Optimization of provision of specialized medical care for patients with maxillofacial neoplasms in the Penza region of Russia

We report the experience of radical treatment by photodynamic therapy of patients with squamous cell carcinoma of oral cavity with serious side diseases. Completed treatment of two patients with serious side diseases (HIV infection with associated pulmonary hypertension of high degree and cardiac pathology) suffered from cancer of oral cavity. Extensive surgical treatment and/or aggressive course of chemoradiation therapy were not indicated to them due to concomitant pathology. Both patients were diagnosed with squamous cell carcinoma of oral cavity, with appropriate stage Ist. сT1N0M0. Patients received treatment by photodynamic therapy with chorine photosensitizer in dose 1 mg/kg. Options of photodynamic were: output power – 1.5W, power density – 0.31 W/cm2, light dose – 300 J/cm2. After one time session of photodynamic therapy, in both cases full response was diagnosed (according to RECIST 1.1). In one case the second session of photodynamic therapy was performed due to concomitant disease of oral cavity – multiply lesions of leukoplakia and after was diagnosed full remission of all lesions. Major adverse event was pain during the first 5-7 days after treatment, curable by painkillers. Follow-up (IQR) was 12 and 18 month respectively with no evidence of progression. It is available to avoid extensive surgical treatment and aggressive course of chemoradiation therapy (as an alternative) with the use of photodynamic therapy. Photodynamic therapy is minimally invasive method of radical treatment of localized squamous cell carcinoma of oral cavity with minimal adverse events, and could be especially relevant in patients with serious concomitant diseases.

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Photodynamic therapy treatment of oral cavity cancer in patients with comorbidities

Panaseykin

Капинус

Филоненко

et al. 2023

Biomedical photonics

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Improvement of the Process Approach in the Routing of Patients With Malignant Malignances of the Maxillofacial Region in the Territory of the Penza Region in 2021

Lebedev

Kerimova

I.Yu.

2021

Mediko-farmacevtičeskij žurnal "Pulʹs"

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The worldwide concern about oncological morbidity is due to the steady increase in the detection rate of malignant neoplasms, which has a tendency to increase. More than 7 million people die from oncology every year in the world. The system of organizing the provision of medical care to the population with oncological diseases in the Russian Federation is currently undergoing a stage of improvement. New programs are aimed at early diagnosis and prevention of malignant neoplasms. Each region has the right to create and implement routing taking into account the territorial characteristics and the existing material and technical base and personnel. The routing system, created for a specific region, determines the order of treatment of patients and the functions of all links in the system of providing medical care to patients with oncopathology. An optimized system for routing patients according to the "Oncology" profile for patients with malignant neoplasms of the maxillofacial region should be structured in accordance with the regional healthcare system. A complex system of interaction, an information system capable of containing and processing a set of information, a trained interested staff dictate the need for making management decisions in the direction of optimizing the oncological service. Management decisions and technologies should be focused on improving the quality and speed of patient admission, providing highly qualified medical care using modern equipment and algorithms. The staff, in turn, determines the basis of the health care system, in connection with which it is necessary to continue education, identify and search for specialists that a specific organization needs, on which the functioning of the entire service for providing medical care to patients with oncopathology of the maxillofacial region depends. In general, the optimization of the system of providing medical care to patients with malignant neoplasms of the maxillofacial region dictates the need to combine organizational measures and a clinical approach. Unambiguously, the multi-component system of integration of various directions and departments in the process of organizing an oncological service predetermines the need to use modern management technologies and the use of all available resources in order to improve the quality of medical care.

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Organizational Model of Optimization of Nursing by Introducing the Position of Clinical (Universal) Nurse in the Department of the Center for Maxillofacial Surgery

Lebedev

K.I.

I.Yu.

2022

Mediko-farmacevtičeskij žurnal "Pulʹs"

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The trend of continuous growth in the number of patients with pathology of the maxillofacial region necessitates the optimization of the medical care service in the profile of maxillofacial surgery and the introduction of a patient-oriented approach to medical care. On the territory of the Penza Region, in order to improve the quality of medical care for patients with head and neck pathology, a Center for maxillofacial surgery was established on the basis of the State Budgetary Healthcare Institution "Penza Regional Clinical Hospital named after N.N. Burdenko" in 2020. The work of the Maxillofacial Surgery Center is based on the principles of continuity and complementarity of specialists of a medical organization in the process of providing medical care. For this purpose, new specialists and positions in the staffing table have been introduced into the structure of the Center. In the course of optimizing the medical care service in the profile of maxillofacial surgery, the role of the nursing staff has been revised in the direction of increasing its professional competence. Increasing the competence of nurses is one of the pressing issues of effective development of the healthcare system. The staff of the Maxillofacial Surgery Center has introduced a new form of organization of the work of nursing staff - a clinical (universal) nurse. A clinical nurse has been assigned the duties of a post, procedural and dressing nurse, but the number of patients under observation has been reduced. With the introduction of a new position, nurses have the opportunity to expand the potential of their professional duties, increase the level of personal development. Clinical nurses have become more independent in making decisions when providing medical care within their competencies, and have expanded the scope of professional knowledge. The expansion of the profile of the manipulations performed contributes to the development of nursing specialists, allowing them to become universal, which provides a higher level of qualification. In general, a more professional, patient-oriented approach to the provision of medical care in the Center of Maxillofacial Surgery to patients with pathology of the maxillofacial region in the Penza region has been provided.

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Optimization of provision of specialized medical care for patients with maxillofacial neoplasms in the Penza region of Russia

Cited by 3 publications

References 16 publications

Photodynamic therapy treatment of oral cavity cancer in patients with comorbidities

Photodynamic therapy treatment of oral cavity cancer in patients with comorbidities

Improvement of the Process Approach in the Routing of Patients With Malignant Malignances of the Maxillofacial Region in the Territory of the Penza Region in 2021

Organizational Model of Optimization of Nursing by Introducing the Position of Clinical (Universal) Nurse in the Department of the Center for Maxillofacial Surgery

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