Bulletin of Semashko National Research Institute of Public Health

In order to increase the effectiveness of early diagnosis of oncopathologies, it is advisable to introduce new organizational technologies into the work of outpatient clinics.The purpose of this study is to analyze the problems of routing patients with malignant neoplasms suspected in a city polyclinic.As part of the work, a survey of 103 doctors and 400 patients of the polyclinic was conducted. The data obtained indicate the presence of a number of problems during the passage of a complete diagnostic complex by patients, namely: lack of time for initial and repeated doctor's appointments, the difficulty of recording for all necessary diagnostic studies, the need for multiple visits to undergo a diagnostic complex.At the same time, the prospect of allocating a separate unit for further examination by patients with suspected malignant neoplasms will provide additional time at the reception of specialist doctors for a more thorough examination, will reduce the time of passing the diagnostic complex and, as a result, increase patient satisfaction with the quality of medical care.

The scientific article is an analysis of the experience of a unique healthcare institution - a specialized uroandrological center of the Stavropol Territory in the organization of three-level medical care in the field of male reproductive health.

In recent years, more and more attention has been paid to quality management in healthcare. Studying the satisfaction of medical workers with their work, including diagnostic services and creating the necessary conditions for employees is important for improving the quality of medical services. The purpose of the study: to study the satisfaction of ultrasound doctors in pediatrics with various aspects of their work in medical organizations of different levels. A social study was conducted among ultrasound diagnostics doctors in pediatric medical organizations in Kazan and Naberezhnye Chelny. 70 doctors of ultrasound diagnostics were interviewed by a continuous method about satisfaction with various elements of their work on a five-point Likert scale. Further, a factor analysis of the indicators of satisfaction of doctors with their work was carried out, during which, using the method of analysis of the main components, the results of the survey of respondents were studied depending on the type of medical organizations (children's city polyclinic, children's city hospital, multidisciplinary hospital). According to the results of factor analysis of the satisfaction indicators of ultrasound doctors with their work, depending on the type of MO, statistically significant differences in various factors of work were revealed. Thus, satisfaction with the material and technical factor is higher in the group «children's city polyclinic», the recreational and household factor and the factor of interaction with a nurse are higher in the group «multidisciplinary hospital».

The article discusses the development of medical tourism as an actual trend in the export of services. The review of statistical data and the results of sociological studies reflecting the attitude of consumers of tourist services to technologies, products and the results of tourist trips for medical purposes is carried out. The main directions of development of medical tourism in the world and in the Russian Federation are defined.

An intensive increase of anthropometric indicators of the body is the one of the main features of the first year of a child's life. To ensure an objective assessment of the physical development of children under 1 year of age, it is necessary to consider the values and compare them with the averaged values of these indicators developed and presented in centile tables. A study was conducted to compare the anthropometric indicators of girls and boys under 1-year, registered in the outpatient clinic in Baku (Azerbaijan) during preventive medical examinations as part of the mandatory clinical examination of children.Comparative analysis of mean values showed significant differences in body weight and height during 0-12 months and total chest in the second 6 months of gestational age in boys and girls. There were no significant differences in head circumference in all gender and age groups.

Transgender women (TGW) are individuals who were assigned male at birth but identify as women. TGW are at high risk of being infected with HIV and face severe barriers in access to HIV-related medical care, including testing, prevention and treatment. The present review aims to summarize the data on social barriers to HIV services for TGW published in English-language literature. Systematic search in Web of Science, Scopus and PubMed was used to identify 53 articles available for analysis. The main barriers include: lack of or insufficient knowledge on HIV issues; stigma; suboptimal organization of medical care; lack of awareness and sensitivity on behalf of medical specialists; barriers related to gender identity; financial barriers; lack of support on behalf of the family and close ones; intersectional discrimination. Raising awareness of medical professionals on trans issues, integration of HIV-related services and transgender healthcare, as well as increasing the diversity of methods of testing and prevention are among the approaches to improving the access to HIV-related care.

Patient flow management in hospital departments and observance of stages in the provision of medical care should be systematized, determined by the sequence of implementation of standard operating procedures and worked out in experimental simulation models that assess the level and volume of use of the medical organizations resources.This article discusses the principles of using simulation modeling to assess the efficiency of using the resources of a medical organization and the quality of medical care during the COVID-19 epidemic.The work was performed on the basis of the state budgetary health care institution «Noginsk Central District Hospital» on the basis of retrospective data on the results of hospitalization of 7573 patients over the period April 2020 to June 2021.

The article systematizes information risks that negatively affect the implementation of medical thinking, identifies the sources of their formation and the main points of application. The rationale for the use of medical information systems as a way to neutralize information risks is given, their advantages and disadvantages are analyzed. The medical information system «Differentiated Treatment» has been announced, which increases the effectiveness of medical thinking, reducing the risk of errors in the choice of therapeutic factors. Applied approaches to the construction of medical information systems are presented.

The paper discusses the second part of Robert Koch's Nobel Lecture, devoted to the development of medical legislation, the guidelines development for the TB registration, as well as methods for preventing tuberculosis and the importance of disseminating medical knowledge among the population. Furthermore, the paper summarizes the materials on the history of medical educational initiatives of the Russian Empire at the turn of the 19th-20th centuries.

The article presents the history of the development of transfusiology in the world and in Russia (USSR), from the first mention of the use of blood in the ancient period to the opening of the Institute of Blood Transfusion in the 20th century. Achievements of outstanding foreign and domestic scientists and medic (William Harvey, Karl Landsteiner, James Blundell, Alexander Malinovsky (Bogdanov), Nikolai Pirogov and many others), who made a significant contribution to scientific and technological progress, in particular, to the development of healthcare. The periods of discoveries and prohibitions of scientific research concerning transfusions are considered. It is emphasized that in the 19th-20th centuries there were serious changes in the procedure for collecting and storing blood, which made it possible to optimally solve practical issues, especially during the war years. The introduction of the method of blood reinfusion is described. It is shown that Russia in the innovation process acted as a catching up party. Although, rather, it was sluggishness, allowing you to reap the fruits of trial and error of the West, introducing the most proven developments in the country.The aim of the study was to reproduce the main stages in the history of the development of transfusiology.

The article presents the results of historical and medical research, indicating a high level of injuries among the child population in the USSR in the post-war period (1946⸻1950) and reflecting the upcoming measures to struggle with such an important medical and social problem as childhood military traumatism. An analysis of the archival documents of the USSR Ministry of Health and the scientific works of scientists indicates that, despite a slight decrease of the child military injuries level in large cities by 1948, in many regions further work was required to develop children's orthopedics. In this regard, the central health authorities in 1949 convened the All-Union Conference on Childhood Traumatism and Orthopedics and initiated a number of important measures for helping children with diseases and injuries of the musculoskeletal system, including the deployment of traumatology and orthopedics institutions, active identification of children, who needed the use of prosthetic and orthopedic products, the organization of sanatorium schools for children and adolescents who required long-term orthopedic treatment, the creation of conditions for their normal education and adaptation to work skills.

The article defines the role of Catherine II's associate I. I. Betsky at the beginning of smallpox vaccination in Russia in the second half of the XVIII century and in countering epidemics. On his initiative, in the spring of 1768, a few months before the vaccination of the Empress and the heir to the throne, 80 pupils of the school at the Academy of Arts and the Smolny Institute were vaccinated with smallpox. In 1791, I. I. Betskoy published a treatise on smallpox vaccination and recommendations for combating epidemics based on the experience of countering the employees of the Moscow Foundling House under his leadership of the plague epidemic in 1771-1772.

The article is devoted to the medical activity of the great creator of the Russian dictionary V.I.Dal. Many of us are well aware of the merit of V. I. Dal before Russian literature, but only the true experts of his work are aware of the undoubted abilities of Vladimir Ivanovich in the field of medicine. Meanwhile, in the biography of V. I. Dahl has a lot of bright moments confirming his undoubted contribution to the development of medicine as a scientist and as a practicing doctor.

The article is dedicated to the 85th anniversary of Ruben Karpovich Chailakhyan, Doctor of Medical Sciences, Academician of the National Academy of Sciences of the Republic of Armenia, an outstanding scientist, who has been heading the laboratory of stromal regulation of immunity for more than 25 years at the Research Center of Epidemiology and Microbiology named after Honorary Academician N. F. Gamaleya. Thanks to the method of selective cloning of cells in monolayer cultures developed by Chailakhyan, stem stromal cells of the bone marrow were discovered. Number of cells has been determined, properties, differentiation and proliferative features have been studied. Reverse transplantation of monoclonal diploid strains into the body revealed a category of stem stromal progenitor cells responsible for organizing the hematopoietic and lymphoid microenvironment, providing the formation of hematopoietic and immune organs. These cells represent an independent cell line, histogenetically independent of hematopoietic stem cells. They are pluripotent and, when transplanted back into the body, provide the formation of bone, cartilage, reticular and adipose tissues. The resulting bone tissue is complete and suitable for repopulation by hematopoietic cells, which leads to the formation of a bone marrow organ. The reticular tissue of splenic fibroblasts provides the formation of a stroma that supports the differentiation of B cells to antibody-forming ones. The discovery of bone marrow stromal stem cells, data on their differentiation and proliferative potential formed the basis for the concept of hematopoietic microenvironment, which has international recognition. R. K. Chailakhyan is one of the authors of this concept. The research results are of fundamental importance in the development of cell technologies and tissue engineering for regenerative medicine. The created experimental model of restoring the integrity of bone tissue made it possible to introduce into the clinic a method for replacing bone defects by autotransplantation of osteogenic bone marrow cells grown outside the body. The method of restoring hyaline cartilage in chondropathy caused by trauma to the knee or large joints is based on the same biotechnological principle. Priority is given to data on the use of autologous bone marrow stromal stem cells tissue-engineered constructs that replace the rupture of the Achilles tendon and ensure complete regeneration of the tendon tissue. In order to optimize the terms of treatment and rehabilitation of patients, work is currently underway to find factors (laser exposure, EHF radiation, etc.) that stimulate the formation of the number of bone marrow cells required for autotransplantation, cultured outside the body.

The article discusses homicide as a problem of modern public health and preventive medicine. Information on the epidemiology of homicidal acts in Russia is given; it is stated that the prevalence of lethal criminal violence remains high. The author provides a classification of risk factors. Suggestions for potential directions of homicidal violence prevention are made.