Policy and strategy in the field of health protection

ACTUAL PROBLEMS OF EMERGENCY MEDICAL CARE

Statistics of the frequency and nature of emergency conditions and injuries, the organization of urgent (emergency) medical care provided for them are given. The article describes the features of emergency medical care in single emergency conditions and in accidents and catastrophes, natural disasters with a large number of victims and triage. Both the unified system of emergency medical care in the country, its structure and stages, forms of training and requirements for medical equipment of units at all levels (stages) of emergency medical care are presented.

Medical education

INNOVATIONS IN POSTGRADUATE TRAINING FOR DENTAL DOCTORS

Modern trends in teaching students at the stage of postgraduate education require non-standard and creative approaches from higher school teachers. The staff of the Department of Dentistry of Therapeutic and Pediatric Dentistry KhMAPE implements innovative methods and approaches in the pedagogical process aimed at stimulating interest in learning and mastering practical skills. To our listeners we offer to take an active part in clinico-referee conferences, intellectual competitions on professional subjects, consolidate and practice practical skills in a phantom class, participate in interactive seminar sessions organized by our teachers.

Up-to-date problems in medicine

FAST-TRACK ANESTHESIA DURING ABDOMINAL CAVITY SURGERY IN PATIENTS WITH OBESITY

Implementation of the Fast-track anesthesia is interesting for the Fast-track surgery concept realization in obese patients. We evaluated the influence of combined inhalation-epidural anesthesia (CIEA) and total intravenous anesthesia (TIVA) on the recovery of 56 patients with BMI 37 ± 6 kg/m2 after laparotomy. CIEA-group patients (n = 28) in comparison with TIVA-group pa- tients (n = 28) were extubated earlier (18 ± 10 min vs 37 ± 14 min, accordingly, p < 0.05), developed less amount of pulmonary complications (3 vs 12 cases, accordingly, p < 0.05), felt less level of pain (100 vs 50 % of patients, accordingly, p < 0.05), restored earlier the peristalsis on the 1st day (36 vs 0 % of patients accordingly, p < 0.05) and on the 2nd day (90 vs 39 % of patients, accordingly, p < 0.05). We concluded that CIEA can be considered as a Fast-track technique of anesthesia during laparotomy in obese patients.

Dicsussions

Development axiological potential directors in the professional community of doctors and pedagogues

The definition and structure of the axiological potential formulated within the meaning of the authors. Presented the problem of determining in practice the basic values directors and leaders, as well as the development axiological potential in professional activities of doctors and pedagogue.

Scientific reviews and clinical lectures

MODERN METHODS OF DIAGNOSTICS AND PREDICTION OF UROTHELIAL CANCER OF THE URINARY BLADDER

A literature review of modern methods of diagnosis and prognosis of urothelial bladder cancer was conducted. It is determined that despite the variety of diagnostic methods that allow to establish the diagnosis of a primary tumor with great accuracy, the results of treatment do not always coincide with those expected. For forecasting the risk of developing relapse, progression and metastasis, forecast criteria are needed. Immunohistochemical method of research using diagnostic and prognostic oncomarkers allows to solve the problem by comparing clinical and morphological signs of a tumor with immunohistochemical data. For a more accurate result of the study, the oncomarker panel is used. Attention is paid to the fact that the establishment of direct or feedback of the level of expression of oncomarkers in their various combinations gives a more accurate answer to the problems posed. A clear prognostic panel of oncomarkers recommended by the World Health Organization does not exist. For a differential approach to the treatment of patients, optimization of existing and search for new panels of oncomarkers is necessary.

To help the practicing physician

MECHANICAL COMPONENT OF THE LEAKTIGHTNESS OF ESOPHAGO-ENTEROANASTOMOSIS

The results of various methods of esophago-enteroanastomoses in 157 patients were analyzed. It was established that the best results were obtained in the formation of esophago-enteroanastomoses according to the method proposed by us by using reinforcing sero-serous sutures.
In cases of using reinforcing sutures, cultures from the abdominal cavity are sterile from 5 days after the operation and further, throughout the study. When forming an anastomosis without such an abdominal cavity begins to «clean» from the microflora only by 7 days.
This technique can reduce the number of postoperative complications in the form of anastomoses failure from 13.2 to 6.7 %, which positively affects on the quality of patients’

Tribune of young scientist

RELATIONSHIP BETWEEN COEFFICIENT OF ATHEROGENICITY AND SOLUBLE VASCULAR CELL ADHESION MOLECULE TYPE 1 IN PERSONS WITH ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS

The aim of our study was the determination of relationship between soluble vascular cell adhesion molecule type 1and coeffi ent of atherogenicity in patients with arterial hypertension and type 2 diabetes mellitus. 96 persons with arterial hypertension and type 2 diabetes mellitus (І group), 25 persons with arterial hypertension (ІІ group), 15 practically healthy people (ІІІ group) were obtained. The positive connection between the level of soluble vascular cell adhesion molecule type 1 and coefficient of atherogenicity (r = 0,2; р= 0,0495) is the confirmation of important role of endothelial disorders and immune inflammation in atherosclerosis progression in patients with arterial hypertension and type 2 diabetes mellitus.

Anniversaries

Historical essay to the 90th anniversary of the radiology diagnostics department and to the 95th anniversary of the Kharkiv medical academy of postgraduate education

The article contains data on the foundation of the Department of radiation diagnostics of the Kharkov medical academy of postgraduate education, outlines the achievements of the scientific and educational activities of the head and staff of the department, and the main scientific research conducted in different historical periods. It reports the training of scientific and scientific-pedagogical personnel, the contribution of the department to the development of radiation diagnostics, and the improvement of educational activities.