scholarly journals TECHNOLOGIES FOR SUBSTITUTING THE HOSPITAL CARE IN PEDIATRIC SURGERY

2019 ◽  
Vol 23 (5) ◽  
pp. 258-263
Author(s):  
E. E. Petryaikina ◽  
Mihail V. Korochkin ◽  
G. S. Poddubnyj ◽  
A. N. Murchina ◽  
Iu. D. Gurzo ◽  
...  
Keyword(s):  
Medical Care ◽  
Pediatric Surgery ◽  
Maxillofacial Surgery ◽  
Care Hospital ◽  
Short Stay ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Clinical Hospital ◽  
Stay Hospital ◽  
Surgical Unit

Introduction. Currently, the day-care hospital service is being developed because of the need to improve medical, social and economic efficiency of medical institutions, and by a high demand in this type of medical care. However, there are only few publications on hospital-substituting technologies in pediatric surgery in the domestic literature. In addition, the problem of laparoscopic surgeries in children in a short stay hospital unit is still a controversial issue. Purpose. To evaluate the effectiveness of a short stay surgical department as a structural unit in a multidisciplinary pediatric hospital. Material and methods. The researchers have analyzed the effectiveness of a short-stay hospital surgical unit in the Morozov Children’s Clinical Hospital. The pediatric short stay surgical unit, being a structural subdivision of a multidisciplinary hospital, provides medical care for children in the following profiles: “Pediatric surgery”, “Pediatric urology and andrology”, “Traumatology and orthopedics”, “Ophthalmology”, “Otorhinolaryngology”, “Maxillofacial surgery” and “Gynecology”. Results. From February 2017 till May 2019, 7128 surgical interventions were performed in this unit; 1371 of them were laparoscopic ones for inguinal hernias, varicocele, non-palpable testicular syndrome. In the hospital, a unique anesthetic algorithm for laparoscopic surgeries with a double luminal laryngeal mask and without muscular relaxants and narcotic analgesics was developed. The length of stay of patients in this unit is 6-8 hours, in the average. During the abovementioned 3-year period, only one patient was transferred to a 24-hour hospital. There were no surgical complications. Conclusion. The short-stay surgical unit in the Morozov Children’s Clinical Hospital has radically improved the availability of medical care for children; in addition, more surgical beds for hi-tech medical care are free and available now. Laparoscopic surgeries can be performed in this unit, instead of being performed in the round-clock surgical departments, due to the algorithm of safe anesthesia for planned surgical interventions which had been developed in the short-stay hospital surgical unit.

IRRATIONAL USE OF MEDICINES IN MEDICAL ORGANIZATIONS OF THE VOLGA FEDERAL DISTRICT. (ON THE EXAMPLE OF THE PENZA REGIONAL CLINICAL HOSPITAL NAMED AFTER N. N. BURDENKO, WHEN PROVIDING SPECIALIZED CARE TO CHILDREN IN THE CONDITIONS OF THE ADULT DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY)

2021 ◽  
pp. 168-175
Author(s):  
Lebedev M.V. ◽  
Abdullina Y.A. ◽  
Zakharova I.Y.
Keyword(s):  
Medical Care ◽  
Maxillofacial Surgery ◽  
Federal District ◽  
Oral And Maxillofacial Surgery ◽  
Medical Organization ◽  
Maxillofacial Region ◽  
Clinical Hospital ◽  
Specialized Care ◽  
Rational Therapy ◽  
Medical Histories

The issues of financing in a medical organization are one of the most relevant areas of healthcare in the Russian Federation. Providing departments with the necessary financial resources to provide effective and accessible medical care to the population is important for both the administration and doctors and nurses. In some regions of the Volga Federal District, the departments are combined (Penza, Saransk), that is, all types of medical care are provided to both adults and children in one place, which leads to a number of problems associated with the irrational use of medicines. One of these is the department of Maxillofacial Surgery of the N.N. Burdenko National Clinical Hospital, on the basis of which the disadvantages of using drugs for parenteral use are considered. The purpose of this work is an economic analysis of the effectiveness of the use of solutions for parenteral use in children on the basis of an adult medical organization. The materials of the study were data from patients ' medical histories, prescribing lists, invoices from the pharmacy organization, and data on the cost of medicines. The results of the work are an analysis of the existing problems of combined type departments related to drug provision, a number of medicines for parenteral use that are not available to order, but are included in the standards of treatment of children with injuries of the maxillofacial region. The ABC - analysis of expenses under the item "medicines" is calculated, the data of the VEN – analysis is presented, which includes vital, necessary and secondary medicines for the treatment of children with injuries of the maxillofacial region. An algorithm for the selection of effective and rational therapy has been developed, using the example of antibacterial agents for parenteral administration.

scholarly journals Clinical characteristics of bacterial complications of chickenpox in children

2019 ◽  
pp. 121-125
Author(s):  
O. V. Prokopiv ◽  
N. M. Prykuda
Keyword(s):  
Pathogenic Bacteria ◽  
Soft Tissues ◽  
Clinical Symptoms ◽  
Clinical Course ◽  
Cervical Lymphadenitis ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Clinical Hospital ◽  
Body Regions ◽  
Etiological Agents

The article presents data on the frequency of development and clinical course of bacterial complications of chickenpox in children aged from 2 months to 18 years, who were treated at inpatient department of Infectious Diseases Communal Clinical Hospital in Lviv and surgical department of Communal Municipal Children’s Clinical Hospital in 2000–2016. Bacterial complications were diagnosed in 136 patients (27.2 % out of total number of hospitalized children with chickenpox). Among the complications of chickenpox – lesions of the skin, underlying soft tissues and mucous membranes dominated (43.4 %): surface (pyoderma, erysipelas, conjunctivitis, blepharitis, gingival stomatitis), deep circumscribed (furuncle, abscess), as well as deep non-circumscribed (phlegmons) lesions of various body regions. Particularly severe flow was characterized by phlegmon, which developed in 18.4 % of children, 68% of them with mild forms of chickenpox. Most frequently, phlegmons were diagnosed in children under age 4 years. The first clinical symptoms (swelling and hyperemia with distinct margins, acute tenderness on palpation) appeared on the 3rd–10th day of the disease. Complication of respiratory organs – pneumonia, was diagnosed in 30.1 % of patients. The development of pneumonia was primarily observed in severe forms of chickenpox. Pneumonia, as a rule, developed on the 4th–10th day of the disease and was accompanied by intensification of the signs of intoxication syndrome, appearance of respiratory failure manifestations, cough. Other bacterial complications of chickenpox were also observed in patients: purulent otitis (7.4 % of patients), phlegmonous appendicitis (5.1 %), lacunar tonsillitis (4.4 %), pyelonephritis (3.7 %) cervical lymphadenitis (2.2 %), erosive gastroduodenitis (1.5 %), purulent meningitis (1.5 %), and osteomyelitis (0.7 %). On bacteriological examination of the content, obtained in surgical interventions from the lesion regions in 26 (19.1 %) children, pathogenic and conditionally pathogenic bacteria were isolated. Dominant etiological agents were S. pyogenes та S. aureus.

scholarly journals Outcomes of esophagoplasty in children (a 14-year experience)

2021 ◽  
Vol 24 (6) ◽  
pp. 358-362
Author(s):  
N. N. Akhparov ◽  
S. B. Suleimanova ◽  
V. E. Litosh
Keyword(s):  
Esophageal Atresia ◽  
Pediatric Surgery ◽  
Esophageal Stricture ◽  
Varicose Veins ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Peptic Stricture ◽  
One Stage ◽  
Abdominal Organs ◽  
Points Of View

Introduction. The authors analyze the effectiveness of one-stage esophageal plasty in children. They consider -from different points of view- possible problems accompanying such surgical interventions as well as complications and high mortality.Material and methods. The article summarizes outcomes after esophagoplasty in 61 patient who were at the surgical department of the Center for Pediatrics and Pediatric Surgery (Almaty, Kazakhstan) during 2006–2020 (June). Among them there were 24 (38%) children after the first stage of cervical esophagostomy combined with gastrostomy in esophageal atresia; 34 (56%) children had decompensated post-burn esophageal stricture and after ineffective conservative treatment; 1 (2%) patient had esophageal varicose veins because of the portal hypertension syndrome with formed cicatricial esophageal stricture and with high risk for bougienage; 2 (4%) patients had an extended peptic stricture of the esophagus as a complication of gastroesophageal reflux disease (Barrett esophagus).Results. One-stage coloesophagoplasty was performed in 44 (72%) children. Gastroesophagoplasty with the whole stomach transposition was performed in 12 (20%) children with esophageal atresia; in 3 (5%) - replacement for post-burn cicatricial stenosis and in 1 (2%) - because of varicose veins in the esophagus.Conclusion. The choice of esophagoplasty technique should be individualized depending on patient’s general state, on pathological lesions in the esophagus as well as on previous surgeries on the abdominal organs, if any. 

ORGANIZATION AND STAGES OF ELIMINATION OF DEFECTS AND DEFORMATIONS OF THE DENTAL-MAXILLOFACIAL AREA

2020 ◽  
pp. 109-113
Author(s):  
Eshiev D.A. ◽  
Eshiev A.M.
Keyword(s):  
Maxillofacial Surgery ◽  
Surgical Interventions ◽  
Main Text ◽  
Clinical Hospital ◽  
Hospital Patients

This article covers the issues of surgical and orthodontic correction of maxillofacial deformities and anomalies using all techniques in combination. It presents the results of a study carried out on the basis of the Department of Maxillofacial Surgery, the Osh Interregional Joint Clinical Hospital. Patients with dento-maxillofacial deformities and defects were selected and distributed into groups depending on the nature of the disease. In each group, surgical interventions were performed, as well as orthodontic interventions as necessary and in accordance with the nature of the pathology. The results of the manipulations performed are given below in the main text of the article.

ANALYSIS OF THE STRUCTURAL AND ORGANIZATIONAL RESTRUCTURING OF MEDICAL CARE FOR PEDIATRIC MAXILLOFACIAL SURGERY IN THE PENZA REGION IN 2021

2021 ◽  
pp. 76-82
Author(s):  
Lebedev M.V. ◽  
Zakharova I.Yu. ◽  
Kerimova K.I.
Keyword(s):  
Medical Care ◽  
Economic Effect ◽  
Maxillofacial Surgery ◽  
Maximum Efficiency ◽  
Technical Equipment ◽  
Organizational Restructuring ◽  
Clinical Hospital ◽  
Medical University ◽  
Surgery Center

The annual increase in patients and increased requirements for the quality of medical care lead to the reorganization of the work of various departments of medical hospitals. In order to improve the quality and accessibility of specialized medical care in the profile "maxillofacial surgery" in the territory of the Penza Region, in 2020, the structure of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko will be reorganized, which allows solving a number of existing problems. An important direction in the modernization of the Center was the structural and organizational restructuring. The purpose of the study: to analyze the quality and effectiveness of providing care to children with pathology of the maxillofacial region by doctors of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko. Materials and methods. A comprehensive assessment of the quality of care for children with maxillofacial pathology from 2018-2020 in the Penza region and in the period from November 2020 to July 2021 was carried out. Center of Maxillofacial Surgery of the N. N. Burdenko State Medical University. Results and discussion. Having analyzed the existing shortcomings and problems, established connections, the growth of patients in need of treatment by a maxillofacial surgeon contributed to the opening of the Maxillofacial Surgery Center in the N. N. Burdenko State Medical University, which included 10 specialized children's beds; 2 ultra-short stay beds; an outpatient office; a rehabilitation room; material and technical equipment, tools, medicines for children; maxillofacial surgeon, pediatrician, pediatric dentist, general dentist, clinical nurses, speech therapist. Conclusion. The opening of the Maxillofacial Surgery Center in the Penza region has shown high efficiency. The economic effect in obtaining specialized treatment due to the work of an outpatient office and a rehabilitation office based on a patient-oriented model is noted. In order to achieve maximum efficiency and fully meet the need for providing medical care to the children's population of the Penza region in the profile "maxillofacial surgery", it is necessary to open a department of pediatric maxillofacial surgery due to the projected workload of open beds.

DISADVANTAGES IN THE ORGANIZATION OF OUTPATIENT AND POLYCLINIC SERVICES IN THE FIELD OF MAXILLOFACIAL SURGERY FOR ADULTS AND CHILDREN IN THE GBUZ PENZA REGIONAL CLINICAL HOSPITAL NAMED AFTER V.I. N.N. BURDENKO FOR THE PERIOD 2018 -2020

2021 ◽  
pp. 6-12
Author(s):  
Lebedev M.V. ◽  
Zakharova I.Yu.
Keyword(s):  
Medical Care ◽  
Outpatient Care ◽  
Single Case ◽  
Care Service ◽  
Maxillofacial Surgery ◽  
Outpatient Service ◽  
The State ◽  
Medical Documentation ◽  
Clinical Hospital

The availability and quality of medical care is determined by the state of primary health care. Optimization and development of outpatient care is the primary task of healthcare. For the Penza region, according to the resolution of the Government of the Penza region of 02.10.2013 N 743-PP, improving the quality of outpatient care in the field of maxillofacial surgery and increasing its availability is one of the primary tasks for our region. In this regard, the assessment of the work of the outpatient office of the Department of Maxillofacial Surgery of the Consultative Polyclinic of the State Budgetary Healthcare Institution of the Penza Regional Clinical Hospital named after V.I. N.N. Burdenko. Aim: to analyze the work and effectiveness of a dentist - surgeon in the outpatient office of the consultative polyclinic GBUZ Penza Regional Clinical Hospital named after V.I. N.N. Burdenko. Materials and methods. To achieve this goal, a retrospective analysis of the primary accounting and reporting medical documentation for 2018–2020 was carried out, a questionnaire survey of patients hospitalized through an outpatient office in the Department of Maxillofacial Surgery of the N.I. N.N. Burdenko. Statistical data analysis procedures were carried out using MS Office Excel 2010 spreadsheets and PASW Statistics 18 statistical software package. Results. The analyzed accounting and reporting medical documentation for 2018–2020, the results of the questionnaire indicate the ineffective work of the doctor surgeon - dentist in the outpatient office of the consultative polyclinic GBUZ POKB im. NN Burdenko, the workload of the department with non-core hospitalizations, the increased workload on doctors - the department of maxillofacial surgery. The ways of solving the problem of replacing a dentist-surgeon with a doctor-maxillofacial surgeon are proposed; on the organization of a rehabilitation room for patients of the adult and pediatric population with pathology of the maxillofacial region; to create a single case history. Conclusion. Carrying out the above changes will reduce the burden on doctors - maxillofacial surgeons of the Department of Maxillofacial Surgery, transfer some of the manipulations from the inpatient to the outpatient service (inpatient replacement technology), thereby improving the medical care service in the field of maxillofacial surgery in the Penza region.

scholarly journals Burkholderia multivorans Sepsis Outbreak in a Neonatal Surgical Unit of a Tertiary Care Hospital

2021 ◽  
Author(s):  
Shivani Dogra ◽  
Archana Angrup ◽  
Rimjhim Kanaujia ◽  
Shashi Vig ◽  
Rupinder Kaur ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Burkholderia Multivorans ◽  
Surgical Unit

scholarly journals The association between opening a short stay paediatric assessment unit and trends in short stay hospital admissions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Steve Turner ◽  
Edwin-Amalraj Raja
Keyword(s):  
Hospital Admissions ◽  
Geographic Region ◽  
Health Board ◽  
Short Stay ◽  
Emergency Admissions ◽  
Inpatient Ward ◽  
Assessment Unit ◽  
Stay Hospital ◽  
Clinical Referral ◽  
Health Boards

Abstract Background Many inpatient facilities in Scotland have opened short stay paediatric assessment units (SSPAU) which are clinical areas separate from the usual inpatient ward area and these are where most short stay (also called zero day) admissions are accommodated. Here we describe the effect of opening short stay paediatric assessment units (SSPAU) on the proportion of zero day admissions relative to all emergency admissions. Methods Details of all emergency medical paediatric admissions to Scottish hospitals between 2000 and 2013 were obtained, including the number of zero day admissions per month and health board (i.e. geographic region). The month and year that an SSPAU opened in each health board was provided by local clinicians. Results SSPAUs opened in 7 health boards, between 2004 and 2012. Health boards with an SSPAU had a slower rise in zero day admissions compared to those without SSPAU (0.6% per month [95% CI 0.04, 0.09]. Across all 7 health boards, opening an SSPAU was associated with a 13% [95% CI 10, 15] increase in the proportion of zero day admissions. When considered individually, zero day admissions rose in four health boards after their SSPAU opened, were unchanged in one and fell in two health boards. Independent of SSPAUs opening, there was an increase in the proportion of all admissions which were zero day admissions (0.1% per month), and this accelerated after SSPAUs opened. Conclusion Opening an SSPAU has heterogeneous outcomes on the proportion of zero day admissions in different settings. Zero day admissions could be reduced in some health boards by understanding differences in clinical referral pathways between health boards with contrasting trends in zero day admissions after their SSPAU opens.

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