The psychiatric services of Saratov region and directions of its’ improvement (Clinical, statistical and epidemiological aspects)

2017 ◽  
Vol 41 (S1) ◽  
pp. S568-S569
Author(s):  
Y. Barylnik ◽  
D. Samoylova ◽  
S. Pakhomova ◽  
J. Abrosimova ◽  
E. Kolesnichenko ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Russian Federation ◽  
Psychiatric Services ◽  
Saratov Region ◽  
The Past ◽  
Number Of Patients ◽  
Competing Interest ◽  
Services Effectiveness ◽  
Epidemiological Characteristics

IntroductionThe determining of the actual number of people with mental disorders and their spreading by nosology still remains actual, especially according to different regions.ObjectivesThe determining of the psychiatric services effectiveness in Saratov region on the basis of comprehensive analysis of its’ clinical, statistical and epidemiological characteristics.MethodsThe analysis of mental state indicators based on the example of adults’ schizophrenia Saratov region in dynamics for 10 years (2005–2015) in comparison with Russian Federation.ResultsOver the past 10 years the number of clinically supervised patients with schizophrenia decreased at 0.9% in the city and 2.2% in region population. This is consistent with the tendency of schizophrenia morbidity in Russian Federation over the same period. The number of supervised adult patients with primary diagnosed schizophrenia in Russia remained at the same level and amounted to 10.8 per 100 thousand population. At the same time the noticeable fluctuations in the number of this patients’ category were observed in Saratov and Saratov region. Over the past 10 years, the proportion of patients with primary diagnosed schizophrenia disability in the class structure of mental disorders is quite high, averaging of 41.1% in Saratov region. Analyzing the number of patients with re-confirmed disabilities the gradual decline from 1846 to 755 people (at 59.1%) was found.ConclusionsThe mental health analysis of Saratov region population allows to suggest the long-term forecast of mental disorders’ morbidity, to analyze the level of disability due to schizophrenia, to develop recommendations for the optimal regional model of psychiatric services.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Evolving impact of long-term survival results on metastatic melanoma treatment

2020 ◽  
Vol 8 (2) ◽  
pp. e000948 ◽  
Author(s):  
Olivier Michielin ◽  
Michael B Atkins ◽  
Henry B Koon ◽  
Reinhard Dummer ◽  
Paolo Antonio Ascierto
Keyword(s):  
Targeted Therapies ◽  
Survival Data ◽  
Long Term Results ◽  
Tumor Type ◽  
Term Survival ◽  
Long Term Survival ◽  
The Past ◽  
Number Of Patients ◽  
Melanoma Treatment

Melanoma treatment has been revolutionized over the past decade. Long-term results with immuno-oncology (I-O) agents and targeted therapies are providing evidence of durable survival for a substantial number of patients. These results have prompted consideration of how best to define long-term benefit and cure. Now more than ever, oncologists should be aware of the long-term outcomes demonstrated with these newer agents and their relevance to treatment decision-making. As the first tumor type for which I-O agents were approved, melanoma has served as a model for other diseases. Accordingly, discussions regarding the value and impact of long-term survival data in patients with melanoma may be relevant in the future to other tumor types. Current findings indicate that, depending on the treatment, over 50% of patients with melanoma may gain durable survival benefit. The best survival outcomes are generally observed in patients with favorable prognostic factors, particularly normal baseline lactate dehydrogenase and/or a low volume of disease. Survival curves from melanoma clinical studies show a plateau at 3 to 4 years, suggesting that patients who are alive at the 3-year landmark (especially in cases in which treatment had been stopped) will likely experience prolonged cancer remission. Quality-of-life and mixture-cure modeling data, as well as metrics such as treatment-free survival, are helping to define the value of this long-term survival. In this review, we describe the current treatment landscape for melanoma and discuss the long-term survival data with immunotherapies and targeted therapies, discussing how to best evaluate the value of long-term survival. We propose that some patients might be considered functionally cured if they have responded to treatment and remained treatment-free for at least 2 years without disease progression. Finally, we consider that, while there have been major advances in the treatment of melanoma in the past decade, there remains a need to improve outcomes for the patients with melanoma who do not experience durable survival.

21st century psychiatry: The need for a unitary framework

2016 ◽  
Vol 33 (S1) ◽  
pp. S3-S3
Author(s):  
M. Maj
Keyword(s):  
Mental Disorders ◽  
Protective Factors ◽  
21St Century ◽  
Complex Interaction ◽  
Diagnostic Systems ◽  
The Third ◽  
The Past ◽  
Fourth Level ◽  
Competing Interest ◽  
The Moment

While the plurality of approaches is a richness of psychiatry, we need today a unitary framework in which the vast majority of psychiatrists are able to place and recognize themselves. An essential component of this framework should be the awareness that a major outcome of research efforts of the past thirty years is the notion that a simple deterministic etiological model cannot be applied to mental disorders, which instead represent the product of the complex interaction of a multiplicity of vulnerability and protective factors of different nature (biological, intrapsychic, interpersonal, psychosocial). Most current significant etiological research in psychiatry can be accommodated within this framework, thus appearing much less chaotic, inconsistent and fragmentary. This first level of the framework affects in a probabilistic, not a deterministic, way the second one, that of neurobiological, cognitive and psychological intermediate processes. It is unavoidable that different languages be used to describe these processes, but these languages may be translatable into each other to some extent. Furthermore, comprehensive pathogenetic models usually require the integration of different languages. This second level leads, again in a probabilistic way, to the third level, that of symptoms, signs, cognitive dysfunctions and psychopathological dimensions. These are the elements composing the fourth level, the syndromal one. The ICD/DSM formulation of this fourth level is not optimal, but it is the best we have at the moment. Certainly, the fact that two major diagnostic systems exist in psychiatry adds to the confusion and the uncertainty, and should be overcome in the future.Disclosure of interestThe author has not supplied his declaration of competing interest.

Swallowing Evaluation and Ventilator Dependency—Considerations and Contemporary Approaches

2011 ◽  
Vol 20 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Lori M. Burkhead
Keyword(s):  
Intensive Care Unit ◽  
Best Practices ◽  
Long Term Care ◽  
Term Care ◽  
The Past ◽  
Life Saving ◽  
Number Of Patients ◽  
Care Facilities ◽  
Swallowing Evaluation

With the advent of advanced life-saving practices, speech-language pathologists will continue to see a surge in the number of patients dependent on ventilators in both the acute and chronic phases of the health care continuum. Today, there are more individuals requiring ventilators, whether in the intensive care unit (ICU), in long-term care facilities, or in the community. In the past, it has been common to delay rehabilitation efforts in the ICU patient who requires a ventilator, based on the rationale that patients are too sick. This excuse no longer fits with contemporary knowledge regarding best practices in the ICU. Additionally, this argument is moot with regard to patients with diagnoses that will mandate long-term ventilator use. Our profession must understand and be able to address the unique concerns and needs regarding swallowing in those with either transient or chronic ventilator dependency.

Psychiatry 2017: Acknowledging Complexity While Avoiding Defeatism

2017 ◽  
Vol 41 (S1) ◽  
pp. S1-S1
Author(s):  
M. Maj
Keyword(s):  
Bipolar Disorder ◽  
Mental Disorders ◽  
Psychiatric Research ◽  
Psychiatric Diagnoses ◽  
The Past ◽  
Current Period ◽  
Competing Interest ◽  
Main Components

In the past few years, it has become a sort of cliché to state that psychiatry is in a crisis. In particular, it has been repeatedly argued that: (a) psychiatric diagnoses are invalid; (b) psychiatric research has not progressed significantly (in particular, it has not been able to identify “the cause” of schizophrenia, depression or bipolar disorder); (c) psychiatric treatments are of limited value, and their widespread use has not been able to reduce the incidence of mental disorders. This perception of crisis has been at least in part generated by an identification of mainstream psychiatry with the neo-kraepelinian paradigm, so that the crisis of confidence in that paradigm has expanded into a crisis of confidence in the psychiatric discipline. According to Kuhn, the crisis of confidence in a paradigm is accompanied by a period of “extraordinary science”, marked by a proliferation of competing methodologies, the proposition of a variety of divergent solutions for the problem defining the crisis, and the recourse to philosophy and to debate over fundamentals of the discipline. The crisis of confidence in the neo-kraepelinian paradigm has generated such a period, in which we are all now immersed. In this presentation, I will summarize the main components of the neo-kraepelinian paradigm; I will illustrate why that paradigm has failed, or at least has lost people's confidence; and will summarize the main elements which are emerging in the current period of “extraordinary science”.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals Meningococcal infection: clinical and epidemiological characteristics in modern conditions

2018 ◽  
Vol 20 (4) ◽  
pp. 186-191
Author(s):  
V V Sharabkhanov ◽  
K V Zhdanov ◽  
S M Zakharenko ◽  
N I L’vov ◽  
K V Kozlov ◽  
...  
Keyword(s):  
Russian Federation ◽  
Meningococcal Disease ◽  
Armed Forces ◽  
Meningococcal Infection ◽  
The Past ◽  
The Face ◽  
The Russian Federation ◽  
The One ◽  
Epidemiological Characteristics ◽  
Epidemiological Situation

The problems of the incidence of meningococcal disease and the epidemiological situation in the world, in the Russian Federation and in the Armed Forces are consecrated. In the past decade, there has been a global decline in the incidence of meningococcal disease, but there is still the possibility of new outbreaks and epidemics. From 1996 to 2016, a decrease in the incidence of meningococcal disease was also noted in Russia. In certain regions of the Russian Federation, an increase in incidence was recorded, which did not affect the general trend. Against this background, the idea was formed that in the coming years, thanks to a favorable epidemiological situation and the possibility of preventing meningococcal infection with the help of a vaccine, it is possible to achieve control of this infection. However, meningococcus showed all the classic properties of variability and fitness. Changes in the structure of circulating serogroups of meningococcus led to the formation of a non-immune layer of the population in the face of increasing pathogenicity of the dominant serogroups. The activity of the epidemic process is indirectly indicated by the high diversity of genetic and serological clonal complexes, serogroups and serotypes of the pathogen. The incidence of meningococcal disease over the past ten years in the Armed Forces of the Russian Federation can be assessed as low, but mortality has high values. The peak incidence was in 2010, but the maximum percentage of mortality was in 2017-18,2%. The increase in mortality from invasive forms of meningococcal infection, on the one hand, is associated with an increase in the total number of sources of this infection, on the other hand, with errors in early diagnosis and, as a consequence, in the incorrect provision of emergency care at the prehospital stage, which recur from year to year and are of a similar nature.

scholarly journals Issues of prevention of suicidal behavior in the Armed Forces of the Russian Federation

2019 ◽  
Vol 21 (2) ◽  
pp. 74-77
Author(s):  
V K Shamrey ◽  
K V Dnov
Keyword(s):  
Mental Disorders ◽  
Russian Federation ◽  
Military Personnel ◽  
Military Service ◽  
Armed Forces ◽  
Steady Increase ◽  
Addictive Disorders ◽  
Suicide Rates ◽  
The Russian Federation

The issues of prevention of suicidal incidents in the Armed Forces of the Russian Federation are considered. The analysis of suicide prevalence among military personnel of various categories and their prevailing causes for the period from 2013 to 2017 is indicated. Indicates a change in the percentage ratio of various categories of military personnel who committed suicide, with a steady increase in the proportion of privates and sergeants serving in military service under the contract (from 24,6% in 2011 to 57,4% in 2017). It was established that among the servicemen under the contract family and everyday reasons for suicide prevailed, while conscripts were military professional. A comparison was also made of the long-term (2007-2017) dynamics of suicide rates and the incidence of mental disorders among military personnel, and certain patterns were identified. Thus, in the group of officers and ensigns, a significant correlation was noted between the long-term dynamics of suicide rates with neurotic (r=0,74) and addictive disorders (r=0,86), as well as general mental morbidity (r=0,83), and for conscripts, with personality disorders (r=0,79) and organic mental disorders (r=0,71). A comparison of the long-term dynamics of the overall incidence of mental disorders and the suicide rate among conscripts also showed a positive correlation (r=0,69). Analyzed the system of prevention of suicidal incidents in military personnel, which currently exists and proposed measures for its improvement, including the areas of activity of officials for the prevention of suicidal incidents in the military. It also indicates the need to shift the focus from specific prevention (direct detection and prevention of suicidal actions in military personnel with mental disorders) to non-specific (prevention of general mental distress and suicidal tendencies in mentally healthy people).

Prevalence of tuberculosis in Russian Federation in 1970–2019 and factors influencing its level

2021 ◽  
pp. 23-33
Author(s):  
M. V. Shilova
Keyword(s):  
Drug Resistance ◽  
Hiv Infection ◽  
Russian Federation ◽  
Tuberculosis Patients ◽  
The Past ◽  
Factors Influencing ◽  
Number Of Patients ◽  
The Russian Federation ◽  
Detection Quality

The data on the prevalence of tuberculosis in the Russian Federation are presented. A decrease in the prevalence of tuberculosis over the past 49 years, from 1970 to 2019, and a decrease in the number of patients with tuberculosis are shown. The factors influencing the prevalence of tuberculosis infection in the Russian Federation are considered: timely detection, quality of diagnosis and treatment of tuberculosis patients, MBT drug resistance, HIV infection in tuberculosis patients. The reliability of indicators characterizing the prevalence of tuberculosis has been studied.

Overall incidence of mental disorders in the Russian Federation and federal districts in 2017–2019

2021 ◽  
pp. 45-55
Author(s):  
Nadezhda Konstantinovna Demcheva ◽  
Alla Vladimirovna Yazdovskaya
Keyword(s):  
Mental Disorders ◽  
Russian Federation ◽  
Noticeable Increase ◽  
Number Of Patients ◽  
Specialized Care ◽  
Federal Districts ◽  
The Russian Federation ◽  
First Time ◽  
Annual Decline ◽  
Childhood Psychoses

The aim of the study was to identify the main trends in the overall incidence of mental disorders in the Russian Federation in 2017–2019. The analysis of indices based on statistical reports, revealed changes in the direction of the dynamics of the overall incidence of mental disorders in the Russian Federation. In 2018–2019, the indicator increased (by 0,1 %) for the first time after a yearslong (2007–2018) rather intense annual decline. The most noticeable increase is noted in the incidence of organic mental disorders, chronic inorganic disorders, childhood psychoses, including autism, as well as in indices in the groups of children and adolescents 0–14, 15–17 years old and individuals of 60 years and older. The authors of the article conclude that the change in the dynamics of overall incidence in the Russian Federation observed in 2017–2019 indicates a rise in the referral to psychiatric institutions in the last year with an increase in the total number of patients receiving specialized care.

scholarly journals Social and epidemiological characteristics of alcohol use disorders in the Kostroma region

2014 ◽  
Vol 95 (3) ◽  
pp. 426-433
Author(s):  
I P Pochitaeva ◽  
A P Golubeva
Keyword(s):  
Alcohol Use ◽  
Russian Federation ◽  
Least Squares Method ◽  
Alcohol Use Disorders ◽  
Chronic Alcoholism ◽  
Annual Growth ◽  
Annual Growth Rate ◽  
Absolute Increase ◽  
The Past ◽  
Epidemiological Characteristics

Aim. Prediction of primary, general morbidity and mortality of persons with alcohol use disorders, registered at a dispensary in the Kostroma region of Russian Federation. Methods. Statistical data for 24 districts of the Kostroma region, 1999-2012 was analyzed. In addition to graphical method and mapping the least-squares method, ranking, estimation of absolute increase/decrease and the average annual growth/loss rate were used. Information was obtained from the statistical reports of regional addictions dispensary (statistical form number 37), Statistical yearbook of National Research Center of Addictions, Ministry of Health of Russian Federation. Results. Structure of patients treated for alcohol disorders in the Kostroma region almost virtually unchanged over the past 10 years, the proportion of persons with chronic alcoholism was 46.5%, drinkers with harmful consequences - 32.4%, alcoholic psychosis - 21.1%. In 2012 the number of primary identified alcohol consumers with harmful impact on the health was 72.8% less compared to the average index for Russian Federation and 27.5% compared to Central Federal District. We have revealed mild, prone to stabilization trend of increase in the incidence of chronic alcoholism and psychosis for 14 years studied, average annual growth rate was 0.64%. Based on the primary incidence of alcoholism and psychosis the top three districts were: Sudislavsky, Susaninsky and Mezhevskoy, indicators in these areas were almost 2-3 times higher than the average regional index. In 2012 in 12 districts of Kostroma region no cases of alcoholic psychosis were registered. The latter fact is in doubt, as in 7 of 12 districts the positions of addiction psychiatrists were vacant. Over the past 3 years only 38% of patients who required to be treated for alcoholism were admitted for hospital care and 16.7% - for ambulatory care. Conclusion. Analysis of epidemiological data on alcohol situation in the Kostroma region testifies to its stabilization with the trend to improve; established territorial features show the necessity of purposeful planning of preventive measures.

scholarly journals Diabetes mellitus in Russian Federation: prevalence, morbidity, mortality, parameters of glycaemic control and structure of glucose lowering therapy according to the Federal Diabetes Register, status 2017

2018 ◽  
Vol 21 (3) ◽  
pp. 144-159 ◽  
Author(s):  
Ivan I. Dedov ◽  
Marina V. Shestakova ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Michail А. Isakov
Keyword(s):  
Diabetes Mellitus ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Life Expectancy ◽  
Russian Federation ◽  
Diabetic Coma ◽  
Glucose Lowering ◽  
Number Of Patients ◽  
Diabetes Register ◽  
Epidemiological Characteristics

BACKGROUND: The enormous social lesion caused by high prevalence of diabetes mellitus (DM) determines the state importance of clinical and epidemiological monitoring organization. AIMS: To analyze epidemiological characteristics (prevalence, mortality, morbidity), the level ofHbA1c, evaluate the therapy in Russian Federation in 20132017. METHODS: We have used the database of the Russian Federal Diabetes register 81 regions included in the online register system. RESULTS: The total number of patients with DM was 4,498m. (3.06% RF population), including: Type 1 (T1) 5,7% (0,26 m), T2 92,1% (4,15m), other DM types 1,9% (83,8 ths). Distribution male/female: T1 53.5%/46.5%, T2 29%/71%, other DM types 24%/76%. The proportion of men decreases with aging. Number of patients 65 years was 2.293.520, including T1 21.97ths (3.6%), T2 2m271.5ths (54.7%). The prevalence 20132017 per 100,000 population was as follows: T1 159,8169,6; T2 2455.32775.6; other DM types 51,265,8. Morbidity: T1 9,87,0; T2 226,7185,2; other DM types 7,812,4. The structure of causes of death 20132017: T1: diabetic coma 2,01,5%, myocardial infarction 4,04,4%, cerebral circulation disorders 8,27,6%, cardiovascular insufficiency 18,516,4%, chronic renal failure 6,16,0%; T2 0,20,2%, 4,54,5%, 12,712,2%, 29,028,6%, 1,21,8%, respectively. Mortality: T1 2.3; T2 68.4, other DM types 0,8. Life expectancy (average age of death of patients): T1 male 50.350.2, female 60.257.2; T2 69.870.3, 75.175.9 respectively. The number of patients with targetHbA1clevel 7%: T1 22.334.0%, T2 38.052.4%;HbA1c9.0%: T1 29.221.1%, T2 12.68.8%. The most commonly prescribed classes of glucose lowering medications (GLM) in 2017: in monotherapy Metformin (57.3%), Sulfonilurea (SU) (41,1%); in combination of 2 GLM: Metformin+SU 92,58% Metformin+iDPP-4 5.63%; 3 or more GLM: Metformin+SU+iDPP-4 83,9%, Metformin+SU+iSGLT-2 8.98%. The proportion of patients on aGPP-1 therapy is 0.01%. CONCLUSIONS: We observed the growth of prevalence of DM in Russian Federation and decrease in registered morbidity rate; an increase in life expectancy in T2; decrease in mortality due to diabetic coms and stable mortality rate from cardiovascular events (heart attack, stroke, cv deficiency), gangrene, chronic renal failure in both types of DM; a steady improvement in glycemic control. In the structure of T2 therapy the oral GLMs are dominated, especially Metformin and SU. In the dynamics the prescription of Metformin, insulin, iDPP-4, iSGLT-2 has increased, the proportion of SU has decreased.

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