl bromide, the inhibitor of phospholipases A2 and C. By contrast, cyclooxygenase inhibitor indomethacin had only a negligible effect on Ca2+-signals and suppressed only the second phase of ADP-induced aggregation. It is concluded that the LPG pathway of AA metabolism in platelets might play a crucial role in ADP-induced Ca2+-signal generation and platelet aggregation.

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The aim of this article is to establish a weighted average costs of the workflow of the doctor-the therapist of the district, providing primary health care to the population in the outpatient setting to determine the costs when you visit one patient. Materials and methods. Held fotohronometra working process research 39 physicians in the 17th precinct pilot areas from all Federal districts. Within fotohronometra research conducted 6474 measurement. Results and discussions. The average time a physician of the district while visiting a patient in a medical organization made up of 15.30±2.0 min, while visiting at home - 32.5±2.0 min the Largest proportion of the working time of the doctor-the therapist of the district while visiting a patient in the outpatient setting is necessary to work with medical records (47.31%). On core activities while visiting a patient in the practitioner, the district spends to 45.54% of the time. For other activities - 7.15%. Conclusion. As a result fotohronometra research workflow of doctors-therapists of district, providing primary health care in outpatient settings, set the average time a physician of the district while visiting one patient (15.30±2.0 min), while visiting at home (32.5±2.0 min).

The photo time-keeping monitoring of working of 50 physicians of ultrasound diagnostic was carried out in 20 pilot territories with consideration for modern technical possibilities. The substantiation of the study was based on point 3 of the regulations of development and authorization of type labor standards, approved by enactment of the Government of the Russian Federation of November 11 2002 № 804 (legislation corpus of the Russian Federation, 2002, № 46, article 4583) and point 19 of the plan of actions («road map») «The alterations in sectors of social sphere directed to increasing of efficiency of health care», approved by the enactment of the government of the Russian Federation of December 28 2012 № 2599-p (legislation corpus of the Russian Federation, 2013, № 2, article 130; № 45, article 5863; 2014, № 19, article 2468). The results of study testify the necessity of development of normative documentation related to establishment of standards of load of endoscopy physicians concerning increasing of time spend to implementation of curative diagnostic examinations.

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Aging is one of the major global demographic trends, including in the Russian Federation. In this regard, health officials pay a special attention to the resource and regulatory support for care delivery to people older than working age, taking into account the changed conditions and capabilities of medical organizations. The purpose of the study was to assess normative documents and main indicators characterizing the number and performance of geriatricians providing medical care to the elderly and senile people. Material and methods: retrospective analysis of data from federal statistical observation forms No. 30 for the period from 2015 to 2020, data on the population aged 60 years and older, Rosstat data, orders of the Ministry of Health of the Russian Federation No. 38 and No. 297. Content analysis of regulatory documents, statistical (calculation of extensive and intensive indicators), descriptive statistics using MS Office Excel 2016, Statistica 6.1. The study results showed that, despite a gradual increase in the number of geriatricians and relevant visits by patients of this category, the full-time position staffing remains low, affecting a growth in the part-time coefficient, suggesting a need for training geriatricians. For example, the number of geriatricians in Russia as a whole in 2020 equaled to 0.09 per 10,000 population older than working age. The ongoing decline in medical position staffing against a background of a positive growth rate in the number of medical specialists is probably due to the gap between the increasing number of full-time positions and the staffing rate by individuals. Conclusion: the study results have identified the need for developing time standards that correspond to the modern conditions of primary care delivery by geriatricians, as well as establishing workload standards and the actual number of doctors in this specialty to ensure high-quality care delivery to the elderly.

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Significance. One of the most actual problems in medical care organization is personnel-related problem due to insufficient number and staffing levels of medical organizations against the background of a high incidence of diseases requiring emergency medical care. Purpose of the study. To evaluate the number of ambulance crew doctors and their staffing levels in the Russian Federation. Material and methods. The study used data from the form N30 of the Federal statistical observation «Information about medical organization» for calculating indicators on the number of ambulance crew doctors, staffing and ratio of ambulance crew doctors holding a second job in the Russian Federation, federal districts and constituent entities of the Russian Federation in 2016 - 2020. Analytical, statistical, descriptive methods were used. Results. The study shows that in the Russian Federation, ambulance crew doctors have high rates of holding second job under the study period (2016-2020), their number decreased by 10.0% (from 15107 to 13602) resulting in a decline from 1.03 to 0.93 per 10,000 population and reduced staffing level (from 73.4 to 69.3%). However, in some constituent entities of the Russian Federation, the situation in terms of number and staffing levels of ambulance crew doctors is far from being unambiguous: in some constituent entities the indicators increased under the study period while in others – decreased. However, the trend towards a lower rate of ambulance crew doctors holding a second job is typical for all federal districts. Conclusion. Analysis of the number and staffing levels of ambulance crew doctors showed an unequal situation in constituent entities of the Russian Federation, with a general decrease in the average statistical indicators in the country. Scope of application. The study results can be of interest to health care organizers and practitioners.