2018, volume 14

Medical institutions in the conditions of insurance medicine are faced with not always justified interference of insurance companies in the structure of diagnosis and diagnostic process, whose violate the essence of the concepts of clinical classifications and statistical coding of diagnoses provided by ICD-10. Such a situation ultimately harms the patient and society, makes it difficult both to monitorthe adequacy of the ongoing treatment activities, and to protect the patient's rights to receive qualified medical care and doctor's rights.

Age-related diseases and their link to involutionary processes in human organism remain as one of the burning problems in internal medicine. The article focuses on the discussable questions of the most common mechanisms of atherogenesis and ageing, their similarity and difference. Both processes mutually burdens each other, bringing the "fading" of the organism closer.

The article illustrates the life of Professor Valeriy Vladimirovich Shchukovsky and his scientific contribution into the development of separate branches of emergency medicine, namely intensive care of patients with embolism and acute thromboses of large vessels, severe thermal traumas, endotoxemia and multiorgan dysfunction syndrome, traumatic disease of spinal cord and its visceral complications in acute and early periods, reperfusion visceral injuries following its transplantation and patients with coagulopathic hemorrhage.

The article is devoted to medical, scientific, pedagogical and public activities of V.A. Surat who was a professor and a head of pediatric departments in Saratov, Alma-Ata and Stalingrad Medical Universities.

Objective: to identify the variability of frontal sinuses size patterns divided by sex and age in adults. Material and Methods. 83 X-ray computer tomograms of the head of adults without any signs of paranasal sinuses pathology and without traces of surgery on the external structures and internal nose in the history were studied. Results. It has been found the best pneumatized frontal bones in males; the rapid growth of the frontal sinuses occurs more in men in the 1st age group, whereas in women, the formation of the frontal sinus is smoother and more uniform during the whole life. Conclusion. Men have depth prevailing characteristics of frontal sinuses in the 1st age group and the width on the left side in the 2nd age group differing significantly in comparison to women group; height of the sinus in men decreases with age, whereas in women it does not change its value significantly; bilateral values for the parameters of the frontal sinus do not have reliable sex and age differences.

.The goal of the workwasto determine on the basis of sociological research the representation of medical students about the possible risks of sexual relations. Materials and methods. The survey of 659 students of medical and pediatric faculties of Saratov State Medical University n.a. V. I. Razumovsky and Volgograd State Medical University. Results of the research demonstrate that the most significant risks of sexual relations considered by the students are sexually transmitted infections and unwanted pregnancy. However, despite a high level of awareness of probability of their occurrence less than a half of the students always use necessary remedies to avoid these risks, this fact allows to refer students to a group with an increased risk of STI and unwanted pregnancy. It is determined that self-treatment practice in regard to STI is not wild-spread among medical students due to the presence of deeper knowledge about reproduc- tive health. Conclusion. The analysis of author's research data and the works devoted to the problem of sexual relations risks among youth allows to state the imbalance between students' knowledge of sexual contacts risks and their real behavioral practices, and a significant decrease in the level of preventive work. Medical students can be considered as a resource for optimizing this type of work with students of high schools, colleges and other universities.

Objective: to conduct an analysis of the provision of beds and medical personnel of medical institutions in the region that render medical care to patients with circulatory disorders. Material and Methods. Calculation of the optimal volume of inpatient medical care, the required number of beds and staff units of cardiologists in the region was carried out in accordance with regulatory legal acts. Results. In medical organizations, an excessive number of round-the-clock beds on the "cardiology" profile (more for 186 beds) and insufficient number of cardiac beds in day hospitals (less than 40 beds) were deployed; the number of cardiologists working in cardiological rooms of polyclinic medical organizations, dispensaries for cardiology and daily hospitals has been identified. Conclusions: Redistribution in the region's medical organizations of the bed fund, material, and financial resources leads to the optimization of patients' referrals and promotes rational use of resources of health care, increasing the availability and improvement of quality of medical care to adult population of the region.

The searching of effective methods of staff management is the most important task for healthcare managers. The purpose of the study: to assess the degree of work satisfaction of doctors and nursing staff of dental organizations of various forms of ownership and to analyze the factors that determine it. Material and Methods. The survey was conducted using a specially developed questionnaire, which included blocks describing the following parameters: satisfaction with various aspects of the work; factors affecting labor activity; rating characteristics of work; motives that determine professional interest; conditions that stimulate activity. Results. As a result of the study, differences were found in the satisfaction with the professional activity and working conditions of medical and nursing staff of dental organizations of various forms of ownership. Factors determining the motivation of the work of the personnel of the modern medical organization are revealed. This allowed for a differentiated approach to the development of measures to improve the diverse motivation of the staff. Conclusion. It was established that the main directions in improving the staff motivation system may be: material and non-material promotion; optimization of work organization; involving staff in the management of organization and making management decisions; improvement of professional skills of employees, fair distribution of remuneration and social services.

Objective: assessment of the impact of labor peculiarities in urban and rural areas on the quality of life of doctors. Material and Methods. The study involved 198 doctors of various specialties from rural areas of the Saratov region and the city of Saratov. Sanitary hygienic examination of labor conditions and questionnaire SF-36 on quality of life assessment of health-care workers were conducted. Results. The objective hygienic characteristics of working conditions of city doctors of various specialties, and physicians working in rural areas are presented. It was found that doctors in rural areas are much more likely to combine work in the main and related specialties than urban ones: 31,6 and 15,6% respectively. It is important to note that the frequent combination of rural doctors in related professions also adversely affects the quality of their lives. Conclusion. The analysis of the results of the conducted research proves that when assessing the severity and intensity of the labor process of rural and urban health workers, it is necessary to take into account not only the working conditions but also the level of compatibility.

The aim: to determine the complication's rate, based on a seven-year experience, after the stress urinary incontinence correction in women with different methods of setting suburethral polypropylene meshes. Material and Methods. The analysis of seven years of experience of surgical correction with different methods of setting suburethral meshes in 1260 women with stress urinary incontinence; obturator fixation the mesh inside-outside and outside-inside: supra-pubic fixation the mesh; non-trocar fixation the mesh type mini-sling was carried out. Results. The greatest frequency of complications were identified in the first two years of implementation the setting of suburethral meshes, after that the complication's rate decreased progressively and it was in the range 7-8% the last three years. The frequency of early operative complications at a different setting of suburethral meshes had no statistically significant differences, but there were more the statistically significant intraoperative and mesh-associated complications at suprapubic fixation. Conclusion. The study confirms that the installation of suburethral meshes by the method of suprapubic fixation of mesh is associated with a higher incidence of complications and should be performed only in the target group of patients who are not suitable for surgical correction in safer ways.