scholarly journals Dermatovenereology of Russian Federation in 2020: Working Under a Pandemic

2021 ◽  
Vol 97 (4) ◽  
pp. 8-32
Author(s):  
Alexey A. Kubanov ◽  
Elena V. Bogdanova

The article presents an analysis of the resources and activities of medical organizations providing medical care in the field of dermatovenereology for the period 20152020. Up-to-date data on the number of medical organizations and units providing specialized medical care in the field of dermatovenereology are provided. A description of the main changes in the provision of the population of the Russian Federation with dermatovenereologists, staffing with dermatovenereologists of medical organizations is given. Changes in the number of outpatient visits in 2020 are given. The dynamics of the bed fund of 24-hour and day hospitals of a dermatovenereological profile, the bed occupancy, the number of patients treated is described. The data on the incidence of sexually transmitted infections, infectious skin diseases are presented. Prevalence and incidence rates of diseases of the skin and subcutaneous tissue, including atopic dermatitis and psoriasis, are given. The impact of measures aimed at preventing the spread of a new coronavirus infection and organizing the provision of medical care to patients with COVID-19 on the performance rates of dermatovenereologic medical organizations has been demonstrated.

2020 ◽  
Author(s):  
Antonio Leon Justel ◽  
Jose Ignacio Morgado Garcia-Polavieja ◽  
Ana Isabel Alvarez Rios ◽  
Francisco Jose Caro Fernandez ◽  
Pedro Agustin Pajaro Merino ◽  
...  

Abstract BACKGROUNDHeart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF.METHODSThis is a real-world, before-and after-intervention trial, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before and after an intervention. The primary objective was the rate of readmissions, due to a HF event, post-intervention compared to pre-intervention. Secondary outcomes compared the rate of ED visits and the number of patients who had reduced NYHA score pre and post-intervention. A cost- analysis was also performed on these data.RESULTSAdmission rates significantly decreased by 41% after the intervention (total length of stay was reduced by 55%). The rate of ED visits was reduced by 55%. Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was €139,717.65 for the whole group over 1 year.CONCLUSIONSA personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care- associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.


2018 ◽  
Vol 15 (5) ◽  
pp. 410-415
Author(s):  
Eleonora I. Pilguy ◽  
Leyla S. Namazova-Baranova ◽  
Nikolay N. Murashkin ◽  
Igor A. Gundarov

Background. Taking into account the variability in the incidence of skin and subcutaneous tissue diseases among children aged 15–17 years by constituents of Russia is an important condition for optimizing pediatric dermatological care. According to modern literature, this issue has been underinvestigated.Our aim was to study the nature of the variability in the incidence of skin and subcutaneous tissue diseases among children aged 15–17 years by constituents of the Russian Federation.Patients and Methods. State medical statistics for 83 constituents of the Russian Federation for 2009–2015 were used. The risk aggregation method was used in the study. The degree of morbidity variability by region was assessed by the range of variation and coefficient of variation. Subjects were ranked according to the annual incidence rate. To assess the sustainability of the subjects’ belonging to a certain rank place, the Spearman's rank correlation coefficient was used.Results. In 2009, the incidence of skin and subcutaneous tissue diseases among children aged 15–17 years in Russia had significant variability: the range of variation was 8.3 times, the coefficient of variation was 29%. Subjects were ranked by year. In 2010–2015, annual variability indicators remained high. Ranked places of subjects had rank correlation coefficients of 0.53–0.83 as compared to 2009. Groups of subjects with different levels of pediatric dermatological morbidity have been identified.Conclusion. The incidence of skin and subcutaneous tissue diseases among children aged 15–17 years by constituents of the Russian Federation during 2009-2015 was characterized by significant variability. Subjects had a stable belonging to a certain rank place. The constituents of the Russian Federation have been divided into groups according to the incidence rates for skin and subcutaneous tissue diseases.


2019 ◽  
Vol 65 (5) ◽  
pp. 300-310 ◽  
Author(s):  
Natalya G. Mokrysheva ◽  
Svetlana S. Mirnaya ◽  
Ekaterina A. Dobreva ◽  
Irina S. Maganeva ◽  
Elena V. Kovaleva ◽  
...  

BACKGROUND: There are no large-scale epidemiological studies on primary hyperparathyroidism (PHPT) in Russia. The high prevalence of the disease, the high risk of disability and death in this cohort of patients requires the study of the epidemiological and clinical structure of PHPT to determine the extent of medical care. AIM: Evaluate the frequency of PHPT detection and characterize its clinical forms in Russia using an online registry. METHODS: The object of the study is the database of the State Register of Patients with PHPT 1914 patients from 71 regions of the Russian Federation. New cases of the disease, as well as dynamic indicators are recorded when patients visit outpatient clinics or medical institutions. The analysis of data made at the end of December 2017 was carried out. The following parameters were evaluated: demographic and clinical indicators; indicators of phosphorus-calcium metabolism, the main forms of PHPT and its course, the primary characteristic of PHPT in hereditary syndromes and parathyroid carcinoma. Results are presented as mean and standard deviations, or medians and quartiles; descriptive statistics of qualitative attributes absolute and relative frequencies. RESULTS: the total number of patients with PHPT in the registry on 31 of December 2017 was 1914 cases (0.001% of the population of the Russian Federation). Identification of PHPT was 1.3 cases per 100 thousand of the population in Russia, 7.6 cases in Moscow, 6.1 cases per 100 thousand in the Moscow region. The average age of patients at the time of diagnosis was 55.6 10 years. The active phase of the disease was registered in 84.6% of patients (1620/1914), most of whom had a symptomatic PHPT 67.1% (1087/1620), and 32.9% a asymptomatic disease (533/1620). Symptomatic disease with visceral complications was detected in 15.8% cases (172/1087), with bone complications in 48.4% (526/1087). The mixed form of the disease was detected in 35.8% of patients with manifest form (389/1087). Normocalcemic variant PHPT (nPHPT) was registered in 14.5% cases (234/1620). Sporadic PHPT occurs in 83% of cases (1592/1914). 326 patients (17%) had a suspicion for hereditary form of the disease: average age was 31.2 12.3 years. A genetic analysis was conducted in 61 patients (3.2%): showed the mutation in the MEN1 gene in 2.9% of cases (55/1914) and the mutation in the CDC73 gene in 0.3% of cases (6/1914) (HPT-JT syndrome). Parathyroid carcinoma was confirmed in 1.8% of all patients (35/1914). Surgical treatment was performed in 64.5% of patients (1234/1914). Remission was achieved in 94% of cases (1160/1234), in 6% of cases relapse after surgical treatment or persistence of PHPT was recorded. CONCLUSION: detection of PHPT in the Russian Federation raised in comparison to 2016, which is associated with an active start of registration of patients in the regions. At this stage, it is necessary to modify the principles of registration and control, to make a platform for gathering information and calculating the necessary volumes of medical care for PHPT patients.


Author(s):  
G. R. Hachatryan ◽  
T. S. Teptsova ◽  
V. A. Lemeshko ◽  
N. Z. Musina

The aimis to analyze the medical records of patients with malignant lymphoproliferative diseases (LPD) in the Russian Federation in 2016- 2017.Materials and methods. Treating physicians in 75 regions of the Russian Federation were asked to fill the survey questionnaire containing 9 types of malignant LPDs (according to the ICD-10 classification). The questions covered the epidemiology of LPD (prevalence, resistant forms, relapses and mortality), the existence of specialized institutions and beds, the costs of medical care in patients with malignant LPD, and the financial support of pharmacotherapy in these patients during their hospital stay.Results. We found that the most common malignant LPD in 2016-2017 was Hodgkin’s lymphoma (73.5 and 73.4%, respectively). The prevalence of resistant forms and recurrences of malignant LPD over this period accounted for 6.8% of the total patient population. In 2017, the number of patients who died was 7.5% less than that in 2016. There are 815 and 1,763 specialized institutions of the oncology and hematology profiles that provide medical care to children and adult patients, respectively. Among the malignant LPDs, the highest costs of drug therapy in 2016 pertained to lymphosarcoma, and in 2017 – to Hodgkin’s lymphoma. In the system of compulsory health insurance (OMC), the largest spending for both adult and pediatric patients in 2016 and 2017 was accounted for Hodgkin’s lymphoma; a similar result was obtained for the cost of therapy based on high-tech medical care.Conclusion. In 2017, the total number of patients with malignant LPD in the Russian Federation increased by 2.65% as compared to 2016, while the proportion of primary LPD decreased by 1.2%. In 2017, the total costs of drug supply in patients with malignant LPD in the RF increased by 55.35% as compared with 2016.


2019 ◽  
Vol 100 (2) ◽  
pp. 310-316
Author(s):  
I A Poslavskaya

Aim. To perform the analysis of psychiatric service of the Moscow region and to determine the basic targerts to improve the availability of psychiatric service for the population of the Moscow region. Methods. The study included the methods of retrospective statistical observation based on the data from the official statistical forms of annual reports (forms №14, №30, №36) of psychiatric institutions of the Moscow region in 2013-2017. Results. The Moscow region is a territory of sustainable social economic development. In terms of fertility it takes the 1st place among the subjects of the Central Federal district, and 27th place in the Russian Federation. Specialized psychiatric care for the population of the Moscow region is provided in neuropsychiatric dispensaries, hospitals, day hospitals of psychiatric clinics, based on three principles: a differentiated approach to assist different patient cohorts, stepwise and continuity of care at different stages. Despite the restructuring of the psychiatric service and the widespread reduction of the number of beds in the Russian Federation, bed capacity of psychiatric hospitals in the Moscow Region remains at the same level, although there has been a negative dynamics in the work of the hospital bed from 354.3 days in 2013 to 329 in 2017. At the same time, the efficiency of day hospitals has increased: the length of stay of patients in the day hospital has decreased from 51 in 2013 to 39 days in 2017, the day bed turnover rate has increased from 5.5 to 5.9. In five years, the number of patients discharged from day hospitals has increased: 2 200 in 2013 and 2 521 in 2017. In the outpatient service there is a steady decrease in the number of dispensary patients (decreased from 71 413 to 69 364 in 5 years), and vice versa, the number of patients provided with counseling and treatment increased from 79 023 to 93 697. The number of diseases-related visits to a psychiatrist is decreasing. In 2013, 781 243 disease-caused and home visits occured, in 2017 - 496 540. Conclusion. The results of the conducted study indicate both positive tendencies and negative sides of psychiatric service for the population of the Moscow region, which should be taken into account when planning reorganization and optimization of functioning of psychiatric service in the modern conditions: increased number of day beds, establishing medical rehabilitation departments, reduction of inefficient hospital beds.


Author(s):  
V.V. Chuksina ◽  
◽  
K.A. Mirvoda ◽  

The subject of this article is Law of the Russian Federation on Amendments to the Constitution of the Russian Federation (14.03.2020 No. 1-Federal Constitutional Law) «On improving the regulation of certain issues of the public power organization and functioning», namely, aspects of «coordination of health care» and «protection of the family, motherhood and childhood». The authors analyzed the issues of the medical care provision centralization, the impact of these amendments on the legal capacity of citizens. For a more in-depth analysis, the experience of foreign countries (Canada and Germany) was used. Despite the fact that the health care systems of the countries cited as an example differ in their essence and organization, nevertheless, they influence the formation of the availability of medicine for the population. As a result of the study of this experience, it was concluded that the delegation of freedom in the provision of medical care to lower levels of government allows to provide to the population affordable and high-quality medical care. It is noted that at present it is necessary to review the degree of participation of local governments in ensuring the availability of medical care in accordance with the federal law.


2020 ◽  
pp. 26-36
Author(s):  
I. V. Laricheva ◽  
◽  
I. M. Son ◽  
E. S. Yastrebova ◽  
V. V. Neroev ◽  
...  

Retinal diseases are significant causes of blindness and vision loss and they take the second place in the structure of disabilities due to blindness in Russia. Objective: analysis of the official statistical data on the disease and availability of health care to patients with age-related macular degeneration (AMD) and diabetic retinopathy (DR) that are prescribed intravitreal injection of drugs (IVD) as the first-line therapy for wet age-related macular degeneration and diabetic macular edema, respectively. Materials and methods: Epidemiological parameters were assessed by the data obtained from the form of statistical records № 12 for 2018–2019 years. The availability of IVD was analyzed by the information registered in the form of statistical records № 14 for 2016–2019 with a recalculation per 1000 population. Results: In 2019 in the Russian Federation 330 thousand patients with AMD were registered (0.45% among the population older than 40 years old). The incidence rate was significantly lower than in other countries (8.69%). The data on the number of patients with DR was unavailable for statistical recording because of the absence of the code Н36.0 IDC‑10 in form № 12. However, according to the federal register of diabetes mellitus, the total rate of DR can reach 760 thousand people all over Russia. The availability of IVD for all-day inpatient health care was 0.39 injections per 1000 population. In 26 subjects of the Russian Federation, the availability was higher than the average in Russia, while in the rest 59 subjects, the availability was lower than the average. Presently, there are no data on the number of IVD performed in day-time inpatient facilities. Conclusions: The current rate of application of IVD in Russia can be estimated as low considering the revealed problems with the registration and accounting of patients with AMD and DR. It is impossible to perform a complete evaluation of the availability of IVD for the Russian population within obligatory medical health insurance because of the lack of data on the provision of IVD in day-time inpatient facilities. For the rational planning of the volumes of medical care provision to patients with AMD and DR, the form of statistical records should include the data on the indication of IVD in the day-time inpatient facilities in the subjects of the Russian Federation.


2016 ◽  
Vol 21 (5) ◽  
pp. 264-270
Author(s):  
L. M Kogoniya ◽  
M. Yu Byakhov ◽  
A. Yu Fedotov ◽  
M. Orlando ◽  
A. A Minasyan ◽  
...  

Objective. The aim of the study is the evaluation ofpsychosocial and medico-social aspects of outpatient cancer care by patients in Russian Federation for the time present. Material and Methods. There was executed a sociological survey of consecutively included oncological patients who received chemotherapy or hormonal therapy at two medical institutions in Russia from May 2009 to May 2011. Results. A total of 350 oncological patients participated in the study. The majority of participants (79.7%) were females, the age of the majority of patients ((79.7%)) varied between 50 and 79 years. The most common primary lesion type was breast cancer (51.1%). 17.3% of patients reported that they felt fear, and this number increased to 37.5% in the aged group of from 40 to 49 years. A substantial number of patients (24.0%) felt uncertainty over outcome of their disease and 5.0% reported a feeling of hopelessness. A part of surveyed patients (21.7%) would like to get an understandable instructions in the form of the booklet as on the organization of everyday living as about their disease. 10.9% of patients noted that they had insufficient information about their disease and 18.8% of cases would like to know more about their diagnosis. Approximately the one-third ofparticipants reported about the improvement of the attitude of their spouses (31.7%) and children (32.0%) after the establishment of the oncological diagnosis. Conclusions. Diagnosis of the oncological disease was frequently associated with feelings of discomfort andfear that it might negatively impact on the quality of life in patients and their families. These feelings and the impact may be reduced by virtue of more effective communication and provision of information concerning the disease. Results of the performed two-center survey indicate to the need for elevation of the efficacy of communication between the patient and physician.


Author(s):  
I. V. Isaeva

Relevance. In accordance with the Decree N 254 of the President of the Russian Federation dated June 06, 2019 “About strategy of the public health development in the Russian Federation up to the year 2025”, one of the primary challenges of public health is providing access to medical care for every citizen irrespective of his/her location in the country. Patients with life-threatening acute conditions should get emergency medical care within so-called “golden hour”, with selecting optimal routes to the appropriate specialized medical centres as soon as possible. In Russia, this can be realized only via air medical evacuation.Intention. To assess an existing routing system based on the aero-medical evacuation in the regions of the Russian Federation, both under emergency and routine conditions.Methodology. Reports of the Territorial Centres for Disaster Medicine and health authorities of the entities of the Russian Federation were studied.Results and Analysis. Standard locations of the capitals of the Russian Federation entities are described, along with need to cooperate with adjacent regions for evacuating patients both routinely and in case of emergencies. Trends and options of air medical transportation are prioritized to minimize risks of health deterioration in patients and casualties. The study showed increase in the number of patients evacuated via air transportation. Control over routing during medical evacuation of injured in emergencies can reduce the mortality rate due to transporting them to specialized medical centers.Conclusion. Aero-medical transport is extremely demanded for evacuating the injured in emergencies to interregional and federal medical centres.


2018 ◽  
Vol 97 (10) ◽  
pp. 967-971
Author(s):  
I. V. Yatsyna ◽  
Elena N. Kryuchkova ◽  
I. Yu. Zhadan

Introduction. High anthropogenic load in the industrialized regions poses a threat to the health of children. Atopic dermatitis (AD) takes one of the leading places in the overall structure of allergic diseases. The purpose of the study was to substantiate preventive measures aimed at reducing the incidence of atopic dermatitis among children living in the territory of the industrially developed region and to evaluate their effectiveness. Material and methods. the analysis of the state of the environment and the incidence of allergodermatosis in children residing in the Mytishchi district of the Moscow region. Two groups of patients aged from 14 to 17 years (70) were selected to develop measures for the prevention of atopic dermatitis. The first group received intravenous laser irradiation of blood (ILRB) and traditional therapy, the second - only traditional treatment. Laboratory studies included indices of immune and antioxidant status. Results. The unfavorable trend in the prevalence of allergic skin diseases in children is presented: allergic dermatoses make up 44.5% (AD - 36.8%, eczema - 7.7%). The increase in severe and moderate forms of AD by 7% and 15% was noted. In this region statistically significant correlations between indices of the air pollution, drinking water, technogenic loading and level of the morbidity rate of skin, including (AD)(r=0,73-0,84) are revealed. Application of the ILRB in children with atopic dermatitis had a positive impact on the state of cellular immunity: the number of CD3+and CD8+ lymphocytes increased by 1.2-1.4 times, the level of IL-10 and IL-4 decreased by 1.5 times; humoral immunity (the number of patients with a positive effect on indices of IgA, IgM, IgE, CIC, was more than 80%); antioxidant status (MDA decreased by 1.3 times, the activity of serum catalase increased by 1.2 times). In general, there was an improvement in the clinical course of the skin damage process, an increase in terms of remission. During the six-month following-up of patients included in the study, in the ILRB group, only 20% had an exacerbation of the disease compared to 68% of the group receiving traditional treatment.


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