卷 64, 编号 2 (2020)

Introduction. In the current environmental situation in Russia, the organization of early detection of cancer in women of fertile age is of particular importance, which has medical, social and demographic consequences. Among malignant neoplasms in women - breast cancer takes the first place in the Russian Federation. 30% of the cases are women of working age. The increase in the incidence of breast cancer in the Chelyabinsk region from 2008 to 2018 was about 30%. In 2018, the proportion of stage I-II breast cancer is 67.5%. To improve the quality of specialized medical care for patients with suspected and/or established breast cancer on the basis of the state medical institution «Chelyabinsk regional clinical center of Oncology and nuclear medicine» in 2018, a center for diagnosis and treatment of breast tumors (hereinafter - the Center) was established.

Purpose of work. Analysis of the first results of the Center’s work.

Materials and methods. Patients referred for consultation to the Center from 01.11.2018 to 31.08.2019.

Results. As a result of the work of the Center for 10 months, there was a reduction in the time of examination of patients with suspected breast cancer from 30 to 14 calendar days. The share of detected breast cancer in the region at localized stages for 10 months of 2019 was higher (69.5%) compared to the same period of 2018 (66.7%), which is based on an increase in active detection of pathology in the established Center.

Discussion. The creation of the Center has increased the availability of specialized care for patients with breast pathology. Reduced time for examination and conduct of trepan-biopsy of the tumor to confirm the diagnosis. Patients with breast cancer have a personalized approach to the treatment program.

Conclusion. The establishment of the Center allows to improve the quality of specialized medical care for patients with suspected and/or established breast cancer.

Studying the dependence of eating disorders with several factors at the same time will reveal the target population groups that have the highest risk of developing these disorders, work with which will allow more efficient use of various methods of its correction.

Purpose: to identify risk groups for the development of eating disorders depending on the individual psychological characteristics of the population, taking into account age and sex and social characteristics.

Material and methods. 688 people aged 18 to 70 years were surveyed, individually-psychological characteristics, eating disorders were diagnosed. The relationship of eating disorders with age and gender, social and individual psychological characteristics was carried out by one-dimensional and multidimensional analysis.

Results. It was showed that among the respondents 33% of sanguine people, 49% had a high level of personal anxiety, 49% had moderate stress tolerance, a tendency to develop emotional (1.9 ± 0.9) and restrictive (2.5 ± 1.0) types of eating behavior was also noted. Taking into account one-dimensional and multi-dimensional analyzes, the risk groups for developing eating disorders are: restrictive - women older than 28 years old inclusive with choleric temperament; emotiogenic - single respondents with low and high levels of anxiety; external - married men with a low level of stress tolerance and women with increased personal anxiety.

Conclusions. The considered individual psychological characteristics of the population are associated with the types of EB disturbances with a combination of several parameters. The results indicate a possible risk of developing eating disorders in the population in the context of their individual psychological characteristics, age, sex and social characteristics, which can be used in targeted counseling and preventive work with the population by developing a specialized program for correcting eating behavior for each risk group.

Introduction. A comprehensive approach in providing of medical aid to a child with comorbid pathology is intended to mean that child receives high-quality diagnostics, treatment, rehabilitation and informational support in the full extent in regard to all the diseases child has. The main problems of this category of patients are need of expanding treatment and diagnostic activities, attracting of consultants and also increasing of resource costs and breakdown of response to treatment.

The goal of research is to study the efficiency of hospital treatment of children with comorbidities in complex examination and treatment.

Material and methods. It was examined 616 children aged 7-14 years, hospitalized for asthma. At the same time, 368 children had comorbidities. One half of patients with comorbid pathology received a comprehensive examination and taking into account comorbidities, the other half - a standard set of examination and treatment of the main disease. The survey of parents and catamnestic observation of patients for 1 year was carried out.

Results. The presence of comorbidities in children with bronchial asthma, in particular the obesity and gastroenterological diseases, has a significant negative impact on the course of asthma, the efficiency of its therapy and the need for medical aid. The results of the study showed that children with high levels of comorbidity have more frequent and prolonged hospitalizations. Comprehensive screening and early treatment of comorbidities reduces the incidence of exacerbations, the risk of emergency hospitalizations and improves asthma control.

Discussion. An increase in the duration of hospitalization of patients with comorbid pathology may be associated with a severity of the main illness and a lower rate of response to therapy, possibly with reduced compliance. Although the presence of comorbidities contributes to the lengthening of hospitalization, a comprehensive examination and treatment does not increase the duration of the child’s stay in the hospital.

Conclision. The expansion of diagnostic and therapeutic actions in relation to concomitant diseases in a patient with bronchial asthma within the framework of hospitalization increases the clinical and economic efficiency of treatment measures, reduces the subsequent burden on the hospital and out-patient hospital, increases the assessment of medical care by parents and their adherence to the prescribed treatment.

Introduction. Technical products that are part of pesticides recommended for use in agriculture must undergo a comprehensive sanitary and Toxicological examination, which is the basis for preventing the adverse effects of pesticides on the health of workers and the population, as well as on the sanitary state of the environment. Purpose of research - the study of the biological effect of the technical product derived triazolinthionov, with its repeated oral intake in mammals (rats), justification of the permissible daily dose (DSD) for humans.

Material and methods. Chronic (12 months) experiment was conducted on male rats with a body weight of 200-210 g tested doses: 5.0; 50.0 and 500.0 mg/kg body weight (1 control and 3 experimental groups and 20 individuals each). In the dynamics of the experiment, we observed the condition and behavior of animals, water and food consumption, fixed the timing of death, recorded changes in body weight, physiological, biochemical and hematological parameters.

Results. It was found that the dose of 5.0 mg/kg body weight does not cause significant changes in all studied parameters, doses of 50.0 and 500.0 mg/kg body weight had a polytropic effect on the body of experimental animals.

Discussion. The studied technical product at repeated intake in doses of 50,0 and 500,0 mg/kg of body weight causes changes in the state of the Central nervous system of animals (statistically significant changes in SPP, total activity, path length, rest time), as well as changes in carbohydrate, lipid, and lipoprotein metabolism in the body, as evidenced by statistically significant changes in biochemical and hematological indicators. Consequently, doses of 50,0 and 500,0 mg/kg of body weight have a polytropic effect on the body of male rats and are effective. The dose of 5.0 mg/kg of body weight, when administered in animals of the experimental group in comparison with animals of the control group, there are no changes in all the studied parameters throughout the experiment, is accepted as invalid. On the basis of an inactive dose of 5.0 mg/kg of body weight and a reserve factor of 100, we have scientifically justified DSD for humans at the level of 0.05 mg/kg.

Conclusion. Studies have shown that long-term repeated oral administration of the studied product into the body of animals (male rats) at a dose of 5.0 mg per 1 kg of body weight does not cause statistically significant changes in all the studied parameters, so the indicated dose is invalid. Doses of 50,0 and 500,0 mg/kg MT have a polytropic effect on the body of male rats and are effective. DSD for humans at the level of 0.05 mg/kg is justified based on the inactive dose at the level of 5.0 mg per 1 kg of body weight, established in a 12-month chronic experiment conducted on male rats, and the reserve coefficient of 100 (taking into account the unexpressed specific and long-term effects).

Introduction. The development and application of medical robotics, medical robotic devices, automated technical systems in the field of health care are already quite successful and have great potential. Such large-scale technological changes inevitably actualize the social roles of law, that should properly settle, protect and guide the development of nascent social relations, which until recently occurred everywhere in a kind of regulatory vacuum.

Material and methods. The methodological basis of the study included general scientific methods (dialectical, logical, systemic, historical, sociological, statistical) and private scientific methods of legal science (formal-legal, historical-legal and comparative-legal). The empirical basis of the study was Russian and foreign regulatory legal acts and law enforcement practice, as well as legal doctrine.

Results. Based on the comparative legal study a legal definition of the medical robots and various options for their classification, among them a special one, including surgical robots, robots used in restorative medicine, rehabilitation of immobilized patients, nursing and care robots, have been developed. Cyborgs are biological organisms containing mechanical or electronic components are allocated to a special group. Legal mechanisms for ensuring security and cybersecurity in this area are highlighted. The necessity of more flexible legal regulation of personal data concerning the health of citizens and medical confidentiality under new technological conditions is justified.

Discussion. Legal regulation of the medical robots should be of a staged nature. General norms of sectoral significance can be formulated at later stages. At the moment, it is more rational to direct efforts to determine the legal regime of certain types of created artificial intelligence systems in the healthcare sector.

Conclusion. The legal concept of robotics in healthcare should take a significant place in a wide range of scientific studies of the development of new technologies for the benefit, not to the detriment, of a person.

Introduction. Chemicals are spread in all human life spheres that proposed a high risqué of poisons and occasions. In this one it’s urgent to improve of toxicological training of medical staff.

Aim: to reveal a basic knowledge at students about toxicology for developing a new offer in studying of this discipline in medical education facilities.

Material and methods. A survey of students of the Northern State Medical University was conducted on the subject of their awareness of the household, environmental and industrial aspects of chemical hazard, the structure of chemicals in the environment of the Arkhangelsk region.

Results. The degree of awareness on the basic issues of toxicology, as well as the readiness of medical students to provide first aid to people poisoned by chemicals outside the medical organization, their knowledge of the procedure for conducting preventive measures and the adoption of organizational and medical decisions in case of mass poisoning turned out to be unsatisfactory, which is due to extremely insufficient attention to discipline «Toxicology» in the implementation of the educational program.

Conclusions. It is proposed to take into account the results of students’ knowledge for the correction of the learning process with a focused study of the structure of household and industrial chemicals specific to the territory of residence and employment, as well as the assessment of chemicals from the standpoint of medical and tactical characteristics. The necessity of restoring the academic discipline «Toxicology and radiology with medical protection against toxic substances» with at least 3 credits and developing an interdepartmental program in a medical university within the framework of a new scientific and practical direction - toxicological preventology is substantiated.

As a rule, the state of health and the potential of public health is assessed based on the use of biomedical criteria. Today, these assessments need to be supplemented by social criteria, among which one of the most important is the criterion of the active attitude of individuals and communities to their health. The article presents the potential of health as a specific social phenomenon. From our point of view, the potential of health as a social property of individuals and communities has three sources and three components: the needs, abilities and willingness of individuals and communities for years with practical actions to maintain good health (physical and mental) and performance. The formation of developed systems of needs, abilities and willingness of individuals and communities to learn and use health practices is a real way to reduce social inequalities in health. Movement in this direction can lead to a significant increase in the number of Russian citizens who are able to independently solve problems to improve their health in situations that do not require emergency professional assistance. In order to revitalize the population and relevant social institutions in recreational activities, the author proposes to define the year 2021 (or another year) as the year of health.

The important and jubilee dates of history of medicine in 2021