On the role of diagnosis of prostate diseases at the outpatient appointment of a therapist

2021 ◽  
Author(s):  
А.Л. Кебина ◽  
А.С. Сычёва ◽  
А.Л. Вёрткин ◽  
Г.Ю. Кнорринг
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Healthy Lifestyle ◽  
Prostate Gland ◽  
Care Physician ◽  
Malignant Neoplasms ◽  
Behavioral Risk ◽  
Low Grade ◽  
Tier System ◽  
Prostate Diseases

Злокачественные заболевания остаются важной проблемой медицины, при этом ее решение зависит от эффективности выявления ранних стадий онкозаболеваний на амбулаторном этапе, включая терапевтическое звено оказания медицинской помощи. Существующие в настоящее время подходы к пропаганде основ здорового образа жизни преимущественно направлены лишь на профилактику поведенческих факторов риска: табакокурения, нерационального питания, недостаточной физической активности и пагубного употребления алкоголя. При этом, по оценкам экспертов, даже воздействие только на них позволит предотвратить по меньшей мере 40% случаев развития злокачественных новообразований. В России организована 3-уровневая система оказания медицинской помощи. Именно первый уровень оказания первичной медико-санитарной помощи и должен обеспечивать профилактическую направленность здравоохранения: грамотная диспансеризация способна обеспечить существенный, до 30%, вклад в снижение общей смертности населения, в том числе и смертности от злокачественных новообразований. Первым звеном диагностики онкологического заболевания являются терапевты, к которым пациенты обращаются с жалобами общего характера (утомляемость, субфебрилитет, боли в суставах, дизурия и т. д.). Наиболее актуальными задачами в работе терапевта являются своевременное обнаружение опухолевого заболевания и направление больного на лечение к онкологу. Статья рассматривает возможности скрининговых мероприятий с участием терапевтов, врачей общей практики, предлагает специально разработанные алгоритмы диагностики доброкачественных и злокачественных новообразований предстательной железы. Формирование навыков онкологической настороженности у врача первичного амбулаторного звена необходимо для раннего выявления и снижения частоты продвинутых стадий опухолей и более раннего начала специализированного лечения. Выявление симптоматики, подозрительной на злокачественные новообразования, с помощью алгоритмизированных подходов и последующая консультация пациента урологом или онкологом должны улучшить результаты лечения. Malignant diseases remain an important problem in medicine, while its solution depends on the effectiveness of detecting the early stages of cancer at the outpatient stage, including the therapeutic link in the provision of medical care. Currently existing approaches to the promotion of the foundations of a healthy lifestyle are mainly aimed only at the prevention of behavioral risk factors: tobacco smoking, unhealthy diet, insufficient physical activity and harmful use of alcohol. At the same time, according to experts, even exposure only to them will prevent at least 40% of cases of the development of malignant ovariances. A 3-tier system of medical care has been organized in Russia. It is the first level of primary health care that should ensure the prophylactic focus of health care: competent clinical examination is able to provide a significant, up to 30%, contribution to reducing the overall mortality of the population, including mortality from malignant neoplasms. The first stage in the diagnosis of oncological disease are therapists, to whom patients come with general complaints (fatigue, low-grade fever, joint pain, dysuria, etc.). The most urgent task in the work of a general practitioner is the timely detection of a tumor disease and referral of a patient for treatment to an oncologist. The article considers the possibilities of screening measures with the participation of therapists, general practitioners, and offers specially developed algorithms for the diagnosis of benign and malignant neoplasms of the prostate gland. The formation of oncological alertness skills in a primary outpatient care physician is necessary for early detection and reduction of the incidence of advanced stages of tumors and earlier initiation of specialized treatment. Identification of symptoms suspicious of malignant neoplasms using algorithmic approaches and subsequent consultation with the patient by a specialist urologist or oncologist should improve treatment outcomes.

Organization of primary health care and specialized medical care for patients with prostate cancer in the Nizhny Novgorod Region

2021 ◽  
pp. 20-31
Author(s):  
Egor Aleksandrovich Perevezentsev ◽  
Maya Andreevna Kuzmina ◽  
Dariya Dmitrievna Vasina ◽  
Denis Igorevich Volodin
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
Medical Personnel ◽  
Malignant Neoplasms ◽  
Medical Organization ◽  
Primary Health ◽  
High Level ◽  
Nizhny Novgorod Region

At present, the quality and availability of medical care are the aspects to which close attention is paid in the system of organizing medical care. One of the ways to achieve a high level of quality and accessibility of medical care is building up human resources, i.e. the presence of highly qualified general practitioners, sub-specialties and middle medical personnel in sufficient numbers in a medical organization. Currently, the oncological service of Russia has been assigned tasks to fulfill the instructions from the State Program for the Development of Health Care. The results of the work should lead to a decrease in mortality and an increase in the quality of life of the population. To address the issue of reducing mortality from malignant neoplasms, in particular from prostate cancer, a three-level system of oncological care has been created on the territory of the Nizhny Novgorod Region, including 1 regional center, 2 interdistrict cancer centers, 88 primary oncology rooms and 96 examination rooms. The tasks set to reduce morbidity and mortality from oncological diseases can be realized only with close interaction of the oncological service with the primary health care sector, in which the prevention should be the priority direction of work.

Informational Evaluation of Epidemiological Aspects of Prostate Cancer Cases Among Citizens of Saint Petersburg

2020 ◽  
pp. 4-11
Author(s):  
K.N. Movchan ◽  
Val.Vas. Hizha ◽  
K.E. Chernov ◽  
A.V. Zharkov ◽  
B.S. Artyushin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Medical Care ◽  
Healthy Lifestyle ◽  
Development Program ◽  
Health Department ◽  
Incidence Rates ◽  
Malignant Neoplasms ◽  
Cancer Data ◽  
The City

Introduction. Prostate cancer ranks first among all malignant neoplasms in men. The use of information and analytical tools in comprehending the results of examining and treating verified prostate cancer cases in St. Petersburg is important for implementing measures to increase life expectancy and to improve the quality of men’s health. Materials and methods. We analyzed indicator medical statistics on prostate cancer cases in St. Petersburg in 2013–2017 based on the municipal population cancer registry data. Results. The results showed that the increase in prostate cancer incidence rates in the city was not related to poor quality of medical examination or treatment. The latter remained appropriate and was ensured by the proper level of modernization of technological and organizational methods for providing medical care to such patients. Successful mastering of innovative information techniques of cancer data analysis by local specialists is one of the prerequisites for efficient cancer prevention with a full-fledged implementation of actions envisaged by the Russian Healthcare Development Program. Conclusions. Some quality indicators of St. Petersburg oncology service in terms of providing medical care to prostate cancer patients are comparable to those in other Russian regions or turn out to the best in some respects. Targeted measures taken by the City Administration and its Health Department to promote a healthy lifestyle and to inform the citizens about dangers of prostate cancer yield positive results.

scholarly journals MEDICALLY-PREVENTIVE FOUNDATIONS OF HEALTH SAFETY OF PUPILS OVER THE DECADE OF CHILDHOOD IN RUSSIA (2018-2027)

2019 ◽  
Vol 21 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Vladislav R. Kuchma
Keyword(s):  
Medical Care ◽  
Healthy Lifestyle ◽  
Learning Objects ◽  
National Standards ◽  
Adolescent Medicine ◽  
Behavioral Risk ◽  
Educational Organizations ◽  
Healthy Nutrition ◽  
Labor Safety ◽  
Social Advertising

There are goals, tasks and expected results in the sphere of health saving of students which can be implemented in the Decade of Childhood, announced by the Decree of the President of the Russian Federation for the period 2018-2027. The program measures on the development of health care for children, adolescents and young people friendly to children and their healthy life include proposals for the improving legislation and regulatory legal acts in the sphere of the organization of medical care for students in educational organizations, for intersectoral interaction in the sphere of the protection and promotion of children’s health, training employees and payment for their labor, the restoration of medical offices in schools and their equipping with modern equipment and medicines, the quality assessment of medical care in schools, the development of adolescent medicine, the development of strategies for the formation of a healthy lifestyle for children, adolescents and youth, the development of national standards for physical and cognitive development of children, monitoring the quality of life and behavioral risk factors, hazardous to health of students, the formation of databases of health saving pedagogical, health and fitness sports technologies, active recreation technologies, safety of digital education, monitoring healthy nutrition, safety of adolescents’ labor, safety of products for children and learning objects, social advertising for children. Activities held within the framework of the Decade of Childhood should be discussed by professional communities, their effectiveness should be assessed and corrections should be made, if necessary.

On the appropriateness of including phytotherapy in the therapeutic activities of a general practitioner

1997 ◽  
Vol 78 (2) ◽  
pp. 145-149
Author(s):  
V. F. Bogovyavlensky ◽  
R. M. Gazizov
Keyword(s):  
Health Care ◽  
Medical Education ◽  
General Practitioner ◽  
Medical Care ◽  
Family Physician ◽  
Healthy Lifestyle ◽  
Gradual Transition ◽  
Medical Sciences ◽  
The Family ◽  
Therapeutic Activities

At present there is a gradual transition of domestic health care to a new method of medical care according to the regulations of the family physician (general practitioner). According to Professor I.N. Denisov, Corresponding Member of the Russian Academy of Medical Sciences, the curator of this type of activity, it is necessary to radically restructure the program of higher and secondary medical education with maximum attention to creating a doctrine of healthy lifestyle within the family, collective and society as a whole.

Primary Health Care and the ICD-11

2013 ◽  
Vol 10 (01) ◽  
pp. 33-37 ◽  
Author(s):  
M. Klinkman ◽  
D. Goldberg
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Medical Care ◽  
Special Needs ◽  
Field Trials ◽  
Primary Medical Care ◽  
Dsm 5 ◽  
Primary Health ◽  
Icd 10

SummaryThis paper describes the necessity of adapting the major classifications of mental disorders exemplified by the ICD-11 and the DSM-5 for the special needs of primary medical care. An earlier version of the classification – the ICD-10-PHC – is described, and the process of adapting it is described in detail. The new 28 item version of the classification is described, and the procedures to be adopted in the Field Trials to be held during 2013 are set out, together with the specific problems these field trials will address.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

Medical Care for Children with Cancer in the Donetsk People’s Republic: Results of an Ecological Study in 2014–2017

2018 ◽  
Vol 5 (3) ◽  
pp. 145-154
Author(s):  
M. Yu. Rykov ◽  
I. N. Inozemtsev ◽  
S. A. Kolomenskaya
Keyword(s):  
Medical Care ◽  
Pediatric Patient ◽  
Ecological Study ◽  
Medical Service ◽  
Care Delivery ◽  
Benign Tumors ◽  
High Tech ◽  
Malignant Neoplasms ◽  
Children With Cancer ◽  
Patient Capacity

Background.Analysis of medical care delivery for children with cancer in armed conflict is highly important because the high-tech treatment in this context is extraordinary difficult and challenging task. Objective. Our aim was to analyze the morbidity and mortality rates in children with malignant tumors, to assess the pediatric patient capacity and medical service density in the Donetsk People’s Republic.Methods.The ecological study was conducted where the units of analysis were represented by the aggregated data of the Republican Cancer Registry on the number of primary and secondary patients with malignant and benign tumors, the deceased patients in the DNR in 2014–2017, pediatric patient capacity, and medical service density.Results.The number of pediatric patient capacity for children with cancer was 10 (0.27 per 10,000 children aged 0–17), pediatric patient capacity for children with hematological disorders — 40 (1.37 per 10,000 children aged 0–17). The treatment of children with cancer was performed by 5 healthcare providers: 1 pediatric oncologist (0.02 per 10,000 children aged 0–17), 3 hematologists (0.08 per 10,000 pediatric population aged 0–17), and 1 practitioner who did not have a specialist certificate in oncology. Morbidity rate for malignant neoplasms from 2014 to 2017 decreased by 25% (in 2014 — 9.6 per 10,000 children aged 0–17; in 2017 — 7.2). In the morbidity structure, the incidence proportion of hemoblastoses was 68.4%, brain tumors — 2.6%, other solid tumors — 29%. The death rate due to malignant neoplasms decreased by 37% (in 2014 — 2.7; in 2017 — 1.7).Conclusion.Low levels of the incidence rate and pattern of morbidity indicate defects in the identification and recording of patients. This explains the performance of the bed: low average bed occupancy per year and low turnover. For a reliable analysis of mortality statistical data is not available: in 2014–2015 only the number of in-hospital deceased patients is presented. Limited data is due to the lack of reliable patient catamnesis which is explained by the high rate of population migration. 

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