scholarly journals Recommendatory base for the delivery of specialized medical care to patients with spine and spinal cord injury in Russia: subject field review

2021 ◽  
Vol 18 (4) ◽  
pp. 41-54
Author(s):  
Alexandr Kaisinovich Dulaev ◽  
Denis Igorevich Kutyanov ◽  
Sergey Viktorovich Iskrovskiy ◽  
Natalia Timofeyevna Menshova ◽  
Pavel Viktorovich Zhelnov
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Medical Care ◽  
Russian Federation ◽  
Care Delivery ◽  
Ministry Of Health ◽  
Subject Field ◽  
Wide Range ◽  
Cord Injury ◽  
The Russian Federation

Objective. To evaluate the composition and content of the recommendatory base for delivery of specialized medical care to patients with spine and spinal cord injury on the territory of the Russian Federation.Material and Methods. The published recommendations specifying the content of the diagnostic, therapeutic, rehabilitation and preventive components of the provision of medical care to patients with spine and spinal cord injury were reviewed. The search for information was carried out in the eLibrary.ru bibliographic resource, documents of the Ministry of Health of the Russian Federation, publications of specialized medical professional non-profit organizations, and other manuals. The depth of information selection was 18 years (since 2003). The review was prepared following the PRISMA-ScR and PRISMA-S guidelines.Results. The current Russian recommendatory base in the field under consideration includes articles in peer-reviewed scientific journals, practical guidelines, regulatory documents and eight clinical guidelines prepared by the Association of Traumatologists and Orthopedists of Russia and by the Association of Neurosurgeons of Russia approved or submitted for approval by the Ministry of Health. A significant degree of cross-use of information has been established, in general covering a wide range of diagnostic, therapeutic, rehabilitation and preventive issues.Conclusion. Most of the Russian recommendations on the provision of medical care to patients with spine and spinal cord injury do not have high strength, are not based on high-certainty evidence, are general in nature, especially in terms of diagnostic and therapeutic tactics, and are created without consideration of the medical care delivery setting. The methodology for their development is reported extremely poorly.

Recommendations of the Ministry of Health of the Russian Federation on the formation of a temporary staff table of a medical organization providing medical care to citizens with coronavirus infection COVID-19

2020 ◽  
pp. 5-12
Author(s):  
Olga Shinkareva
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Medical Organization ◽  
Ministry Of Health ◽  
Organization Of Work ◽  
Coronavirus Infection ◽  
The Russian Federation

Article is devoted to the analysis of the Order of the Russian Ministry of Health of 19.03.2020 № 198n (an edition of 29.04.2020) “About a temporary order of the organization of work of the medical organizations for implementation of measures for prevention and reduction of risk of spread of a new koronavirusny infection of COVID19” regarding formation of the temporary staff list of the division of the medical organization providing medical care to citizens with a koronavirusny infection of COVID-19 and also the requirement with the staff of this division. The criteria recommended by the Ministry of Health of the Russian Federation for determining the number of rates of medical workers in these divisions, requirements for medical workers of the division have been considered, a practical example of calculation of rates has been given.

Improving sit-to-stand transition by the saddle-assistive device in the spinal cord injury: A case study

2021 ◽  
pp. 095441192110033
Author(s):  
Akbar Hojjati Najafabadi ◽  
Saeid Amini ◽  
Farzam Farahmand
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Limb ◽  
Reaction Force ◽  
Assistive Device ◽  
Limb Weakness ◽  
Sit To Stand ◽  
Lower Limb Weakness ◽  
Wide Range ◽  
Cord Injury

Physical problems caused by fractures, aging, stroke, and accidents can reduce foot power; these, in the long term, can dwindle the muscles of the waist, thighs, and legs. These conditions provide the basis for the invalidism of the harmed people. In this study, a saddle-walker was designed and evaluated to help people suffering from spinal cord injury and patients with lower limb weakness. This S-AD works based on body weight support against the previously report designs. This saddle-walker consisted of a non-powered four-wheel walker helping to walk and a powered mechanism for the sit-to-stand (STS) transfer. A set of experiments were done on the STS in the use of the standard walker and the saddle-assistive device(S-AD). A comparison of the results showed that this device could reduce the vertical ground reaction force (GRF) of the legs up to 70%. Using this device could help a wide range of patients with lower limb weakness and SCI patients in changing from sitting to standing.

scholarly journals Efficacy of Virtual Reality Rehabilitation after Spinal Cord Injury: A Systematic Review

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Amanda Vitória Lacerda de Araújo ◽  
Jaqueline Freitas de Oliveira Neiva ◽  
Carlos Bandeira de Mello Monteiro ◽  
Fernando Henrique Magalhães
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Virtual Reality ◽  
Motor Function ◽  
Current Evidence ◽  
Pain Level ◽  
Positive Effects ◽  
Wide Range ◽  
Cord Injury ◽  
Aerobic Function

Background. Spinal cord injury (SCI) is often associated with long-term impairments related to functional limitations in the sensorimotor system. The use of virtual reality (VR) technology may lead to increased motivation and engagement, besides allowing a wide range of possible tasks/exercises to be implemented in rehabilitation programs. The present review aims to investigate the possible benefits and efficacy of VR-based rehabilitation in individuals with SCI. Methods. An electronically systematic search was performed in multiple databases (PubMed, BVS, Web of Science, Cochrane Central, and Scielo) up to May 2019. MESH terms and keywords were combined in a search strategy. Two reviewers independently selected the studies in accordance with eligibility criteria. The PEDro scale was used to score the methodological quality and risk of bias of the selected studies. Results. Twenty-five studies (including 482 participants, 47.6 ± 9.5 years, 73% male) were selected and discussed. Overall, the studies used VR devices in different rehabilitation protocols to improve motor function, driving skills, balance, aerobic function, and pain level, as well as psychological and motivational aspects. A large amount of heterogeneity was observed as to the study design, VR protocols, and outcome measures used. Only seven studies (28%) had an excellent/good quality of evidence. However, substantial evidence for significant positive effects associated with VR therapy was found in most of the studies (88%), with no adverse events (88%) being reported. Conclusion. Although the current evidence is limited, the findings suggest that VR-based rehabilitation in subjects with SCI may lead to positive effects on aerobic function, balance, pain level, and motor function recovery besides improving psychological/motivational aspects. Further high-quality studies are needed to provide a guideline to clinical practice and to draw robust conclusions about the potential benefits of VR therapy for SCI patients. Protocol details are registered on PROSPERO (registration number: CRD42016052629).

scholarly journals THE ANTITUMORAL MEDICATIONS

2018 ◽  
Vol 24 (3) ◽  
pp. 146-150
Author(s):  
Boris K. Romanov ◽  
N. B Dmitrieva ◽  
T. A Zatsepilova
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Final Stage ◽  
Clinical Studies ◽  
Ministry Of Health ◽  
State Register ◽  
Oncologic Patients ◽  
The Russian Federation ◽  
Official Sources

The article presents the review of antitumoral medications for treatment registered in Russia nowadays and being at the final stage of their development - clinical studies in authorized testing centers for subsequent registration. The summarized information is presented by official sources - the State register of medications of the Ministry of Health of the Russian Federation, the Electronic Subject Heading List of Clinical Recommendations and Clinical Handbooks and prepared on their basis Orders on Standards of Medical Care. The place and role of chemotherapeutic remedies are demonstrated in relation to therapy of oncologic patients and typical schemes of application of anti-blastoma remedies in case of the most prevalent and most severe nosological forms of neoplastic diseases.

scholarly journals Betulinic Acid Inhibits ROS-Mediated Pyroptosis in Spinal Cord Injury by Augmenting Autophagy via the AMPK-mTOR-TFEB Signaling Pathway

2020 ◽  
Author(s):  
Chenyu Wu ◽  
Huanwen Chen ◽  
Rong Zhuang ◽  
Yongli Wang ◽  
Xinli Hu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Signaling Pathway ◽  
Betulinic Acid ◽  
Neurological Diseases ◽  
Underlying Mechanism ◽  
Autophagy Flux ◽  
Wide Range ◽  
Cord Injury

Abstract Background：Spinal cord injury (SCI) results in a wide range of disabilities. Its complex pathophysiological process limits the effectiveness of many clinical treatments. Betulinic acid (BA) has been shown to be an effective treatment for some neurological diseases, but it has not been studied in SCI. In this study, we assessed the role of BA in SCI and investigated its underlying mechanism. Methods：Using a mouse model of SCI, survival and functional outcomes following injury were assessed. Western blotting, ELISA, and immunofluorescence techniques were employed to analyze levels of autophagy, mitophagy, and pyroptosis; ROS- and AMPK-related signaling pathways were also examined. Results：Our results showed that BA significantly improves functional recovery following SCI. Furthermore, autophagy, mitophagy, ROS-activity and pyroptosis were implicated in the mechanism of BA in the treatment of SCI. Specifically, our results suggest that BA restored autophagy flux following injury, which induces mitophagy to eliminate the accumulation of ROS and subsequently inhibits pyroptosis. Further mechanistic studies revealed that BA likely regulates autophagy and mitophagy via the AMPK-mTOR-TFEB signaling pathway. Conclusion: BA can significantly promote the recovery following SCI and that it may be a promising therapy for SCI.

Mechanisms of Behavioral Changes After Spinal Cord Injury

2019 ◽  
Author(s):  
Karim Fouad ◽  
Abel Torres-Espín ◽  
Keith K. Fenrich
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Function ◽  
Lesion Size ◽  
Behavioral Changes ◽  
Sensory Function ◽  
Wide Range ◽  
Cord Injury ◽  
New Treatment ◽  
Recovery Of Motor Function

Spinal cord injury results in a wide range of behavioral changes including impaired motor and sensory function, autonomic dysfunction, spasticity, and depression. Currently, restoring lost motor function is the most actively studied and sought-after goal of spinal cord injury research. This research is rooted in the fact that although self-repair following spinal cord injury in adult mammals is very limited, there can be some recovery of motor function. This recovery is strongly dependent on the lesion size and location as well as on neural activity of denervated networks activated mainly through physical activity (i.e., rehabilitative training). Recovery of motor function is largely due to neuroplasticity, which includes adaptive changes in spared and injured neural circuitry. Neuroplasticity after spinal cord injury is extensive and includes mechanisms such as moderate axonal sprouting, the formation of new synaptic connections, network remapping, and changes to neuron cell properties. Neuroplasticity after spinal cord injury has been described at various physiological and anatomical levels of the central nervous system including the brain, brainstem, and spinal cord, both above and below injury sites. The growing number of mechanisms underlying postinjury plasticity indicate the vast complexity of injury-induced plasticity. This poses important opportunities to further enhance and harness plasticity in order to promote recovery. However, the diversity of neuroplasticity also creates challenges for research, which is frequently based on mechanistically driven approaches. The appreciation of the complexity of neuronal plasticity and the findings that recovery is based on a multitude and interlinked adaptations will be essential in developing meaningful new treatment avenues.

New requirements for hospitals to conduct internal control of quality and safety of medical care: content, goals, prospects

2019 ◽  
Vol 2019 (6) ◽  
pp. 7-14
Author(s):  
Михаил Мурашко ◽  
Mihail Murashko ◽  
Ирина Серегина ◽  
Irina Seregina ◽  
Игорь Иванов ◽  
...  
Keyword(s):  
Medical Care ◽  
Continuous Improvement ◽  
Russian Federation ◽  
Internal Control ◽  
Quality And Safety ◽  
Ministry Of Health ◽  
The Russian Federation

In order to form common approaches for organization and conduction internal control of the quality and safety of medical care, and to assuring mechanisms for continuous improvement of medical processes in medical organizations of the Russian Federation, the Ministry of Health of Russia, together with Roszdravnadzor, developed an Order of June 7, 2019 No. 381n “On Approval of Requirements for organization and conduction internal control of the quality and safety of medical care in hospitals”.

Medical Care for Children with Cancer in the North-West Federal District of the Russian Federation: An Ecological Study

2018 ◽  
Vol 5 (3) ◽  
pp. 155-163 ◽  
Author(s):  
M. Yu. Rykov ◽  
I. A. Turabov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Care Delivery ◽  
Pediatric Population ◽  
Federal District ◽  
Children With Cancer ◽  
North West ◽  
The North ◽  
Bed Capacity ◽  
The Russian Federation

Background.Analysis of statistical data in the federal districts of the Russian Federation provides opportunities to assess the quality of medical care delivery in children with cancer and plan further development with consideration for the point elimination of existing defects. Objective. Our aim was to analyze the main indicators characterizing medical care for children with cancer in the North-West Federal District.Methods.The study analyzed operative reports for 2017 provided by the executive public health authorities of 11 subjects of the Russian Federation affiliated to the North-West Federal District.Results.The pediatric population was 2 537 133 children (0–17 years), the pediatric oncological bed capacity — 174 (0.7 per 10 000 aged 0–17 years), the annual berth average occupancy — 290.7 days. 6 (54.5%) subjects did not provide pediatric population with departments of pediatric oncology, 4 (36.4%) subjects did not have bed capacity. The number of practitioners providing medical care to children with cancer was 38, 27 among them (71%; 0.1 per 10 thousand 0–17 years) had a certificate of pediatric oncologist. 2 (18.2%) subjects did not have pediatric oncologists in the medical stuff. The incidence of malignant tumors in children aged 0–17 was 15.6 (per 100,000), the prevalence was 92.6 (per 100,000), the mortality rate was 2.6 (per 100,000), one-year mortality rate — 4.5% (18/397). The number of patients identified actively was 11 (2.8%). 160 (40.3%) primary patients were sent to Federal medical facilities, 6 (1.5%) — left the territory of the Russian Federation for the further treatment.Conclusion.The incidence and mortality rates are rather low which indicates the defects in patient detection and lack of reliable follow-up data. The percentage of patients referred for treatment to Federal medical facilities is not very high; however, to interpret this indicator according to patient routing, we have to analyze the medical history of all the patients. We can assert that health care delivery service for children with oncological diseases is at an acceptable standard level but needs to be improved. 

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