Modern approaches to prevention of non-communicable diseases in the state program of healthcare development of the Republic of Kazakhstan

Problems of prevention of noncommunicable diseases are relevant for many countries of the world. This is due to the fact that the burden of noncommunicable diseases is growing from year to year, creating new challenges to the health systems of various countries. To address these problems, various programs are being implemented, both defining General prevention strategies across the country, and programs to combat individual risk factors. The article presents an analysis of programs aimed at fighting cancer, implemented in various countries. The essence analysis of the program showed that the main tasks, key priorities and directions of the state program for health development of the Republic of Kazakhstan “Salamatty Kazakhstan” (Healthy Kazakhstan) for 2011–2015 were formed and implemented taking into account the trends of economic, social and demographic development of the country. The usefulness of this complex intersectoral organizational technology for strengthening public health at the national level is shown, and evidence of the effectiveness of the program is provided.

In memory of academician I.N. Denisov

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Assessment of the bioelectric activity of the masticatory muscles in orthopedic treatment with partial removable plate prostheses

Relevance. According to a number of authors, it is known that full adaptation to complete removable dentures occurs within 3 months [3–5, 9]. The main criterion for patients getting used to removable dentures is the synchronization of the work of the masticatory muscles and, as a consequence, the normalization of the chewing function.The aim of the study was to evaluate the bioelectrical activity of the masticatory muscles in patients using the CSPP.Materials and methods. In patients of the control (n = 23) and main (n = 63) groups, electromyographic examination was performed using the electroneuromyographic system "Synapsis" (Neurotechnology, Russia). Registration of the bioelectric activity of the chewing muscles was carried out directly on the day of applying the prostheses, after 1 and 3 months, respectively.Results and discussion. The electromyographic indices of the masticatory muscles in the patients of the control group decreased within one month after the treatment and amounted to 231 ± 18.2 μV for the right and 229 ± 16.1 μV for the left proper chewing muscles. The values were also reduced for the right and left temporal muscles – 228 ± 15.2 μV and 225 ± 24.1 μV (p < 0.05). It should be noted that the electromyographic parameters in patients of the main group were comparable to the lower limit of the norm and amounted to 269 ± 16.5 μV and 256 ± 20.4 μV, respectively, after one month of treatment.Conclusions. In the treatment of dysfunction of the temporomandibular joint with the use of thermoplastic prostheses, an increase in the biopotentials of the masticatory muscles is observed. In the orthopedic treatment of patients with terminal dentition defects using thermoplastic prostheses, the electromyographic parameters of the masticatory muscles are most close to normal after 3 months of using these prostheses.

Modern methods for adhesive bowel obstruction diagnosis

Topicality. Adhesive intestinal obstruction is a common disease in abdominal surgery with a significant increase from year to year. During the last 20 years, the frequency of cases of adhesive intestinal obstruction (SCN) has increased by 2 times and has no tendency to decrease. In the UK, small bowel obstruction was an indication for 51% of all emergency laparotomies. Scott et al. reported seven emergency surgeries, accounting for 80% of all hospital admissions, morbidity, mortality, and health care costs in relation to general surgery in the United States. These seven operations included partial colectomy, small bowel resection, cholecystectomy, peptic ulcer surgery, adgeolysis, appendectomy, and laparotomy. Adhesive intestinal obstruction of the small intestine was the most frequent diagnosis in the behavior of four out of seven surgical interventions (partial colectomy, resection of the small intestine, adgeolysis and laparotomy). Postoperative adhesive processes are the main cause of small intestine obstruction, accounting for 60% of cases. Among all cases of intestinal obstruction, acute small intestine is 64.3–80%, while having a severe course and a worse prognosis. This causes a high mortality rate in this pathology. It ranges from 5.1% to 8.4%, occupying a leading place among all urgent diseases.The purpose of the study was to evaluate various modern methods of diagnosing adhesive intestinal obstruction.Material and methods. In this study, the method of classical analysis of domestic and foreign literature was applied, based on current data on the diagnosis of adhesive intestinal obstruction.Results. Historically, there has been a certain algorithm for examining patients arriving with suspected adhesive intestinal obstruction, which includes: complaints, anamnesis of the disease and life, objective status, as well as additional diagnostic methods. Patients with OCD usually present a wide range of complaints, such as nausea, vomiting and periodic abdominal pain. Nausea and vomiting follow the appearance of pain and are an early sign of proximal adhesive OCN. However, clinical symptoms are only partially able to diagnose adhesive intestinal obstruction. Laboratory data are of little significance in the diagnosis of intestinal obstruction, but they help to determine the presence and severity of metabolic disorders, homeostasis disorders, as well as to indicate possible starngulation. For the diagnosis of OCN, OBP survey radiography is routinely used. Computed tomography (CT) has a higher sensitivity and specificity compared to abdominal X-ray examination and is recommended by the Bologna Guidelines. Ultrasound examination (ultrasound) is increasingly used in the diagnosis of OCD. Ultrasound is a relatively simple inexpensive non-invasive imaging method that is devoid of radiation exposure, but depends on the operator's experience. To minimize the effects of ionizing radiation in children and pregnant women, magnetic resonance imaging is an effective alternative to computed tomography for intestinal obstruction.Conclusion. The problem of adhesive intestinal obstruction remains highly relevant, given the prevalence of the disease and high mortality rates. Currently, new promising methods for diagnosing this disease, including biomarkers and high-tech methods for visualizing the pathological process, such as computed tomography and magnetic resonance imaging, are acquiring high importance. At the same time, one should not forget about the routine research methods – X-ray of the abdominal cavity and classical methods of examining the patient – collecting complaints, anamnesis and determining the objective status.

Interrelation of venous and osteoarticular pathology in patients with Giacomini's vein

Objective: To establish a possible relationship between the Giacomini vein and osteoarticular pathology of the lower extremities in chronic venous diseases (CVD).Materials and methods. In 115 examined patients (out of 321), we identified the Giacomini vein (92 women, 23 men). The average age of men was 44.82 ± 1.62 years; women – 45.36 ± 3.31 years. All patients were divided into 3 groups by anatomical randomization. The first group was without pathology, the second group of patients had only CVD, and the third group included patients with CVD and osteoarticular pathology. The criteria for inclusion in the groups were: the presence of Giacomini vein in patients, chronic venous disease and osteoarticular pathology on one or both lower extremities. Exclusion criteria: age of patients less than 18 years, the presence of CVD C5-C6 according to the CEAP classification, post-traumatic changes in the osteoarticular system, post-thrombotic transformation of the veins of the lower extremities. Using triplex angioscanning, the anatomical features of the structure of the venous system of the lower extremities were assessed. The study of the condition of the foot was carried out using the Friedland method.Results. Group I with an absolute norm of the venous and osteoarticular systems included 30 people (26 %). The second group consisted of 45 patients (39.22 %) with CVD C0-C4 according to CEAP, and the third group consisted of 40 patients (34.78 %) who, in addition to venous, osteoarticular pathology. Chronic venous diseases in patients of groups II and III were distributed as follows: C0 – 25.6 %; C1 – 16.4 %; C2 – 49.4 %; C3 – 4.3 %; C4 – 4.3 % on the CEAP scale. Among the osteoarticular pathology, the most numerous group consisted of changes in the configuration of the foot, non-traumatic deformities – 32 (27.81 %) cases. To confirm the relationship between venous and osteoarticular pathology, we used the Pearson criterion. We found a significant correlation in the presence of nontraumatic deformities of the foot in the group of patients with CVD (Pearson's criterion 0.749642; p < 0.22). A strong correlation was established between the age of patients and changes in the venous and osteoarticular systems of the lower extremities (Pearson's criterion 0.7677696; p < 0.22), which confirms the relationship between the development of nontraumatic changes in the foot and CVD in patients with Giacomini vein with age.Conclusion. It was found that the presence of an altered Giacomini vein leads to an aggravation of venous stasis in the lower extremities, which in turn increases the likelihood of developing venous pathology. Chronic diseases of the veins of the lower extremities contribute to dystrophic changes in soft tissues, most pronounced in the distal part of the extremity and, as a consequence, predispose to the development of osteoarticular pathology.

Features of medical support of physical training and mass sports events in the Armed Forces of the Russian Federation

Introduction. Physical training is the most important element of the combat readiness of the troops, its goals and objectives are defined by the Manual on Physical Training in the Armed Forces of the Russian Federation. The solution of these tasks should contribute to the formation of military personnel's readiness to endure extreme physical and mental stress during the preparation and conduct of combat operations. Comprehensive provision of physical training in the troops requires the hard work of various services, including the medical service.The purpose of the study. Identify problematic issues of medical support for physical training and sports events in the Armed Forces of the Russian Federation and identify ways to solve them.Materials and methods. The article uses the materials of the work of medical and nursing teams in the medical provision of physical training of units of the Southern Military District from 2016 to 2019. Additionally, the data of an in-depth medical examination of the personnel of some units of the district subordination for 2018 were used.Results and discussion. When analyzing the work of visiting medical and nursing teams during the medical support of passing the standards for physical training, a number of problematic issues were identified. First, there are always military personnel who regularly do not engage in physical training and during the delivery of standards make excessive efforts and work at the limit of their capabilities. Secondly, some exercises are very dangerous, either in terms of injuries or the likelihood of developing complications from the cardiovascular system. All this applies to the medical support of the competition. As an example, the championship of the Armed Forces of the Russian Federation in fire and rescue sports, held from 3 to 6 September 2019 in Rostov-on-Don on the territory of the garrison fire brigade, is given. The program of the competition included passing the obstacle course, climbing the training tower, extinguishing the fire, etc., all very traumatic. Therefore, for the medical support of these competitions, a medical and nursing team of the resuscitation profile was allocated on a reanimobile with specialized stowage, respiratory and oxygen equipment.Conclusion. It is necessary to strictly monitor the correctness of the definition of the group of physical training and the gradual increase in physical activity in order to avoid complications and further progression of diseases or even deaths in military personnel. It is impossible to approach formally the conduct of an in-depth medical examination of military personnel.

Influence of interferon types on COVID-19 prevention and treatment

This article discusses the properties of endogenous and exogenous interferon as the most effective element in the fight against a new coronavirus infection, analyzes the use of various groups of interferons, the time criteria for their use, and resistance to modified strains of coronavirus.